Glucose is urinated out if the level goes above about 10 mmol/L. So it is not necessarily related to metabolic status (although how else would it get that high), but more the current level in the blood.
This is the same as Arencibia-Albite’s stuff. It does not argue against CICO, it just points out that you cannot necessarily get an accurate, overall picture by looking at “Calories In,” alone.
I’m beginning to suspect that this discussion always results from a fundamental confusion between the notion that all calories are fungible, which is denoted by the shorthand “CICO” or “eat less, move more,” and the Second Law of Thermodynamics. To say that the former is nonsense is not to reject the latter.
Coca-cola uses the notion that calories are fungible to persuade us that their product is okay to include in our diet. As long as we don’t ingest too many calories, they could all come from Coca-Cola, and we will be fine. This is indeed nonsense. As Feinman and many others point out, calories are clearly not all the same, which means that CICO is nonsense. No one is rejecting the laws of thermodynamics here, only saying that in reality they apply much differently from the way they are said to apply when people trot out CICO and “eat less, move more.” As Gary Taubes likes to point out, of course when we shed excess fat it means we took in less energy than we expended, but the real questions of interest are why did that happen, and how did that happen. The thinking denoted “CICO” or “eat less, move more” tells us nothing to answer those questions.
@OldDoug You seem to have your own idiosyncratic definition of CICO. Any mention of ‘calorie’ or ‘energy’ confirms CICO.
In the world where I live, a primary, essential element of CICO - the common dietary regimen - is any calorie from any source is exactly the same as any other calorie from any other source and those identical calories will have exactly the same effect on metabolic activity. Thus, you can simply add and subtract the gross caloric in/out to calculate changes in fat storage.
Starting with the article by Feinman and Fine, this primary, essential element of CICO - the common dietary regimen - is shown to be just flat wrong. This forum is full of folks who went through CICO - the common dietary regimen - some of them multiple times, damaging their metabolisms in the process. I’ve been reading their stories for 3+ years! I don’t know how you can continue to claim that CICO - the common dietary regimen - is valid while standing amid the wreckage all around you.
I had my say. If you remain convinced of the validity of CICO, so be it.
It was a rhetorical question to @OldDoug ’ s previous comment to make a point.
10 mmol/L above what level?
It’s a reference to the absolute concentration of serum glucose; in other words, 10 mmol/L above 0.
As @Naghite states, the fact of insulin resistance alone is not enough to cause the excretion of glucose, it requires a sufficient amount in the bloodstream to “spill over” into the urine. This is one of the body’s safety mechanisms, since hyperglycaemia is both dangerous and damaging.
The word “diabetes” is supposedly derived from an ancient Egyptian word meaning “syphon,” since it appears that sugar is being syphoned out of the body in the urine. This, of course, was observed in the context of Type I diabetes, which is an auto-immune disease that has been with us since ancient times. Type II diabetes, on the other hand, is a metabolic problem that was vanishingly rare until inexpensive refined sugar hit the market in the middle of the 19th century. (Elliott Joslin observed the beginnings of the diabetes epidemic at Massachusetts General in the 1880’s.)
Although both diseases have the issue of glucose control in common, they are very different. Type I is cause by damage to the pancreas and is typified by an inability to secrete insulin right from the beginning. The lack of insulin causes glucagon to elevate serum glucose to dangerous levels, at which point glucose starts to be excreted and the patient essentially starves to death. Insulin treatment stops both the wasting and the excretion of glucose.
In Type II, the problem is one of insulin resistance and the secretion of too much insulin, so glucose remains in check until the later stages of the disease. Glucose in the urine is not typical of Type II until the very late stages of the untreated disease, when the pancreas finally stops producing insulin. If the disease is properly treated, glucose remains controlled and is not excreted in urine.
This is a good point. To elaborate: “bone density” isn’t even the only important thing. Bone is not just a big crystal of calcium phosphate. Healthy bone has cells constantly moving through it and adding collagen to the matrix. Bone without calcium would lack compressive strength, but calcium crystals lack tensile strength and flexibility, so bone without collagen would be like concrete without rebar: weak and brittle.
I saw a study some months ago that showed that in old people, fractures didn’t correlate very reliably with bone calcium density. IIRC, they specifically said loss of bone protein was to blame.
Wasn’t there also a study recently that found vegan kids are more prone to fractures?
edit: I realize this is off-topic, but no one ever said I was a good citizen!
That’s not true, though, Paul. Different macronutrients, as with carbohydrates and others (as mentioned many a time on this forum) can change the disposition of energy and the weight of a person.
Feinman, etc., have noted this, certainly. And so we have different states of CICO, not any indictment of CICO. Let’s say the first case is eating 2000 calories of carbs, and the second case is eating 2000 calories of fat and protein, and that in the second case it results in more of the “Out” via a higher metabolism. Over time, many people in the second case will display more weight loss than people in the first case. Okay, great.
The argument is not that “calories are (entirely) fungible.” Especially on such a forum as this.
I think it’s true for vegans in general.
Isn’t that precisely the point? And it is a direct refutation of what I understand “CICO,” “a calorie is a calorie,” and “eat less, move more” to mean. It appears that your definition of CICO, etc., is precisely what Feinman is asserting in opposition to his understanding of what it means. So we have here a matter of terminology being used imprecisely, not a disagreement on the actual reality.
That is why these forums exist, no? But the mainstream view is precisely as I stated it. There are considerable economic forces that have a vested interest in its being so. Just ask Walter Willet and his friends in the sugar industry.
Well, if looking at it from a rational, scientific point of view is idiosyncratic, then I guess so.
The problem is that you are talking about more than one thing, there, and they are not all the same.
The argument is not that all calories on the “In” side are necessarily the same (they are obviously not), nor the same in effect on the human body. Even for the Twitter opinion from the original post, it would not have to be that way.
And when you talk about the “Out,” then that is a separate thing. The best argument against the notion that “all calories are the same” is CICO itself - the often-observed phenomenon that equal caloric intake can have markedly different effects, via dissimilar access to stored fat, altered metabolism, etc. That is reflected on the “Out” side, and it is folly to pretend that the “Out” side does not matter.
Michael, you are claiming that a misunderstanding of part of it damns the entire thing, and that’s just not true.
It’s like having two cases. One is 2 + 3 = 5. The other is 2 + 1 = 3. Your logic has us seeing that the results of 5 and 3 are not the same, and then crying out that “Mathematics is bollocks!”
1 = sqrt(1x1)
Damn, you are right!!
Perhaps it is (still) the mainstream view. No argument that “a lot” of people think that way. But I’d argue just as strongly against that, as against the notion that we can discard CICO on the basis of the “In” side alone.
I really don’t see anybody disagreeing about the end result. That takes CICO into account, rather than only looking at calories on the ‘In’ side.
I hear you on terminology. Sometimes it feels like we have to constantly ‘reinvent the wheel,’ to be totally and strictly correct. Something like “all calories are the same” brings that on, since of course they are not. One example - different macronutrients have different energy densities - the guy from Michael’s link about ‘Serious analytical inconsistencies challenge the validity of the energy balance theory’ mentions that.
Specific to that, there are two different things present. One is that not all calories are totally “the same.” We can agree on that, but to judge ‘calories in, calories out,’ on the basis of a possible misunderstanding of only one part of it doesn’t make sense.
If nothing else, we at least have to take the “calories out” part into account.
The second thing is that “Eat less, move more,” can be correct. Even the Twitter deal in the original post: "as simple as "eat less, exercise more" - this works for many people. And, if done enough, if weight loss is what’s desired, then it’s going to work for everybody.
The problem there is not the prescription, but that people can’t maintain it. Changes in metabolism, feelings of deprivation, etc. - so, because of “the way people are” (rather than any fault in CICO) it often also does not work for many people.
I don’t have a ‘bumper-sticker’ answer for the Twitter post, and I don’t think there are any true ones.
I would note what we talk about on this forum - that one’s insulin situation can make a huge difference, among other things. I’d also have to say that, as stated (and even without arguing on the different types of calories) it’s not necessarily true. While if done enough, yes, it’s going to work, but the unqualified statement leaves the door open for some degree of less eating and some degree of increased exercise, which might fall short of achieving weight loss.
Except that a number of studies have shown that by the end of twelve months of calorie restriction people have generally regained the weight lost and then some. And a number of studies of exercise as a means of creating a caloric deficit have shown similar results. Moreover, Kevin Hall’s follow-up of Biggest Loser contestants showed that, not only had they regained more than they had lost, but that most of them had permanently damaged their metabolisms because of the extreme tactics used on the show.
Given that the body responds to calorie input (within broad parameters, at least) by adjusting the metabolic rate up or down, I don’t think it is sufficient to say that a caloric deficit is per se sufficient for shedding excess fat. Particularly given, as Jason Fung points out, that we are dealing with a two-compartment situation, so that any weight lost can just as easily be from muscle or reduced bone density as from fat loss.
On the other hand, it appears to be safe to say that a well-formulated ketogenic diet, eaten to satiety, has been shown to be a good strategy for maintaining muscle and bone while shedding excess fat. And while there is generally some increase in weight by the end of twelve months, in general the fat comes off and mostly stays off.
That has certainly been my experience. The fact that my food intake was ad libitum during my period of fat loss is what has sold me on this way of eating, because calorie-counting drives me absolutely nuts, which is why all my previous attempts to shed excess fat were abject failures. If there was any caloric deficit during my keto fat loss, it was the effect of the diet, not an intentional cause of weight loss. There was certainly no intention on my part to engineer a deficit—though there has to have been one, because I shed close to 40 kg without intentionally cutting calories. And the weight lost appears to have been all fat, because there is evidence to suggest that I gained some lean mass while growing thinner.
Again, as I said, all we are really arguing here is terminology; we appear to agree fully on the underlying physical reality.
Paul, nothing I said failed to take into account the points you made there. No argument that long-term, calorie restriction, per se, is not a good way for many people to go. I’m not at all saying that everybody can do the “eat less, exercise more” thing with success nor that it’s going to be good for them, overall.
However, as long as somebody can do it enough, then it’s definitely going to work, from the standpoint of physics alone.
As long as we look at the overall “In” and “Out” things, as with your mention of calorie restriction - metabolic slowdown, then it will all make sense. It has to, from a rational-scientific-mathematical perspective.
I’m starting to feel an intense migraine headache coming on from reading your posts.
Cold temperature increases testosterone and testosterone increases lipolysis to facilitate thermogenesis. Therefore the bolded part is incorrect.
Are you eating carbohydrates by any chance?
Well, if you want “bumper sticker” answers, and anything more than that brings on the pain, then so be it.
Okay, so there is some of CICO in action. Why would this be a problem?
CICO in action as you admitted. Then their mass/weight does change.
No offense but do you have Alzheimer’s?
Friend, this is unnecessary.
This has been a civil discussion with people presenting different opinions and explaining their viewpoints; you don’t need to resort to insults.