Low carb and calories, part 2

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

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

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

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

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

MID-AFTERNOON SNACK: nuts and cheese again.

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

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

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

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

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

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

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

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

How can this be?

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

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

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

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

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

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

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

Eat low carb = you CAN’T GAIN fat.

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

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

Please note: I reserve the right to delete comments that are offensive or off-topic.

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59 thoughts on “Low carb and calories, part 2

  1. Given your comment about total energy expenditure, I’m wondering what you think of Taubes’ assertion that exercise doesn’t help weight loss. It seems as though it could make a big difference, especially if you are running a few miles a day and don’t add any more calories to your diet. I realize Taubes basically believes that exercise will just make you eat more. From my own experience, though, I’m not sure that’s true.

    When Taubes said that exercise doesn’t help weight loss he made a distinction that most people didn’t pick up on. He said that exercise as typically prescribed – i.e., to move a little more, to walk 20 minutes, etc. – doesn’t help weight loss. And the medical literature backs him up. When people are put on these fairly gentle regimens and are compared to others who don’t follow the protocol, they don’t lose any more weight. More intense exercise – running a few miles per day, for example – is a different story, and Gary would be the first to agree.

  2. Dr Mike, for the past two weeks I have been invoved in lots of projects here on campus. New students coming in, orientations and so on. I am from Suny Downstate < Brooklyn campus. Given all those extra tasks and no time to cook i was loading on lots of dark chocolate Belgian chocolates, sugar free candy and protein bars. i seemed to be happy and so was my body for the first week. Until one day walking with a friend of mine i experienced the worst bout of diarrhea humanly possible. There was very little warning, just a huge cramp in a stomach area, and a grand boom afterwards. I barely had time to get to the campus bathroom, and when I came out i looked like a reborn person. My boss said that i looked like a Bhuddist monk in trance, thats how happy i was! sometimes little pleasures can go a long way to make one happy! Those damn dark chocolates, sugar free candies form low carb stores are really good and addicting, but loaded with alcohol sugars. I haven’t lost any weight for two weeks, even though I was quite busy and still found time to exercise! I am not sure I did overload on calories though, but most of my intake was at night before bed. I finish work at 12 am and get home at 1 am. that is the time when I unwind, put my feet up, turn on a tv and eat like a king ! All together I did eat under 2500 calories, however third of it was an hour before bed. I wanted to ask this question for the longest. Is meal timing an important factor on low carb lifestyle? I know on all other diets it is recommended not to eat at least 2 hours before bed. I might not be a good example because I did eat two chocolate bars, two candies and two chocolate instone pudding with whip cream an hour before bed. But I still managed to keep my cal relatively low for my lifestyle and my carb relatively low under 30 grams. i know you are not too keen on alcohol sugar or low carb commercially manufactured substitutes.but are some better then others? Thanks again, I know I tend to ask a lot and at times jump form a point to a point, but I will improve, promise!

    A few studies have shown that eating meals earlier in the day brings about more weight loss than skewing meals more toward the evening. The subjects in these studies were not on low-carb diets, so it’s only a guess as to how applicable they are to the low-carb lifestyle. But, I would bet that there is a difference. I try never to eat late at night.

    And I avoid sugar alcohols like the plague to prevent problems like the one you had. For me, a little sugar alcohol goes a long, long way.

  3. I’m dealing with this right now!
    I have lost 116lbs and have maintained my loss for about 6years on <45ecc per day. I have never actually gotten to my goal weight…I have 20lbs to go.
    I’ve been working on those 20lbs for many many moons! I have, in the last six months, reduce my calories from about 2400 to 1800.
    I lost about 4lbs, but then lost nothing over the next two months and experienced more hunger than I have in years! I wonder if I dropped it too far? Is that possible? Maybe now my calories are just too low? I always exceed my protein minimum, and never exceed my carb maximum.
    I recently upped my fat/calories again to 2000 per day and therefore am not feeling hungry, but I’m also not losing…
    I’m not making these changes “willy-nilly”. I try something for about 2-3months before I make any adjustments.

    I think sometimes trying to find our balance is more exhausting than running a marathon!!

    (I’m a 200lb female and the high point of my goal weight from your book is 178. I workout 5times a week doing a mixture of light cardio and hard resistance.)

    Although it’s a pain in the rear, you’re going about it the right way. There is enough individual variability that one has to fiddle with any regimen to fine tune it for maximal results.

  4. With regards to Bian’s comment about the effect of exercise on body composition, I find that i tend to eat less on the days when i am active, and therefore, create a big caloric deficit on such days. On the other hand, when i’m lounging about, i tend to eat in excess of my caloric needs, namely because i like to eat when at rest, as it promotes relaxation, at least for me.

    With regards to today’s post, my experiences add weight to the premise. That is, when i first started low-carbing, i ate more or less a total carnivourous diet, consuming nothing but red meat, fish, eggs, and cheese. While i was lean before eating this way, this dietary regime shedded my body fat even further. Thus, now i know why it is that nowadays i can eat foods contaning carbs, such as nuts and alcohol, along with huge amounts of other high-calorie, high-fat foods without gaining body fat; i don’t lose body fat, but i don’t gain any either.

    As a side note, when i ate in a carnivorous fashion, i supplemented my diet with vitamins and minerals, paying particular attention to vitamin-c, and calcium and magnesium.

  5. Hi Mike,

    I wonder if you would care to address those of us for whom this isn’t true. I truly envy those who can eat as much as they like on maintenance, but like quite a few others, I find that I need to be careful with high calorie items that I love (like cheese) and also nuts, cream etc. I hope you can trust me when I say this is not a ‘carb creep’ phenomenon. I only very rarely eat more than induction level carbs, but find my weight goes up if calories go up too much, or exercise is more of the toiling at the keyboard variety.

    One thing that I think many low carb experts ignore is the diet mentality. The reason people eat less when they first turn to low carb to lose weight is not just a physiological response to the change in macronutrient intake (although that is undoubtedly a big help), they also eat less because they are dieting! I doubt many of those who turn to low carb with weight issues are trying to lose weight for the first time. Coupled with that inclination to cut back (eg. many people wouldn’t eat dessert for a while, at least not every night) there is in many cases a lingering fat phobia, so no matter how often we are told, (with very convincing science) that all we thought we knew about fat intake (particularly saturated) is wrong, it also takes a while to sink in, so the new regimen is low carb, high(er) protein and not very high fat. This is another reason why calories are kept low … initially.

    We also exercise more – again a long learned diet/behaviour association.

    By the time a goal weight has been reached, things have changed. No diet mentality – this is a “WOL” … and Mike says we can eat as much as we like, as long as carbs remain in check. We are now also well read (well a lot of us are!). We have now also read Taubes, Kendrick, Ravnskov … etc, and we now ‘know’ just how wrong Keys was … so our ‘WOL’ is higher in fat from cheese, cream, nuts … and calories. Oh, and exercise doesn’t seem such a high priority any more, or we just get busy with other things.

    I remember the first time I read your books, I read about your 5000 calorie lady, and I read about those who could raise their carb intake at maintenance tp a 100g or more. I think like many others no doubt, I decided then and there I was going to be one of those! Of course it turns out I’m not, and I’m fine with that … now 😉 but, as I say, I’d like to know if my carb tolerance has in fact declined since the weight loss phase (nearly 5 years ago now) and I will always have to keep an eye on ‘calorie creep’ to prevent myself gaining on a very low carb regime.

    Is this a case of declining insulin sensitivity? – (I thought low carbing should improve this) or are there just some of us for whom adherence to low carb intake never drops insulin low enough for calories to cease to be an issue?

    Hope you will forgive the long post and that all is well with you guys now that deadline has been met!

    Cheers,

    Malcolm

    Hey Malcolm–

    Good to hear from you.

    I remember your discussing this same phenomenon in a past comment. Sorry you’re one of the so-afflicted few.

    There is enough individual variability that nothing specific works for everyone. Most people can pretty much eat what they want in maintenance as long as they keep carbs low enough. Some people, however, still have to watch calories a little. There is an age creep that causes problems because as we age, our metabolic rate falls. If we continue to consume the same types and amounts of food that kept our weight steady at age 40 we are likely to gain weight at age 60. And it’s a function of hormonal status as well. If we have declining testosterone and/or thyroid hormone levels, it’s likely that we will have difficulty maintaining weight without reducing intake a little more. There are a plethora of details in play that all have to be fiddled with to fine tune the weight maintenance phase.

    Having said all that, it’s also important to realize that maintenance has to be maintenance, i.e., the act of keeping weight at a ‘normal’ level. If you try to maintain while you still have a fair amount of excess body fat, the excess fat sets up a metabolic hormonal milieu that makes maintenance more difficult.

    BTW, your countryman, the prat from Downunder, is on his high horse again. I’ll have to slap him around again soon.

    Cheers–

    MRE

  6. I think many people overlook that exercise, besides actually burining calories, probably has a greater effect on weight loss by decreasing insulin levels.

    From:

    http://www.marksdailyapple.com/diabetes/

    It’s all right there in your DNA blueprint. First off, exercise does have a major impact on improving insulin sensitivity since muscles burn your stored glycogen as fuel during and after your workout. Muscles that have been exercised desperately want that glucose inside and will “up regulate” insulin receptors to speed the process. That’s one reason exercise is so critical for type 2 diabetics in regaining insulin sensitivity. It’s also the reason why endurance athletes can eat 400 or 600 grams of carbs a day and stay lean – they burn it all off and make room for more.

    Resistance training seems to be as effective as aerobic activity, but a mix of the two is the best. And because you are now “insulin sensitive”, you don’t require as much insulin to store the excess, which “up regulates” all the fat burning enzymes, so you burn your stored fats at a much higher rate throughout the day. Important amino acids and other vital nutrients have access to the cells when insulin sensitivity is high, so you’re building or maintaining muscle and losing fat weight. Go team.

    It sort of works this way in theory, but the reality is a little different. There are papers showing that people who run 6-8 miles per week still gain weight with age. In order to keep their weight stable, they have to continuously increase the distance they run. Which, ultimately, has to hit a limit. I think exercise brings many benefits, I’m just not so sure that weight loss is among them.

  7. Another excellent article! I’ve been checking this blog everyday – waiting for this second ‘part’ to the whole carbs/calories conundrum. What a great post :)

    Of course, I have a couple of questions…

    Just for clarification – are you saying that in the context of a low carb diet, and as long as the person is getting their minimum protein requirement – that there’s no real risk of the so-called ‘starvation mode’ ie. metabolic slowdown?

    Second – how low in carbs? I’m switching to Protein Power from Atkins – I feel much, much better, and am enjoying a more varied diet with lots of different veggies and so on. That said, I’m so new at it that I’m still kind of leery of ‘higher carbs’ than my usual 20 grams or less total. Will it work? No, don’t answer that – I’ll just figure that one out…(patience!)

    Third – with the increase in carbs on PPLP, my calories are dropping off and fiber is much higher. So, again – no risk of ‘starvation mode’ ? Switching to PPLP hasn’t triggered any cravings, and it seems to be going well – but as I said – cals are dropping. Is this ok?

    Thanks again for a great series of articles.

    As long as protein is adequate, you’ll do fine. No real risk of starvation mode.

    And your doing it the right way. YMMV, so you’ve got to fiddle with the carb intake to find what works for you. And, unfortunately, what works for you right now may not be what works for you in 5 or 10 years.

  8. I just realized that my questions are more relevant to the first article – somewhere in the comments, I got the impression that a person wouldn’t damage their metabolism in the context of a low-carb diet.

  9. High-intensity exercise definitely helps weight loss. The typical advice to do aerobics has led to an epidemic of repetitive stress injury. Walking is good, but it’s more for maintenance than weight loss or improved fitness. Two of the best high-intensity exercises are hard rebounding (jump as high as you can for as long as you can) and stair climbing (run up, walk down).

    There is a great deal of research on “high intensity Interval training” (HIIT) and how it rapidly improves weight loss, endurance, and fitness. Read these articles (and others) about interval training on Clarence Bass’s site. These inspired me years ago and I got rapid results, but it is definitely important to be in good shape before starting. Check with a doctor first.

    http://cbass.com/FATBURN.HTM
    http://cbass.com/SEARCHOF.HTM
    http://cbass.com/EACAPING.HTM
    http://cbass.com/Intensity.htm

    If you want to be really lean, you have to eat very little (unless you have perfect genes). Ask all the body-builders and fitness models: what do they eat? Very little. Maybe 1800-2400 kcal for men, 1200-1500 for women. And they have to exercise hard to get that lean. Most people will never achieve that look, unless they change their relationship with food. No matter what you eat you wil have to eat very little of it. And unless you limit carbs severely, you will have to deal with hunger to get that fitness model physique.

  10. My experience is, when on a low carb diet, watch out on the wine intake! My diet is very high in fat and protein and quite low in carbs. (Salads and a piece of fruit here and there.) But when I get weak in the wine department, I gain fat faster than you can say Jackie Robinson. I think many people don’t realize that even though a glass of wine only has about 3 grams of carb equivalent, alcohol is metabolized rapidly. So the glasses (let’s face it folks) of wine with my big grass fed steak may not be the smartest thing in the world for fat loss.

    And I can tell you from experience that using aerobic exercise to lose fat is a losing battle. In order for it to work you have to do A LOT of it and even if you can after such you will be starving for…take a guess.

    Hey Fred–

    Amen on the wine issue. I have to watch it closely myself. I don’t seem to have the problem if I drink spirits that I have with wine. I’m sure everyone is different, but in my case (and yours, apparently) wine is problematic.

    Cheers–

    Mike

  11. So is this the mechanism that kick starts those people for who have trouble losing. The slapdown of carb and an increase in fat and protein increase the NEAT mechanism. Then as they cut back on the calories, while maintaining volume, by adding back in veggies and fruits the caloric deficit happens.

    If I have this right then it sounds like revving the engine before you let the clutch out on the hill.

    Thanks for the explanation, you answered my question from your previous post. I sure hope it is true because I am within a couple of months of my goal weight and I tell you I am absolutely in fear of coming off the weight loss regimen, but I know I cant keep living with such a restricted menu…..low carb and low calorie for me since I had 165 pounds to lose (55 to go)….I can easily live with the low carb but the 100g of protein per meal limit is not something I can sustain for the next 40 to 45 years I have left on this earth.

    I feel better about the future now. Thanks Dr E.

  12. so let me see if I got it…if I up my carbs, by eating cheese or nuts, I have to count calories to lose weight; if I decrease carbs to 5 gms/daily(or lower) I don’t have to count calories to lose weight? Does this mean it’s still all about carbs after all?
    con

    The second part of your statement isn’t correct. If you decrease your carbs you don’t have to really count calories to MAINTAIN weight.

    And it is pretty much all about carbs in one way or another.

  13. Dr. Eades,

    When you say, “They were cutting the carbs, but not enough to bring about insulin lowering to the point required to enjoy the benefits of low-carb dieting,” how low are you talking about for carbs? Less than 60? 50?

    Thanks again,
    Jeff

    YMMV, but cutting them to below 50 seems to work fine for most.

  14. You said, “Once you’ve reached maintenance you can pretty much eat all you want without gaining as long as you watch your carb intake.”

    Sorry, but this hasn’t been my experience. I’ve been maintaining for a little over a year, and if I don’t watch calories as well as carbs, the weight gradually comes back.

    I should have said that ‘most people once reaching maintenance…’ Unfortunately, as with most everything else in the diet world, YMMV.

  15. As a bodybuilder trying to lose fat while maintaining muscle mass, I consider it essential to count calories, carbohydrates, and protein. How do you feel about zigzagging calories while creating the same overall WEEKLY caloric deficit? For example, on workout days consuming a slightly higher number and all other days slightly lower. Could this help me gain muscle while losing fat?

    Some people believe that it does. I haven’t really had any first hand experience, so I can’t say for sure.

  16. I did the Atkins diet 7 years ago and lost 70lbs pretty quick i was 36 at the time and didnt even workout.Iam again starting tomorrow on Atkins or your protien power,is there a big diffrance in taking in 20 grams compared to your 30 grams will i still reach ketosis.I have been lowcarbing for about 4 months prior to starting again tomorrow. And only lost 13 pounds even working out.I could not figure out why the slow weight loss intill i read your article.To much meat and cheese there is no telling how many calories i was eating i will now watch my carbs close and calories.I was also using taco seasoning in my burger meat and didnt relize that had a lot of carbs in the package.
    Thanks Doc

    For most people – especially males – there is not a big difference between 20 g and 30 g of carbs per day in terms of ketone production.

  17. This was awesome, Dr. Eades! I’ve lost about 10 pounds the last week or so by cutting back on fat for two meals (as well as cutting out as much sodium as I can). Its really good to know that cutting back on calories only needs to be done temporarily.

  18. Thanks for these posts on the importance of calories.

    I did a post on my blog that lays out the ideas graphically http://www.emotionsforengineers.com/2008/06/unified-feed-theory.html

    One of the comments to the post has a great explanation of the ASP pathway as well.
    It’s at http://sparkofreason.blogspot.com/2008/06/swift-kick-in-asp.html

    Cheers,
    T

    Hey Tony–

    Great post. It’s one for all the engineers who are readers.

    I’ve read Dave’s post as well, which is also a good one. I’m glad we’ve got some bright minds working on the problem.

    Cheers–

    MRE

  19. I do believe the duration and intensity of the exercise regime is important. I have recently started jogging 5 miles a day, 5 or 6 days a week and noticed a return to weight loss and a somewhat diminished appetite. Over a period of months I have been slowly increasing the pace of my jogging and now jog at a fraction over 7mph: covering the same distance in a shorter period of time each week. All of a sudden I am losing 1 or 2 lbs a week, particularly around my stomach. I am now begining to think that a 32 inch waist is now a realistic objective. At some stage I will need to tail off the increase in pace – but I think there of plenty of adaptions I came make – such as interval training, sprinting, distance variations,etc, to keep me going and interested for some time to come.

    This week my weight loss has accelerated and it seems to have coincided with a reduction in my consumption of almonds – not deliberate, just through a reduction in snacking.

    Its my belief that on a low carb diet the body quickly switches to using fat as a fuel source and that, in combination with prolonged aerobic exercise is a good recipe for weight loss, and, I suspect, improved insulin sensitivity.

    This may lead to a virtuous circle: the lower weight makes exercise easier which makes weight loss and maintenance easier to achieve. Plus, you tend not to eat whilst exercising.

    Its a shame they don’t tend to measure inuslin levels in the UK. Their primary concern seems to be to measure cholesterol, using either the Friedwald formula of the non HDL measure if a fasting test is undertaken. I would find a measure of fasting insulin levels quite instructive and possibly motivating.

    So, in summary, based on my experiment of 1 (vitally important to me) intensive exercise is beneficial to weight loss. I believe it enhances the effects of a low carb diet.

    Paul.

  20. Dr Mike, this has not been my experience. As a 75 year old woman, I have managed to lose 50 pounds on PP and PPLP to my goal weight. BUT I kept BOTH carbs and calories down. When I hit maintenance, I increased calories while maintaining my low level of carbs (30 ECC). I have regained 20 pounds.

    I asked you why in an earlier question to your previous post and you told me to wait for the new book. I see by this post, you are still not dealing with the issue of overconsumption of fat and resultant weight gain. Indeed you reiterate that you will not gain weight if you overeat fat while keeping carbs down.

    I can’t believe I am alone in my experience.

    Pam Brink

    I don’t think you’re alone. But I do think that most people can maintain as long as they keep their carbs low. Some, I’m sure, will have to continue to watch fat intake.

    Cheers–

    MRE

  21. Dr. Mike,

    This is off-topic, but I was hoping that you could tell me whether or not a high level of bilirubin (50 umol/l) should be of concern even when a person’s fasting blood glucose, and cholesterol and triglyceride readings are fine? My mother’s sister just received her examination results and was alarmed when she saw the word Bilirubin emphasised in bold writing. I have not clue as to its meaning and ramifications, and thus, i wanted to ask an expert who i trust; hence this post. Using the calculations that you provided for me previously, I computed her results from european measurments to the one’s used in the USA and got the following:

    Cholesterol 272 mg/dl
    HDL 76
    LDL 177
    Triglycerides 96
    Glucose 76

    Triglycerides:HDL = 1.3
    Total Cholesterol/HDL = below 4
    LDL/HDL = below 3

    I can’t say what a high bilirubin means in isolation without a lot more information. When I get a lab back on one of my patients that has a finding that seems out of place given the rest of the labs, I repeat the lab. Lab errors abound.

  22. Yes, but you’re still leaving out the fact the most people, because of their intense exercise, will be hungrier and eat more, thereby losing the calorie deficit. Good, sweaty workouts have never helped me lose weight. I trim down and feel better but no weight falls off.

    I am the poster child for not losing weight on a low-carb diet. I have been trying to lose weight this way for over 6 years. My blood work is excellent and my health is good, but the only way I’ve ever lost weight is by giving up all dairy and nuts. Just meat, veggies, and a little fat. That’s really hard for me to maintain. I love my dairy and I don’t like being hungry. So, while LC is a lifestyle for me, the occasional lapses and the dairy keep me from losing weight.

  23. about the exercise – I used to run/swim/stairmaster religiously 6x week, for at least 60 minutes, often more. I stopped (a few months after starting Slow Burn), and didn’t gain a pound. So, for me at least, even intense exercise didn’t affect my weight.

    about NEAT – one of the little things I’ve noticed since starting LC six years ago, I no longer feel the need to sit down as much, say, on the subway, in a bar, or out wandering around in public… I remember in the pre-low carb days, I was always looking for a place to land my fat a$$, haha. I would even pick subway stops based on my chances of finding a seat. Seems incredibly ridiculous to me now.

  24. Hi Dr. Mike. You’re probably familiar with the story of Jay Cutler, the quarterback for the Denver Broncos. During the course of last season he lost about 35 pounds, going (I think) from 238 to 203, very odd given the diet and workout regimen of a professional football player. During the off-season, Cutler was diagnosed with Type I diabetes. Once he started insulin treatment, his weight shot back to normal over the course of a month. So it goes to show the power of insulin, and how little inputs like diet and exercise matter when your hormones are wacked.

    Another contributor to the low-carb stall might be acylation stimulation protein (ASP), which I blogged about here: http://sparkofreason.blogspot.com/2008/06/swift-kick-in-asp.html

    Knowing about ASP probably doesn’t change the prescription for dealing with a low-carb stall, but I think it puts a nice bow on top of the metabolic scenario you described.

    Hey Dave–

    I read your post a few days ago. It is excellent. I encourage all to read it.

    Jay Cutler’s history is pretty standard for an undiagnosed type I diabetic. A huge weight loss without even trying. I would be he was eating like a horse. And I would also consider betting a little more heavily on the Broncos now that they’ve got a QB with his disease under control.

    Cheers–

    MRE

  25. Dr. Mike,

    In relation to my previous post which iinquired about bilirubin, i just spoke to my mother’s sister, and i found out that she had jaundice as a kid. Maybe this might explain her high bilirubin level, maybe not. I have no idea what her high level of bilirubin means and if she should be concerned.

    Thanks for your time (and patience).

    I wonder if she’s jaundiced right now. Sometimes jaundice is patently obvious – other times not so much. Jaundice as a kid doesn’t necessarily have any relationship to jaundice as an adult. Could be a number of things – she needs to be evaluated by a competent physician.

  26. I was diagnosed with gestational diabetes while pregnant with my 2nd last year. Of course I was subjected to “education” on the mainstream treatment for gd, but I was scared to death to go on diabetes medication while pregnant so I decided to low carb instead and hope for the best. And it worked very well, I kept my blood sugar numbers at mostly normal ranges.

    My secondary concern with low-carb was weight loss, which I didn’t want (my normal physique is actually underweight for my size), so I loaded up on fats. I did drop just a couple pounds in the first two weeks of the low-carb but that was all. Weight gain after that continued normally. A healthy, normal size baby at the end told me the approach was a good one.

    I know you’re not an OB, but I would like to know if you have any comments about low carbing during pregnancy. We get preached at so much about the importance of gaining weight during pregnancy, but does it have to be weight from the momma just getting fat? As long as the caloric needs are met? They lectured against low-carbing during the gd “education” session, stressing the importance of carbs to meet the bodies needs. I took everything they said with a grain or two of salt. I would like to be even better informed if I go through this again.

    Thanks.

    As far as I’m concerned, a low-carb diet (as long as sufficient in calories) is fine during pregnancy. But you should work with your OB with it. The important thing is to keep refined carbs fairly restricted during the first trimester (when the fetal pancreas is developing) and keep protein high during the last trimester when the baby is growing rapidly.

  27. Does this mean that one can eat sugar too, as long as the carbs remain low. I would assume that this would increase the insulin levels.

    It wouldn’t be the best choice, but if kept low enough it shouldn’t pose a great problem.

  28. Hi Mike,

    I seem to remember an interview with Gary Taubes (Larry King if I’m not mistaken, although it wasn’t Larry King interviewing that night) and Taubes was asked about Lance Armstrong. Taubes said that in his view, Armstrong isn’t lean because he exercises; instead, he can exercise because he is lean. I thought that was a really interesting, if not counter-intuitive for most ‘experts’. I can appreciate Taubes’ point and I wonder if you would find that view also interesting enough so you would elaborate on that. Thanks in advance.

    Hey Gabe–

    I don’t know if I buy into that idea totally, but I think Gary does. In fact I got an email from Gary telling me I mischaracterized his position when I answered the first commenter on this post. Gary feels that any exercise will be compensated for by an increased food intake. He has some valid reasons for his point of view, but I’m not sure I can buy into it to the extent he has. I suppose I need to do more research before I can speak intelligently on the subject.

    Cheers–

    Mike

  29. Here’s a great one!

    http://www.foxnews.com/story/0,2933,368462,00.html

    Jesus, Mary, Joseph and Moses wept.

    With articles like this being published, I keep waiting for headlines like, “Shooting up with heroine key to mental health and longevity”.

    You notice that this is a study yet to be presented. The researchers have put out a press release that the members of the press have dutifully picked up on. When I look at the calorie count of the two diets, I think something doesn’t quite ring true. We’ll wait to see when (and if) the paper is published. It may be such a lame study that it never gets accepted into a journal. Almost anyone can present findings at one of these meetings – getting them accepted into a peer-reviewed journal is a different story.

  30. I love reading things like this – it helps me understand HOW IT IS that I can eat so many wonderful, high-fat foods, while keeping my carbs pretty low (because that’s really how I LIKE to eat) and STILL not gain weight. I’ve been in maintenance now for over 5 years.

    A typical day for me might go like this:

    Breakfast – a cup of decaf Americano with a good splash of heavy cream

    Mid-morning snack – a wedge of Brie (probably 2 ounces) and/or some bacon

    Lunch – 4 oz. cream cheese, a can of smoked oysters, a handful of pork rinds (on which to schmear the cream cheese and plop an oyster on top) and a few of those wonderful sweet red/orange/yellow small peppers

    Mid-afternoon snack – not usually, but if I get peckish, I’ll have a piece or two of homemade, SF beef or salmon jerky

    Dinner – grilled centercut pork chop, sauteed zucchini/onions, green salad with homemade vinaigrette, maybe a glass of wine; OR, a sandwich made on 2 slices Ezekiel bread with pepperjack, sliced meat of some sort, lettuce, and a side of peppers, pickled cherry peppers, and SF sweet gherkins

    Snack – a slice of homemade flourless lemon cake with whipped cream/cream cheese icing (small slice!) and a cup of decaf hot tea

    That’s just a “typical” day, the constituents may change a bit. My weight fluctuates between 129 and 132. I am 5’5″ and of medium build and gonna be 55 in October! I have GREAT energy levels, am the sole caregiver for my 77 year old mother who is pretty much nonambulatory at this point (bad osteoporosis leading to 3 compression fractures and YES you can bet I DO take calcium citrate, magnesium, and D3 daily AND get plenty of weight-bearing activity) and I am so very happy with my lifestyle!

    I did Weight Watchers previously for a couple years, lost 34 pounds on it but couldn’t tolerate the sugar swings and lack of energy from trying to fill up on low points but sugar-loaded CRAP. Switched to low carb, lost 10 MORE pounds and couldn’t be happier!

    Thanks for posting so much wonderful information – I always forward it on to my low carb friends – AND a few who aren’t! 😉

  31. A few weeks ago in a reply to comments you recommended trying a high fat diet that was successfully done by one of your readers. That is an 80% cals from fat diet. I’m a 5’7″, 198 pound woman and from the charts in PPLP I need 102g of protein, which is 408 cals more or less. (I don’t recall the exact protein requirement from PP, but it was quite close.) If I eat no carbs at all, that means I need to consume 2040 cals to be on an 80% fat diet. If I eat 20g total carbs, that pushes calories to 2440. I don’t lose with either caloric intake or if I do lose it is in tenths of a pound per month. Granted, I am one person not “everyone.”

    My question is how do you reconcile that sort of high fat diet with the fact that if you eat too many calories you fail to lose weight? Many or most of the people I know doing high fat/low carb diets do them at the expense of protein. My belief is that this will result in weight loss, but the weight may well be muscle and fat, not just fat or even predominantly fat.

    You can probably reduce your protein intake somewhat and still maintain your lean body mass. There is nothing magic about the 80 percent fat number. It’s what one woman found to be effective for her, which doesn’t mean that it will work for everyone. Were I you I would decrease my protein to 80 g or so, keep my carbs below 20-30 g and fill in the rest with fat. And I would keep my calories low enough to create a deficit, which should result in weight loss.

  32. What a great post! I’ve been low-carbing for seven years and for the first six year maintained a weight loss of 65 lbs, but I couldn’t get off the last 10 pounds. I started to believe this was the lowest weight my unique biochemistry would allow, but I began to take a deeper look at my eating and discovered that I was mindlessly eating a TON of low carb snacks and meals (mostly, of course, nuts and cheese, although tuna and chicken salad with real mayo were eaten even day for lunch or dinner). Even though I never lost more eating this way, I never gained an ounce from it either. When I lowered my caloric intake, I began to lose again. Now, I’m 7% bodyfat, and I even have a 4-pack (almost a 6er!). Great post!

  33. Dr. Mike – What would you recommend in terms of diet for a bike racer? The traditional cyclist is told to shovel in lots of carbs (bars, goos, drinks, etc.) with some protein thrown in for easier absorption, replenishment and recovery. However, despite riding 300 miles a week or more (some with very great intensity – heart rate in the 180 to 190 bpm range) and attempting to keep calories in line my wife’s weight does not decrease during race season despite her best efforts to restrict calories. Instead, she is either hungry because of the calorie restriction or grumpy that she ate “too much” and is above her weight. (Of course, this recognizes that her weight is normal but that for cycling she would like to be lighter in order to go faster up the hills. She is 5′ 8″ and about 137 lbs but would like to lose 5 to 7 lbs.) Would you modify your dietary approach for an athlete in hard training? Any thoughts as to appropriate nutrition? Thanks!

    I would avoid the carbs (bars, goo, drinks, etc.) and follow a good quality whole-food low-carb diet. And during intense riding I would carry a glucose (not fructose, not sugar) drink to consume when I felt like I was hitting the wall.

  34. With respect I have to disagree with you here on your comment to Brian. Taubes DOES very much believe that exercise increases appetite and that even vigorous exercise is not that conducive to weight loss. In order to maintain homeostasis the human body will increase appetite. He wrote an article about this very subject at http://nymag.com/news/sports/38001/

    I wonder has ‘another low carber’ tried going lower on carbs as even 30 carbs can be too much for some folks. Even a small amount of carbs will cause an insulin release in people with hyperinsulinema and extreme insulin resistance. Sad but true. Zero carbers have had a lot of success eating this way. As Bruce said “Unless you limit carbs severely you will have to deal with hunger to get that fitness model physique”. The key there is “limit severely”. You can count cals or you can eat zero carb. It’s not fun but it’s true.

    You’re right. Gary read my comment to the comment and sent me an email about it. I’m not sure I totally agree with him on this point, however.

  35. Can increased water intake help with a fat loss on low carb diet? I haven’t lost any weight for the past two weeks even though I did work out and burned lots of calories while eating low carb and relatively low calories. I did lose few inches of my waist though. What is explanation of losing few inches of the waist and not losing any weight? Is it possible that my body is holding to the water since I increased my salt intake duet to eating low carb commercial candies and chocolate?

    You may be adding muscle if you’re working out. If you lose 3 pounds of fat and gain 3 pounds of muscle, your weight won’t change. Yet you will be much smaller. If you continue the weight loss should pick up.

  36. I take the ketogenic cocktail recommended by Dr. McLeary in The Brain Trust for control of my migraines. He reccomends taking it up to 3x daily. I only take it once, because when you toss in all of the calories from that, plus my calories from my daily dose of Cod Liver Oil, I wind up with not a lot of wiggle room, since I’ve found that I will not lose unless I stay below 1600 calories a day.

    Which reminds me – slightly off topic – but still having to do with calories – I have calculated my BMR to be slightly over 1600 – and I am pretty active (I engage in moderately intense sports/workout activity 4-5 days a week) – so I am losing weight only below my calculated BMR. Will eating adequate protein prevent muscle wasting, or am I just fooling myself and losing muscle, not fat? I can’t seem to lose any other way (and trust me, as a 5’5″, 200 lb woman, I’m pretty sure I need to lose still). I realize that BMR is sort of a guesstimate – but I don’t want to lower what is already a low metabolism by wasting muscle. Especially since about 400 calories a day goes to just the supplemental fats I take for my health.

    Consuming adequate protein should prevent muscle loss.

  37. Dr MIke, one more important question! a coworker of mine suffered from hyperinsulinimia for years with bouts of anxiety, obesity and debilitating fatigue. She said nothing seemed to work. I gave her your 30 day low carb solution book and she was doing fine and lost about 10 pounds in 3 or 4 weeks. She was eating lots of nuts though and swore it helped her with fatigue. Then she kind of hit a plateau and decided to abandon nuts. She lost a pound or two but now she feels horrible fatigue again in a day time with brain fog and heavy body feel, whatever it means. she told me today that her doctor said she might have reactive hypoglycemia. How is it possible with low carb diet, is it possible? Sometimes I too have low energy and feel very tired, but I always attributed to sleep deprivation. What is the best snack on a low carb diet for a brain fog or low energy ? What is the best way to upbring the glucose back if it is indeed possible to have hypoglycemia on a low carb diet? I know in my case I was either using nuts or a protein shake with a bit of buttermilk, which does have 6 grams of carb, but thats not much.

    The first lesson you should learn is to never believe what anyone tells you about his/her diet. I’ve learned that lesson the hard way too many times.

    Second, as far as I’m concerned, the best snack to raise sugar without adding carb to the diet is protein. Beef jerky is what I like to use myself. Or any kind of jerky.

    I’m not sure how one could have reactive hypoglycemia on a low-carb diet since reactive hypoglycemia occurs when glucose goes too high, stimulates an overproduction of insulin, which knocks blood sugar too low. On a low-carb diet the blood sugar should never go too high since there is minimal carbohydrate in the diet.

  38. This is not strictly related to the article (though it is about carbs and calories), but why is it that this sort of thing is still thrown around as “fact?” http://www.yourlivetrainers.com/Article_32.html

    I read a little of this article, and I don’t that I’ve ever seen more mistakes and misinformation in such a small collection of words. On the internet anyone can present anything as fact. The internet makes a ton of information available, but you’ve got to be discriminating in what you accept as true.

  39. Hey Mike

    I find the key for me in regards to keeping my calories in check whilst having more variety is simply to do them within my meals. I don’t like to cut nuts and dairy, especially dairy as I seem to do really well with it and find it more satisfying then other protein foods (e.g. meat and salad seems to make me hungry). So, I just have cheesecake for breakfast or lunch. I seem to do much better weight wise when I do this plus I feel like I had a treat so there goes that problem too. I don’t snack much if at all and never have dessert unless its for a special occasion and my dinners always come with a huge serving of fibrous veggies with some fat such as butter, cheese or cream. When I was doing this and counting calories (was aiming for 1500) I found myself having to force a snack or protein shake in just to get those calories up.

    With maintenance I had no problems and felt I had a pretty good carb tolerance, I doubt I really ate that much more but rather just stopped counting and allowed small servings of muesli for breaky and the occasional carby meal, e.g. spaghetti with my bolegnaise, rice with curry or potatoes with my roast or say when out I might treat myself to a nice cake and coffee. I maintained for two years a weight of 55kg with just the odd water fluctuations that never went over 57kg.

    Then I fell pregnant and gained 30kg really fast whilst eating the same way, mind you I lost most of that not long after but gosh that wasn’t a fun pregnancy!

  40. Even frequent, strenuous aerobic excercise causes me to lose a little fat and gain more muscle for a slight net weight gain. However, exercise has always caused my appetite to increase, which completely agrees with the research Taubes provides.

    I’ve found exercise very helpful in repartitioning the tissues in my body, but I’ve never lost weight that I would attribute to exercising.

  41. Dr. Eades,

    Ravnskov once said after a meeting with Colpo, that this is an “angry young man”. After having read his latest postings I think Colpo nowadays even is a mentally very very ill person, obviously struggling with extremely severe aggressions and an extremely low selfesteem. He should seriously look for professional help quite soon, because otherwise he will decompensate sooner or later.

    Please do NOT address this pitiable person or his tirades of hate any longer. Please do simply ignore him! He wants to sell his e-book and you should not promote this indirectly. On the other hand it would be quite interesting to read a brief summary or review of his recommendations so that nobody should feel urged to buy his e-book any longer…

    Greetings from (old) Germany
    (and once again excuses for my mediocre English)
    guzolany

    I pretty much try to ignore him, but he has struck again with a cheap shot. I’ll do another quick post to set the record straight, but not a lot more.

  42. Ditto on the wine for me. It’s not that much either, but a glass or two several nights a week equals several pounds and some increase around the middle.

  43. hi dr. eades,

    this is exactly the experience i just had! i’ve been enjoying steady weight loss while doing a combination of natural low carb whole foods (i don’t eat low carb products, just real food) and intermittent fasting. i just got home from a 3 week business trip where i continued low carb/if but ate all the unsalted nuts in my mini bar every single night! and sure enough..i didn’t lose an ounce during this trip, but what do you know…i also didn’t gain an ounce.

    interesting stuff…

    best,
    ida

  44. I’m glad the wine subject came up. As I mentioned on another post, I’ve lost 132 lbs on low carb (almost 2 years now) and using Fred’s “Slow Burn” which all worked out great. Still trying to tweak out another 3 lbs.

    But all that time I included wine or light beer in my diet. If I understand correctly, as long as the alcoholic drink is low carb, the alcohol itself is similar to fat in it’s effect on the metabolism and insulin.

    For me, it would always come down to a choice between a couple glass of wine, or a couple low carb beers, or 1.5 ounces of peanuts. Same calories and carbs. The wine usually won that contest. And in the long run it seemed to work out just fine.

    But the alcohol does seem to temporarily cause water retention probably in response to dehydration. So that can move the scales. But when you take that into account over time it balances out.

    Just my experience, I vote wine!! :)

  45. Someone was mentioning the dairy – my experience has been that my favourite low-carb food (any and all dairy) wasn’t my friend. In fact, I couldn’t lose any weight, because I was intolerant to dairy foods and didn’t realize it for the longest time. I kept on lowering my carbs further, and to no avail. It was the dairy. Then I got rid of dairy, and some issues magically resolved themselves. But, I was still stuck on this practically no carb diet with all kinds of fat – this didn’t work either. I’d have eggs and meat for breakfast, then not be hungry for lunch – end up snacking on mac nuts at 3pm – then not hungry for dinner, and end up eating a bunch of grilled chicken or whatever topped with tons of dressing and/or dip for ‘dinner’ at 8pm. Um – this really didn’t work out for me. I didn’t gain any weight at all, but I didn’t lose either. Saying that I ‘maintained’ sounds a bit better than saying I was ‘stalled out’ somehow.

    Back to the dairy idea…

    Even if not intolerant to dairy – I think it’s still worth going a week without it, just to ‘see’ if it makes any difference. The carbs relative to portion size (and the calories) mean that a splash of cream here, a slice of cheese there, some blue cheese dressing here…and you’re at your carb limit for the day, and you’ve added lots of calories. I don’t think this is all about the calories, but they do seem to count, especially as you get into that ‘middle phase’ or are heading towards a point where you can sort of imagine reaching goal. Furthermore, even without considering the cals – there is this ‘carbs relative to portion’ size thing. I’m very happy not to be trying to get all chintzy with the cream in my coffee or worrying about just how much cheese is on that burger…(who am I kidding? I sloshed all kindsa cream into my coffee…)

    Just an idea.

  46. Pam: “I see by this post, you are still not dealing with the issue of overconsumption of fat and resultant weight gain. Indeed you reiterate that you will not gain weight if you overeat fat while keeping carbs down.”

    Have you considered that the type of fat might be your problem? Maybe fats from vegetable sources that are high in PUFAs (common in mayonnaise, salad dressings, and cooking oils)? Or perhaps you have a problem with cooked/pasteurized fat. Have you tried limiting THOSE fats, but eating all the natural unprocessed fat you want? I think overconsumption of protein is a bigger problem with low-carb diets. Most eat too little fat to become fat-adapted. Read the high-fat blog (HyperLipid), where people focus on eating mainly fats (75-85%).

    http://high-fat-nutrition.blogspot.com/

  47. MRE: “Gary feels that any exercise will be compensated for by an increased food intake.”

    My experience says otherwise. Years ago, I lost from 235 to 185 doing hard exercise based on Clarence Bass’s interval training articles, and Art De Vany’s Evolutionary Fitness. I did all of my exercise at the highest intensity, like 85-90% of max heart rate (180-190+ bpm). I didn’t notice a big increase in appetite. I lost weight fast. And in fact the studies on interval training show that it blunts appetite and results in 9-fold greater fat loss for every calorie burned. See the articles on Bass’s website that cited above, as well as others.

    http://www.cbass.com/

    guzolany: “After having read his latest postings I think Colpo nowadays even is a mentally very very ill person, obviously struggling with extremely severe aggressions and an extremely low self esteem. He should seriously look for professional help quite soon, because otherwise he will decompensate sooner or later.

    BTW, did you know that “Colpo” is a prefix meaning Vagina? Ex: colposcopy, colpospasm, etc. I’m not drawing any conclusions, but that may explain some things. Give the guy a break. His last name is Vagina. I can see how that might give him issues. And I agree that Anthony needs to seek professional help soon, before he self-destructs.

  48. Can the good Dr or any of you smart arses tell me why elevating ones legs is deeply relaxaing for the bod ?

    Pleasum and thankum.

  49. Dr. Mike, you wrote:

    “[e]ven if your caloric intake goes up – as long as your insulin stays low – you won’t store more fat in the fat cells. And your weight will stay the same….

    “The phenomenon is pretty vividly demonstrated in people with type I diabetes, the type of diabetes in which no (or very little) insulin is produced. …[t]hey are losing weight like crazy while eating everything in sight. [They can] lose 40 pounds in a month. These people have no insulin and a lot of glucagon. Without the insulin they can’t store fat, so they dump fat from their fat cells….The combination of calories lost to ketones and urine can add up to a few pounds per month, but not 40….And people with uncontrolled type I diabetes eat and eat and eat and lose and lose and lose.

    “The same phenomenon holds true in low-carb dieting. Insulin is low and glucagon is high, making it difficult to gain weight…. You won’t lose[.]”

    This is not the same phenomenon. The LC dieter doesn’t lose weight, but the Type I diabetic does.

    In both cases insulin is low and glucagon is high. In both cases calories are elevated. Let’s say the caloric elevation is comparable, even though the diabetic is most likely eating as much as s/he can while the dieter is eating as much as s/he wants.

    Why the difference in weight loss?

    What is the difference in what is happening?

    P.S. I followed your suggestion to eat only meat and noncaloric beverages for two weeks. I’ll report on that in a separate comment. Thanks.

  50. I seem to have missed out on the energy boost that many seem to get from low carbing. I seem to be as tired now as before starting (4 years ago). My maintenance level is about 100g and I do slow burn strength exercises.

    Any ideas why this might be?

    Has anybody else found this?

  51. Hi Mike.

    I can’t save your precious articles on my Pc as .mht files anymore.

    :-(

    Any suggestions?

    Marco

    Hey Marco–

    Good to hear from you. I don’t have a clue as to why you can’t save the articles as .mht files. Moreover, I don’t even know what an .mht file is. Sorry.

    Cheers–

    MRE

  52. My personal experience is that exercise is sometimes suppressive but very occasionally will make me want to eat a lot. Most of the time, I train 3-5 times a week in a strenuous, competitive “sport” and will go into the training hungry rather than eat anything and get nauseous. After a bit in the workout and right after I am not hungry at all, and when I do get hungry I don’t have a feeling of extreme hunger, I just want my dinner.

    Sometimes, though, if I have been shorting my calories (not intentionally), or for no discernible reason I will just want a huge dinner instead of the usual small meal we eat at home. I cannot explain it, I don’t understand it, but most of the time exercise has a suppressive effect on my appetite, but not always.

  53. I read Colpo comment after hearing about this guy for a while. I have a simple philosophy when it comes to menhood and it comes from sports; any man that resorts to degrading, nasty, name-calling tactics ought to examine himself! There is absolutely no need for that. In arguments truth is born, but it has to be civil and respectful. Dr Mike I dont know you personally but being here and seing you on tv makes me your follower and a believer! I just intuitively trust you! I was too paralized by analysis of many different diets but eventually decided to go back to low carb and it is working so far. I know that there is no one size fits all when it comes to human, in any regard. Dr Mike I trust you, respect you and am sure many thousands of others do as well. For every Calpo out there there are thousands and thousands of Vadims. And once again thanks for your patience, free advices and world of information!

  54. It seems that my comment/question has gone into the ether. Trying again.

    Say I’m at maintenance, and that I acquire the habit of snacking on coconut oil right off the spoon. If I ate 10 tablespoons a day of this stuff, I would be ingesting an extra 1260 calories of fat. My question is, what happens to the extra fat? Does my body become a mini-furnace and burn it off? Do I excrete it in my urine and/or feces? Or does something else happen to the fat that I’m not thinking of? Does somebody hit the “Delete” button and it all disappears?

    Similarly, what happens to the extra protein that I eat–the amount that I consume in excess of what is needed for maintenance and repair of my tissues? You say that if blood sugar is not low, the protein does not get converted to glucose. I wonder if that’s true, because my blood sugar does rise after I’ve eaten a meal that consists only of fat and protein. Am I simply seeing a release of stored sugar in response to glucagon? If the extra protein doesn’t become glucose, does it get converted to ketone bodies and get burned or excreted that way? Or does it get broken down into amino acids and leave the body in that form?

    Dr. Eades, or any physiologist who happens to read this, I would appreciate any input you could provide. Thanks in advance.

    Hey Stargazey–

    A pretty complex question for a comment.

    Assuming you could eat 10 TBS of coconut oil without puking what would happen? A number of things.
    You would probably decrease your caloric intake for the rest of the day or even the next day. The extra fat calories would be burned off in a number of ways: increased futile cycling, an increased proton leak across the inner mitochondrial membrane and an increased production of uncoupling proteins leading to an uncoupling of oxidation and phosphorylation. You would no doubt move and fidget more, your body wouldn’t do anything to conserve energy. I could go on. There are a host of ways that excess calories can be dissipated under the right metabolic (read: low insulin) conditions.

    Protein acts pretty much the same. It’s simply another fuel.

    Cheers–

    MRE

  55. Thanks for answering my question, Dr. Eades. Sorry for the complexity, but what I was getting at (and I think what Vesna was getting at earlier) was the need to understand the mechanism of how low carb plus mass quantities of fat and/or protein leads to weight maintenance and not weight gain.

    We’re not clinicians, and we can only observe an “n” of 1 in most cases. So when we read your two posts on low carb and calories, we know you’re telling us the truth, but we don’t understand how it works, exactly. It’s helpful for us to get an explanation on a biochemical and physiological level. Just to brown-nose a bit, you do a good job of explaining biochemistry and physiology for the masses. :) In any case,thanks for your patience!

    Thanks. I should probably do a post on calorie wasting because it’s extremely interesting (at least to me), and I think a lot of readers would find it interesting. Problem is that it’s pretty technical, and I don’t know how simple I can make it while still keeping it accurate. If I keep it accurate, then it can become textbook like and dull as dishwater.

    Cheers–

    MRE

  56. I read a very interesting post on Peter’s Hyperlipid blog (which I only found from a comment in another of your blog posts). It pretty clearly explains the mechanisms of excess fat storage even on LC diets. His most interesting statement is about an often overlooked fact: even with LC diets and low insulin levels, fat consumed at each meal must still be stored for use until the next meal, accomplished by the Acylation Stimulating Protein (ASP) enzyme NOT insulin. Also, he states that excess protein is converted to glucose, requiring a hefty dose of insulin. His post makes sense to me in an evolutionary aspect: if our ancestors were LC, they still had to store fat! It’s just that their mechanism for releasing the stored fat for energy needs was humming along nicely, and not compromised by grains, medications, and the many other bombs of modern life that affect insulin sensitivity. It’s worth a careful read.

    http://high-fat-nutrition.blogspot.com/search/label/Weight%20loss%3B%20when%20it%27s%20hard

  57. To Leslie: very interesting link, thanks! One must be careful, however, in the interpretation of the ASP information, which applies to rats or mice and ‘mice are not humans’. Mike has discuss these differences elsewhere on this blog and that is something very important to keep in mind. I should know… we use to make mice very obese by giving them a ‘high-fat’ diet (which in the end has a hefty 25% of their energy intake as one or another type of carbohydrate, plus a nice amount of transfats as part of the ‘fatty’ portion of their diets). That, as we all have experienced or read, doesn’t necessarily translate into what happens to humans on a true low carbohydrate diet. I was usually laughed at when I made the remark that ‘mice aren’t humans’… something really not very popular when you do research in a group where the dogma is that it is the fat what is making their animals fat…

    I just wanted to add a few comments that I think may be of help when reading the information in Peter’s Hyperlipid blog. The ‘breadcrumbs’ in Peter’s Hyperlipid blog lead to another blog (Conditioning Research: http://conditioningresearch.blogspot.com) with a link to an article published in 1998 about a study of changes in ASP in humans (with a very small sample size) after different intake of meals containing high doses of lipids. In that study, at least, there was no difference in the levels of ASP regardless of how much fat was in their diets. The study, in my opinion, had a couple of weaknesses; very small sample size, it was done using liquid and semi-liquid meals. I also think that any nutritional study comparing diets cannot be done in short periods of time as adaptation plays an important role in the effect of the macronutrients (and their composition) in any diet. The reason I bring that article up is to reiterate that if it happens in rats or mice, it doesn’t necessarily happen in humans. The information on Peter’s Hyperlipid blog refers to studies in mice.

    In Peter’s Hyperlipid blog also there is continuous mention of protein necessarily being converted to glucose. While that is true for some amino acids, that responds to the need for glucose, not an automatic response. Furthermore, the glucose made from amino acids (gluconeogenesis) is not ‘meant’ to be use to supply energy demands but for stabilization of blood glucose when this is necessary. For energy supply, utilization of ketone bodies is a process far more efficient that yields more energy, thus sparing muscle protein to be use for energy, unless one is in an extended fasting period, which is ‘true’ starvation, as opposed to an overnight fast.

    I found this very interesting:

    “Excess weight is the result of a failure of adipocytes to release energy, hunger is needed to supply any shortfall needed for metabolism.”

    Under a low carbohydrate diet, that may not be what needs to happen. There are other reasons for weight gain. Whether that weight is in excess or not depend on individual parameters. In other words, the question would be whether on a low carbohydrate diet one gains weight to the same levels of pre-LC, which would be a complete failure of the diet. I don’t think that is the case with low carbohydrate diets.

    The studies conducted by Margriet Westerterp-Plantega, have shown that while once the weight loss phase is over after following a higher intake of protein in the diet, the weight gained is not from fat but from ‘fat-free’ mass. On average and according to her, the amount of weight gain was 1-2 kg. The importance of those and other studies is not only that the weight is from fat-free mass, but also that the weight gain came during the maintenance phase, when individuals were still consuming a protein-rich diet. So, at least from that perspective, weight gain is not a bad thing as long is from fat-free mass. Unfortunately in Peter’s Hyperlipid blood is difficult to read if the weight gain he writes about is from fat-free mass or not. One easy way to find that out at any time during the maintenance phase (or any other phase for that matter), is to estimate our lean body mass and track that parameter instead of just total weight.

    Thanks again for the link, which I agree is worth reading.

  58. The fact that somebody doesn’t become obese on a high-carb diet does not mean that diet is not damaging their health. Obesity is one symptom of a failure in the many mechanisms which regulate energy intake and utilization. The regulation is accomplished via a fairly complicated (and as yet incompletely understood) system of hormones and the central nervous system. Hormones activate genes, so of course genetic differences may account for differences in the manifestation of symptoms like obesity. That a particular individual does not respond with obesity to the major excursions in insulin brought about by a high-carb diet does NOT mean that those excursions are not screwing up their health. And there are basic biochemical reasons like glycation to believe large carbohydrate intake is detrimental to health.

    Similarly, it can be misleading to draw conclusions from a particular aspect of metabolism, such as how insulin or ASP influences energy storage in fat cells. Those particular actions must be considered in the larger context of regulatory network, which (I think at least) was clearly designed by evolution to avoid obesity (and other metabolic problems). The regulation of appetite, digestion, and energy utilization (e.g. increased thermogenesis) should all play together with fat storage to maintain the body’s state in a healthy range. If you’re storing too much fat, something is broken. There is plenty of evidence to suggest that a high-carb diet perturbs this system through its effect on insulin, not only promoting excess fat storage, but also screwing up appetite regulation. Though ASP can hypothetically store fat without insulin, I can’t come up with a reason why a high-fat diet would perturb the rest of the rest of the system. I believe you’d need some other dysfunction, e.g. a genetic problem that causes fat cells to secrete little or no leptin.

  59. I don’t have any articles to cite–just reasoning and all its attendant faults.

    Peter said, “In to the gap steps ASP, which allows us to store the fat from our current meal as adipose tissue for use in the time before our next meal.” This may come from studies in mice, but it seems logical that ASP or something similar would operate in this way in humans. Otherwise we could not sleep all night without needing to eat. Glycogen stores and gluconeogenesis from muscle probably wouldn’t cover energy needs for that many hours.

    It also seems logical that if more fat is stored by ASP than is subsequently utilized, in the long run there would be a net increase in the size of fat stores. To avoid large accumulations of fat, one would expect that thermogenesis and activity level would increase. Leptin would also tend to decrease appetite. If excess fat continued to be consumed, it is possible that the person would not become obese, but might become overweight.

    Finally, there has to be some mechanism by which people are able to deposit fat from an exclusively protein and fat diet. Historically the Inuit lived on such a diet for 6-9 months a year and carried sufficient body fat that they were able to reproduce with no particular problems.