Fat Logic

[cosmicaug]

I've got some logic for discussion-

What if both extreme hypertension and obesity are caused by pinched nerves? Vagus in particular?

There seems to be some linkage of a positive feedback loop of hypertension caused by an artery pulsing against the vagus nerve. The more pulse, the more interference in the nerve signal, the brain raises blood pressure, with pulses harder against the nerve, rinse, repeat until a vessel explodes in your head. The fix is called "arterial decompression microvascular surgery". Also some cases of extreme hypertension are relieved incidental to neck disc surgery.

But doesn't the same nerve go to the stomach, and sense things like fullness? Irritate the nerve, get less signal of fullness? The vagus nerve enters the abdomen through the same window in the diaphragm as the esophagus- eat to much, dampen the signal that you are full?

Yes, it's still CICO, but appetite control is the key to less CI, the signals have to work right for that.

Side note- There is a group of symptoms tied to heart disease risk. Four items, called Syndrome X- one item for each leg of the X. Obesity, hypertension, diabetes, and hypercholesterolemia. I think I got that right. The vagusd nerve goes to the stomach (obesity) the heart (hypertension) the liver (cholesterol & diabetes) the pancreas ( diabetes). hmmmmm.

As a digression, here's a bizarre vagus related article. Vagus and Parkinson's disease:
http://neurosciencenews.com/parkinsons-gastrointestinal-tract-neurology-2150/

 

[casebro]

As a digression, here's a bizarre vagus related article. Vagus and Parkinson's disease:
http://neurosciencenews.com/parkinsons-gastrointestinal-tract-neurology-2150/

Not bizarre. It's an epidemiological study that shows the ulcer patients who have had a vagus nerve severed surgically have only half the chance of getting PD. Plus ulcer patients in general have a greater risk of PD.

Hmmmm, isn't Heliobacter Pyloris related to the Syphilis germ? Know to get into brains....

I winder if they've done a study on PD rate among those who have had ulcers treated with antibiotics, which might control a bacteriological infect, but have no effect if PD is caused by a virus?

 

[cosmicaug]

A poster describing a (soon to be published) study:


It looks at the carbohydrate/insulin hypothesis, metabolic advantage, etc. (think Taubes).

 

[Aepervius]

The reaction of the youtube commenter to the video was very predictable . "not long enough" "you did not measure the correct stuff" "what quantity of carbo ? I saw study which pretend 100g carbo was low carbo" etc...etc...

 

[Cain]

I thought this thread got bumped because of the article in the NYT today: http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html

After losing a ton lot of weight, their metabolisms slowed to a crawl. As per the title, "Their Bodies Fought to Regain the Lost Weight." This means you should never, ever become fat in the first place. Maybe parents can get charged with a crime for having obese children. A woman(?) is suing her parents now because she has a permanent heart condition that could have been fixed in infancy. Her parents didn't believe in surgery and opted for "faith healing." Surprisingly, the faith healing didn't work...

 

[blutoski]

I thought this thread got bumped because of the article in the NYT today: http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html

After losing a ton lot of weight, their metabolisms slowed to a crawl. As per the title, "Their Bodies Fought to Regain the Lost Weight." This means you should never, ever become fat in the first place. Maybe parents can get charged with a crime for having obese children. A woman(?) is suing her parents now because she has a permanent heart condition that could have been fixed in infancy. Her parents didn't believe in surgery and opted for "faith healing." Surprisingly, the faith healing didn't work...

I shared my opinions in another thread about how I am concerned about the weight loss model employed in the Biggest Loser. Basically it's a crash diet that concentrates on rapid weight loss through exercise. Which is shown to be an ineffective way to achieve sustained weight loss. In other words: "This is how to fail."

In that sense, my response is "Well obviously." We already knew the participants had a low 5 year success rate, despite their NDAs that limited professionals' access.

However, the article makes some assertions - very specific claims about metabolic adaptation - that I have never seen in any research... so not sure how strongly the claims can be weighed versus published research that has never shown these effects. The actual study was published yesterday, so I'll have a more informed opinion shortly.

 

[blutoski]

I shared my opinions in another thread about how I am concerned about the weight loss model employed in the Biggest Loser. Basically it's a crash diet that concentrates on rapid weight loss through exercise. Which is shown to be an ineffective way to achieve sustained weight loss. In other words: "This is how to fail."

In that sense, my response is "Well obviously." We already knew the participants had a low 5 year success rate, despite their NDAs that limited professionals' access.

However, the article makes some assertions - very specific claims about metabolic adaptation - that I have never seen in any research... so not sure how strongly the claims can be weighed versus published research that has never shown these effects. The actual study was published yesterday, so I'll have a more informed opinion shortly.

I've found an earlier study by the same team: [Metabolic Slowing with Massive Weight Loss despite Preservation of Fat-Free Mass]

It's nice to see replication, but I admit I have less confidence when the only replication is by the same team.

 

[casebro]

....
In that sense, my response is "Well obviously." We already knew the participants had a low 5 year success rate, despite their NDAs that limited professionals' access.
..,

I think the stats for successful weight loss goes something like this: " Less than 10% of people can lose 10 pounds and keep it off for a decade".

In other words, for 90% of people, NOTHING WORKS. You might as well crash diet, marathon and pump iron, and enjoy a few years of being light in your loafers. Rinse. Repeat.

I'm over 60 years old. I've seen a lot of friends get a clogged artery, get it fixed, lose 30-50 pounds under specter of death, and regain it all in a couple years. Even the exercise of walking through the valley of the shadow of death does not work.

 

[Emily's Cat]

I know a very, very small number of people who have lost weight and kept it off. They were all people who had put weight on fairly quickly as an emotional response to trauma or other major stresses, ate their way through it, then reverted to normal (for them)

Then again - this is a sample size of 3 people, so there's always the chance of some selection bias in my inferred correlation

 

[Prometheus]

I think the stats for successful weight loss goes something like this: " Less than 10% of people can lose 10 pounds and keep it off for a decade".

In other words, for 90% of people, NOTHING WORKS. You might as well crash diet, marathon and pump iron, and enjoy a few years of being light in your loafers. Rinse. Repeat.

I'm over 60 years old. I've seen a lot of friends get a clogged artery, get it fixed, lose 30-50 pounds under specter of death, and regain it all in a couple years. Even the exercise of walking through the valley of the shadow of death does not work.

I think a better way to put it would be that 90% of people, for whatever reason, do not continue to do the one thing that does work.

 

[casebro]

I think a better way to put it would be that 90% of people, for whatever reason, do not continue to do the one thing that does work.

And that is the crux of the matter, not whether dieting triggers a slower metabolism.

 

[blutoski]

More new, on-topic for the thread, links that have come across my desk.

Gary Taubes' "definitive" NuSI study: Interview with Dr. Kevin Hall here in Vancouver for ICO 2016, where he was presenting his results prior to publication. [YouTube Video]

Macronutrient ratio metabolic stuff "basically falsified".

What's worth mentioning is that this study was completed in the summer of 2014, but Taubes has been misrepresenting it as in progress and supportive for his thesis during paid appearances. I think this is clear evidence of fraud.



ETA: notice this is the same Dr. Kevin Hall from the Biggest Loser postmortem study that was released on Monday. He's been pretty busy, lately.

 

[Monza]

And that is the crux of the matter, not whether dieting triggers a slower metabolism.

I completely agree. Most people who lose weight do it by means of a temporary diet. When they reach their goal, or get close, they revert back to the nutrition and exercise habits they had before and rebound to their original weight. The only way to lose weight permanently is to permanently change your habits. It's hard.

I've never been obese, but at one time I was out of shape and had a belly at 6'6" 270 lbs. I'm now about 220 lbs, but my daily nutrition and exercise routine is completely different. I can never go back to how I previously ate and moved without re-gaining weight. I'm not on a diet, I just consistently eat smarter and keep active and it will need to stay this way if I want to maintain being fit.

 

[casebro]

Monza, how long have you been successful?

And I bet the charts say "obese" at 270. But the charts and the word are pretty meaningless. Kaiser did a actual study of 8,000 people with digital medical records. Healthy BMI turned out to be anywhere from 17-34. 17, 22 or 34, all just as healthy. And there was a hint that as height goes out of normal, the BMI is even more wrong.

 

[Monza]

Monza, how long have you been successful?

And I bet the charts say "obese" at 270. But the charts and the word are pretty meaningless. Kaiser did a actual study of 8,000 people with digital medical records. Healthy BMI turned out to be anywhere from 17-34. 17, 22 or 34, all just as healthy. And there was a hint that as height goes out of normal, the BMI is even more wrong.

I started gaining weight in 2006 and hit my peak in 2007. By 2009 I was down to the 230's and have been where I'm at now since about 2010-11. At my heaviest, you wouldn't have looked at me and called me fat per se, but definitely out of shape (for comparison my pants were 38" waist and 36" inseam and now they are 34" waist). BMI was probably high but yes, for tall people it's out of whack anyway.

 

[cosmicaug]

 

[pipelineaudio]

I shared my opinions in another thread about how I am concerned about the weight loss model employed in the Biggest Loser. Basically it's a crash diet that concentrates on rapid weight loss through exercise. Which is shown to be an ineffective way to achieve sustained weight loss. In other words: "This is how to fail."

This terrifies me! I have a thread in the science section about weight loss. I went from 270 in august to 170 in december, through (not much, but regular) exercise. I eat far, far more now than when I was 270 and am scared the weight will go back up. My weight is still fluctuating bouncing about 5 pounds, but generally trending down. I certainly am not eating less, does this remove the crash diet risk?

 

[jimbob]

I shared my opinions in another thread about how I am concerned about the weight loss model employed in the Biggest Loser. Basically it's a crash diet that concentrates on rapid weight loss through exercise. Which is shown to be an ineffective way to achieve sustained weight loss. In other words: "This is how to fail."

This terrifies me! I have a thread in the science section about weight loss. I went from 270 in august to 170 in december, through (not much, but regular) exercise. I eat far, far more now than when I was 270 and am scared the weight will go back up. My weight is still fluctuating bouncing about 5 pounds, but generally trending down. I certainly am not eating less, does this remove the crash diet risk?

This might give you some comfort:

http://m.huffpost.com/us/entry/my-take-on-that-biggest-l_b_10055486.html

ETA: I looked very briefly at it but not critically - I was just reminded of it by your question.

 

[rustypouch]

[qimg]https://pbs.twimg.com/media/CUsIUgdVAAA-pu3.jpg:large[/qimg]

And what's the point?

For how dietary habits have changed, this article is interesting: http://www.vox.com/2016/5/18/11704458/american-diet-changes

The average person is eating around 800 calories more per day than they were sixty years ago.

 

[blutoski]

I shared my opinions in another thread about how I am concerned about the weight loss model employed in the Biggest Loser. Basically it's a crash diet that concentrates on rapid weight loss through exercise. Which is shown to be an ineffective way to achieve sustained weight loss. In other words: "This is how to fail."

This terrifies me! I have a thread in the science section about weight loss. I went from 270 in august to 170 in december, through (not much, but regular) exercise. I eat far, far more now than when I was 270 and am scared the weight will go back up. My weight is still fluctuating bouncing about 5 pounds, but generally trending down. I certainly am not eating less, does this remove the crash diet risk?

I think the two principles that are problematic were:

• the weight loss trajectory was so intense that it wasn't a lifestyle change - they were abandoning a life to temporarily concentrate on weight loss; the weight loss was extremely rapid
• the effect was that participants were required so endure unsustainable regimens; participants would do this until they reached their target weight and then... well no real plan for maintenance

I believe the metabolic impact is probably a result of #1 rather than #2, but nobody knows the actual mechanism involved because there have been no related studies with controls; there is also some new accusations that drugs were involved, which further complicates analysis.

 

[Corsair 115]

And what's the point?

For how dietary habits have changed, this article is interesting: http://www.vox.com/2016/5/18/11704458/american-diet-changes

The average person is eating around 800 calories more per day than they were sixty years ago.

And how much less physically active are they compared to sixty years ago? That would seem to me the other factor in the equation.

 

[cosmicaug]

And what's the point?

For how dietary habits have changed, this article is interesting: http://www.vox.com/2016/5/18/11704458/american-diet-changes

The average person is eating around 800 calories more per day than they were sixty years ago.

That's exactly the point: it's the Calories, stupid! Some folk suggest that only carbohydrates matter (with simple sugars —sometimes even specific sugar mixes— being singled out for vilification).

 

[blutoski]

And how much less physically active are they compared to sixty years ago? That would seem to me the other factor in the equation.

There's research on this, and the results are that Westerners (USA, Canada, UK, France, possibly others) have become slightly more active every year during the same period. Nowhere near enough to compensate for the increase in calories, so there is a net weight gain despite increased activity.

What surprises people is that when we compare the obese west with underweight underdeveloped countries' underweight populations, we're actually a bit more active. To put this another way: obese Americans are on average more active than thin sub saharan Africans.

Nobody's invested in 'exercise isn't a solution' so there's no marketing dollars spent on it. The marketing dollars promoting the 'if only we exercised more' message are spent by those selling calories and those selling exercise.

 

[rustypouch]

That's exactly the point: it's the Calories, stupid! Some folk suggest that only carbohydrates matter (with simple sugars —sometimes even specific sugar mixes— being singled out for vilification).

Indeed. The rest is details.

Interestingly, usage of HFCS has increased while sugar has decreased, but the use of sweeteners has been relatively stable.

Also, I would like to know exercise habits of people now compared to in the 50s, and what effect that had.

 

[blutoski]

Also, I would like to know exercise habits of people now compared to in the 50s, and what effect that had.

The studies involved are taking a more general approach to estimating caloric expenditure, not so much 'exercise habits'. For example, occupational caloric expenditure has declined as labour shifts from factory production lines to office cubicles. In contrast, kids used to play board games for hours on end, now parents have them swimming before school, and karate and soccer back to back in the afternoon.

The takeaway, though, is that activity has increased slightly, but only slightly. There is a credible theory that absent discipline, people probably have a fixed amount of voluntary exercise 'energy' per day and that is has not changed in recent history, and possibly not even over thousands of years.

 

[cosmicaug]

Indeed. The rest is details.

Interestingly, usage of HFCS has increased while sugar has decreased, but the use of sweeteners has been relatively stable.

Yup, some single out HFCS for vilification.

 

[jimbob]

The studies involved are taking a more general approach to estimating caloric expenditure, not so much 'exercise habits'. For example, occupational caloric expenditure has declined as labour shifts from factory production lines to office cubicles. In contrast, kids used to play board games for hours on end, now parents have them swimming before school, and karate and soccer back to back in the afternoon.

The takeaway, though, is that activity has increased slightly, but only slightly. There is a credible theory that absent discipline, people probably have a fixed amount of voluntary exercise 'energy' per day and that is has not changed in recent history, and possibly not even over thousands of years.

Pretty strong circumstantial evidence in support of your comment about "thousands of years"

http://europepmc.org/articles/PMC3405064

PLoS One. 2012; 7(7): e40503.
Published online 2012 July 25. doi: 10.1371/journal.pone.0040503
PMCID: PMC3405064
Hunter-Gatherer Energetics and Human Obesity

Abstract

Western lifestyles differ markedly from those of our hunter-gatherer ancestors, and these differences in diet and activity level are often implicated in the global obesity pandemic. However, few physiological data for hunter-gatherer populations are available to test these models of obesity. In this study, we used the doubly-labeled water method to measure total daily energy expenditure (kCal/day) in Hadza hunter-gatherers to test whether foragers expend more energy each day than their Western counterparts. As expected, physical activity level, PAL, was greater among Hadza foragers than among Westerners. Nonetheless, average daily energy expenditure of traditional Hadza foragers was no different than that of Westerners after controlling for body size. The metabolic cost of walking (kcal kg−1 m−1) and resting (kcal kg−1 s−1) were also similar among Hadza and Western groups. The similarity in metabolic rates across a broad range of cultures challenges current models of obesity suggesting that Western lifestyles lead to decreased energy expenditure. We hypothesize that human daily energy expenditure may be an evolved physiological trait largely independent of cultural differences.

 

[xjx388]

I know I'm late to this but . . .

There is no doubt that CICO is the basic model for weight loss/gain. The other factors don't modify this basic mechanism but one of the two sides; mostly the CI. Simplisticly put, for example, a low-carb diet manipulates hormones to modify the factors that lead to increased satiety.

The basic problem is that the kind of eating that leads to obesity has roots in the brain's reward centers -it's an addiction of sorts. To overcome that is not easy, thus, CICO is too simplistic. We all know we need to eat less and move more; the question is how do we actually do that?

 

[Prometheus]

Yup, some single out HFCS for vilification.

HFCS should be vilified, but not because of the fructose content. It's the dihydrogen monoxide used to make it a syrup that's really dangerous.

 

[Skeptical Greg]

I know I'm late to this but . . .

There is no doubt that CICO is the basic model for weight loss/gain. The other factors don't modify this basic mechanism but one of the two sides; mostly the CI. Simplisticly put, for example, a low-carb diet manipulates hormones to modify the factors that lead to increased satiety.

The basic problem is that the kind of eating that leads to obesity has roots in the brain's reward centers -it's an addiction of sorts. To overcome that is not easy, thus, CICO is too simplistic. We all know we need to eat less and move more; the question is how do we actually do that?

You eat less and move more?

 

[blutoski]

I know I'm late to this but . . .

There is no doubt that CICO is the basic model for weight loss/gain. The other factors don't modify this basic mechanism but one of the two sides; mostly the CI. Simplisticly put, for example, a low-carb diet manipulates hormones to modify the factors that lead to increased satiety.

To be frank, the evidence is against this model. This is the 'macronutrient' model. This is why the link above from the Vancouver presentation is pretty important. Taubes himself could not get results consistent with this model, even through an experiment he had a hand in designing. That's a NuSI study, I'm referring to. Put people in an isolated environment where we control 100% of their caloric intake (as opposed to journals and recall, which can be unreliable) and measure the relationship between carb/fat/protein ratio diets and weight accumulation/loss over time.

Dr. Kevin Hall - just to clarify for those unaware... Hall was hired by NuSI, which is co-chaired by Gary Taubes - describes this model as "falsified".

Satiety appears to be highly psyhcological, rather than physiological, at least under normal conditions. Environment appears to be more important than food content, for small volumes of food. (stomach tissue tension comes into play for significant volumes, obviously). There are some fascinating studies with patients who have anterograde amnesia. Under controlled conditions, they eat until they claim they're satisfied, forget they have eaten, and eat over and over again.

The basic problem is that the kind of eating that leads to obesity has roots in the brain's reward centers -it's an addiction of sorts. To overcome that is not easy, thus, CICO is too simplistic. We all know we need to eat less and move more; the question is how do we actually do that?

Agreed, but there are commercial interests who benefit from spreading doubt about this, so the public is understandably confused and resistant. It is by design.

 

[steve s]

That's exactly the point: it's the Calories, stupid!

The problem with such a simplistic view is that it ignores the fact that your body processes different types of calories differently. Eating 500 calories of insoluble fiber is a lot different than eating 500 calories of donuts.

I think a better way to put it would be that 90% of people, for whatever reason, do not continue to do the one thing that does work.

Agreed. About 8 years ago I was diagnosed with diabetes. I went on a strict low-carb diet and lost 20 pounds in 5 months. Eight years later I still haven't gained back the weight because I've stuck with what worked. Every day for lunch I have a side salad from McD's or Burger King, etc. For dinner I have baked or grilled chicken or fish with a green vegetable. No fried or battered food. No junk food or fast food. It works.

Steve S

 

[Tsukasa Buddha]

The problem with such a simplistic view is that it ignores the fact that your body processes different types of calories differently. Eating 500 calories of insoluble fiber is a lot different than eating 500 calories of donuts.

Well, emphasising this wrinkle in CI is rather unrevealing, IMO. The US already has rules about soluble and insoluble fiber for its labels.

Agreed. About 8 years ago I was diagnosed with diabetes. I went on a strict low-carb diet and lost 20 pounds in 5 months. Eight years later I still haven't gained back the weight because I've stuck with what worked. Every day for lunch I have a side salad from McD's or Burger King, etc. For dinner I have baked or grilled chicken or fish with a green vegetable. No fried or battered food. No junk food or fast food. It works.

Steve S

Yay for anecdotes. Is it the "low carb" you are claiming "works" independently of CICO?

 

[blutoski]

Well, emphasising this wrinkle in CI is rather unrevealing, IMO. The US already has rules about soluble and insoluble fiber for its labels.

Specifically, that insoluble fiber is 0 calories, and we want lots of it in our diet, despite its being a category of 'carb'. FDA food energy content calculations are not ignoring this fact, it's baked into their calorie estimates. As is bioavailability in general. There is still error bars to the calorie estimates, though, for various other reasons. For example, carrots of the same varietal still vary quite a bit in composition depending on when and where they were grown. Some have more starch, some more water, by mass, just as an example.

Yay for anecdotes. Is it the "low carb" you are claiming "works" independently of CICO?

This is why I like Hall's approach, and am a bit relieved I couldn't find any significant flaws with his experimental protocol. Specifically, the experiment was double blinded, which addresses what I call the 'fanboi' problem with so many diet studies. Diets are not immune from biased perception, selective memory, and other expectation effects. "The doctor told me this will work, so I'll stick with it," is especially relevant where diets' relative effectiveness is heavily dependent on adherence over time.

I'm reminded of an analogy from when I was a kid. My dentist had bought into applied kinesiology. He wanted to prove to me that it worked, so he asked me to resist his downward push on my arm, then tapped a probe on one of my teeth and tole me my arm was now weakened, and he pushed down on my arm again. I expect he'd shown this to other people and found their arm had weakened. But mine didn't. Undaunted, he doubled down and just short of jumped onto my arm to push it down. "See! Your arm got weaker." (No Doc, you were pushing harder to protect your belief, I appreciate it may not be a conscious decision). I consider this to be one of my pre-Skepticism skeptical experiences.

For Hall's experiment, neither the patients nor the doctors knew the composition of the food, and we can see that absent expectations and hype, composition does not appear to impact appetite or weight management. But adjusting calories does. No surprise, but it's nice to see an experiment that addresses a lot of potential weaknesses in other studies so directly.

 

[cosmicaug]

I'm reminded of an analogy from when I was a kid. My dentist had bought into applied kinesiology. He wanted to prove to me that it worked, so he asked me to resist his downward push on my arm, then tapped a probe on one of my teeth and tole me my arm was now weakened, and he pushed down on my arm again. I expect he'd shown this to other people and found their arm had weakened. But mine didn't. Undaunted, he doubled down and just short of jumped onto my arm to push it down. "See! Your arm got weaker." (No Doc, you were pushing harder to protect your belief, I appreciate it may not be a conscious decision). I consider this to be one of my pre-Skepticism skeptical experiences.

I had a "science teacher" in 9th grade who put a great deal of stock into that sort of demonstration. In her case, it wasn't a demonstration of applied kinesiology per se but a way of showing "force lines" had been broken. She brought a big kid to the middle of the room. She had him stand with his arms horizontal to his sides (like a capital letter 'T') and told him to resist. She demonstrated not being able to pull the arm down. Then she waved her hand in front of him using a vertical motion (as I recall) and she repeated the demonstration. In the after condition she was able to lower the kid's arm.

It wasn't her only deficit in the sciences.

 

[Skeptical Greg]

The problem with such a simplistic view is that it ignores the fact that your body processes different types of calories differently. Eating 500 calories of insoluble fiber is a lot different than eating 500 calories of donuts.

.................

The absurd analogy aside, can you elaborate on eating 500 calories of insoluble fiber; such as what that might consist of in a realistic diet plan?