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Interesting that this is "news" when the medical understanding of fasting and ketosis is pretty far along. Highly recommend the book "The Complete Guide to Fas

by mcfunk 7y ago

Interesting that this is "news" when the medical understanding of fasting and ketosis is pretty far along. Highly recommend the book "The Complete Guide to Fasting" by Dr. Jason Fung. When you think about it, while the "naturalness" argument is always suspect, it's very odd that humans eat as often as we do in the US, and unsurprising that negative health consequences follow (and positive health consequences follow fasting).

coldtea 7y ago
>Highly recommend the book "The Complete Guide to Fasting" by Dr. Jason Fung. Such books and doctors, promoting this or that diet, heavily cherry-pick from research papers, they don't reflect the scientific consensus on the matter.
- mcfunk 7y ago
  I'll be interested to see where the scientific consensus is in 10 years. I think the evidence is very much on the side of the hormonal theory of obesity and fasting, especially given the monumental failure of the "calories in calories out" model.
  - wyldfire 7y ago
    > especially given the monumental failure of the "calories in calories out" model. Can you explain this in more detail? CICO seems like it might oversimplify things but it always seemed like a really sane basis for helping shape your diet. If you need to lose weight, you should plan meals to create a calorie deficit. But yes, I would not be surprised to learn that fasting on day X and consuming double your normal calories on day X+1 are not equivalent. The description of CICO as a "monumental failure" sounds like there's substantial evidence to the contrary -- can you share more info?
    - qntty 7y ago
      This article makes a case against a calorie-centric approach to dieting. It boils down to something like Michael Pollan's "Eat food, not too much, mostly plants." A guy (who has since become an expert in public health) wasn't able to control his weight using standard calorie-counting techniques and had a lot of success changing his diet to "high quality" (as opposed to "highly processed") food. The article isn't super clear on specifics of what that means but it sounds like there might be something to it. Also worth noting that he began exercising in between this switch. https://www.1843magazine.com/features/death-of-the-calorie https://www.1843magazine.com/features/death-of-the-calorie
      - AnIdiotOnTheNet 7y ago
        Eh. the articles argument appears to be that even though nutritionists, physicists, and dieters all agree that eating fewer calories than you expend causes weight loss, it isn't easy for a variety of factors. No shit. The thing is, it is the simplest expression of what needs to happen, and there is no getting around it. I was once well north of the weight of the subject in the article and have since shed about half of it and kept it off for years. I've been through all the games your brain and body play to try and get you to eat more, and all the fad diets out there sound to me exactly like those games. It's nice to believe you don't have to suffer to reach your goals, but it isn't true and anyone telling you otherwise is trying to sell you something.
        mcfunk 7y ago
        There's also good evidence that people don't maintain that weight loss over time despite maintaining their lower calorie consumption. Because base metabolic rate is something that the body can adjust, just like if you had less money to pay for heat, you could just put less heat into the house. The role of hormones (especially insulin) in regulating fat storage and whether stored fat is available to the body as energy is better understood now, and much has been documented about how high insulin combined with low calories over time results in a lowering of the metabolic rate (resulting in stalling weight loss and then weight gain) rather than sustainable weight loss. Also "it's nice to believe you don't have to suffer to reach your goals" is a silly and moralistic thing to say. But it typifies the american "scientific understanding" of weight loss. Fat is immoral, suffering is virtue, therefore in order to lose your immoral fat you must suffer. Just look at all the massive success of those in the IF and keto community in living joyful lives, not deprived, losing fat etc. etc. And then look at all the people for whom calorie counting has completely failed. The information is out there (shruggie)
    - mcfunk 7y ago
      This is a good place to start: https://idmprogram.com/how-do-we-gain-weight-calories-part-1/ https://idmprogram.com/how-do-we-gain-weight-calories-part-1...
    - magnamerc 7y ago
      I used to be firmly in the CICO camp, with the whole 1st law of thermodynamics as a sane argument. But I've recently changed my views on this. If you think about it, the human body doesn't have a 'calorie sensor'. All it has are nutrient sensors, and cells metabolize nutrients depending on the current metabolic environment, which includes proteins and hormones for example.
    - beagle3 7y ago
      CICO is only true in a useless sense. Do you know how much energy you are putting in? Paper (cellulose) is carbohydrates, but not used by the body; gasoline is more energy dense than fat (at 12kcal/gr) and still unusable by the body.... So, it obviously isn’t just “carbs time 4k/cal”. Ok, let’s assume we can tell which carbs are useful and which aren’t. It takes energy to extract that energy. How much? IIRC there is over 50% variation between people (and even same person at different time) of the amount of energy actually extracted - yet almost everyone uses 100year old Atwater factors as if they were a fundamental physical constant. Glucose storage is supply based. But gluconeogenesis (conversion of protein to glycogen) is demand based, so you must be at a deficit for the 4kcal/gr protein measure to be used. How about body temp? A person at 35.6C uses a few tens or hundred calories less per day than a standard 36.7C person. Yes, these exist. Did you take this into the CO equation? Did you consider the liter of ice cold water you drank? Takes 37kcal to warm it up to body temp. CICO as usually practiced has 20-30 margin of error, which makes it much less useful than people assume. Unsurprisingly, it does work for e.g. 70% of the people, who assume the rest are not properly counting.
  - SketchySeaBeast 7y ago
    > especially given the monumental failure of the "calories in calories out" model. I don't think that's the case at all - do we have examples where people, strictly observed didn't lose weight when eating under their caloric requirements? There absolutely is a pile of mitigating factors in how someone eats or lives, but that's like saying "exercise has been proven to not help people run marathons" just because most people who try to run a marathon don't succeed.
    - beagle3 7y ago
      There is a serious problem with counting both in and out calories, to the point that makes this useless in general - e.g. in serious studies they lock you in a room with controlled air and temperature in order to measure carbon out (or fit a respiration mask to do that). Anything less involved has error in the tens of percents. Furthermore - on phone now, can’t find ref - but mass general IIRC had a study where people where being significantly over fed (with a feeding tube) yet lost weight; google Robert Israel and Michel Cabanac for more info. CICO is an often useful approximate description - but it is not (other than tautologically useless) a law.
      - SketchySeaBeast 7y ago
        You're not describing a failure of the calories in/out, you're describing a failure to measure the caloric requirements correctly. How do you find that? Eat less, measure your weight. Titrate as required. Worked for me, works for many.
        beagle3 7y ago
        Why do you call it ci/co then? Call it “weight in / weight out” - it better describes your system, in which calories (and their elusive measurement) is a red herring.
        SketchySeaBeast 7y ago
        Because in order to determine how much I eat I'm going to calculate it with calories.
  - coldtea 7y ago
    It's only considered a "monumental failure" by people peddling this or that alternative diet. On the regular medical world, there are just new inputs about things that also matter, as science and our understanding progresses (as opposed "the calories thing is wrong, let's throw it out altogether").
    - kemiller 7y ago
      The calories thing is wrong in the context of telling people to count them. In practice it is very hard to know exactly how many calories are coming in or going out in real life situations. Even labeled boxed foods are often way off from their official calorie numbers, and it’s not like most people are running their poop through a crucible, or doing all their exercise in a tank of water to measure their heat output.
- la_barba 7y ago
  As far as dieting goes what would a scientific consensus look like? FWICT, it looks like our metabolism differs enough from person to person, to allow for various diets to work.

by mcfunk 7y ago

coldtea 7y ago

>Highly recommend the book "The Complete Guide to Fasting" by Dr. Jason Fung. Such books and doctors, promoting this or that diet, heavily cherry-pick from research papers, they don't reflect the scientific consensus on the matter.

mcfunk 7y ago
I'll be interested to see where the scientific consensus is in 10 years. I think the evidence is very much on the side of the hormonal theory of obesity and fasting, especially given the monumental failure of the "calories in calories out" model.
- wyldfire 7y ago
  > especially given the monumental failure of the "calories in calories out" model. Can you explain this in more detail? CICO seems like it might oversimplify things but it always seemed like a really sane basis for helping shape your diet. If you need to lose weight, you should plan meals to create a calorie deficit. But yes, I would not be surprised to learn that fasting on day X and consuming double your normal calories on day X+1 are not equivalent. The description of CICO as a "monumental failure" sounds like there's substantial evidence to the contrary -- can you share more info?
  - qntty 7y ago
    This article makes a case against a calorie-centric approach to dieting. It boils down to something like Michael Pollan's "Eat food, not too much, mostly plants." A guy (who has since become an expert in public health) wasn't able to control his weight using standard calorie-counting techniques and had a lot of success changing his diet to "high quality" (as opposed to "highly processed") food. The article isn't super clear on specifics of what that means but it sounds like there might be something to it. Also worth noting that he began exercising in between this switch. https://www.1843magazine.com/features/death-of-the-calorie https://www.1843magazine.com/features/death-of-the-calorie
    - AnIdiotOnTheNet 7y ago
      Eh. the articles argument appears to be that even though nutritionists, physicists, and dieters all agree that eating fewer calories than you expend causes weight loss, it isn't easy for a variety of factors. No shit. The thing is, it is the simplest expression of what needs to happen, and there is no getting around it. I was once well north of the weight of the subject in the article and have since shed about half of it and kept it off for years. I've been through all the games your brain and body play to try and get you to eat more, and all the fad diets out there sound to me exactly like those games. It's nice to believe you don't have to suffer to reach your goals, but it isn't true and anyone telling you otherwise is trying to sell you something.
      - mcfunk 7y ago
        There's also good evidence that people don't maintain that weight loss over time despite maintaining their lower calorie consumption. Because base metabolic rate is something that the body can adjust, just like if you had less money to pay for heat, you could just put less heat into the house. The role of hormones (especially insulin) in regulating fat storage and whether stored fat is available to the body as energy is better understood now, and much has been documented about how high insulin combined with low calories over time results in a lowering of the metabolic rate (resulting in stalling weight loss and then weight gain) rather than sustainable weight loss. Also "it's nice to believe you don't have to suffer to reach your goals" is a silly and moralistic thing to say. But it typifies the american "scientific understanding" of weight loss. Fat is immoral, suffering is virtue, therefore in order to lose your immoral fat you must suffer. Just look at all the massive success of those in the IF and keto community in living joyful lives, not deprived, losing fat etc. etc. And then look at all the people for whom calorie counting has completely failed. The information is out there (shruggie)
  - mcfunk 7y ago
    This is a good place to start: https://idmprogram.com/how-do-we-gain-weight-calories-part-1/ https://idmprogram.com/how-do-we-gain-weight-calories-part-1...
  - magnamerc 7y ago
    I used to be firmly in the CICO camp, with the whole 1st law of thermodynamics as a sane argument. But I've recently changed my views on this. If you think about it, the human body doesn't have a 'calorie sensor'. All it has are nutrient sensors, and cells metabolize nutrients depending on the current metabolic environment, which includes proteins and hormones for example.
  - beagle3 7y ago
    CICO is only true in a useless sense. Do you know how much energy you are putting in? Paper (cellulose) is carbohydrates, but not used by the body; gasoline is more energy dense than fat (at 12kcal/gr) and still unusable by the body.... So, it obviously isn’t just “carbs time 4k/cal”. Ok, let’s assume we can tell which carbs are useful and which aren’t. It takes energy to extract that energy. How much? IIRC there is over 50% variation between people (and even same person at different time) of the amount of energy actually extracted - yet almost everyone uses 100year old Atwater factors as if they were a fundamental physical constant. Glucose storage is supply based. But gluconeogenesis (conversion of protein to glycogen) is demand based, so you must be at a deficit for the 4kcal/gr protein measure to be used. How about body temp? A person at 35.6C uses a few tens or hundred calories less per day than a standard 36.7C person. Yes, these exist. Did you take this into the CO equation? Did you consider the liter of ice cold water you drank? Takes 37kcal to warm it up to body temp. CICO as usually practiced has 20-30 margin of error, which makes it much less useful than people assume. Unsurprisingly, it does work for e.g. 70% of the people, who assume the rest are not properly counting.
- SketchySeaBeast 7y ago
  > especially given the monumental failure of the "calories in calories out" model. I don't think that's the case at all - do we have examples where people, strictly observed didn't lose weight when eating under their caloric requirements? There absolutely is a pile of mitigating factors in how someone eats or lives, but that's like saying "exercise has been proven to not help people run marathons" just because most people who try to run a marathon don't succeed.
  - beagle3 7y ago
    There is a serious problem with counting both in and out calories, to the point that makes this useless in general - e.g. in serious studies they lock you in a room with controlled air and temperature in order to measure carbon out (or fit a respiration mask to do that). Anything less involved has error in the tens of percents. Furthermore - on phone now, can’t find ref - but mass general IIRC had a study where people where being significantly over fed (with a feeding tube) yet lost weight; google Robert Israel and Michel Cabanac for more info. CICO is an often useful approximate description - but it is not (other than tautologically useless) a law.
    - SketchySeaBeast 7y ago
      You're not describing a failure of the calories in/out, you're describing a failure to measure the caloric requirements correctly. How do you find that? Eat less, measure your weight. Titrate as required. Worked for me, works for many.
      - beagle3 7y ago
        Why do you call it ci/co then? Call it “weight in / weight out” - it better describes your system, in which calories (and their elusive measurement) is a red herring.
        SketchySeaBeast 7y ago
        Because in order to determine how much I eat I'm going to calculate it with calories.
- coldtea 7y ago
  It's only considered a "monumental failure" by people peddling this or that alternative diet. On the regular medical world, there are just new inputs about things that also matter, as science and our understanding progresses (as opposed "the calories thing is wrong, let's throw it out altogether").
  - kemiller 7y ago
    The calories thing is wrong in the context of telling people to count them. In practice it is very hard to know exactly how many calories are coming in or going out in real life situations. Even labeled boxed foods are often way off from their official calorie numbers, and it’s not like most people are running their poop through a crucible, or doing all their exercise in a tank of water to measure their heat output.
la_barba 7y ago
As far as dieting goes what would a scientific consensus look like? FWICT, it looks like our metabolism differs enough from person to person, to allow for various diets to work.