The Energy Balance Consortium Study is underway!

The Energy Balance Consortium Study NUSI

The Energy Balance Consortium Study at NuSI is underway. Read the story from Wired magazine about the initiative. “Hubris” science writer Gary Taubes and Peter Attia, MD have hired a team of scientists including those skeptical and eager to prove them wrong. A head to head battle encompassing three studies (Boston Children’s Hospital Study, Energy Balance Consortium and Stanford University) will determine Why We Get Fat (Book by Gary Taubes). “Do we get fat because we overeat or because of the types of food we eat?” What do you think will be the answer?

  • “Do we get fat because we overeat or because of the types of food we eat?”
    Yes.

    Obesity is not a dichotomy. It’s multi-factorial, as per http://www.shiftn.com/obesity/Full-Map.html

    • Nigel, thanks for sharing this mind numbing interactive graphic ‘Obesity Influence System Diagram’; http://www.shiftn.com/obesity/Full-Map.html. Dr. Stephan Guyenet is addressing brain reward in his research including many of these pathways; http://authoritynutrition.com/why-junk-food-makes-you-fat/. I wanted to personally meet Stephen @ AHS14. He is young, brilliant and still postulating. Certainly combinations of foods, refined and processed (carbs and fats) are the worst offenders.

      With all this complication where do we start the conversation with those less informed? I can tell you that most of my physician colleagues in 2014 only understand energy balance, overeating and blaming behavior. That carbs are good and fats are bad. “Junk food” is ill-defined. From the perspective of root cause analysis (using Ivor’s engineering terminology), I find the Taubes dichotomy (although oversimplified) not a bad place to begin the conversation. We are not trying to blind them with science (https://www.youtube.com/watch?v=nMWGXt979yg) but rather educate.

      NUSI (http://nusi.org) may prove Taubes right or wrong. Personally, I think he is right.

      • Please check your Spam folder, as my reply to feardorchamacgabhann has disappeared. It contained a link to my blog explaining how LC diets result in weight loss in free-living IR, IGT & T2DM people, but not in IS people and not in Metabolic Ward studies.

        Blaming-behaviour by doctors must be stamped out a.s.a.p, as it’s as ridiculous as blaming someone for falling asleep after they’ve taken a sedative!

        The fact that minimally-processed, whole-food, plant-based diets with ~70%E from carbohydrates can be and regularly are used (by http://thedavisclinic.com/ , for example) to treat IR, IGT & T2DM, shows that Gary Taubes is completely wrong. Sorry.

        • Nigil, I never saw your reply (not in spam) to feardorchamacgabhann. Sorry, but could you re-post the comment?

          Ok, so I drew the line in the sand with this post but still I agree more with what you have to say than disagree. Not everyone can tolerate high carb whole foods, low glycemic load diets. I would expect that http://nusi.org will do proper experiments, specifically looking at macronutrients including quantity, quality, sugars, processing vs. whole foods, etc…

          BTW there are three separate studies – the Stanford Univ. study is described as “free living” and not performed in a metabolic ward; http://nusi.org/the-science/current-science-in-progress/stanford-university-study/#.U_pSzvldWoM

          • The Stanford Uni Study was a good ‘un. See http://youtu.be/eREuZEdMAVo?t=39m35s

            The fact is that LC diets only work better than LF diets in free-living IR (or IGT or T2DM) people. LF diets work better than LC diets in free-living IS people.

            The proper solution is to restore Insulin Sensitivity in IR, IGT & T2DM people by finding the root cause of their IR. According to http://jrs.sagepub.com/content/29/6/658.extract , people need to eat >~150g/day of carbohydrate to prevent physiological IR, which worsens underlying IR.

          • Nigel, I’m friends with the author Christopher Gardner of the A to Z weight loss study. We have had several discussions related to diet and his research. Yes, different diets based on level of insulin resistance, even discuss this in my ‘Fat Reform’ presentation @45.42m: http://youtu.be/5jKXO8-laHQ?t=45m42s. Yet 150 grams/day of healthy carbs sounds high, maybe <120 g/day for those who are insulin sensitive.

          • “maybe <120 g/day for those who are insulin sensitive."
            Did you mean "maybe <120 g/day for those who are insulin insensitive." ?

          • You understand what I implied. The semantics get confusing. I use insulin sensitive mean the opposite of insulin resistant!

          • I understand what you meant. What you wrote is the opposite of what you meant. Those who are insulin sensitive don’t need to limit carbs to <120 g/day. Those who are insulin resistant do.

          • Call the two groups insulin resistant and not insulin resistant.

          • I’m happy to do that.
            So, did you mean:-
            “maybe <120 g/day for those who are insulin resistant."
            or
            "maybe <120 g/day for those who are not insulin resistant." ?

          • Nigel, I had friends in town today and realized that I needed to address the second part of your comment regarding how many carbs earlier, but was atop Pikes Peak mountain toady! 120 g/day is the ceiling in terms of max healthy carbs that I recommend for all takers. If you are insulin resistant 120g/day is too much.

            For the not insulin resistant group you say 150g, I say 120g as a ceiling. It looks like we are not that far off.

          • “If you are insulin resistant 120g/day is too much.”
            I disagree. See http://nigeepoo.blogspot.co.uk/2014/08/dry-carbohydrates-wet-carbohydrates.html and http://nigeepoo.blogspot.co.uk/2013/05/type-2-diabetes-which-are-safest.html

            “For the not insulin resistant group you say 150g, I say 120g as a ceiling. It looks like we are not that far off.”
            The figure of 150g/day is a minimum amount for the not insulin resistant, to prevent physiological IR, as per http://jrs.sagepub.com/content/29/6/658.extract

            Would you like to have a go at explaining http://youtu.be/KFfK27B_qZY?t=4m51s ?

          • Nigel, I attended Denise Minger’s talk and said hello. I really like her ending @20.26m and hypothesis; http://youtu.be/KFfK27B_qZY?t=20m26s. Why not attend AHS15 in Boulder Colorado next year. I plan to be there. You could even submit a proposal to present.

          • I’m like Theakston’s “Old Peculier” – I don’t travel well! My passport expired in 1992, and I have no intention of renewing it.

            Were you as astounded as I was over the humongous sugar (up to 400g/day) & carbohydrate (565g/day) content of the Rice Diet, that cured type 2 diabetes?

            I’m guessing that humans who live in the jungle eat a fruit-based diet (very high %E from sugars, very low %E from proteins & fats), so have an adaptation to thrive on such a diet.

          • The high carb Kempner experiment reminds me of the high carb Ancel Keys Minnesota starvation experiment. Keys was studying how to re-nourish WWII refugees. Keys used 1470 calories mimicking refugee diets including; bread, potatoes, root veggies and pasta during the starvation phase. Kempner used 2400 calories mostly from rice, fruit and sugar for “healthy weight loss”. Patients were forced to eat this way because it was “hard to do”, maybe they were starving. Starving can cure a lot of metabolic illness at the expense of malnutrition.

            BTW Minger also calls LCHF extreme in the presentation.

            I agree that there are healthy carbs, even for some diabetics. The benefit or not of healthy carbs need to be tested on an individual basis. Nice post by you listing those foods; http://nigeepoo.blogspot.co.uk/2013/05/type-2-diabetes-which-are-safest.html.

          • “Keys used 1470 calories mimicking refugee diets including; bread, potatoes, root veggies and pasta during the starvation phase.”
            1470kcals/day isn’t exactly starvation rations, but the men were also doing hard physical labour.

            Kempner’s diet was mind-boggling. 94% carbs (with lots of white sugar), 4% protein & 2% fat? Such a diet would soon become mind-numbingly boring, unless someone had access to a large variety of fresh fruits. I don’t think that anyone was feeling starving hungry on that diet (white Basmati rice is very filling), but I can’t be certain.

            “BTW Minger also calls LCHF extreme in the presentation.”
            She referred to 65%E from fats as extremes. The problem is that there are LC extremists who call their VLCVHF diet a LCHF diet. It’s misrepresentation.

            There are populations who get ~50%E from fats, but no higher. ~50%E from fats (LCHF) diets aren’t a problem for most people (except for those with ApoE4/E4). ≥80%E from fats (VLCVHF) diets are a problem.

            “I agree that there are healthy carbs, even for some diabetics. The
            benefit or not of healthy carbs need to be tested on an individual basis.”
            Diabetics should always “eat to their meter”. If a food sends their BG “through the roof”, they shouldn’t eat it (or so much of it).

            “Nice post by you listing those foods; http://nigeepoo.blogspot.co.uk/2013/05/type-2-diabetes-which-are-safest.html
            Thanks. We Nerds love to make lists! 😉

          • All should limit to <120 gms/day and lower based on the degree of insulin resistance.

          • I reposted it. It appeared for a while, then disappeared again. It must be in another folder, somewhere. This is really annoying, as it’s wasting my time writing comments.

          • I went to DISQUS and no luck. Everything else is posted.

          • 1) Are they in the “Deleted” section (just to the right of “Spam”)?
            2) Have you set any Restricted Words? That may result in comment disappearance.

          • Thanks I have to look at restrictions

      • “With all this complication where do we start the conversation with those less informed?”
        The solution to the problem is to advise patients to eschew manufactured “crap-in-a-bag/box/bottle”, and return to a minimally-processed produce-based diet.

        In the US, the expression “whole-grain” has become corrupted. Therefore, advise patients to eschew all grains that don’t look anything like grains any more. Obviously, breakfast cereals are a no-no, except for rolled wheat, rolled oats, puffed wheat & puffed rice with no added sugar. Anything made from flour is a no-no.

        White Basmati rice is fine to eat. 50g dry weight (~39g of carbs) swells-up to such a large volume due to absorbed water, that the effect on blood glucose from eating it is virtually zero. Ditto all other “wet” carbs (I’m not linking to my blog again until the Spam problem is resolved) like legumes, veggies, root veggies, tubers and whole fruits.

      • “From the perspective of root cause analysis (using Ivor’s engineering terminology), I find the Taubes dichotomy (although oversimplified) not a bad place to begin the conversation.”
        I’m sorry, but Ivor is wrong in his root cause analysis. Reductionism of a complex problem to a false dichotomy really isn’t helping anybody.

  • billslo

    Thanks for that link. Very interesting.

  • feardorchamacgabhann

    Types of food. No doubt about that. I’m 42lb down on LCHF diet and not hungry.
    The End.

    • The question almost seems silly in 2014, but most healthcare professionals (my dear colleagues) have little time to explore the mechanisms beyond energy balance.

    • .

    • See http://nigeepoo.blogspot.co.uk/2014/07/how-low-carbohydrate-diets-result-in.html for an explanation of how you lost 42lb on a LC diet without even trying. Cliff notes: You were overeating and possibly also under-moving on your previous diet.
      The End.

    • Nigel, the two posts were marked as spam and I approved them. Thanks for the tip, now why were they blocked? I added you to the white-list however Only once or twice did I ever adjust the sapm settings

      • I had exactly the same problem on ItsTheWoo’s blog. I accused her of censoring me!

        If you have certain restricted words, that may flag a white-listed commenter’s post as spam. I don’t have any restricted words on my blog’s Disqus.

        I have a clearly-displayed link to a fairly lax Moderation Policy, which gives a list of things to not write in comments. I de-white-list commenters for minor breaches, and black-list them for major breaches.

        I’ll delete one of my replies below.