5 ms·

So Jason Fung is actually misreading this study. The main issue around all of this is: If someone eats the exact same amount of calories but spreads it out thr

So Jason Fung is actually misreading this study. The main issue around all of this is: If someone eats the exact same amount of calories but spreads it out throughout the day does this have any effect on metabolism or weight? So far IF proponents have had a really hard time showing isocaloric diets have any different outcomes regardless of meal timing. This study attempts to address this issue by serving the same amount of food, but it does not ensure that the same amount of food is consumed, and so we are right back to where we are with all IF studies that show results like this: IF contributed to the participants abilities to eat the right amount of food, but there is still not a single study showing isocaloric intake and any different outcomes. Besides that the standard: this is done on 8 people over a very small period of time, so it's at best a pilot study anyway. IF may be a great way for some people to comply to their dietary goals better, but there is still not a single study that shows it actually does anything besides that.

jmull 8y ago
Which study are you referring to? He references different studies to make different points and I can’t tell which one you’re talking about.
- wdewind 8y ago
  https://www.ncbi.nlm.nih.gov/pubmed/29754952 https://www.ncbi.nlm.nih.gov/pubmed/29754952 This one, mentioned in this context: > This was a randomized crossover, isocaloric and eucaloric study. That is, all patients did both arms of the study eating the same foods and the same calories and then compared against themselves. The two arms of the study were eating between 8am and 8pm, and the eTRF strategy of eating between 8am and 2pm, but remember, both groups ate three meals per day of the same foods. Some would start with the conventional diet, then cross over to eTRF, and others did the opposite, separated by a seven-week washout period. Subjects were men with prediabetes. > The benefits were huge. Mean insulin levels dropped significantly, and insulin resistance dropped as well. Insulin is a driver of obesity, so merely changing the meal timing and restricting the number of hours you ate, and also by moving to an earlier eating schedule, produced huge benefits even in the same person eating the same meals. That’s astounding. Even more remarkable was that even after the washout period of seven weeks, the eTRF group maintained lower insulin levels at baseline. The benefits were maintained even after stopping the time restriction. Blood pressure dropped as well. Specifically this sentence: > so merely changing the meal timing and restricting the number of hours you ate, and also by moving to an earlier eating schedule, produced huge benefits even in the same person eating the same meals is incorrect, and is basically the lynchpin of the entire IF idea.
  - jmull 8y ago
    But isn’t that exactly what the study shows? You started by saying Fung misreads the study, but that’s what the study says, isn’t it? Maybe you meant to question the study itself, but I don’t understand your objection to that either. The study tests whether this form of IF improves certain markers of metabolic health, and it shows it does — within the design of the study, of course, but that’s true of every study and doesn’t make it meaningless. You seem to be implying it doesn’t work in the way IF proponents think it does. That may be true, but isn’t relevant to this study since it doesn’t attempt to answer.
    - wdewind 8y ago
      My honest read of the study is that it's a poor attempt at making a case that sets out to prove something, ignores several variables that disprove its central hypothesis (like weight loss) and then steam rolls the idea that its showing something it absolutely is not. The study, like all similar IF studies, showed that people who do IF sometimes are able to use it to consume fewer calories. That is important from a compliance standpoint: it means you can use this diet to treat obesity for some portion of the population for whom it is going to be effective because it will get them to comply with not eating too much. Not eating as much is associated with weight loss which is associated with all kinds of good outcomes. That's awesome, but it doesn't mean that metabolically there is something significantly different going on outside of eating less. This is an important discussion in nutrition in general, and shows up in IF as well as keto discussion frequently, with proponents of each arguing that beyond the compliance aspect, there is also something special going on with your metabolism (ie: insulin sensitivity and other metabolic markers). The problem is that all of these are things that improve when you are in a caloric defecit, and the studies never disambiguate between the effects of a caloric deficit and the meal timing itself. Fung makes the same mistake the authors of the paper do in interpreting their own results too optimistically. The dietary controls are set up in a way to make it seem convincing in an abstract if you are familiar with this area and what the current core issues are, but it is not at all if you dig in.
voidlogic 8y ago
>IF may be a great way for some people to comply to their dietary goals better, but there is still not a single study that shows it actually does anything besides that. I think Keto is the same way. There isn't strong evidence of a clear metabolic advantage (I'm not saying there is not one), but its one of the few ways I have eat a caloric deficit and not hate my life. I think if IF and Keto take people off a insulin roller-coaster and let them comply with their targets, that is still a huge win, in and of itself. We know their are other benefits too such as depletion of stored liver fat or better acute insulin responsiveness, but these may be gravy, the real win is in compliance IMHO.
- wdewind 8y ago
  The real win is compliance, and it is a real win that deserves being talked about, but that's not the point the study Fung is talking about in the article is trying to make. It specifically sets out to prove that beyond caloric deficit there are benefits to IF: > We demonstrate for the first time in humans that eTRF improves some aspects of cardiometabolic health and that IF's effects are not solely due to weight loss. It fails to do so because it does not measure food ingested, only food served, and so we have no idea if the diet was actually isocaloric (hint: it wasn't). Keto and IF proponents both want to see a metabolic advantage that simply is not there. Compliance is huge, but there is no existing study showing a metabolic advantage that doesn't also have a caloric deficit.
  - bad_user 8y ago
    The evidence is there though. A caloric deficit eventually forces the metabolism to slow down, hence the yo-to effect afterwards, whereas fasting doesn’t, not when implemented correctly. In other words, yes you have the caloric deficit with fasting, but without some of the downsides of the body going into starvation mode. If you are to believe the hyperinsulinemia theory of obesity, it actually makes perfect sense — it has been shown that insulin inhibits the body from accessing its own fat deposits. It has also been shown that you can make anybody fat by injections with insulin, no matter how thin they are. And there are several drugs known to make people fat by stimulating insulin. These are facts. So by eating multiple meals per day, you’re stimulating your pancreas to trigger insulin in the bloodstream multiple times per day. Thus the body will not have access to its fat store while that happens. As long as your insulin is high, no matter how much fat you have, you’re starving without eating food. N.b. there has been plenty of evidence of this for the last several decades. What is new is the discovery of leptin and glucagon, two other hormones that are the opposite of insulin and that do a lot to fill in the blanks and explain why insulin is having the effects we’re seeing. Also the metabolism is slowing down on caloric deficit, with the result that people eventually regain that weight back and then some, this has been shown in many studies, including that huge one from the Women’s Health Initiative. When you’re doing keto or fasting, the insulin goes down. Again, this is a fact. This allows the body to consume energy from its own fat deposits. This means that the metabolism shouldn’t slow down, when implemented correctly. Having fat isn’t for good looks, but an evolutionary advantage, we are supposed to use our fat store when in need, otherwise we would have evolved to excrete the excess. Now of course, here we are talking of healthy people. It’s debatable if the metabolism slows down or not when we are speaking of diabetics or the obese. And actually I talked with people that claimed they measure their metabolic rate and it did slow down with fasting. So it works better for some people than for others. But on the metabolic advantage, that advantage is undeniable for diabetics at least. In the next couple of years you will hear more and more of keto being promoted in the treatment of diabetes, because it works and there’s also a large study that’s still in progress, but that promises great results. And btw, the reason for why keto hasn’t taken off in the medical community is due to perverse incentives. Nobody wants to invest hundreds of millions of dollars in proving that a diet works, because a diet doesn’t generate profit. The cold, harsh truth is that it’s more profitable to sell statins and synthetic insulin. Funny enough, they did invest hundreds of millions (billions?) in trying to show that saturated fats and salt are bad, anything and everything to blame, except for sugar. All such studies failed of course, but that didn’t stop the dogma, anything to keep us consuming sugar, which is where the “_a calorie is a calorie_” bullshit comes from.

jmull 8y ago

Which study are you referring to? He references different studies to make different points and I can’t tell which one you’re talking about.

wdewind 8y ago
https://www.ncbi.nlm.nih.gov/pubmed/29754952 https://www.ncbi.nlm.nih.gov/pubmed/29754952 This one, mentioned in this context: > This was a randomized crossover, isocaloric and eucaloric study. That is, all patients did both arms of the study eating the same foods and the same calories and then compared against themselves. The two arms of the study were eating between 8am and 8pm, and the eTRF strategy of eating between 8am and 2pm, but remember, both groups ate three meals per day of the same foods. Some would start with the conventional diet, then cross over to eTRF, and others did the opposite, separated by a seven-week washout period. Subjects were men with prediabetes. > The benefits were huge. Mean insulin levels dropped significantly, and insulin resistance dropped as well. Insulin is a driver of obesity, so merely changing the meal timing and restricting the number of hours you ate, and also by moving to an earlier eating schedule, produced huge benefits even in the same person eating the same meals. That’s astounding. Even more remarkable was that even after the washout period of seven weeks, the eTRF group maintained lower insulin levels at baseline. The benefits were maintained even after stopping the time restriction. Blood pressure dropped as well. Specifically this sentence: > so merely changing the meal timing and restricting the number of hours you ate, and also by moving to an earlier eating schedule, produced huge benefits even in the same person eating the same meals is incorrect, and is basically the lynchpin of the entire IF idea.
- jmull 8y ago
  But isn’t that exactly what the study shows? You started by saying Fung misreads the study, but that’s what the study says, isn’t it? Maybe you meant to question the study itself, but I don’t understand your objection to that either. The study tests whether this form of IF improves certain markers of metabolic health, and it shows it does — within the design of the study, of course, but that’s true of every study and doesn’t make it meaningless. You seem to be implying it doesn’t work in the way IF proponents think it does. That may be true, but isn’t relevant to this study since it doesn’t attempt to answer.
  - wdewind 8y ago
    My honest read of the study is that it's a poor attempt at making a case that sets out to prove something, ignores several variables that disprove its central hypothesis (like weight loss) and then steam rolls the idea that its showing something it absolutely is not. The study, like all similar IF studies, showed that people who do IF sometimes are able to use it to consume fewer calories. That is important from a compliance standpoint: it means you can use this diet to treat obesity for some portion of the population for whom it is going to be effective because it will get them to comply with not eating too much. Not eating as much is associated with weight loss which is associated with all kinds of good outcomes. That's awesome, but it doesn't mean that metabolically there is something significantly different going on outside of eating less. This is an important discussion in nutrition in general, and shows up in IF as well as keto discussion frequently, with proponents of each arguing that beyond the compliance aspect, there is also something special going on with your metabolism (ie: insulin sensitivity and other metabolic markers). The problem is that all of these are things that improve when you are in a caloric defecit, and the studies never disambiguate between the effects of a caloric deficit and the meal timing itself. Fung makes the same mistake the authors of the paper do in interpreting their own results too optimistically. The dietary controls are set up in a way to make it seem convincing in an abstract if you are familiar with this area and what the current core issues are, but it is not at all if you dig in.

voidlogic 8y ago

>IF may be a great way for some people to comply to their dietary goals better, but there is still not a single study that shows it actually does anything besides that. I think Keto is the same way. There isn't strong evidence of a clear metabolic advantage (I'm not saying there is not one), but its one of the few ways I have eat a caloric deficit and not hate my life. I think if IF and Keto take people off a insulin roller-coaster and let them comply with their targets, that is still a huge win, in and of itself. We know their are other benefits too such as depletion of stored liver fat or better acute insulin responsiveness, but these may be gravy, the real win is in compliance IMHO.

wdewind 8y ago
The real win is compliance, and it is a real win that deserves being talked about, but that's not the point the study Fung is talking about in the article is trying to make. It specifically sets out to prove that beyond caloric deficit there are benefits to IF: > We demonstrate for the first time in humans that eTRF improves some aspects of cardiometabolic health and that IF's effects are not solely due to weight loss. It fails to do so because it does not measure food ingested, only food served, and so we have no idea if the diet was actually isocaloric (hint: it wasn't). Keto and IF proponents both want to see a metabolic advantage that simply is not there. Compliance is huge, but there is no existing study showing a metabolic advantage that doesn't also have a caloric deficit.
- bad_user 8y ago
  The evidence is there though. A caloric deficit eventually forces the metabolism to slow down, hence the yo-to effect afterwards, whereas fasting doesn’t, not when implemented correctly. In other words, yes you have the caloric deficit with fasting, but without some of the downsides of the body going into starvation mode. If you are to believe the hyperinsulinemia theory of obesity, it actually makes perfect sense — it has been shown that insulin inhibits the body from accessing its own fat deposits. It has also been shown that you can make anybody fat by injections with insulin, no matter how thin they are. And there are several drugs known to make people fat by stimulating insulin. These are facts. So by eating multiple meals per day, you’re stimulating your pancreas to trigger insulin in the bloodstream multiple times per day. Thus the body will not have access to its fat store while that happens. As long as your insulin is high, no matter how much fat you have, you’re starving without eating food. N.b. there has been plenty of evidence of this for the last several decades. What is new is the discovery of leptin and glucagon, two other hormones that are the opposite of insulin and that do a lot to fill in the blanks and explain why insulin is having the effects we’re seeing. Also the metabolism is slowing down on caloric deficit, with the result that people eventually regain that weight back and then some, this has been shown in many studies, including that huge one from the Women’s Health Initiative. When you’re doing keto or fasting, the insulin goes down. Again, this is a fact. This allows the body to consume energy from its own fat deposits. This means that the metabolism shouldn’t slow down, when implemented correctly. Having fat isn’t for good looks, but an evolutionary advantage, we are supposed to use our fat store when in need, otherwise we would have evolved to excrete the excess. Now of course, here we are talking of healthy people. It’s debatable if the metabolism slows down or not when we are speaking of diabetics or the obese. And actually I talked with people that claimed they measure their metabolic rate and it did slow down with fasting. So it works better for some people than for others. But on the metabolic advantage, that advantage is undeniable for diabetics at least. In the next couple of years you will hear more and more of keto being promoted in the treatment of diabetes, because it works and there’s also a large study that’s still in progress, but that promises great results. And btw, the reason for why keto hasn’t taken off in the medical community is due to perverse incentives. Nobody wants to invest hundreds of millions of dollars in proving that a diet works, because a diet doesn’t generate profit. The cold, harsh truth is that it’s more profitable to sell statins and synthetic insulin. Funny enough, they did invest hundreds of millions (billions?) in trying to show that saturated fats and salt are bad, anything and everything to blame, except for sugar. All such studies failed of course, but that didn’t stop the dogma, anything to keep us consuming sugar, which is where the “_a calorie is a calorie_” bullshit comes from.