Good summary on why keto works for some and not for others

[gitanacv]

People really need to understand this.

[Baytowvin]

Do you have any understanding of what insulin resistance is?

Your approach to keto, which I say loosely since at best it’s the red headed step kid of keto, assumes the person is metabolically healthy. A VAST majority of the people here ARE NOT metabolically healthy.

People generally come to keto because the “eat less exercise more” CICO approach you use DIDN’T WORK.

[Mglasbrener]

Yup. Just ask Tim Noakes.

[Keto6468]

I’ve heard this guy before. I used to buy it. No longer.

K

[dlc96_darren]

@Baytowvin, @Mglasbrener and @Keto6468 I appreciate you not letting me waste my time watching this.

[gitanacv]

Noakes is addressed in the next video I just posted.

[Mglasbrener]

I love Noakes! He is able to alter his perspective based on evidence and champions the cause regardless of threats and coercion from entrenched interests. I brought his book regarding the trial. It’s a good read.

[Brunneria]

This is the second vid I have seen today which is repellant before I even click on it.

The ‘cover picture’ of naked beefcake… I mean, ffs! I can’t really value the opinion of anyone who promotes a video with a screen shot like that. Apart from putting me off my cornflakes, I just assume they don’t live in my world, so their opinions are irrelevant.

The other vid was some poseur dressed up as a prehistoric man.
I mean… my body may have a lot in common with MrsNeolithic. Doesn’t mean I want to play dressup - or take advice from someone in pristine buckskin with designer stubble.

[Mglasbrener]

I can’t see a link to the second vid. Initially I just agreed with @Baytowvin point. Now I watched 7-8 min. Of the first vid. This guy is completely clueless. He is currently metabolically healthy and therefore flexible. He does not actually understand keto nor does he cite any evidence. He has no idea what people who are currently metabolically damaged are dealing with. He would be demolished by Fung, Noakes, the 2 dudes, Taubes… He just doles out “tough love” in reintegrating the common sense. Eat less move more, calorie deficit. No hormone, body adaption to diet, nothing. I now want those 15 min credited back to my longetivity.

[collaroygal]

Thanks Guys, I didn’t watch it because of your comments. I wasted 35yrs. on CICO BS, no more. Like Mike, I would like that time credited back to me, no wait, I can’t afford to live THAT long.

[Screenack]

The ‘cover picture’ of naked beefcake… I mean, ffs! I can’t really value the opinion of anyone who promotes a video with a screen shot like that.

Don’t forget we may flag specious posts for moderation. I sincerely hope the admins take action.

[gitanacv]

He has no idea what people who are currently metabolically damaged are dealing with…

This is an important comment. There are many people that post on this site. Many of them are not obese. So not every post is directed toward those who are obese, those who fall outside of the norm. Rather than chafe, move on and read what is applicable to your situation.

[Baytowvin]

Many of them are not obese. So not every post is directed toward those who are obese, those who fall outside of the norm.

Obesity and insulin resistance are not mutually exclusive. Either one can, and often does, occur without the other.

[richard]

This thread was flagged as inappropriate, I disagreed with the flag but I want to explain why.

@gitanacv is allowed to be wrong. He’s not the first person to assert that establishing a caloric deficit, by eating fewer calories than you burn off through exercise, is the only method to achieve weight loss.

You can cut your leg off, you’ll lose weight.
You can dehydrate yourself, you’ll lose weight.
You can eat a bicycle (it better be a low calorie one) and you’ll gain (a bicycle’s worth of) weight.
You can get a nasty case of giadia and you’ll shit yourself thin, no matter how many calories you eat.

Clearly the statement on it’s face is not correct, but it’s worth digging into the reason why people think this describes weight loss. It comes down to a simplistic idea that the food we eat is converted completely into the energy we use to fuel activity, and if we short change our bodies by giving them less energy (by stopping eating before we’re satiated) and getting off the couch and running a 5K then our bodies will withdraw the balance from storage (body fat). If we keep doing that every day then eventually one day we’ll have 0 body fat, right?

It’s clearly illogical when taken to it’s extreme, but you hear reasonable people parroting off the more moderate version - just eat less and move more. And they don’t sound like complete idiots. And many of us have tried this repeatedly for decades, and you lose a little weight, then you yoyo right back up again heavier and fatter.

Human energy dynamics is complex.

The reason the ketogenic diet works, is not that it creates a calorie deficit.
The reason it works is because it treats the cause for why “Eat less and move more” wasn’t working for you.

So we have to unpack why eat less and move more doesn’t work.

The first is that not all calories are calories. You burn protein in a furnace you get 5.6kCal/g of energy of combustion. You eat the same protein and you get around 4kCal/g because every amino acid your body needs to invest energy into to extract ammonia and turn it into urea and filter it out into urine.

Some sources of calories directly raise the hormone insulin - that will change how you use energy. Carbs will provoke secretion of insulin, protein will roughly half as much, fat doesn’t (not directly). About 1/3rd of the population make very little insulin go along way, the rest of us make a lot of insulin - let’s table the conversation of what causes insulin resistance for now and focus on the effect of a LOT of insulin.

Insulin is a switch between being in a fed state when insulin is high and that signals that you have food to digest, and a fasted state when insulin is low which signals that you are running off your batteries (body fat).

Insulin does several things. Firstly it gets amino acids digested from protein into cells to be used for construction (and excess to be used for energy). Secondly it get’s glucose in excess of 5 mmol/l out of the blood supply and into cells. Thirdly it instructs fat cells to hoover up fat in circulation and not to release any.

Insulin doesn’t just look after supply of energy, it also alters demand. At the cellular level insulin tells your cells to turn some carbs into fatty acids and export them to circulation where they will be vacuumed up by fat cells. When your cells MAKE fat they stop burning it. When you cell burns fuel, they hand the fuel off to an organelle called the mitochondria which turns it into energy.

As long as your cell has glucose, it is turning some into pyruvate and transporting it into the mitochondrial matrix with the membrane enzyme pyruvate translocase. Fatty acids are different. Short and medium chained ones diffuse easily across the membrane. But long chained fatty acids, the ones we get from food or from out body fat need a special transporter called the Palmitoyl-Carnitine shuttle (CPT1). And here’s the real problem … that is inhibited when you are making new fatty acids (which you do when you have high insulin) and that inhibition can be up to 60x at levels of insulin that insulin resistant people produce all day. When the Carnitine shuttle is inhibited, so the fatty acids just pool up in lipid droplets in your cells - and your cells use a different slower technique of cleaving the molecules in another organelle called the peroxisome into short chained fatty acids so you can use them. And that process is very inefficient and produces a lot of pollution - like heat and peroxide. WHich will make you even more sick.

This is the nub of the problem. If you are IR, you cells really try super hard to avoid burning fatty acids. So you store the energy you can’t use.

This also explains the “sloth” and “gluttony” of diabetes. Why would a man with 100 lbs of body fat, ever be hungry, or not have enough energy to go for a jog? Has 2/3rds of the western world all of a sudden developed a moral crisis with 2 of the 7 deadly sins?

Of course not. The reason he is HUNGRY all the time, is that he can’t use the energy he has evidently been storing. The reason he appears to be lazy is that he has not energy despite the appearance of carry 100lbs of it.

What a low carb, moderate protein, ad libitum fat diet does is it lowers insulin.

That is why people suddenly drop 100lbs in 6 months. It’s not some magical satiety effect of protein, or fat, or ketones that makes you eat less. You eat less because you can USE the energy that you have stored, and your body isn’t running out of energy and so it doesn’t NEED to remind you to eat.

BTW don’t worry about the video in the OP, the guy has a simplistic understanding of the Bro Science, but just wants an excuse to harangue fat people, and to slip in how impressive his body fat cut was … yes he said “impressive”. What a douchcanoe

[Ruina]

I remember in high school, when we burned that peanut, thinking… but there is no literal fire in my body. I don’t burn food, I metabolise it. But at the time I just figured the experts were right about calories and there was something I was missing.

Also, on the subject of sins like sloth and gluttony, I think it’s important to remember the Bible condemned behaviors… it never condemned being fat. Fat in food represents blessing. People may have extrapolated that fatness is a result of sinning, but that’s their own interpretation, it’s not in the text. And gluttony, also translated as greed, is a good description of many a slender food company executive.

[dlc96_darren]

I think it’s important to remember the Bible condemned behaviors… it never condemned being fat. Fat in food represents blessing. People may have extrapolated that fatness is a result of sinning, but that’s their own interpretation, it’s not in the text.

Oh, @Ruina, you hit the nail on the head! Couldn’t have said it better myself!

One like isn’t enough. Here’s some more!

[dlc96_darren]

Human energy dynamics is complex.

I think this is the real take-away here.

Seriously, thank you @richard for that extremely informative response. I’ll be honest, I need to read this several times to let it sink in, but I appreciate your attention to the details.

Actually, I’m probably just going to print it out and carry it around with me, for future reference.

[ctviggen]

It’s even more complex than that. There’s a theory that PUFAs cause your fat cells to be “hungry” while saturated fat causes your fat cells to be “full”. By going low carb, you could also be lowering the amount of PUFAs, thereby affecting your fat cells. Also, as Gary Taubes points out, if people go on a low calorie, low fat diet, they invariably also lower their carb intake. It’s their weight loss due to calorie restriction, lower carb intake, or both?

And many still believe in low calorie. Phinney and Volek for instance advocate reducing your fat calories so that you use your own body fat instead of the fat you eat. This is the whole “fat on your plate means you’re not burning your own body fat” idea. To me, this is a low calorie diet in disguise.

And why do some people lose weight, then hit a wall? Why do some people still have high insulin even after low carb and fasting? Why does the body continue to hold onto fat it does not need?

[OldDoug]

As long as your cell has glucose, it is turning some into pyruvate and transporting it into the mitochondrial matrix with the membrane enzyme pyruvate translocase. Fatty acids are different. Short and medium chained ones diffuse easily across the membrane. But long chained fatty acids, the ones we get from food or from out body fat need a special transporter called the Palmitoyl-Carnitine shuttle (CPT1). And here’s the real problem … that is inhibited when you are making new fatty acids (which you do when you have high insulin) and that inhibition can be up to 60x at levels of insulin that insulin resistant people produce all day. When the Carnitine shuttle is inhibited, so the fatty acids just pool up in lipid droplets in your cells - and your cells use a different slower technique of cleaving the molecules in another organelle called the peroxisome into short chained fatty acids so you can use them. And that process is very inefficient and produces a lot of pollution - like heat and peroxide. WHich will make you even more sick.

This is the nub of the problem. If you are IR, you cells really try super hard to avoid burning fatty acids. So you store the energy you can’t use.

This also explains the “sloth” and “gluttony” of diabetes. Why would a man with 100 lbs of body fat, ever be hungry, or not have enough energy to go for a jog? Has 2/3rds of the western world all of a sudden developed a moral crisis with 2 of the 7 deadly sins?

Of course not. The reason he is HUNGRY all the time, is that he can’t use the energy he has evidently been storing. The reason he appears to be lazy is that he has not energy despite the appearance of carry 100lbs of it.

Great explanation, Richard (and of course it’s far from the first time).

The mechanics of this are fascinating.