Great write up by Dr. Jason Fung

obesity
fung
#61

I don’t disagree with your comments about Fung’s characterization being inadequate, but as a keto devotee who is routinely asked to explain to friends of friends/strangers the hows and whys of my keto lifestyle, I can assure you the general public I encounter is wholly ignorant of all knowledge of their own bodies and how food affects them and drives health or disease. Truly most are lemmings listening to standard American medical advice and would rather take a pill or have a simple explanation as Fung offers rather than thinking for themselves.

I routinely lose people when I start to explain basic biology and how food and the body and weight loss and gain and blood sugars, cholesterol et al interact in our wonderfully, amazingly complex bodies. They want a simple one sentence answer, and like it or not, Fung provides that. The general American public has been willingly brainwashed and are comfortable staying there.

Sadly, I know MUCH more than my own physician sometimes when it comes to the details of how and why things work the way they do with my health, because she was trained in medical school and fortunately, I wasn’t. I keep her because she is the only half decent option in my locale; she doesn’t fight me on the choices I am making and is instead willing to learn and help me keep moving forward by ordering labs and supplements I need from her for insurance to cover my labs.

#62

I think this blog post is completely misleading. The common currency is not insulin, it’s ATP (specifically net).

(What The Fast?!) #63

Have tried both and can say for CERTAIN, that yes…yes it does.I gained weight eating high calorie keto (extremely minimal carbs) and have lost it fasting.

I am not metabolically deranged, I have low fasting insulin (2.2), and very low insulin resistance…and I still gained weight on high calorie keto. In fact, it’s been damn near impossilbe over the course of 7-8 months to lose any weight on keto. The only thing that’s moving the needle is fasting.

(VLC.MD) #64

I’ve heard Dr. Fung say many times that calories do matter. When pressed, he will say that calories matter. But he likes to drum up controversy by saying calories dont matter as a gateway for understanding insulin matters more.

#65

His explanation is oversimplified to the point of being untrue, thus unhelpful.

Taking it to its logical extreme, it would suggest that calories are unnecessary. If calories don’t count for gaining weight, then they don’t count for losing weight, so why eat at all?

(VLC.MD) #66

Fung did write a fasting book !

#67

Exactly. For losing weight.

(Crow T. Robot) #68

Well, more precisely, for fixing your insulin and other hormones and thus losing weight.

(Ross) #69

That is amazing and would seem to fly in the face of the hormonal model!

If you don’t mind me asking, what are your exercise habits?
Do you do regular resistance and/or aerobic workouts?

It occurred to me over the weekend that we have a potential research goldmine here on the forum.
We are a community of long-term keto adapted people with a variety of lifestyles & sub-diet variations.
Oh, what we might learn from a few carefully crafted questionnaires & some data mining!

(Ross) #70

In the whole theme of correlation VS causation, caloric intake could be a proxy for insulin levels in most people.

Would probably be very high correlation in people who eat a moderate or greater carb diet.

There would be a correlation between calories and insulin (weight gain/loss) but the causation would be related to the macros nutrients.

(What The Fast?!) #71

@ggv I work out a lot. I’m a cyclist (though now in off season), I do TRX, kettlebells, yoga, Pilates, etc.
There is zero explanation why I haven’t been able to lose on keto. But, I also had tried macros before keto and that didn’t work either, even with working out 5-6 days/week.

I work out a bit less now, allow my body to actually recover, but in general, I work out more than most people and don’t have results to show it.

Things I have tried since starting keto: tracking everything and keeping calories low (didn’t gain, didn’t lose), tracking everything and eating OVER my TDEE (total daily cal expenditure) with fat cals (gained), eating zero carb (gained), relaxing on tracking and eating some carbs (gained). Now, I fast more than I eat (though I do feast/fast and do not track) and while my weight has finally started to trend down, it is a much slower loss than you’d expect for doing SO MUCH fasting.

It seems that some people (myself included) have very efficient bodies that are VERY good at maintaining weight. If I was a caveman, I’d outlast everyone. :rofl:

Here’s a pic of my weight trend since end of March when I started keto. (Please note the initial loss and then a jump because my body underwent a significant amount of stress when I sustained 2nd degree burns on my chest from boiling water.
I started in late March of this year, so ignore the first weight there, I started at about 149lbs. You’ll see a consistent trend UP and then I started fasting at the peak of that trend, about 6 weeks ago (10/15/17).

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(Ross) #72

@KetoLikeaLady oh my! I hope the burns healed up well. That must have been awful! ::sob::sob::sob:

Looks like you dropped 10 pounds (7% of your total weight) very quickly then had the accident, put on some stress weight to about 157#, and are now quickly dropping back to around 140# again (with some dally variation)?

Oddly, I’m reading through an engineering textbook on “root cause analysis” right now. Very pertinent.

(What The Fast?!) #73

Haha, yes VERY pertinent. I started about 148-149lbs, dropped to about 142, then had the burns. Got up to about 154, and am back down to 145 at the moment. My lowest fasted weight is 142.0. I’m hoping to get (and stay) in the 130’s in the next 1-2 weeks. Total loss from pre-keto weight is only about 6 lbs, but 10 lbs from my highest keto weight.

My weight fluctuates like crazy. I love vegetables, but they do not like me. I get bloated and retain water when I eat a lot of vegetables. For example, I was 142.0 yesterday before I broke a 62 hour fast. I ate lunch and dinner (and did a 15 mile bike ride) and was up to 145.3 today. I have huge swings based on what food I eat and what workouts I do. Seeing a 5lb swing in 12 hours is not abnormal for me, so I don’t feel like I know what my true weight is. I just had a cobb salad with lots of vegetables and my stomach is literally 1.5 inches larger right now. The bloat is real.

(Marty Kendall) #74

To my knowledge, no such tool is readily available.
have you seen @Marty_Kendall 's site? It’s pretty close.

Cheers 4dml. Thanks for the kind words!

We’re building the Nutrient Optimiser to help you optimise insulin load, food quantity and food quality to help you reach your specific goals.

I’ve been doing a lot of reports for people and the automated tool is getting very close!

#75

That’s AWESOME! :medal_sports:

(Troy Gwartney) #76

In this comment thread, you have repeatedly attributed Dr. Fung as saying “calories don’t count.” He never says that. That’s your simplification of his essay. He says that calories are not the common currency of the body, insulin is. So your test of which of 20g, 200g, or 2000g of sugar would trigger more fat gain implies that it is because of the different caloric content of each that the 2000g of sugar would trigger more fat gain. But I think you agree that the fat gain is not simply a result of the caloric content of each of these, but the insulin response associated with each dose. The calories are important, but only as a secondary indicator as to what energy is available for storage. And if you agree, then you agree with Dr. Fung’s premise.

Supposing that 20g of sugar would result in 5g of fat gain, would it be your position that 2000g of sugar would result in 500g of fat gain? I think not. There is much more to the equation than calories which is why Dr. Fung says (and many others agree) that insulin is the primary driver of fat storage. So your question which is meant to undermine Dr. Fung’s point, fails. There is not a 1:1 relationship between calories and fat gain. Indeed, there is no defined relationship at all between calories and fat gain. It all depends on the hormonal response triggered by the calories.

Maybe a better question would be which would cause more fat gain:
4 g of bacon,
40 g of bacon, or
400 g of bacon?

The 400 g of bacon will trigger more insulin response at least by all the markers of satiety if not by the nutritional content. But I’d bet that the difference in insulin response between 4g, 40g, and 400g of bacon are minimal and will not result in much difference at all in fat storage. It is all so complex and maybe someday we’ll understand it, and then maybe someday we’ll be able to measure it.

It seems to me that you’ve latched onto some perceived premise in Dr. Fung’s essay that “calories don’t matter” which is never stated. He only states that the “body don’t care” about the calories in the food, only about how the calories trigger the hormones necessary to process them.

Peace.

(Crow T. Robot) #77

Good post! You said what I was thinking but didn’t have the wit to compose.

(Richard Hanson) #78

… Your body doesn’t give a hoot about calories. Calories are not an accepted currency in our body. It does not count calories so why should you? A calorie is a calorie. So what? Who cares? Certainly not your body. …
.

…Your body just doesn’t give two flying f***s about calories. …

Dr. Fung.

It is not a simplification to understand the message of these statements as “calories don’t count.”

Also, I have never tried to undermine Dr. Fung’s point, the hormonal model of obesity, rather I have consistently stated that the source of calories is more important than the number of calories, but that does not mean that your body just doesn’t give a flying … about calories. I AGREE that insulin is the primary driver of fat storage, but that does not mean that your body does not give a hoot about calories.

Yes, the problem is complex and involves many variables, one of the variables is how much energy is consumed or not consumed.

If Dr. Fung did not intend for people to think that calories don’t count, then will you be happy to agree that calories do in fact count, that energy intake is one of the variables is this problem?

Keto for Life!

Most Respectfully,
Richard

(CharleyD) #79

I like the line in Apollo 13: Gentlemen, what are your intentions? (With this argument?)

Some days I really wish there was a calorie sensor like mTOR is for nutrients cause then there wouldn’t be this debate. It’s moot. It’s circular. It’ll never end.

Dr Fung has said if you want to lose weight don’t eat. I would say it doesn’t get plainer than that but then some subtext tries to be extruded from that, like:

  1. does he mean keto since that’s like a high calorie starvation diet, since mTOR acts the same as you’re fasting, or
  2. does he mean calorie restriction (as primary) [eat just a tiny bit no matter the macro ratio], surely not since we know that’s CRaP, or
  3. does he mean not eat anything and let insulin come down, stopping DNL, starting lipolysis, letting autophagy do its thing and letting the liver even out serum glucose? Spoiler: it’s this one.

I got started with Dr Westman’s manual, and my experience was textbook. It only got more potent by adding Dr Fung’s IF protocols. I don’t think it does us any good arguing over ideological purity in this case. Can it rest?

#81

The issues you are describing are not well researched yet based on my reading, plus what data does exist is from studies done primarily with men.

My Keto MS Nutrionist regularly reminds me that the female “programming” in our DNA to maintain the species is MUCH more complicated than is understood and routinely works in ways opposing our goals.

Female hormones also change with age starting in your early 30’s, and tremendously impacts metabolism and body composition.

I’d encourage you to go to some of the Keto conference websites and see who is addressing issues similar and read their stuff.

Also Fung has a distance program where you can get coaching and now there’s a new really great program at Virta/Dr. Sarah Hallberg that gives daily feedback with Keto nutrition, blood work and Keto doctor.

Additionally, Dr. Hallberg just completed a two year study with 400 patients on LCHF and is planning to identify why some people move in the opposite direction of goals even when compliant, while others do well (oversimplification here). Both of these docs focus on diabetes for health, but they know the science for Keto for everybody.

KU Med in Kansas City Integrative Health Dept. has a Keto nutritionist who works with athletes and other more health challenged patients including cancer patients. Randall Evans is his name.

Finally, www.dietdoctor.com has hundreds of exceptional videos from pro-LCHF docs all across Europe, Canada and USA who are interviewed and answer questions on a huge number of topics.

Good Luck!