Six common beliefs addressed, Part 199

1. Not all overweight/obese people are "leptin resistant".

The overweight/obese who see maximum results from their weight loss treatments are those with intact leptin sensitivity. These are the people who actually get to lean, even from morbid obesity. They aren't common as weight loss treatments fail for most people. There are many things that affect leptin sensitivity in the long term. This is still being researched, so there are no definitive answers to the riddle yet, but we have found out that fat cells have fantastic memories. We also know that people who ruin their leptin sensitivity tend to all have one or more of the following histories in common:

• Overweight/obesity that started in childhood.
• Overweight/obesity that was mostly caused by fructose consumption (e.g., sweetened beverages).
• Long term sedentary lifestyles (e.g., never having been active even in youth).
• History of "yo-yo" or fad dieting.
• History of starvation protocols (e.g., chronic caloric restriction, extended fasting, eating disorders).

What is the common theme in all of the above? Chronic disruption of their blood glucose regulation. The longer this has been happening, the more difficult to reverse. Remember, obesity is an metabolic adaptation. If you have been disrupting your blood glucose for decades, your metabolism is pretty much adapted to continue on its trajectory. 

All of these people seem to develop intractable "leptin resistance". That is when doctors will pull out the big guns of bariatric surgery. These people are also massively obese. It is amazing the amount of fat they can put on while still maintaining "non diabetic" blood glucose levels. Not normal glucose levels, just non diabetic ones. This means their metabolisms adapted to disruptions in blood glucose that did not necessarily reach clinical hyperglycemic levels. It's as if their body has evolved to put on massive amounts of fat with seemingly no detriment to their health. At least, in the short term. Like I said before, fat cells have great memories and they can be honed and primed to hold on to fat and store more until they literally explode.

So, it's unfortunate but the reality is that without leptin, there is no fat loss and leptin comes from these suicidal fat cells. How leptin changes with time is not fully understood. For example, the leptin sensitive, like myself, who lost enormous amounts of weight, are not necessarily out of the woods. Any challenge to fat mass decreases leptin sensitivity over time, so the fact that we can lose so much weight, might also be what can make us put on weight much more easily in the future.

Only time will tell how successful anyone is in the battle of the bulge since the war is not with the bulge itself, but with obtaining and keeping your leptin sensitivity.

2. You only store fat from food if you are in a consistent surplus of calories, regardless of whether it's protein, fats or carbs.

You can store fat from food even at a deficit. In fact, being at a deficit ramps up the body's ability to store more fat, than at any other time, since this is when it most needs this reserve. This has been seen consistently in starvation studies and obesity research. Like I wrote above, fat cells have a long memory when it comes to starvation and they will do everything possible to prevent it in the future.

For the fat cell, real prolonged starvation that ends in death is the only breaking point. That death might come from malnutrition before it gives up a pound. This is why the fat cells of concentration camp victims did not have the ability to store fat during their ordeal as there was literally no food for a very long time and they were not obese to begin with. We do not recommend this unhealthy way of trying to lose weight because if it doesn't end in death, it will end in more obesity. Calorie proponents, on the other hand, seem to deem this just fine because for them, as long as you aren't losing weight, you aren't starving enough.

I have explained before that in the short term a caloric surplus will cause "weight" gain, just like a deficit would cause "weight" loss. All weight loss and gain is mitigated through overall calories due to their effect on insulin. But in the long term this effect wanes as the body adapts to its nutrient availability.

The body also uses and allocates calories differently, depending on where they come from. The body doesn't only guide itself by nutrient availability as a whole (leptin), but by what nutrients are available (insulin). So whether the calories come from protein, fats or carbs matter. They matter a lot.

3. Homeostasis in the body relies on overall energy, not what substrate the energy is derived from.

There is no such thing as pure "energy homeostasis" in the body, except at the mitochondrial level. There is only metabolic homeostasis and metabolism uses much more complex metrics to acquire this homeostasis than just overall energy information. If the body only uses overall energy information, it would starve very easily and none of us would be here as famine has been a threat to us since our beginning.

The body's output of energy varies depending on many factors. The body does not use its energy in a "general" manner. It partitions energy in different ways according to what substrate the energy is derived from. This allows it to know what type of energy it is and what it would be best used for. That is why it has a separate storage compartment for fat, than it does glucose, and they are both used differently. The body also uses the calories from protein in a very different way than it does fat or glucose.

4. If our bodies didn't burn fat daily, where would the dietary fat go?

The body burns both fat and glucose daily but it burns them at different rates depending on activity type, not level, and other factors. This is why I said in the reply above that the body does not use its energy in a "general" manner and why general energy should not be used to determine "energy homeostasis". That has been the failure of calories in/calories out which is a measure of general energy.

Aside from using very little glucose, in order to keep glucose dependent cells alive, the body burns glucose during high intensity activity. This activity must be explosive and short term as there is only a very limited amount of this fuel available to it. Glycogen stores are not very large. This is because this type of high intensity activity was not something that occurred often enough, in our history on earth, for the body to evolve large stores for as the demand was low. There has also never been an abundance of carbohydrates in the diet, until recently, for this to even be possible. So large glycogen stores were simply never needed. This is why athletes have to constantly replenish their glycogen stores through diet or "burn out". They have an adaptive glucose dependency.

The body burns fat for all other activity that is not intense. This means that the body is mostly burning fat throughout the day and night. It burns fat while sedentary and while doing steady state low/moderate intensity activity. Low/moderate intensity does not mean lounging around. The body will burn fat while jogging or cycling, two activities that aren't considered "lounging". So it takes a lot to push the body to burn glucose. It just prefers burning fat. It has many ways of burning fat but only one of burning glucose.

Fat is a very efficient and versatile fuel and this is why it is so difficult for metabolically healthy people to gain body fat through the consumption of dietary fat. It is almost impossible to continue gaining weight after they gain their first 20 - 25 pounds, even while eating astronomical amounts of dietary fat. They will just keep burning through it as the body adapts and increases its metabolic rate. If you listen to the stories of people who have tried to prepare themselves by gaining weight, for climbing Mount Everest or spending a couple of months in the wilderness, they can't do it through the consumption of olive oil even at a large caloric surplus. They must turn to carbohydrates. This is also why morbidly obese people can consume copious amounts of fat and still lose weight. At least, until their leptin set point catches up to them.

"Leptin resistance" is the difference between a healthy person and an overweight/obese person. The healthy person can't put on the weight, regardless of what they do and the overweight/obese person can't get it off, regardless of what they do. This is completely modulated through leptin and the hormonal states that affect its function.

5. Because I like to eat large quantities of food, I usually do not eat fats with my meals. Who wants to eat 100 grams of avocado, that has 160 calories, instead of 700 grams of cauliflower which has the same? It is not mandatory to include "healthy fats" with my meals.

Fat is never mandatory unless you are only eating rabbit stew or elk jerky for a prolonged period of time. Then you would be on a protein sparing modified fast which is not a good long term protocol unless you are significantly overweight/obese. The body requires some dietary fat to avoid malnutrition. Fat is widely used by the body and not just for energy but to build cells and produce sex hormones. Of course, you would be hard pressed to find someone in the United States dying of “rabbit starvation” even at very low to "no fat" diets.

Aside from that, I understand that you like to eat large quantities of food, but I am unsure why. Cauliflower is not particularly nutritious nor does it contain adequate protein. The only reason I can think of is you're hoping to ward off hunger. Feeling hungry is usually a sign that something is wrong with your diet, especially if you aren't losing weight nor building muscle. A large bowl of cauliflower is not a proper way to ward off hunger. A steak would be a much better choice. It wards off hunger much better, contains protein and you don't have to eat “large quantities” to achieve satiety. This is where counting calories goes wrong. Yes, cauliflower has less calories than an avocado but they are both basically junk.

You don't want to eat like a cow. Cows have four stomachs so they can continue in-taking large quantities of carbohydrates. The problem with this large serving of cauliflower is not that it’s a particularly malignant carbohydrate because it’s not. It’s just that it’s replacing protein and that's where the malignancy comes in. People do this all the time with carbohydrates, whether it’s cauliflower, avocado, rice or beans. Any carb that replaces protein is a problem carb. Protein should always be the main focus of your meals. Items like cauliflower or avocado are side dishes and/or garnishes only.

So, unless you are a healthy person, I suggest you drop this habit of stuffing yourself with cauliflower. At best, it won’t be of any benefit to you and at worse it will be a detriment.

6. Eating fat builds muscle.

Only protein builds muscle. Fat only builds fat.

The body uses protein to build its lean muscle mass and for this reason it never uses it for any other type of energy requirement, even though it has the ability to do so. If the body is not getting enough energy to meet its energy requirements from elsewhere, like fat, then it will break down its muscle mass and turn it into glucose in order to then convert that into fat. This is what usually occurs during chronic caloric restriction. The person is jumping for joy at the lower scale number, not realizing it was caused by the loss of muscle for the sole purpose of building more fat. This is especially true for the overweight/obese.

For this reason, eating adequate dietary fat can protect your muscles, but the fat itself is not what’s building the muscle. That is always the result of protein coupled with exercise.

Six common beliefs addressed, Part 128

1. It is not possible to gain weight on "fizzy" water, since it has 0 calories and is also flavorless. 

Carbonated drinks have been shown to stimulate ghrelin release and increase appetite. The exact mechanism for this is unknown, but consuming carbonated water, even without the artificial sweeteners or any flavor, increases body fat as if the drink contained sugar. Research is focused on the pressure caused by carbonated drinks against the stomach wall. Of course, the consensus falls back on calories and how an increase in appetite makes you eat more overall. On this blog, I don't focus on this nonsense. 

Even if you don't succumb to the increase in appetite, body fat will still increase. For this reason, I don't pay attention to what the carbon does to the stomach, but what it does to hormones overall. Ghrelin, like all other hormones does not work in a vacuum. It is part of a complicated feedback loop that effects all hormones. So, carbon causes an increase in body fat, not because it rises ghrelin in isolation and makes you eat more, but because it causes an overall obesogenic hormonal profile that effects other hormones as well, causing everything you eat, irrespective of calories, to be stored as fat. 

Stop eating and drinking novelties. There are no carbonated drinks in nature. There is only water. Water is 0 calories, 0 taste and 0 carbonation. Carbonated drinks are "party foods". Stop eating like you're at an endless birthday party. 

2. Is there a profound way of affecting leptin?

Though leptin is most commonly manipulated through nutrient availability, such as eating more frequently, the effect is temporary. Leptin is a slave to insulin and though nutrient availability can boost it in the short term, insulin over sensitivity of the fat cells, will halt leptin's benefits in the long term. After all, insulin action on fat cells is what keeps fat trapped inside and forces more to come in. Therefore, leptin is more profoundly affected, in the long term, by exercise. 

Exercise "bypasses" insulin action on the fat cells, as it now mainly focuses on the building of muscle, rather than "locking down" your fat stores. You need those fat stores for energy if you are doing the right kind of exercise. This allows leptin to go into action. You know the old adage of "If you don't use it, you lose it"? Well, your fat mass's signal to the brain is no exception to this rule. If you never burn enough fat stores, leptin simply under expresses its signal to the brain, and the brain will no longer "see" how much fat you have. Exercise helps force a reconnection. 

You need to have a purposeful exercise routine, that you follow consistently on a daily basis. Walking through the mall, while shopping, is not going to cut it. You need to go out for a walk that is moderately intense and of long duration. Taking short strolls frequently, through out the day, is just not enough to achieve this proper signaling. 

3. If low carbohydrate diets work, there wouldn't be all these different iterations of them that include additional protocols like "fasting" and "keto". 

In 1972 the Old Testament of low carbohydrate dieting was written by Robert Atkins. In 2007 the New Testament was written by Gary Taubes. Both books, together, form the 'Low Carbohydrate Bible' and from this Bible sprung the 12 Tribes of Bull Sh-t. These tribes took what was in these books, modified it to their own liking and agendas, and created their own cults. 

All of these cults believe in the 'Carbohydrate/Insulin Hypothesis' (CIH) to some degree. Basically, this hypothesis states that carbohydrate causes "hyperinsulinemia" and that eventually leads to weight gain and diabetes. That is incomplete and incorrect. We know this because: 

• Carbohydrate isn't the only macronutrient that affects insulin levels. 
• Carbohydrate is the main staple of certain cultures and produces no diabetes in them. 
• Some overweight/obese people do not have significantly high insulin levels, therefore no "hyperinsulinemia". The same is true of some lean people who have high insulin levels with no obesity. 
• Blood glucose dysregulation is the metric that tracks linearly with obesity, more so than insulin and blood glucose is affected by many things other than just diet. 
  

So, basically the reason there are so many variations to low carb is because people want to find a message that preaches what they want to hear and they toss out what they don't. Usually, what they want to hear are outlandish promises, watered down information and a way to make money. What they don't want to hear is what promises nothing, is super complicated and can't be monetized. 

4. The 'Fat Loss Blueprint Program' is much more thorough and complete than other "weight loss programs" on the market. 

Ah, yes. Though the 'Fat Loss Blueprint Program' has not been that popular, it is slowly making its rounds in the diet sphere. Well, you know how I feel about "diet programs". They won't tell you anything that you don't already know or haven't tried before. This is a known fact and why diet programs are so profitable. People just can't stop coming back to them because they can't stop being fat. Diet programs are sort of like funeral homes - inevitable and always in demand. 

The 'Fat Loss Blueprint Program' is the brainchild of Alex Leaf, a nutrition expert, researcher and teacher of nutrition at the University of Western States. So, what does this obesity resistant "athlete", with the Barbie doll model wife, have to say about the obese? Nothing you haven't heard before. But he does package it in a new modern gift box that makes it appear like a shiny new present. Unfortunately, you won't be surprised, once opened. It's the same tie you get every year but in a different color.

The good thing about Leaf is that he's not a zealot. Well, sort of not a zealot, which is very refreshing. He actually understands that obesity is much more complex than just "insulin and carbohydrates", so in that sense, he has a better understanding of the problem. After that though, nothing new is brought to the table. Leaf is a true believer of the Stephen Guyenet camp. They aren't quite a cult, but yes, they are totally a cult. 

Guyenet wrote a book called 'The Hungry Brain', which makes the claim that the modern food environment "overrides the body's evolutionary circuits", in the brain, and causes "inappropriate levels of hunger", while reducing satiety. All which, of course, facilitate "overeating". In other words, this is a very fancy way of saying - calories in/calories out (CICO). In Guyenet's defense though, he has a good knowledge of leptin and its role in obesity, which is oftentimes overlooked by others. That's not surprising though, as his PHD is in neuroscience and he has done extensive studies in the "neuroscience of obesity". It sounds so impressive! But what does it all mean? 

Well, remember that what's impressive on paper, does not always translate to practice and as we can see, none of this has helped anyone lose one pound, so it technically means that obesity is still on the rise and nothing discovered, so far, has helped curb it. Obesity is still, as of this post, a "disease" with no known cure. But, some of the good things which Leaf believes in, and modeled this program after, are the personal fat threshold theory, energy toxicity, the effects of circadian rhythms, acknowledgement of body composition and eating habits, awareness of fat cell dysfunction, etc. This is much more thorough than the failed 'Carbohydrate/Insulin Hypothesis', which no one believes in anymore, since it's been thoroughly debunked numerous times over. 

Taking all of this into consideration, Leaf came up with the 'Fat Loss Blueprint Program'. Essentially an expensive, 18 lesson program, which takes you around the world and drops you off in the same location that you were picked up in - calories in/calories out. That's right. A series of complicated lessons that go right back to the root of all diet programs - food availability. This complicated flip flop dancing routine still hasn't helped you lose a pound, whether true or not. Nobody even cares. But wait one second! How can this be possible if we already have numerous, countless, hundreds of diet programs available that use the same calories in/calories out foundation? 

Well, of course, Leaf will vouch that this program is totally different because it takes into account all of the things (mentioned above), that have been overlooked by all the other calorie centered programs in existence, which is what really sabotaged your weight loss. But wait, there's more... Um, I don't think so. 

What sabotaged your weight loss was the under expression of leptin, which is the norm when under chronic caloric restriction, particularly deficits. I am pretty sure Guyenet knows this, very well, and has still not been able to come up with a magic pill, that will prevent it from happening. But, at least, he's still working on it. I salute him for his efforts. Whenever he's not going after Taubes, he is diligently working on leptin, the brain, palatability and how to keep people from reaching for that doughnut. I can probably come up with a solution faster than he can. It's called handcuffs. Wake me up when he wins the Nobel Prize though. While we wait for that, you can pay up to use the 'Fat Loss Blueprint Program' from his minion Leaf. 

Of course, you can acquire everything you need for free, from just reading through this blog and personalizing your own program for yourself. But if you have the cash and want to try out yet another program, that promises the world and delivers nothing, go ahead and open your wallet to this one. 

5. "Too much exercise" can damage the kidneys and aggravate cortisol, which can waste your muscle. 

This is correct, but "too much exercise" is very subjective. In other words, for this to be a factor, you have to be doing one hell of a work out, chronically. This would not be of concern for the majority of the people on this blog. 

For example, training athletes can experience rhabdomyolysis (skeleton muscle breakdown), a condition in which muscle mass breaks down rapidly and spills its contents into the blood stream. Myoglobin is a protein that is contained within muscle cells, and if enough is spilled into the blood stream, it can lead to kidney failure. This condition is caused by very intense, consistent, strenuous exercise, with little to no recovery time, of which I am sure no one on this blog does or is even remotely capable of. What the people, on this blog, would be more at risk of is an exaggerated stress response from exercise, mainly through an over expression of cortisol. 

Cortisol is catabolic to muscle and will cause loss of lean muscle mass if exercise is too strenuous. Again, "strenuous" is subjective. Because the majority of people, on this blog, have metabolic syndrome and this causes an exaggerated stress response, we emphasize walking routines, a bit of body weight exercise, etc. We do not recommend high intensity interval training (HIIT), unless it's a milder, beginner's version. We also don't recommend extensive weight training or hot Yoga or anything of this nature. In other words, our emphasis is for long duration, steady state exercise of low to moderate intensity and nothing more. This is also why consuming the right protein is vital for the prevention of muscle loss from exercise. 

6. It is not scientifically correct that extended fasting will not result in the loss of lean body mass.

Normally, muscle is never lost before fat, unless there is starvation. This is why calorically restricted diets and fasting protocols for weight loss fail. The person ends up losing lean muscle mass, rather than fat. If you lose lean muscle mass, rather than fat, then you end up fatter by volume, when all is said and done. Being fatter only puts you at risk for becoming even fatter, furthering the deterioration of your blood glucose regulation and insulin, and this is why we see so many calorie tracking dieters being diagnosed with diabetes. 

The body burns through its protein (muscle) when it is under starvation. That is a proven, biological fact. Basically, the body burns fat after it exhausts the contents in its digestive tract and glycogen reserves. Once starvation is prolonged (extended time in hypoglycemia) the body uses the protein within muscle tissue as a fuel source. This is basically the only time that the human body will use protein for energy, rather than for building. This makes perfect sense because if you are starving, you want to preserve your body fat. That's what will keep you from dying and you don't really need your muscle as that expends even more energy, which you want to conserve. Muscle becomes an enemy for the starved and fat becomes their friend. That's why you can't starve yourself to thin, unless you're really ready to starve for real. Starvation is the loss of lean muscle mass. 

The explanation that "the body will not use protein because there is plenty of fat available" is a dumb marketing slogan, that is not based on what actually occurs in reality whatsoever. It's just something that appears to make sense, so therefore it must be true. Well it's not. Things aren't wished into reality just because they make sense in your head alone. This is precisely why the people who make this claim cannot prove it scientifically, except by showing you intermittent fasting studies. Well, intermittent fasting is not extended fasting and the effects of one does not translate to the other. 

The only reason intermittent fasting does not put your muscle mass at risk is because it simply does not last long enough to do so. But you have to keep in mind that metabolic syndrome changes everything and even fasts that would be considered intermittent can have very negative health effects for some metabolically ill people. This is because the metabolically ill have a very exaggerated stress response that breaks down lean muscle mass very quickly and they have a very hard time regaining it. So, these people have to be careful.

Six common beliefs addressed, Part 70

1. You need carbohydrates to build muscle.

No. Only protein builds muscle.

2. The "fast/feast cycle" will protect you from muscle loss.

The "fast/feast cycle" is a marketing term and it protects you from nothing.

There is no “fast/feast cycle”. You are either eating or not eating and there’s no mysterious “cycle” involved in it. The body knows how to recognize anabolic/catabolic states, through nutrient availability. It does this every night, as you sleep. 

This has nothing to do with "protection" from muscle loss, as the person with metabolic syndrome/diabetes is exceptionally good at muscle breakdown, since these are conditions of adaptation to starvation. Eating again after a short fast, allows muscle mass to grow, but long fasts diminish it again and you never grow as much as you lose, so you don’t even break even. You know what grows exceptionally well, when you eat after a long fast? Fat. You grow fat mass very, very well.

It’s very simple - Fast for a short duration and there’s no muscle loss. Fast for a long duration and there’s always muscle loss. This is not unknown. This is a well documented fact. It’s one of those rare facts that has actually been seen consistently in experiments. So no, the magical “fast/feast cycle”, whatever that is, will not save your muscle mass, it will only spare your fat mass.

3. Is there a cure for fatty liver disease?

Fortunately, fatty liver disease is much easier to treat than diabetes. The only known method of reversal, which does not require a liver transplant, is a very low carb/ketogenic style diet.

4. Is there anything that can be done about excessive hunger after a fast?

Yes. Shorten your fast, until that doesn’t occur.

Excessive hunger after fasting, while still obese, is a sign of active obesity. The body is making you eat more in order to increase fat storage. This is specifically triggered by fasting for long periods. There is no metabolic advantage to going hungry.

5. Hyperinsulinemia is the main driver of obesity.

It’s one of the drivers of obesity. The main driver is your entire neuroendocrine system. Remember insulin is not an obesity hormone, but it’s necessary to grow fat. Being hyperinsulinemic simply means that you are in a hormonal state, which is powerfully contributing to your obesity. Remove the hyperinsulinemia and you greatly improve your chances of controlling and reversing obesity. It’s actually the simplest obesogenic driver to take control of, as it responds to dietary changes relatively quickly and well.

But, it’s certainly not the main driver, nor is it the only driver. There are many drivers in obesity and that’s why you have to focus on an anti-obesity lifestyle, which addresses all drivers.

6. Hyperinsulinemia is the same as insulin resistance.

Hyperinsulinemia (HI) is a direct result of a high insulin demand on the body. This high insulin demand is being driven primarily by a combination of four things:

• Too much glucose in - The body must handle the tsunami of glucose that’s coming in from the diet, by raising insulin levels to disperse it out of the blood.
• Too much glucose out - The body is producing an enormous amount of glucose from itself, through the breakdown of lean muscle mass, which further stimulates insulin release from chronically high blood glucose.
• Too much fat in - Any dietary fat that is not burned, is stored and the storage of fat requires insulin. This raises basal insulin, further contributing to blood glucose dysregulation. 
  
• Too much body fat - The body requires a high basal insulin level to keep fat in storage, as that fat cannot be released into the bloodstream. Insulin is like a dam, keeping body fat in place, and this is actually where the bulk of high basal insulin is coming from. 

All of this leads to insulin resistance (IR) of certain organs and tissues, but not of the fat mass. If the fat mass became insulin resistant, it could not hold all that fat inside, nor store more of it. So, the fat mass requires high insulin sensitivity.

So, when people group all of these effects together and simply describe them as “Mah’ bad insulin resistance”, they are not truly understanding insulin’s effect on the body. Yes, it’s IR and HI, but they work in specific ways, which you need to understand, to be able to tackle the condition long term. Just viewing it under general IR will not allow you to address it fully.