Saturday, January 19, 2013

Join Me on Facebook Too

Weight of the Evidence is on Facebook too.

The group page (private) is Weight of the Evidence Group Page

Once you ask to join, you'll be approved.  The group is moderated and the group is private, so discussions within the group are not publicly visible.

The main page (public) is Weight of the Evidence

That is an open page where I post links to articles here and elsewhere that are of interest.  Discussion there is open and seen by anyone who opens the page.

I hope to see you on Facebook, and I'll be continuing to post here too!

Monday, December 31, 2012

Wishing You a Happy New Year

“We will open the book.
Its pages are blank.
We are going to put words on them ourselves.
The book is called Opportunity and its first chapter is New Year's Day.”
― Edith Lovejoy Pierce

Thursday, December 27, 2012

The Protein Leverage Hypothesis

Back in 2006 I stumbled upon the research of Dr. Stephen Simpson and wrote Again It's the Protein, highlighting the findings from a small study that looked at protein requirements and how altering protein density in the diet may effect consumption of calories. 

The study was borne from the Protein Leverage Hypothesis, authored by Simpson and his colleague David Raubenheimer in 2005. I found it after reading the above study data and have remained intrigued by the concept ever since.

Briefly, the Protein Leverage Hypothesis (PLH) holds that our protein requirement influences our consumption of food, with excess carbohydrate and fat consumed to meet requirements when foods provide low protein density, and less consumed when foods are protein dense.  

Their mathematical model was formed from data in animal studies that found various insects and mammals regulate total consumption of food around protein requirements - in poor protein environments, excess is consumed to meet requirement, and in protein rich environments too little is consumed to meet energy requirements.  Their emphasis was that protein - what we tend to ignore in our diets because it remains fairly constant - is prioritized over fat and carbohydrate, and the changing dietary landscape of foods provides for less protein, leading to over consumption to meet requirements.

In their paper above, they laid out four scenarios that look at the implications if protein is indeed prioritized over fat and carbohydrate.

1. There is a shift to the diet containing a higher percentage of carbohydrate and fat

This could occur where fat- and/or carbohydrate-rich foods are more accessible, more affordable, in greater variety, or more palatable than alternatives, leading to people effectively being trapped on a suboptimal diet. Under such circumstances, maintaining the amount of P eaten requires over-consumption of C+F.

2. There is a shift to the diet containing a higher percentage of protein

If the diet contains a higher percentage of P, yet the absolute amount of protein eaten is regulated to the intake target, the result will be that C+F intake will fall, bringing the body into energy deficit and leading to weight loss.

The example noted, [a]n increase of 1.5% in dietary P from 14% to 15.5% results in an 11% decrease in C+F eaten.

3. There is an increase in the requirement for protein

If diet composition remains unchanged, yet protein requirements increase, then over-consumption of C+F will result. Shifting the intake target ratio from 14% to 15.5% P in the diet leads to a 13% increase in C+F eaten – with attendant risks of weight gain.

They provided the following example as to how such might occur - [o]ne source of protein loss is hepatic gluconeogenesis, whereby amino acids are used to produce glucose. This is inhibited by insulin, as is the breakdown of muscle proteins to release amino acids, and therefore occurs mainly during periods of fasting. However, inhibition of gluconeogenesis and protein catabolism is impaired when insulin release is abnormal, insulin resistance occurs, or when circulating levels of free fatty acids in the blood are high. These are interdependent conditions that are associated with overweight and obesity, and are especially pronounced in type 2 diabetes. It might be predicted that the result of higher rates of hepatic gluconeogenesis will be an increased requirement for protein in the diet. Unless either more high-P, low-C+F items are included in the diet (i.e. scenario 2), or rates of removing excess co-ingested C + F are increased, weight gain will occur. And the system becomes unstable – further increases in fat deposits [especially abdominal fat ] will increase protein needs further, which will drive even greater weight gain.

4. Diet remains unchanged but exercise levels decline

For this we find, 

It seems that while humans respond by increasing intake following very high levels of energetic expenditure, we are less responsive to lowered needs. One interpretation is that our intake target and the associated regulatory mechanisms controlling food intake have evolved to assume a certain level of non-protein energy expenditure. But if this energy is not actually expended, the excess is stored as fat. [...] Therefore, the result of lowered levels of exercise is, in effect, to lower the position of the intake target on the C+F axis, while causing P requirements to increase (scenario 3). Unless the diet changes towards a higher percentage of P, the result will be weight gain.

They noted,

"The scenarios introduced above are not independent. Either shifting the diet composition to a lower percentage of P (scenario 1), or effectively doing the same by having low levels of energy expenditure (scenario 4), will result in over consumption of carbohydrate and/or fat to maintain protein intake. This in turn will predispose towards weight gain and lead to disinhibition of gluconeogenesis, which will increase protein demand (scenario 3). Unless this increased demand is met by selecting high-P foods, protein appetite will drive increased intake of C + F, resulting in further weight gain, and so on in a vicious cycle leading to obesity and its associated diseases."

In their conclusions, they wrote,

"The key assumption upon which our hypothesis resides is that when humans are forced to trade-off protein intake against that of carbohydrate and fat on nutritionally unbalanced diets, physiological regulatory mechanisms prioritize protein. If this is true, then all else that we say must follow – it is a mathematical inevitability. [...] Given the implications that follow from our hypothesis, we would suggest that this is a vital subject for future research in human nutrition. In reference we suggest the design of such experiments. Finally, our ‘vicious cycle’ provides a candidate-positive feedback mechanism for the spiral into morbid obesity. It predicts a key role of hepatic gluconeogenesis in the development of obesity."

To say I was intrigued, is an understatement; while the paper had its flaws, the concept had merit and had been validated in various animal models.  Additional study would hopefully bear fruit and further refine the concept or have it dismissed as yet another dead end in nutrition research.

In the years since, there have been a number of trials designed to test the PLH, and I'm in the middle of reading through some, but wanted to post this to whet your appetite before I dig in and take a look at those studies and the findings.  The above is the prelude, to give you information about the posts I'll make in the coming week, so you have the background information to work with the data I'll go through!

Sunday, December 23, 2012

Gnosticism is Alive and Well

Over at Conditioning Research, Chris posted a short, but concise article  - Gnosticism in Health and Fitness; where he notes "[i]ncreasingly I am finding that so much of the fitness & fitness blogosphere is a strange place which I am seeing more as a form of gnosticism."

He continues by explaining the meaning of the term and and continues that "[w]e are on a constant search for the  'special, hidden knowledge'.  The are looking for the secrets: the special diet, the new routine, the amazing new supplement or exercise.  And on this search we become vulnerable to the gurus and to the marketing people."

After noting a number of ways many are enticed by the 'gurus' (they're good salesmen, it's easier than researching yourself, distrust of the mainstream, etc.), he asks, "What if it is all a lot simpler?"

Simplicity, Persistence, Habit

What if it is all actually a lot simpler.  I think it is time to reject the search for the special knowledge and embrace the basics.  A sensible diet.  Exercise.  Sleep.  Social interaction.  Stress management.  Time outdoors.

Most of all though the need is for persistence.  Just keep going.

For anyone really wanting to know the secret to good health - there it is, in the open, free.  

It is as simple as that.  

If you look up at my tag line, it's the same as the day I started this blog back in 2005 "Health = Lifestyle, Nutrition and Activity" - the trifecta for health and well-being; the mind-body-spirit connection so to speak, so often praised, yet it remains elusive for many.

I was going to write a post about long-term success - but really, it comes down to simplicity, persistence and habit. 

Gosh, who knew I only really needed three words?

It is what it is.

It's why I wrote an entire series on what I believe are some of the long-term goals of the short-term Rules of Induction.

It's why, since launching this blog, my focus was and remains on nutrient-density, not absolute carbohydrate grams, percentages of calories, or even absolute calories; it's all in context.

It's why I believe calories, in context, do matter.

It's why I pay particular attention to protein and meeting essential amino acid requirements.

It's why I believe it's about making choices and forming good habits.

It's why I believe in tweaking and making observations along the way to formulate your own personal dietary approach for the long-term.

It's why don't think a very low-carb diet is the optimal diet for the entire population all of the time and why the evidence doesn't support that view except for some unique populations (ie. type 2 diabetes, apple-shaped PCO).

And it's why my radical view point remains (gasp) that if you fine tune your food choices, opting for nutrient-dense real foods, your carbohydrate intake may be lower than some or seemingly higher than others, but it will be unique to you and to your goals, health and activity levels.

My view may come from the fact I started low-carb before it was trendy, before it caught on, and before it made it to prime-time.  In some ways I was sheltered from the quirkiness that we now see in the ever-evolving low-carb community, where once the biggest debate was how long to stay at 20g or less if one did Atkins, or whether the Atkins' model to restrict carbohydrate to 20g then increase them slowly was better than the Zone's 30:30:40 ratios from the start or Life Without Bread's 72g recommendation was ideal.

We're now a community with extremes going from one end to the other, from zero carb to eggfests; from 85% fat intake to serial finger pricking multiple times daily; from only grass-fed is worthy to the idea that grains are the devil; and from the idea that you won't gain weight if you keep carbs low enough to the belief that those who include 'safe starches' are just addicts needing validation. 

All the while these extremes are couched with the individual assured that they need to find what works for them, but give it a try, you never know; and with often confusing contradictory advice given when one needs some help.  Increase fat, decrease protein, increase carbs, decrease calories, take supplements, don't take iron, get your thyroid tested, low-carb doesn't affect thyroid, see your doctor, doctors are quacks who know nothing about nutrition, take fish oil, no take vitamin D, do reistance training, no do cardio, no don't exercise it'll make you hungrier - have you seen the gammut of contradictions out there when one asks the simple "why am I stalled?"

Why do we find it so difficult to suggest looking at the obvious first?

Now while I bet you are thinking I'm talking calories, I can say not this time; I'm talking about looking at whether one is meeting essential nutrient requirements; while you do that, you're going to have a good look at your calories, carboohydrate, protein and fat too, but the big question in my mind is are you malnourished or eating a nutritionally deficit low-carb diet - whether you're in a calorie deficit (at a good level or too low) or not is secondary.

Yet as a community, you'll find a hundred different things to answer why you're stalled, other than the obvious; the most likely answer will be whatever the flavor of the day favorite is because as a community we're still in search of the "special, hidden knowledge" rather than what common sense would suggest.

If as a community we agree that carbohydrate restriction is superior - then we must answer why; and "why" is not because 85% fat is sustainable and healthy, or shunning all plant foods is ideal - it's because a "well forumlated" carbohydrate restricted diet, when done properly, meets your essential nutrient requirements and does it better than traditional approaches.  You cannot do that at the extremes, but you can when you take a reasonable look at the evidence and understand why micronutrients matter in the context of our physiology, which lays at the center of controlled-carb nutrition.

While gnosticism is alive and well in the low-carb community, the question I have is what do we do about it?  Please feel free to comment and debate in the comments section!

Thursday, December 20, 2012

Does "Nutritional Ketosis" Require 85% Fat?

For some if you bring calories into the discussion of low-carb diets, you're pontificating, unless of course you're not.

"...of course, if one eats too much fat during that low-carb diet, you're not going to lose weight; there are differences in metabolism, but calories count in the process of eating a low-carb diet."
-Steve Phinney
August 25, 2012, Ask the Low Carb Experts Podcast

I start with Dr. Phinney since he's co-author of The Art & Science of Low Carbohydrate Living, The Art & Science of Low Carbohydrate Performance, and The New Atkins For You.

A funny thing happens when you read all three books - you find they all explain the role of calories in a low-carb diet.  

Imagine that.

In The New Atkins for You we find, "Don't count calories, although we ask you to use common sense.  In the past, some individuals made the mistake of thinking they could stuff themselves with protein and fat and still lose weight.  If the pounds are falling off, forget about calories.  But if the scale won't budge or it seems to be taking you forever to lose, you might want to do a reality check, caloriewise."

In The Art & Science of Low Carbohydrate Living we find, "The definition of 'maintenance' is that your daily energy intake equals your daily expenditure"

Additionally there is, "In order to judge how best to formulate the mix of macro-nutrients in a low-carb diet, it is helpful to visualize how your total energy intake will change from induction to maintenance.  As indicated in the graph on the next page, a typical male with a BMI of 34 might start out eating 1600 kcal in induction while his body burns 3200 kcal per day (thus the weight loss).  But after losing 50 pounds to a BMI of 27, his daily energy intake will need to increase substantially to eventually maintain him stable at that reduced weight."

In The Art & Science of Low Carbohydrate Performance, calories aren't the focus per se; rather formulating a ketogenic macronutrient mix for performance is detailed with two key features - that initially carbohydrate intake, to keto-adapt, should be less than 50g carbohydrate each day, and that once adapted one may remain keto-adapted with up to with up to 100g of carbohydrate each day; and that protein intake should be between 0.6g and 1.0g per pound of lean body mass (LBM).  In the book, the authors refer back to The Art & Science of Low Carbohydrate Living for those who wish to lose weight.  

The salient point about calories however is that once you've determined protein and carbohydrate, your remaining calories come from fat to fuel your energy needs for performance, with this being especially true for those who do not have high levels of body fat.

In the podcast above, Dr. Phinney took pains to emphasize that a "well formulated" low-carb diet restricts carbohydrate, is moderate (not high) in protein and is high in fat.  Yet what that means wasn't well defined.  Details are found in the above books and the formulation is not based on percentage of calories from each macronutrient, but rather expressed as specific grams for carbohydrate and protein requirements based on height and gender (The New Atkins For You), based on kilograms of LBM (The Art & Science of Low Carbohydate Performance) or 1.5g to 2.5g of reference weight (The Art & Science of Low Carbohydrate Living).  

Interestingly, in the last one, detail was provided to show how initially on a calorie restricted low-carb diet, protein intake will appear to be high as a percentage of calories - yet when factoring total calories being expended through weight loss, it really is less a percent of the total calorie expenditure; and that once one refines calories for maintenance of body weight, percentage of protein usually falls within "...15% and 25% of your daily energy intake coming from protein."

So in each of the books, calories are not ignored, but fundamentally part of what you eat to lose or maintain weight. More importantly, each details why within context of a low-carb diet - which for weight loss reduces calories and stabilizes hormonal function, and in weight maintenance keeps body weight and hormones stable.  '

Over the years I've written quite a lot on how to do a low-carb diet that allows for weight loss while being nutrient-dense.  From my experience, three things are needed for long-term success - one is adequate calories because if you restrict calories too much, that is counter-productive to weight loss as the body makes adjustments when energy intake is too low to prevent additional weight loss; two, a nutrient-dense selection of foods each day, to provide adequate intake of essential nutrients from EFA, EAA, vitamins, minerals and trace elements; and three, a calorie deficit.  

As you lose weight, I've long recommended looking at protein intake and calories if you stall - you see, protein intake confounding weight loss is not a new concept - since 2005 I've been writing about the critical importance of protein and how much one needs to meet EAA based on their weight.  In August, I posted a chart, based on weight and the standard 0.8g/kg body weight minimum protein required daily and the range of 1.0-1.5g typically needed when one is in ketosis to fuel gluconeogenesis.  I noted in that post, that some individuals, due to higher activity levels, may need up to 1.5g/kg body weight to meet needs, and that for most, the 1.0g-1.2g/kg seemed to work nicely.  That chart is helpful to understand how protein needs change with weight loss and can help with adjusting protein intake as one loses weight.

So the question remains, is Jimmy Moore following a "well formulated ketogenic diet"?

While he is in ketosis ("nutritional ketosis"), he is not within the well detailed guidelines in the above books.  That's okay too - his body, his experiment - I'm writing this to provide accurate information to anyone out there whom may wish to attempt replicating what Jimmy is doing, me pointing to the areas that may be problematic if one duplicates exactly what Jimmy is doing based on the little information he's provided in the last six months.  

Jimmy has provided scant detail about what he is eating in grams or calories, instead sticking to percentages of calories and a few representations of meals that were indeed within those ranges.  The interesting thing though is that none of the above books specify a percentage of calories - they look at absolute grams for protein and carbohydrate and explain how these work out to ratios, highlighting how percentages changes from weight loss to maintenance; not percentages to define how you eat when losing weight.

A couple of examples:

In Chapter 6 of The Art & Science of Low Carbohydrate Living, the authors note "Second, when someone goes on the Atkins or another low-carb diet, they usually lose weight, right?   Much of the weight loss comes from body fat, which typically provides up to half its daily energy from "inside" (ie. endogenous stores) during the initial weight loss phase.  So if someone is eating 1400 kcal/day consisting of relatively lean "protein foods" that are helf protein (700 kcal) but burns 2800 kcal per day, his/her dietary protein intake is actually supplying about 25% of their total daily energy need, falling below the empiric 30% ceiling noted above.  But to the casual observer who is ignoring the contribution of body fat stores, the actual food being eaten appears to be high protein."

Chapter 16: "In order to judge how best to formulate the mix of macro-nutrients in a low-carb diet, it is helpful to vizualize how your total energy intake will change from induction to maintenance.  As indicated in the graph on the next page, a typical male with a BMI of 34 might start out eating 1600 kcal in induction while his body burns 3200 kcal per day (thus the weight loss).  But after losing 50 pounds to a BMI of 27, his daily energy intake will need to increase substantially to eventually maintain him stable at that reduced weight."   The example given considers that his energy requirements are 2800 kcal a day, with 150g of protein (600 kcal) and now 100g of carbohydrate (400 kcal), leaving 1800 kcal from fat.  That would represent 64% of his energy requirement each day.

So what is Jimmy doing?  Let's look first at protein intake.  Jimmy says he averages 80g a day and that represents 12% of his calories. 

Is that enough?

When he started at 306 pounds, no; at his last weight of 245.8, no.  

In fact, it appears Jimmy is eating below his protein requirements during this experiment - something that for long-term success I do not recommend.

  • Using my chart online, at 306 his minimum requirement was 110g, good level for GNG 135g; at last weight minimum 90g, good level for GNG 115g. 
  • Using The Art & Science of Low Carbohydrate Living, which references back to The New Atkins for You, it would be based on height and gender, 95g-199g
  • Using The Art & Science of Low Carbohydrate Performance, with 155.92 pounds LBM in November, would be 92g-156g

Taking a look at carbohydrate, representing 3% of his calories, he's averaging 20g-25g a day.  He's been doing this now for six months and has not yet increased his carbohydrate intake, basically remaining within what is traditionally called "Induction" level carbohydrate.  

He may want to re-read The New Atkins for You, where they agree with Atkins' original concept to increase carbohydrates as you lose weight to broaden your horizons and variety.  

"Don't make the mistake of staying in Induction too long just because you love how the pounds are peeling off.  Eventually it's important to move through the phases to ensure that you have cured yourself of your old habits and can reintroduce foods without halting your weight loss or provoking cravings.  Losing weight fast is exhilarating, but it will likely be a temporary fix if you don't find your comfort zone for eating in the "real world".

Lastly, he details that his fat intake represents 85% of his calories each day.  It is interesting to note that none of the menus within the above books has that much fat - the range is between 68% and 74%, varying daily if one were to just follow those menus; that range falls within the range you'd find in the original Atkins' diet books published between 1972 and 2002, and the most recent The New Atkins For You.  Personally, I do like The New Atkins For You as it explains a lot more of the science behind why low-carbohydrate diets are effective for weight loss.

My recommendation to anyone looking to experiment with "nutritional ketosis" is to first read the books above to understand how to do it properly, they provide details about what your protein requirements are, how to increase carbohydrate and include a wider variety of foods as you lose weight, what level of fat is needed, and more importantly, how to transition to maintain your weight.  If you don't want to buy new books and have the older versions of Atkins' books, re-read them, the older version is very similar without need to buy a ketone meter and strips.  If that's you thing and you feel you need to, fine measure blood serum, but remember, you do not need to.

If you just want a quick refresher on following Atkins, here is my Review Time post from August.

Whatever you do, remember, calories do matter - in context; that context is nutrient-density and endocrine function.  

Jimmy Moore has spent incredible time repeating that his "well formulated" ketogenic diet is very high in fat, 85% of calories - before you leap to do the same, because ketosis does not require 85% of calories from fat, please educate yourself and understand how it's really done!

Friday, December 14, 2012

The Calorie Talk Taboo

For a fair number of people, talking about calories is akin to blaming the victim; the implication of sloth and gluttony, being lazy or pigging out - blame heard without words spoken (or written).

This comes from, I believe, decades of a message from experts - that if the overweight and obese would just eat less and move more, they'd lose weight.  If only it were that simple!

A few years ago I wrote about this in Poor Math Skills Leading to Weight Gain and noted,

"We're repeatedly told that we suffer mindless eating habits, a toxic food environment, and a host of other influences which lead us to overeat; all of which can be overcome if we simply set our minds to choosing foods wisely, strictly rationing our intake with portion control methods, and sticking to recommended intakes of each food group to target particular ratios of calories from carbohydrates, proteins and fats.

When doing these things fails to produce long-term weight management, the individual is often the target of blame - they failed by failing to follow the recommendations. They failed to have adequate willpower to continue as directed. They failed to restrict calories sufficiently enough for the long-term to maintain weight effectively.

Rather than challenge the concept - consciously restricting food intake - we instead accept that such is normal and focus on the failure as an execution problem by the individual, often stated many different ways, but always boiling down to calories in exceeding calories out if the individual could only get it right then all would be well.

This makes weight loss and management a math problem.

In order to lose and maintain weight one must then be good at math in order to be able to constantly be vigilant in counting their calories in each day to keep consumption within target outputs.

So, maybe it isn't willpower, but poor math skills leading to long-term failure to maintain weight loss?

No, I don't really believe that...but, it does open the door to consider the idea that weight isn't simply a math problem that is easily solved by changing inputs and outputs of numbers; that in the long-term exerting will to restrict calories over desire to eat is not really all there is to successful weight management."

I wrapped up with "Weight is chemistry.  Chemistry thus influences obligate requirements for nutrients and energy, as well as our ability to exert our will over our desire."

Over the years, I've noted that while those who initially follow a low-carb diet do not need to count calories, calories do count - in context.  The context is physiology, the chemistry within our metabolism which is driven by our endocrine system.  It isn't simply a math problem to calculate input of calories and output of energy expenditure - it requires actual nutrients within the context of those calories because a calorie is not a calories in our body - a sugar calorie acts differently in our body than a fat calorie.  Context.

And while I've made it clear that blaming the victim is an unscientific approach to resolving obesity, it continues and those who gain or remain above desired weight feel it when calories come into the discussion about weight loss and maintenance; yet even with hurt feelings, calories remain in the proper scope of discussion for weight management.

If you look back at Forget the Cake, Let Them Eat Steak, I specifically included a rough estimate of just how few calories Jimmy Moore required to gain the six pounds he did earlier this year before starting his nutritional ketosis experiment - the equivalent of 1.5 tablespoon of butter. If you're a low-carber, you know that's something easy to miss day-to-day!

But truth be told, I'm not even convinced Jimmy's weight gains are simply too many calories!

Remember, I hold that calories in, calories out (CICO) matter in context.  

And I do think Jimmy's experience is a necessary exercise in discovering why he's gained weight while maintaining a carbohydrate restricted diet.  Often the examples we see with weight gain are clear - they've increased carbohydrate back to levels that again disrupt the endocrine system and create a milieu for fat storage and weight gain.  

That is not Jimmy's experience now or in the past - each of his gains and losses have been within the context of a controlled-carb diet. 

When Jimmy posted his latest update, he linked to my post and said "Was it the keto-adaptation or the calorie-cutting that has worked in producing the weight loss success I’ve seen? If you ask me, I say WHO CARES?!"

Well, I care - not only about Jimmy as a person and friend, but also for those within the low-carb community, who despite doing everything seemingly right, fail to lose weight or gain and will do anything - even something extreme - to lose the weight.

So then, what has been going on?  

What context might explain Jimmy's weight gains and losses? 

And more importantly, why are those important considerations for anyone ready to jump on board the nutritional ketosis bandwagon and do what Jimmy's doing?

If nothing else, Jimmy is a prolific blogger - he's got websites, podcasts, YouTube videos, a forum, twitter and facebook - and this leaves us with a lot of information to ponder about his weight maintenance, gains and losses.

Going back and looking at each period where Jimmy gained enough weight to motivate a weight loss attempt, we can see - clearly - he was in a calorie deficit.  And while it would be infinitely easier to simply chalk his gains and losses up to calories, I think, after reading back on dozens of his posts, it was more than that; and something I almost missed in my haste to write this post.

I've written a lot about how low-carb diets often work so well because they resolve underlying metabolic perturbations; endocrine issues like high insulin or hyperglycemia; they set-the-stage, so to speak, to enable to calorie restriction (often spontaneously) necessary for weight loss in a more 'righted' endocrine environment.

Since it is the endocrine system which largely controls our weight and hunger, it needs to function well for weight loss and maintenance. Yet, there are some endocrine issues which a diet alone cannot resolve - they are genetic - and Jimmy has, we've learned through his posts, hypogonadism.

Simply understood, that's where you, if male, have low testosterone, elevated LH and/or FSH, and often it leads to high serum ferritin (iron).  

Jimmy has shared with readers that he has this condition - and it's something, that after reading up on it last night, one cannot change with diet alone. Now this isn't an excuse - but a reason that helps explain why Jimmy's appetite is such that he's driven to eat more than he requires.  Those with hypogonadism are often insulin resistant, suffer abdominal obesity and gain weight easily.

It doesn't take long to look back at Jimmy's eating habits to realize he has a big appetite and eats a lot.  This isn't because he's lazy or a glutton, it's from within him, genetic, from his endocrine system working out of balance.

In the right context, calories come into play as a reasonable explanation of weight loss and gain, and before starting his nutritional ketosis experiment, Jimmy started on hormone replacement therapy - an estrogen agonist and testosterone cream is addressing the issues in his endocrine system that his diet does not address. 

He also added Glycosolve, a berberine supplement that helps with glycemic control.

He started routine blood donations to address his iron levels.

And he's recently re-introduced an exercise regime to build muscle, so yes, he's increased his level of activity too.

Jimmy has not simply changed his diet - he's changed the context of his endocrine system AND his diet.  

Whether or not he wants to recognize it or not, the diet part has led to the necessary reduction in calories which is explaining his weight loss; but the other changes are important factors, ones that I do think will make his weight management long-term easier this time.

He doesn't have a broken metabolism - but he has had unaddressed endocrine issues; those now being addressed should help him long-term because, as I've said, context with calories matters.

In an upcoming post I'll look at nutritional ketosis and hope to explain benefits, risks and whether one should consider it long-term or not.

Thursday, December 06, 2012

So Much for Cake, Let Them Eat Steak

Jimmy Moore recently exclaimed "...did you know that if you ate too much protein, it's actually just like eating chocolate cake? I'm not kidding, it is!" (see 21:10 in video)

Take that in for a second. 

Mull it over.

Now then, when someone, even a friend, comes out with something so gobsmacking ridiculous, I can't remain silent anymore.

No Jimmy, eating too much protein is not just like eating chocolate cake; sorry, it just isn't.  My readers can quick run-down of the fate of excess protein here.

So then, Jimmy has, historically, had a roller coaster relationship with the scale.  His ability to gain and lose show he does not have a broken metabolism. In fact I'd say his metabolism is rather robust in its persistence over the years to remain doing what it's designed to do, store and release energy as needed.

His weight ranges since 2004 show a pattern of gain-loss that repeats, year after year, with each successive high higher than before.

2004 - 410
2005 - 230
2006 - 220-245
2007 - 212-250
2008 - 257-274
2009 - 239-260
2010 - 265-289
2011 - 248-300
2012 - 300-306

In May 2012, having reached 306 pounds, Jimmy again modified his diet to lose weight.  And at last check-in, he was down to 256 - honestly, I congratulate him on his efforts and his success to date.  But I cannot, for the life of me, understand his fascination with attributing it to just too much protein, when his calorie intake is the real problem and his current dietary change, while it's increased fat as a percentage, has actually reduced fat in absolute grams, along with calories.

When Jimmy started 2012 at 300 and gained to 306 by May, this helps us understand just how little his excess calorie consumption was - to gain 6 pounds in 135 days took only 156 extra calories a day, or about 1.5 tablespoons of butter or mayo; the absolute easiest things, in a low-carb diet, to add a bit too much of daily.

Simple math can figure out what Jimmy changed for calories without factoring in other changes he's made with hormone replacement, supplements and increased activity.

At 300 pounds, Jimmy required at least 3600 calories a day to maintain that weight based on his basal metabolic rate + the Harris Benedict Formula for his active metabolic rate.

At his reported 175g a day average at the time, that means from real food protein, he was averaging 1870 calories a day from meat, eggs, cheese, etc. since those foods have an average 60% fat and 40% protein mix. 

Add in another 130 calories from carbohydrate and we're up to 2000 calories. 

That leave us to figure out his fat intake. 

To 6 pounds required 156 extra calories a day, on top of his other 1600 calories remaining from fat, to meet his energy requirements, thus he was consuming an estimated 1756 calories from fat, or 195g a day in fat; add that to the 60% from his meats, and we get 3,756 calories, 175g protein, 32.5g carbohydrate, 320g fat - his baseline to calculate changes to his diet in his latest dietary modification.

In macronutrient ratio terms, that was 77% fat, 18% protein, and 3% carbohydrate.  In line with what Jimmy has reported in the past.

He writes that he's now consuming 85% fat, 12% protein and 3% carbohydrate; and has said he's averaging 80g of protein each day.

That looks like he increased his fat, and he keeps insisting he's increased his fat intake - but he hasn't - he's actually reduced not just his protein, but also his fat and his calories; allow me to explain.

If he's consuming 80g of protein, that's 320 calories and 320 calories from protein at 12% of his diet means he's consuming an average of 2,630 calories a day. With 80 calories from carbohydrate (3%), that leaves 2230 calories from fat, or 247g of fat.

Wait a minute!

That's not just reduced protein, it's also less fat, and a significant reduction in calories!

With an average estimate of 2,630 calories a day. With 80 calories, 20g from carbohydrate (3%), and 320 calories, 80g from protein, that leaves 2230 calories from fat, or 247g of fat.

247 is less than 320, is it not?

2630 is less than 3756, is it not?

And if that isn't enough to get you to think about it, consider this - to lose 50 pounds in six months, the boogeyman calorie theory holds that one would need a calorie deficit of about 1,000 calories a day.

Jimmy's calories are not precisely thae same each day, but if you subtract 2650 from 3756, you get 1106 calories a day less than he was eating at baseline.

 Now look up - Jimmy is in range of the calorie deficit that explains his weight loss, with less calories, less fat and less protein.

By golly, he's eating less, and even moving more.

And to be clear, this does not mean I think only calorie in, calories out matter; but Jimmy's experience over the last six years show how strong an influence calories, in a carbohydrate restricted context, do matter.