In ruminating on keto/carnivore type diets, EvilSheldon commented that he thought the main – 95% – mechanism for the effectiveness of those types of diets is getting people to eat less. I guess the implication of that is that the effectiveness of low carbohydrate diets is due to the energy balance theory of metabolism – Calories-In-Calories-out (CICO) and I think someone followed up with a comment about CICO. Anyway, being an advocate and practitioner of keto along with time-restricted eating and fairly regular periods of pure carnivore, it triggered me – as many of the articles and comments here do – to think about my premises and how I understand these things to work. Of course, it started as an entry in my ‘Random Thoughts’ collection of half formed ideas but grew in length as I fleshed it out and became more appropriate for a single-issue topic.
What follows is a non-exhaustive set of thoughts about keto, specifically in regard to its impact on how much we eat and what it says in relation to the CICO theory. For completeness, the alternative theory about nutritional intake and metabolism is loosely known as the energy partition theory (I don’t think it has a cool acronym yet, so clearly can’t be valid science), where hormone production and signaling is the main driver of metabolic health, including obesity or lack thereof. In this context, the quality/type of the CI part of CICO and how it impacts hormones and signaling in the body is an important question. I’ll largely leave out what I think are a lot of important metabolic benefits of keto type diets and focus on caloric intake and CICO.
Now of course, CICO is at some level tautological. The question is really does the complex human metabolic system respond and react to CI in such a way that it is physically possible to naturally control both CI and CO in the long term independently of the composition of CI. If CI < CO, then you will lose weight, for as long as your body will allow you keep CI low and CO high through sheer willpower even if you destroy your metabolic system in the process – but we’re not focusing on general metabolic health. I think that’s EvilSheldon’s proposition – keto allows you to more easily, some might say effortlessly and naturally, control CI. I will quibble with the percentage but that’s not important – it is certainly a benefit of this type of eating.
The main problem with CICO is that body is not a bomb-calorimeter; a pound of cardboard has a caloric value, but if you stuff it into your pie-hole (CI) you will get minimal usable energy from it and CO will ~= CI, after it rips your intestines to shreds. The implication that people are making when they talk about CICO – eat less, exercise more – is that this is all that matters vis-a-vis weight loss. They cast it as a matter of will power, disregarding what the CI do to hormone levels and signaling which will in turn change what CO is. Very rarely do people mean or even understand true CO when they say eat less, exercise more. They really mean “starve yourself and get off your fat ass and exercise”.
As an illustration, consider Type 1 diabetes. This is an autoimmune disease in which the pancreatic beta cells responsible for insulin production are destroyed by the body’s immune system. Insulin is the signaling hormone that tells the cells of the body what to do with energy, CI, especially if the CI produces high blood glucose levels (high carb), both at the muscle and the fat tissue. Without insulin, you will not store energy. With high insulin (signaled by high blood glucose levels from high carb CI), you will store CI in your fat tissue and very little will be available for immediate energy needs. There’s a thing called diabetic bulimia, diabulimia. With this disorder, the type 1 diabetic will deliberately under-dose their insulin. Let’s never mind the very dire downstream impact e.g. death – under-dosing insulin allows the diabetic to eat whatever they want in whatever quantity they want, and they will not gain weight. The existence of this effect should put the simple CICO theory to rest immediately. CI is very high and ‘traditional” CO can be minimal – they can sit around and play video games or stare at the wall all day – and they will not gain weight. One can argue, correctly, that CICO really does hold, CO must be a prodigious amount of shit. But that’s not what is meant by CO traditionally in the way it’s commonly talked about – we never measure true CO, just manifest physical activity.
As another illustration, consider basal metabolic rate – this is the energy your body uses just to maintain itself with 0 outwardly manifested physical activity, an intrinsic CO. There are studies that show an increased metabolic rate on keto style diets (though not fully established at this point). One of those showed a 300-400 calorie increase in metabolic rate on keto style diets (Figure 3) – that’s roughly the equivalent of 30+ minutes of moderate exercise per day. By way of explanation, since the basal metabolic rates in all groups decrease, just 300-400 calories less in the very low carb arm of the study, there was a run in period where all groups were monitored to establish baselines and then lost 10-15% of body weight – that lowers you basal metabolic rate since you have less to maintain – followed by isocaloric diets with different macro nutrient composition from standard high carb town to very low carb/high fat. The latter group maintained very close to their initial pre-run-in metabolic rate while the other groups dropped by several hundred calories. That’s a very significant effective increase in CO that is never measured or considered by traditional “exercise more you lazy bastard” CICO advocates. Yes, CICO still holds, but not in the way we are conditioned to think of it.
Analogous to the above is the thermic effect of food. This is effectively the amount of energy the body must expend to process the food you intake to make it available to the body. Fat and carbs have a low thermic effect – they are relatively cheaply processed by the body and used or stored, whereas protein has a high thermic effect. The body will expend a lot more energy to process protein. So same CI will lead to very different – and not accounted for by traditional CICO advocates – CO.
Another example is ketone production – the ‘keto’ in keto diets. Background: Ketones (largely acetone and Beta-hydroxybudyrate) are produced in the liver by the oxidation of free-fatty acids. Free-fatty acids are released from your fat cells during lipolysis. Lipolysis only occurs in a low insulin environment since high insulin levels suppress the the activity of lipase, the enzyme that breaks down triglycerides into fatty acids and glycerol. So insulin signaling tells the fat cells to take up glucose from the blood and store it as triglycerides and in addition prevents lipolysis by blocking lipase activity. If insulin is high, you will store fat and you will not burn it. High serum insulin is triggered by high blood sugar levels since even a small amount of excess blood glucose can kill you. A low carb ketogenic diet is effectively an insulin lowering diet since the CI do not produce any significant increase in blood glucose levels. In contrast, a high carb diet, especially simple carbs and very frequent eating, will maintain high blood glucose levels and hence is a high insulin diet that will effectively shut down the possibility of fat burning (along with a bunch of really bad side effects of chronically elevated insulin – but we’re talking about CICO here…). So with that background, what do ketones have to do with CICO? Well, ketone bodies are effectively little packets of energy – they have a ‘caloric’ value. What if you don’t need that energy? Unlike glucose which will be stuffed into fat cells, the ketones will be excreted. One way to test ketone levels is urine strips, so you are peeing out little bundles of energy. You also breath them out. But that CO is never measured/considered in the CICO ‘calculation’.
As an aside and against the spirit of avoiding general health as opposed to just focusing on fat loss/CICO, I’ll mention dementia. There’s a growing understanding of dementia as a metabolic disorder. Basically, the brain is starved of energy and hence brain tissue begins to die – I’m sure you’ve all seen the images of shrinking brains and destroyed tissue. But why? Well, if the brain is relying on glucose for energy, it is relying on insulin signaling; even the brain cannot take up glucose without insulin telling it to. However, if insulin is chronically (over a lifetime) elevated, the brain can become insulin resistant – it responds less effectively, if at all, to insulin telling it take up glucose. This is effectively what happens in Type 2 diabetes as cells in the body become insensitive to insulin signaling after a lifetime of being continuously bathed in it – Type 2 diabetes is not a disease of too little insulin, it is a disease of too much. The parallels are such that some have taken to calling some types of dementia Type 3 diabetes. What do ketones have to do with it? Well, ketones do not require any hormone signaling to be taken up by the brain. Indeed, the brain is glucose-sparing; if a healthy individual with normal insulin and glucose levels is given exogenous ketones, the brain will preferentially shift to taking up ketones for energy. So while ketogenic diets may not be able to reverse dementia (though some studies indicate promise in slowing or halting progression), they may play a part in avoiding it in the first place.
So in conclusion – bet you were wondering if you’d ever see those words: Yes, low carb/ketogenic diets are very effective at controlling the CI part of CICO as EvilSheldon proposes. You don’t really need a complicated study to see that. Just eat a nice fatty steak and see what happens if someone puts another in front of you – it’s not that you can easily resist it, you just really don’t want to eat it. But if you just ate a bunch a fries and someone puts another basket in front of you or a piece of bread, you’re going to keep grazing. But it also alters the CO side in ways that are not usually accounted for by the “eat less, exercise more” (which will, incidentally, drive hormonal balance in directly the opposite way of what you are trying to achieve) crowd. And more importantly promotes a stable hormonal balance that doesn’t drive disorder. You will not win the CICO battle on a modern American diet, evolutionary biology will thwart you at every turn and you will lose. To me, controlling how much you eat is not the primary benefit of ketogenic diets, it is the metabolic stability that they promote and the energy partition/storage that they enable because of the macro-nutrient composition; controlling CI easily/naturally is just a side effect of that.
#ketolife
#🥑
I eat lots of those.
🤮
UCS, UCS, whatever are we going to do with you?
A fresh, firm avocado with a dash of salt, maybe a sprinkle of chipotle or black pepper; sublime.
Now over-ripe mushed up guacamole crap, I’m right there with you at the vomitorium.
🤢🤮
Avocado in all of it’s forms is a vomitous slime-pear of horrible taste and texture.
Also #🥩
And those.
Calories-In-Calories-out observation /thought: I’ve weighed ~132, my powerlifting weight class, since high school. I’ve never changed diets or even really paid attention. (Certainly not enough to have a ‘plan.’ My bro is the same, but ~114 (with several plans.)) I’m pretty indifferent about ‘what’ food I eat. Facetious but truthful, when folk ask what sort of food I want, I sometimes answer “Caloric.” If I get above 140, rarely, I tell myself to eat less. If I get in the 120s, the opposite. I stay in the 130s and that’s just fine. (I eat *a lot* of candy.)
Birthday humblebrag, I s’pose, but as a reasonably smart kid, raised gymnast powerlifter, McBusy Fingers and all, my body burns off TONS of energy just *being.* I suppose I’m back onto my pushup kick. Now a daily thing, I remembered how nice it was to have those productive, positive chemicals flowin’. Now, especially by the end of Walmart pickin’, I’m in the best overall shape I’ve been in since college, likely.
Weight issues, how your body handles the prosperously abundant calorie trough of modern life, is 90% genetic, methinks. Barring something pretty dramatic, I won’t have to worry about my weight, and I’ll keep a full head o’ hair, if Mom’s dad and bro hold out. I do have that going from me. Dad’s side is all bald.
90% genetic
I might quibble with the exact percentage but it is certainly part of it. I think there’s something like 50%+/- of the population that is ‘carb sensitive’, genetically. They are going to have a problem in the modern world of high carb, high sugar, and hence high insulin.
The other issue is the focus on weight. Sure, people may not need to pay attention to macro-nutrients too closely to maintain weight, but that is not, ultimately, the real goal – it is often/most of the time a very good indicator of the actual goal with is metabolic health. There’s such a thing as thin-outside, fat inside, where ‘fat inside’ includes both visceral fat (very bad for you) and hormonal imbalance.
So maintaining weight is an advantage of ketogenic diets, certainly for a significant part of the population. But I think it is also a valuable tool for general metabolic health for everyone – the value of low insulin cannot be over-estimated. You can get a lot of that just from not eating all the time regardless of macro composition, though macro composition can make that easier.
Yeah, I made the number up, but we both agree it’s a big number. (I’d say BIG big.) This is another thing I know very little about cuz I’ve never ‘had’ to pay attention to it, to research and check with myself.
It is interesting how once tremendously advantageous, ‘carb-sensitive’ etc, genes are a big detriment to our world where food is plentiful, cheap, and the ‘cheapest’ (most readily available) food is the worst for many.
It’s a remarkable truth that an ‘overabundance’ of food is of serious concern. I wonder if Ancient folk would understand. (They would after a year or three.)
If it’s white it ain’t right. I try to avoid potatoes, rice and bread as much as possible. Heavy on green salads, a chunk of meat and some fruit for dessert. The big problem is the lack of calories out. I don’t get much physical work done, for other reasons. Sitting is easier and less stressful than standing/walking so I sit more.
Stamina is a word I seldom use in a positive manner. OTOH no one will listen to my complaints and I don’t blame them. I wouldn’t either.
“If it’s white it ain’t right.”
“Pssst! We love this guy! Get ‘im on the p̵r̵o̵p̵a̵g̵a̵n̵d̵a̵ Community Literature phrasing team!” /DNC Influencer
Setting aside potato’s for a second, this is my preferred diet. Just meat and veg. I could care less about bread or rice, and think that they are just filler.
As for potato’s, I do love my pomme de terre.
Whycome you hate cheese?
🥺
Taubes was saying more or less this in Good Calories, Bad Calories damn near 20 years ago now.
That said, there’s probably not any single macronutrient profile that’s a silver bullet. Geographical and climatological conditions have affected the availability and consumption of calories from various sources since our ancestors were getting frisky with Neanderthals. Where meat was relatively scarce, humanity has been consuming fuck loads of grains for ~10,000 years, and yet a 60% obesity rate with 20% of the population having Type 2 Diabetes and another 20% inching their way towards it with metabolic disorder is a phenomenon so recent there are those in their elder years who have witnesses its origin and metastasis.
Insulin control. For our ancestors, it was paucity of calories across different macro-nutrient profiles; that kept insulin under control and can be mimicked by time-restricted eating. Which is easier to do low carb, which I think was partly ES’s point.
Even then, what would be considered healthy relative to today 10000 years ago eating ‘fuck tons’ of grains was not as healthy as those contemporaneous populations that were not eating fucktons of grains, whether it be dentition or stature and brain size.
That’s probably fair, although limitations of historical record would make comparisons more difficult. It’s also a good reminder that, in spite of the drawbacks of western food production, we’re kind of lucky to have this as a major social problem rather than starvation and malnutrition.
Apropos of little, being as the plural of anecdote is not data, let alone the singular, I decided to cut my sugar and refined carb consumption about 10 years ago, among other dietary changes for which I was due entering my 30s. Went from eating white bread and white buns at least 2x daily with a side of potato or corn chips, drinking 3 cans of Pepsi daily, eating lots of processed lunch meats and cheese, and desserts as desired, to 1/2 a bottle of Coke a week, wheat bread and chicken breast for lunch, broccoli/banana/pineapple/whey protein smoothies for dinner, and nuts, fruit and peanut butter for snacks. Didn’t gain or lose any weight that couldn’t be attributed to other factors, and haven’t seen any difference in energy levels or overall wellbeing (I don’t see physicians regularly, but my bloodwork is never stellar when I do). Who the hell knows.
Generally, ruminants should not eat a keto diet.
I fundamentally disagree with every diet concept that calls for extreme limiting of one type/source of calories.
I have no studies at hand to reference. I have no special training to rely on.
I just accept that evolution gave us bodies that can consume anything and everything and that, long term, you need to consume a balance of everything available. I will acknowledge that the modern American diet fails at this goal spectacularly.
I am old and set in my ways. I refuse to listen to any arguments that challenge my preconceived notions.
So there.
Thanks for the write up. It was very informative.
It’s entirely beneficial to absolutely avoid anything containing added sugars.
I just accept that evolution gave us bodies that can consume anything and everything
I agree. The new variable is abundance. Consuming anything and everything will not work where you can consume anything and everything whenever you want rather than when it is available. We evolved having extended periods of time with very low insulin by necessity.
you need to consume a balance of everything available.
I would quibble with the term ‘need’. In the world of scarcity that we evolved in, you need to simply from the perspective of getting enough energy. But there’s nothing magic about ‘balance of everything available’. And, in modernity, balancing everything available is downright bad for you.
Thanks for the write up.
You’re welcome.
I don’t know if I’ve ever managed to attain ketosis. I have managed to crank down the caloric intake side of the equation though.
Don’y worry. The old me that became a fat bastard was eating way too much by any metric.
I have gone from ~300# to ~290# (with water weight fluctations) over the past 45 days. While you hapr about weight loss not being the only thing that matters, but as someone who peaked at 360#, bringing that number down by continually refining habits is a pretty big deal.
Good for you!
Hopefully I can keep the trend up and reach a healthy weight.
I honestly don’t know what I should weigh for my skeletal structure. I’m guesstimating 200-220ish as my initial target. I can refine that goal if I get within striking distance of it.
IMO, if you had attained ketosis, you would have seen better gains in that time frame. Still, don’t let that dissuade you from trying, maybe focus harder on keto induction processes.
Always be wary of over protein intake.
Well done on significantly lowering that number. *fist bump*