The end of the diet wars?

[Julie G]

This blog post from Calories Proper beautifully dissects the recent work by Gardner, et al. and concludes that the best diet for an individual may be determined by where they fall on the spectrum of insulin resistance. Lagakos summarizes that a LF diet leads to more weight loss and improved metabolics for someone who is insulin sensitive; whereas a LC diet does the same for those who are insulin resistant.

This supports a theory that I've been playing around with for years. I see younger E4 carriers do well on a LF diet until IR sets in...and then LC seems to restore insulin sensitivity. This is great stuff. I’m looking forward to Gardner’s work being expanded.

[marthaNH]

Well that's interesting. I suppose it could mean that the optimal diet could theoretically be different for the same person at different times, assuming there's a healthy pancreas at both points. Hm. It might take a little chewing to get this fully digested.

[cdamaden]

Does that also mean one should cycle their diets over time?

[Surfrank57]

Exactly what I pointed out to Dr. Bredesen. If you stay calorie restricted and low carb for enough time, your leptin is going to bottom out. Which then starts a whole cascade of hormonal changes, usually not beneficial to health or weight stability. All bodybuilders cycle carbs at some level for this exact reason.

We call this consistent dieting with very little change, "the jockey or model theory". These people have to eat increasingly small amounts of food to maintain weight, after long bouts of calorie restriction because of hormonal changes that take place over time. One of the best jockeys in the world, Lafitt Pincay Jr. was down to a 600 calories a day diet to maintain weight to ride. He said he only had enough energy for about two minutes of activity at a time. I have seen female gymnasts down to that level as well to maintain weight because they were put on strict diets, way too young. With models this is just the norm, so they turn to diet pills, legal and illegal to stay wafer thin. Therefore, I told Dr. B that his patients might benefit from small cheat meals or small diet breaks. He agreed and said he thinks a sensible approach is best for the long term. That is why the diet guy he recommends is more moderate than what we do.

Frank

Frank

[Tincup]

Full paper: http://onlinelibrary.wiley.com/doi/10.1 ... 05.79/epdf

Research Methods and Procedures

Forty-four obese, healthy normoglycemic women 23 to 53 years old with BMI of 30 to 35 kg/m2 were screened, and 21 of them were enrolled and completed the 16-week inter- vention. Subjects were included in the study if they were IS as determined by a fasting insulin level of <10 uU/mL (N = 12) or IR as determined by a fasting insulin level of <15 uU/mL (N =9).

Subjects from both groups were then randomized to receive a hypocaloric diet (400 kcal deficit/d) comprised of either 60% CHO, 20% fat, and 20% protein (HC/LF) or 40% CHO, 40% fat, and 20% protein (LC/HF) for the following 16 weeks.

My comments: sample sizes are small and both diets are high carb in my book (and not absolutely horrible from an insulin standpoint, though Kraft would have said IS is <6)...

[cdamaden]

I wonder how the cyclic ketogenic diet would pan out. It seems to be big in the weight lifting arena. I didn't see any studies on its effectiveness.

[Surfrank57]

Short answer, very effective in my opinion.You still retain all the benefits of keto: Insulin control, weight control, glucose control, and the variety keeps you happier. People on this site are very dedicated, you have to remember in the general public, being on any diet is torture for them. So when you know you can have some carbs every 4th or 5th day, it is more sustainable to them.
Frank

[Tincup]

I wonder how the cyclic ketogenic diet would pan out. It seems to be big in the weight lifting arena. I didn't see any studies on its effectiveness.

John Kiefer writes about this in "The Carb Nite Solution" (carb spike every 7 days) http://carbnite.com/ and "Carb Backloading" (pushing carbs till the end of the day - more for heavy training) http://carbbackloading.com/. He does podcasts with Phoenix area doc, Rocky Patel http://body.io/authors/. Patel uses these approaches in his clinical practice to good effect. He starts out trying to get people to move their carbs to later in the day, perhaps using "Bullet Proof coffee" (only fat in coffee) in the morning. Then tries to get them to go more LCHF with periodic spikes. Depending on how insulin resistant they are, he may vary the time between "carb nites" (longer for those more IR).

[Julie G]

Great comments and questions raised, team. I’m convinced that metabolic flexibility; the ability to switch from a glucose-based metabolism to a lipid-based metabolism is a key indicator of health. I’m not sure when or if metabolically damaged ApoE4 carriers can or should switch from one fuel to another. Once insulin resistance (IR) has been healed, my guess is that this would have to be carefully explored. The experiences of healthy people may not directly apply to some members of our population.

Don’t forget the J. Stanton presentation that demonstrates mitochondrial deficiency appears to underlie IR. This may be even more true for ApoE4 carriers. We first lose the ability to metabolize lipids, then glucose, before symptoms of insulin resistance appear. Understanding that sequence is huge. This may be why MCT or coconut oil can play a part in healing IR. Both bypass the “broken” route of LCFA and glucose metabilization and go directly to the liver where it is available immediately to be used as fuel.

Also bear in mind that some researchers, like Goetzl, contend that practically all dementia patients exhibit central IR up to ten years before symptom onset. Healing that is certainly our most important prevention and/or reversal strategy. Once accomplished, it remains to be seen if we can return to or alternate a low carb and low fat approach. G seems to be having some success with that approach. Anybody else?

[cdamaden]

When do you know if your IR has been healed?
As you may recall, I've been borderline pre-diabetic with A1C of 5.7 and fasting blood glucose of 95-110 mg/dL. Shifting to LCHF and intermittent fasting, my FBG has been in the mid 70s to low 80s. I've seen a few 1 hr spikes at ~125 but then it drops quickly below 100. So I'm not sure if I was/am IR.
thanks,