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I am a practicing Endocrinologist and have been out in private practice for the last 5 years.I have been counseling diabetics and the overweight to keep carbohy

I am a practicing Endocrinologist and have been out in private practice for the last 5 years.I have been counseling diabetics and the overweight to keep carbohydrates in a low but still healthy range (about 120-180 grams daily) and to not follow the food pyramid. What I generally tell people: Carbohydrates generally follow this pathway: carbs-> glucose-> used for energy vs stored (mainly as fat). Eat less carbs, store less fat in general. Unless one is very active either growing or running marathons it is very difficult to burn through all of the energy in 300 grams of carbs per day (which is the RDA recommendation). Eat protein with each meal. This will not get stored as fat and whatever is not needed is generally eliminated. It also keeps one full for a longer period of time by slowing digestion. It also slows the digestion of carbohydrates. Get lots of fiber. This is an indigestible carbohydrate which again helps to keep one full, yet does not get moved down the sugar to fat pathway. Therefore balance the meal: Carbs (moderate to low unless very active), protein with each meal (lean meat, fish, chicken, nuts, eggs, cheese, etc), and fiber with each meal (especially green vegetables but also fruit). Above all: All Things in Moderation. Also things in medicine change all the time so good judgment and common sense always trump the latest "brilliant" scientific study or fad.

rue 16y ago
> Unless one is very active either growing or running marathons it is very difficult to burn through all of the energy in 300 grams of carbs per day (which is the RDA recommendation). This is just incorrect. 300g of carbohydrates makes only about 5000kJ (1200kcal), a figure well under baseline consumption. About 2 hours of easy to moderate jogging or cycling would take care of it, too, depending on the person. -- Moderation is indeed good. All this talk about specific food substances is just bullshit when the real problem is people stuffing their face with 2-3 times the calories they need.
- ghshephard 16y ago
  If you do a bit of reading, you would discover that the reason why there is this "talk about specific food substances" is so that people don't feel the _need_ to stuff their faces with 2-3 times the calories they need. In fact, the best diets are the ones where people are forcing themselves to choke down food they aren't interested in, because their appetite control system has basically said "No More." Upside - zero caloric excess. Downside - food becomes much more dismal/boring. People almost never make a conscious choice about A) the amount of food they eat and B) how quickly they metabolize it. How much you eat really is not much more than a function of a fairly complex system of your hormones, stomach, and autonomic nervous system. Changing your specific foods is effectively "gaming" or "hacking" that system so you _lose_ the desire to eat. Almost nobody effectively sustains a diet through "willpower" beyond the initial 6-9 months of a sprint where they drop 30 pounds, and put it all back on. I have a colleague at work who runs 5 miles in the gym at lunch, every single day, and is about 20-30 pounds overweight. He is a master of discipline, never misses a day - but simply can't drop the weight he's trying to. All that exercise simply results in him being hungrier, and eating more.
  - tdfx 16y ago
    His diet must be horrific.
  - rue 16y ago
    > I have a colleague at work who runs 5 miles in the gym at lunch, every single day, and is about 20-30 pounds overweight. He is a master of discipline, never misses a day - but simply can't drop the weight he's trying to. All that exercise simply results in him being hungrier, and eating more. Yes. The problem is people eating too much (although 1h of exercise is not that much, and certainly not a marathon…)
    - gruseom 16y ago
      Yes. The problem is people eating too much Saying that fat people eat too much is like saying alcoholics drink too much or that insomniacs don't get enough sleep. It's trivially true, but does nothing to help solve the problem. In fact, it's harmful. To imply that a problem is trivial is to suggest that the solution is easy: just don't be stupid. That's far from the case with alcoholism, insomnia, or obesity.

rue 16y ago

> Unless one is very active either growing or running marathons it is very difficult to burn through all of the energy in 300 grams of carbs per day (which is the RDA recommendation). This is just incorrect. 300g of carbohydrates makes only about 5000kJ (1200kcal), a figure well under baseline consumption. About 2 hours of easy to moderate jogging or cycling would take care of it, too, depending on the person. -- Moderation is indeed good. All this talk about specific food substances is just bullshit when the real problem is people stuffing their face with 2-3 times the calories they need.

ghshephard 16y ago
If you do a bit of reading, you would discover that the reason why there is this "talk about specific food substances" is so that people don't feel the _need_ to stuff their faces with 2-3 times the calories they need. In fact, the best diets are the ones where people are forcing themselves to choke down food they aren't interested in, because their appetite control system has basically said "No More." Upside - zero caloric excess. Downside - food becomes much more dismal/boring. People almost never make a conscious choice about A) the amount of food they eat and B) how quickly they metabolize it. How much you eat really is not much more than a function of a fairly complex system of your hormones, stomach, and autonomic nervous system. Changing your specific foods is effectively "gaming" or "hacking" that system so you _lose_ the desire to eat. Almost nobody effectively sustains a diet through "willpower" beyond the initial 6-9 months of a sprint where they drop 30 pounds, and put it all back on. I have a colleague at work who runs 5 miles in the gym at lunch, every single day, and is about 20-30 pounds overweight. He is a master of discipline, never misses a day - but simply can't drop the weight he's trying to. All that exercise simply results in him being hungrier, and eating more.
- tdfx 16y ago
  His diet must be horrific.
- rue 16y ago
  > I have a colleague at work who runs 5 miles in the gym at lunch, every single day, and is about 20-30 pounds overweight. He is a master of discipline, never misses a day - but simply can't drop the weight he's trying to. All that exercise simply results in him being hungrier, and eating more. Yes. The problem is people eating too much (although 1h of exercise is not that much, and certainly not a marathon…)
  - gruseom 16y ago
    Yes. The problem is people eating too much Saying that fat people eat too much is like saying alcoholics drink too much or that insomniacs don't get enough sleep. It's trivially true, but does nothing to help solve the problem. In fact, it's harmful. To imply that a problem is trivial is to suggest that the solution is easy: just don't be stupid. That's far from the case with alcoholism, insomnia, or obesity.