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cosmoliu

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I sign with an M.D. after my name, but up until a couple of months ago I knew squat about diet and nutrition. I weigh 140# at 5'8", so have never given any thought to diet from a weight loss perspective. Along those lines, I have pummeled my pancreas with abandon for years, starting with a glass of OJ first thing in the morning for as long as I can remember. The simple carb infusions I used to punish my system with throughout the day surely led to insulin spikes on a regular basis. Diabetes, metabolic syndrome and insulin resistance were far off academic concepts to me.

Then I ran across some material on diet and the prevention of Alzheimer's disease. As I got more into it, it began to make a lot of sense. Finally, here is a subject related to diet that has caught my full attention. Who doesn't want a high performing brain into the eighth decade and beyond? I sure do. It turns out that the modern Western diet, as bad as it is for the pancreas, is equally horrible for brain health. Adults with Type 2 diabetes are at a 50% increased risk for Alzheimer's. And the main culprit? Simple carbs. And high fructose corn syrup is the worst actor. Of course, the subject is very complex, but I will see if I can give a cogent summary.

The term Type 3 diabetes has kept popping up. I'd never heard of it. Google that term and one of the first hits to come up is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/ A review article from 2006, the lead author being from Warren Alpert Medical School at Brown university (@Lorenzzo !). The brain can become insulin resistant, just like the rest of the body's systems, and if glucose is the primary fuel source presented to the brain, it starves. This brain's insulin resistance is one of the many manifestations of what has come to be known as Alzheimer's.

So, how does this relate to the OP? Until we understand how simple carbs affect our diet, basically all weight loss diets are doomed to failure. In homo sapiens' history, we were only presented with simple carbs in late summer and fall. The insulin hormonal system evolved to store those sugars as fat for the coming winter. Think bears, berries, and hibernation. American's per capita consumption of sugar in the 1950s, primarily derived from sugar beets and sugar cane, was something like 70# per year. These days it is something like 800# per year. Credit the food industry. From WebMD: https://www.webmd.com/food-recipes/features/sugar-shockers-foods-surprisingly-high-in-sugar#1 Note: 4 gms of sugar = one teaspoon. Seriously- would you add 6.5 TEASPOONS of sugar to a cup of fruit sorbet??? Start reading food labels- sugar is EVERYWHERE. And these days life is complicated by high fructose corn syrup. The thing is: our systems at least recognize naturally occurring fructose and sucrose as substances our ancestors dealt with. However, our systems don't know what to do with high fructose corn syrup, so the only thing we can do with it is to turn it into fat. The food industry is doing an outstanding job of preparing us for winter. The problem is, winter never comes.

And I need to touch on ketosis. Eliminating simple carbs from the diet is a big first step and, strictly speaking, ketosis might not be necessary to incorporate into our lifestyle if weight loss is our primary focus. But it is a key factor if we have long term brain health as our goal. Dr Jason Fung, referenced above, is one of the rock stars in this arena. Dr David Perlmutter is another. Gut health (the microbiome) is another of Perlmutter's key focuses (foci?). If we eliminate simple carbs from our diet as something our body processes as fuel, we have to replace it with something else. It turns out that if the Alzheimer's brain is unable to process glucose as a fuel source, it does very well at utilizing ketone "bodies" as fuel. Dr Mary Newport is big in this arena, and she has a book based largely on her experience with her husband who was diagnosed with Alzheimer's at age 51. There has been a lot of noise in recent years about "burning fat" that I have mostly ignored. But there really is something to it. It's just that it takes a little effort as there is no pill that magically transforms us into fat burning machines. And N.B.- there is "good" fat and there is "bad" fat. Good fats include coconut oil, MCT (medium chain fatty acids) oil, avocados, fatty fishes (SMASH- for salmon, mackerel, anchovies, sardines and herring) and butter. Yes- BUTTER. But it must be from grass fed cows. That's absolutely critical. Grass fed butter is high in omega 3 fatty acids. Corporate farm butter is high in omega 6s. Omega 6 is not "bad" in of itself, but is bad if it is at too high a ratio with omega 3s. Dr Newport brought her husband back from dementia purely by giving him a couple of tablespoons of coconut oil per day. Sounds like hype, but it's true. Coconut oil is high in MCTs and they can be used efficiently as a primary fuel source. And the alternate pathway is completely independent of insulin. Dr Newport was desperate to find a treatment for her husband's dementia and happened upon some research into MCTs. Now, as a neonatologist pediatrician, she knew something about MCTs as they are a key ingredient in infant formula. She thought "what the heck, it can't hurt", and started her husband on coconut oil, with startling results. Here's the top YouTube hit when I input her name. I haven't watched this particular video, but she has been very compelling in other interviews I have seen her in
So, after this complete sidetrack, you might rightly ask: how does this relate to the OP? Well, first and foremost, recognize simple carbs as the big boogie man of the modern Western diet. Just say NO. That's probably enough to get things started. But if you want to incorporate ketosis into your lifestyle, it will take a little more work. Dr. Steve Fowkes, a biochemist and prominent lecturer on nutrition has said something along the lines of, "most individuals who are aging gracefully are in fat-burning mode". Dr Fung's intermittent fasting formula starts it off: fast for at least 12 hours, up to 16. At that point glucose and glycogen stores are depleted and you are in mild ketosis. Then avoid the temptation for a simple carb infusion. Substitute "good" fats and "real food". Michael Pollan defines that as anything your grandmother would recognize as food. However, I feel that as we progress further into the 21st century in the grip of the food industry, we probably need to default to what our great-grandmother would recognize. Pollan's mantra: "Eat food, not too much, mostly vegetables". Lots of colorful, above ground leafy vegetables. Generally raw. Small, wild caught oily fish. Small because they haven't been around long enough to concentrate mercury. Salmon, but it must also be wild caught. Farmed salmon are again high in omega 6s. Grass fed beef. Eggs laid by "pasture raised " chickens, who are actually allowed to run around picking up bugs and anything else that looks good to them to eat. Beware "Free range". It's not the same. Why? Again, it's the omega 3s.

I don't find this diet limiting in any significant way. And the funny thing is- when you eliminate simple carbs, you don't get hunger pangs. That growl in your stomach is driven by the hunger hormone ghrelin, which is secreted when carbs crash. Which happens after insulin spikes. Which happens when you bomb your system with simple carbs. It's a vicious circle. Jump off that merry go round for good. And don't look back.
 
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Eleeski

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I had to eat a couple cookies to get through that post.

Not sure I want to live on anchovies and kale. I'll take my chances with type 3 diabetes and being wonky when I'm too arthritic to do anything. In the meantime it's the basic food groups: beer, steak, guacamole and chocolate - in moderation of course.

And quality exercise - like bumps and powder.

Eric
 

cosmoliu

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Your choice. I'm not willing to take that chance with Type 3 diabetes. Like I said, I don't find the diet the least bit limiting. i've almost completely eliminated simple carbs with a complete 180 degree flip and, at least in a couple of months, haven't fared any worse for it. That's not to say I don't enjoy a bite of dark chocolate every so often. Or the occasional beer. The key is to avoid those insulin spikes.

As far as a ketotic diet for weight loss, I just noticed after my shower tonight that I've lost some 5# since embarking on this diet. That's totally unintentional- my wife has always joked that I have to run around in the shower to get wet. And this is yet another order of magnitude because 5# from my original 140# is a not insignificant percentage. I really must be burning fat because I definitely have less to "pinch" at the waist than before. I originally stocked a drawer in my office with nut butters and nuts, particularly macadamias, which are one of the most calorie rich nuts of all, because I was concerned that cutting out carbs would leave me with a mid afternoon nadir. But like I said above, I just don't get hungry, and I really find myself at the end of the day having forgotten to delve into that stash. I'm a little concerned that I may need to make a concerted effort to consume more daily calories if the trend continues. Time will tell.

Going to sleep now, but it has occurred to me that I need to post an interview with JJ Virgin tomorrow that I ran across last week. She gets into a lot more detail about actual foods to concentrate on.
 
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cosmoliu

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That interview with JJ Virgin. Any woman with guns like those I'm going to pay VERY close attention to.

The interviewer is Dr Mercola. A snowboarder ER physician friend of mine (@Lorenzzo - that would be Bob) put me on to him about ten years ago. His web site is a gold mine of information on heath and fitness.

I'm not sure I'm fully on board with her on the evils of naturally occurring fructose; most of the other authors I've been following are big on fruits in their original state. Fruit juices are another thing altogether.


Off to a shooting match. I'm mentally composing my next post, on the microbiome.
 

Eleeski

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Heart disease is the biggest killer in the US. Not quite ten times more risky than Alzheimer's but close. It's probably more important to focus on what the real risks are. Kind of strange that the speaker looked to be at real risk for heart disease given her weight. Never mind that she would have a hard time on the hill trying to ski and enjoy a physically active life. I'm not wanting her lifestyle.

Suicide is almost half as risky as Alzheimer's, statistically. Worse, it kills young people not the people at the end of their lives like Alzheimer's. Anchovies and kale aren't the first thing I seek when I'm unhappy.

Sugar is the primary fuel for the brain. Sugar makes you smarter!!! (Alcohol does cross the blood brain barrier faster and has a secondary acetate metabolic process but even I don't recommend it as the primary brain nutrient - even if I think I'm smart when I've had a few.) My father was diabetic. If his sugar got low, he got stupid - and unhappy.

" Salmon, but it must also be wild caught. Farmed salmon are again high in omega 6s. " As a fish farmer, this kind of BS makes me question the validity of everything said. From Shape.com "Omega-3 Fats You may have heard that wild salmon contains higher amounts of omega-3 fats. This just isn’t true. Based on the most recent data in the USDA food database, a three-ounce serving of wild salmon contains 1.4g of long chain omega-3 fats, while the same size serving of farm-raised salmon contains 2g. So if you are eating salmon to get more omega-3 fats in your diet, farm-raised salmon is the way to go."

And I couldn't get past the "fruits are bad for you" in the new infomercial. Why did she choose JJ Virgin as a name? At least she might be physically able to ski but the après might be anchovies and kale.

So now that I'm skeptical, my observations have shown little long term benefit from ketotic diets. Sure, initially the weight comes off quickly (despite the bacon or anchovy eating orgy). But after a while, the person regains all the weight and some. Stress the body (ketosis definitely counts as stress) and the body adapts and reacts. Starvation, even if it is just some key nutrients, will cause a rebound as the body banks against future deprivation. Fad diets pay for fancy infomercials - again and again.

Those who have lost weight and kept it off (that I have seen) lost it slowly over a couple year's span. We probably gained our weight a couple pounds a year. Lose it at the same rate and you will do great in the long run. The "plateau" is just a stable point to make the long term changes to get you where you want to be in a few years time.

Eric
 

wyowindrunner

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https://www.trainingpeaks.com/blog/the-importance-of-carbohydrates-and-glycogen-for-athletes/
The above is a fairly current article (2013) on the importance of carbs in the diet of endurance athletes. Reinforces some of the decades old research that was discounted by a previous poster. These guys all look like a ballon on a string!

Eleeski- Bill Rodgers would get up at 2 AM and eat cookies with milk. (He was running 100+miles a week too!) I will eat them any time!! Was a long time subscriber to Runner's World and dropped the subscription- over a period of 15 years the articles on training and recovery and nutrition usually came back to the same thing- glycogen debt recovery and replacement. The quickest way to replace glycogen is simple carbs- less complex carbon chain. Of course if input is greater than output, the survival mechanism of the body will store the unused portion as fat. When looking at human population groups, those that have/do gone/go thru generational feast/ famine cycles develop a genetic propensity to store excess caloric intake as fat to insure survival. This is also evident in tolerance for different food groups among different ancestral groups. Dairy tolerance is a prime example. Blue Streak's comments on ancestry ring very true!

Carbs take a bad rap when the real culprit is inactivity and a growing trend of sedentary occupations and lifestyles.

The good Doctor Cosmoliu above references carbs as a seasonal addition in modern man's (homo sapiens) diet, however there is evidence of grain storage in Israel 26,000 years ago and an article in Scientific American cites evidence of discoveries in a cave in Mozambique dating back 70,000 years which indicate a varied tuber and grain based diet. Grain storage and a non-seasonally dependent source would allow year around access. Think this is sufficient time for adaptation?

Cal G, the body can improve its use of energy and walking a mile efficiency can improve- look at O2 usage and heart recovery rates as a measure prior to exercise and after exercise. Caloric burn will decrease as the body adapts to the new work load.

The comments on booze/cancer are really out of the weight loss issue of the OP- (Unless his primary source of exercise is running from the bar to the car- hey it happens!) But alcohol does interfere with liver function and carbo processing. It also affects vitamin and mineral loss by accelerating breakdown and loss in urine. a contributor to increased cancer risks?

There are so many things that affect weight -when I was maintaining a 28-35 mile a week average running I could eat anything in sight ( and did) and not gain weight. These were fairly intense miles and not an accumulation of "junk miles"- a couple days of eight miles in an hour and inserting a couple miles in the six minute range in five or six mile runs. Was lucky to be mostly injury free during this time so consistency was achieved. Was in my mid-late 40's at the time.

Snow Country, if you have no underlying or undiscovered issues, increasing your effort and time may help continued weight loss.
'Nuff time on this- gotta go get some miles in.
 

Fishbowl

A Parallel Universe
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Animals that primarily eat plant base diets are heavy, slow to move, dim witted, dry skinned, dull eyed, ponderous! All the qualities you need to graze and consume huge amounts of carbohydrates. Elephants, cows pigs...you get the picture.

Animals that primarily eat meat based diets are quick, lean, clever, bright eyed, agile, silky coats, vibrant, alive! All the qualities you need to catch and eat prey. Tigers, panthers, lions, wolves.....you get the picture.

Humans are cable of changing their physiology with their diet choices. So, do you want to be, a cow or a tiger?
 

CalG

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Animals that primarily eat plant base diets are heavy, slow to move, dim witted, dry skinned, dull eyed, ponderous! All the qualities you need to graze and consume huge amounts of carbohydrates. Elephants, cows pigs...you get the picture.

Animals that primarily eat meat based diets are quick, lean, clever, bright eyed, agile, silky coats, vibrant, alive! All the qualities you need to catch and eat prey. Tigers, panthers, lions, wolves.....you get the picture.

Humans are cable of changing their physiology with their diet choices. So, do you want to be, a cow or a tiger?

Would you care to turn that into a longevity argument?
There may be a connection. Hmm Tiger for a few years, or blue whale for 100. Think of the relationships that could be developed.

Animals that LICK water eat meat. Animals that DRINK water have plant based diets. There are exceptions, to better show the rule.
 

wyowindrunner

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Animals that primarily eat plant base diets are heavy, slow to move, dim witted, dry skinned, dull eyed, ponderous! All the qualities you need to graze and consume huge amounts of carbohydrates. Elephants, cows pigs...you get the picture.

Animals that primarily eat meat based diets are quick, lean, clever, bright eyed, agile, silky coats, vibrant, alive! All the qualities you need to catch and eat prey. Tigers, panthers, lions, wolves.....you get the picture.

Humans are cable of changing their physiology with their diet choices. So, do you want to be, a cow or a tiger?

Really- Ever watch pronghorn run? Bison at 40mph? Horses? Any number of African antelope? A cheetah may have a initial short burst that will exceed a pronghorn's top speed (This will vary by individuals) but they are quickly done. Strictly sprinters. A pronghorn can run for miles and miles at 30-40 mph. Have personally experienced this in the Vermillion creek country on the WYO- COLO border- 'Lopes think its a game -will run beside you at a distance in the prairie- you speed up- they speed up- you slow down and they slow down. Not very slow, plodding or any of the other adjectives you attributed to them. On the other hand, now that the subject is broached, I can think of several examples of our specie that are slow, dim witted, lethargic, and have serious aversions to any type of vegetable matter on their dinner plates!
 

wyowindrunner

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https://www.agingcare.com/articles/re-examining-coconut-oil-for-alzheimers-theory-172016.htm
An update on Dr Mary Newports and her position on coconut oil. Alzheimers is terrible for the afflicted and their loved ones. I think there are a significant number of charlatans on the periphery of nutritional science. Don't think after a very brief investigation she is one. But any time there is the chance to make some coin from other's desperation the parasites emerge.
 

cosmoliu

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Thanks for that blog link! Yes, I had commented when I put up that video of Dr Newport that I hadn't viewed it. I did before dropping off to sleep, and it was bittersweet to learn that her index patient had died. What that said to me was that his disease had perhaps had a remission, but that it could not be cured. Kind of like AIDS can now be considered a chronic disease that can be held at bay, maybe indefinitely, but not truly cured. At least as of right now. I'm not sure that anyone I've been following is ready to claim that Alzheimer's, once established, can be cured. But there certainly appear to be many who are focused on preventing it from occurring in the first place.

Yes, many of the researchers I've been following in the past couple of months are authors with books to sell, including NY Times best seller Dr David Perlmutter. And yes, one must always calibrate one's BS meter in digesting their input. But that does not negate the fact that SOMETHING in the Western diet is causing an epidemic of obesity and Type 2 diabetes. And now maybe what is coming to be known as Type 3 diabetes. We as a society need to understand that we're awash in sugars. And that the food industry has foisted that upon us, to our woeful detriment. And artificial sweeteners are no less dangerous. Let's not lose sight of the true danger to our health and throw out the baby with the coconut oil bathwater. I see coconut and MCT oil as players in a larger effort to maintain a metabolism, mild ketosis, that is independent of and an alternative to the insulin/glucose energy pathway that, as abused by the modern Western diet, is the source of many health care woes.
 

Eleeski

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Wasn't coconut the villain a couple decades ago? Big witchhunt with full page newspaper ads forcing coconut oil out of foods. Crackling Oat Bran was my favorite cereal until they removed the coconut oil - now bleah.

Maybe the real problem is that people are living too long. Our society's health is good enough to keep us alive well past anything biologically useful. Too old to reproduce and practically too old to assist in child care. Something will break down in the body. Restricting the sugars that fuel the active youth may extend an individual's lifespan but does nothing for the survival of the species. Except maybe crowd out the vibrant youth.

OK, I'm too old. I've got titanium in me, great training techniques and wonderful diet choices to trick my body into thinking it is still young. So far it's working well and I can still enjoy skiing. Eventually the house of cards extending my body will fail. I will thank western civilization (including a nutritional and tasty diet) for the quality extra time.

Back to the thread, donate blood. Guaranteed 1 pound of weight loss. For males and post menopausal women, probably very good for overall health (check with your doctor). Even if the weight loss is fleeting and there are phantom health benefits, you will help out someone needing blood. I'm over 10 gallons over my life - maybe did some good on different levels.

Eric
 

Blue Streak

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Animals that primarily eat plant base diets are heavy, slow to move, dim witted, dry skinned, dull eyed, ponderous! All the qualities you need to graze and consume huge amounts of carbohydrates. Elephants, cows pigs...you get the picture.

Animals that primarily eat meat based diets are quick, lean, clever, bright eyed, agile, silky coats, vibrant, alive! All the qualities you need to catch and eat prey. Tigers, panthers, lions, wolves.....you get the picture.

Humans are cable of changing their physiology with their diet choices. So, do you want to be, a cow or a tiger?
We don't have a choice. Man is a predator. It's what we are.
Some of us may have eyes on the sides of our heads, but I don't.
 

wyowindrunner

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We as a society need to understand that we're awash in sugars. And that the food industry has foisted that upon us, to our woeful detriment. And artificial sweeteners are no less dangerous. Let's not lose sight of the true danger to our health and throw out the baby with the coconut oil bathwater.
Agree-The Agri- Giants have done a masterful job of designing sugar-salt balance to entice people to eat the stuff they make. It's their job and they are good at it! Aspertane- read some research that concluded this stuff mimics some chemical that is found in AZ patients brain- don't remember all the details.

OK, I'm too old. I've got titanium in me, great training techniques and wonderful diet choices to trick my body into thinking it is still young.

The Running Doctor, George Sheehan ( Died of prostrate cancer in '93- his second go- round. Wrote a book about while continuing to live and bike and run. An introvert and philosopher how was also a renowned cardiologist. The guy was a total enigma and very aware of his own contradictions. One of his kids just wrote a book about growing up in their very large-12 kids Irish Catholic household.) Wrote something to the effect that we are born with a warrantee of 70 years and after that all bets are off. I look at some of my contemporaries and wonder how they will make it without following the requisite maintenance schedule. And you are so right. Western science has given us the ability to whip on the microbial invaders that crippled and killed man by the millions. Influenza, polio, smallpox, malaria, (in the western world) killed indiscriminately. We have free will and extend the warrantee by living like you are.
 

Eleeski

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Actually, anchovies and kale aren't even the last food I seek. Thanks to the wonderful offerings of our western society, I have NEVER had to eat anchovy and kale salad! I'm sure if I were starving, I'd love it. But not for health reasons. Or for the taste... I'm not going to dinner with @Blue Streak - unless I'm cooking.

Aspartame is naturally occurring in one of my favorite foods, asparagus. Do I have to give up asparagus too? Diet Coke has saved my life several times. It is my go to stimulant on long drives or flights. We drive around our babies to get them to sleep. Driving (piloting) is soporific for me - that warm comfortable seat, the gentle vibrations, (the altitude if I'm flying)and I'm getting sleepy just thinking of it. Coffee makes me pee too much so Diet Coke it is. Mix in a little sprite for a dollop of pure sugar so I don't get weird insulin crashes (and I like the twist of lemon) and I've survived many travels. Still OK physically.

The naproxen I use a lot is a somewhat toxic drug. But the health benefits of being able to be active despite bad genetic arthritis far outweigh the toxicity. Too narrow a focus can unbalance our lives.

It's not about having a perfect body - it's about enjoying the ride.

Eric
 

Snowfan

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IMO part of the obesity problem is the proclivity to way overthink the issue and complicate it by filling the mind with endless info. I went from 220 to 160. I had to hit it hard. A casual approach did not work.

Cut out all sugar, caffeine and dairy. Eat some fish or turkey, a wide variety of veggies, and a tiny amount of fruit and nuts each day. Drink a gallon of spring, not purified, water, every day. Work out like never before. When you hit your target weight do not go back to sugar and reintroduce other healthy food slowly.
 

KingGrump

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Some of us may have eyes on the sides of our heads, but I don't.

Forget about the sides. Got to grow eyes in the back of you head if you are going to be a ski instructor. :D
 

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