Calorie restriction (CR)

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Gilgamesh
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Re: Calorie restriction (CR)

Postby Gilgamesh » Thu Aug 21, 2014 7:25 pm

J,

Jetlagged and on prednisone (long story...), but briefly:

No, my concern is more general. Honestly, it's hard for me to know what to do with these discussions about dietary fat without having any isocaloric intervention trial data, nor even well-conducted, very large-scale epidemiological, isocaloric comparisons. Eat more fat, have delayed gastric emptying, feel fuller, eat less, get improved biomarkers because you're eating less (which is hormetic)! Pure CR. If you can do it like the Okinawans do (huge carb-intake), same result. So, I have no "concern" about low carb, except that we may have completely misidentified its mechanism.

Of course, good data on isocaloric diets with different levels of fat might be out there. (And maybe it's even been posted here -- if so, sorry I missed it!) Until I can review it, I feel like I can't say anything meaningful.

GB

P.S.

Julie, my God, THANK YOU for doing so much at the Facebook site! (https://www.facebook.com/apoe4.info) Wow!

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Russ
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Re: Calorie restriction (CR)

Postby Russ » Fri Aug 22, 2014 9:15 am

Gilgamesh,

Just to note that Dr. Mobbs research he described in the podcast was explicitly isocaloric… but in rats.

Looks to me like the NuSi research underway by Taubes and Attia on real people may contain the first real answers to your questions…

http://www.wired.com/2014/08/what-makes-us-fat/

Meanwhile, while I recognize the scientific merit of these studies and think they should indeed be both interesting and useful, when I put my practical hat on I think an important part of the equation is how different diets effect one in a way so as to seek more or less calories naturally. Real ability to naturally adhere to any regimen over the long term is likely important to its true utility. Systems that work with nature rather than fight it seem most likely to work.

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Re: Calorie restriction (CR)

Postby Ski » Fri Aug 22, 2014 9:40 am

These studies are more than likely going to be aimed at the general population and is why even with Attia's very in-depth analysis of cholesterol function, does not have an answer as to why so many of us here have discordant cholesterol responses to ketogenic type diets. Its either IR or "I dont know", so I wouldn't hold your breath on the results of these studies as it pertains to the E4 population.

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Re: Calorie restriction (CR)

Postby Julie G » Fri Aug 22, 2014 12:47 pm

Waves G, sorry you're not feeling well :( Thank you for your kind words re.our Facebook page- a labor of love. All, please check it out if you're not in the habit. It's chockfull of non-controversial strategies and current AD/ApoE4 news. I'm no longer double posting there & here due to time restraints: https://www.facebook.com/apoe4.info?ref=ts&fref=ts

When you mentioned "isocaloric" I immediately thought if the same set of studies that Russ referenced because of their very controlled nature. The result of one will be available around Christmas. It should be telling. But, Ski has an excellent point. Until we have a RCT with E4 subjects, we can only try to glean pertinent information that may or may not apply to us. A cursory search of published research reveals two such supposedly isocaloric studies.

Here's a large meta-analysis of 19 different randomized trials, 316 subjects, that pitted LFHC vs HFLC isocaloric diets. The results (underlined below/my emphasis) indicate a generally worsened atherogenic profile on LFHC. Keep in mind, these subjects were type 2 diabetics and APOE status wasn't stratified.

Influence of Fat and Carbohydrate Proportions on the Metabolic Profile in Patients With Type 2 Diabetes: A Meta-Analysis
http://care.diabetesjournals.org/content/32/5/959.full

RESULTS Changes in values for A1C, fasting plasma glucose (FPG), and total and LDL cholesterol did not differ significantly between the LFHC (24% F/58% C) and HFLC (40%F/40% carbs) groups. However, the LFHC diet significantly increased fasting insulin and triglycerides by 8% (P = 0.02) and 13% (P < 0.001), respectively, and lowered HDL cholesterol by 6% (P < 0.001) compared with the HFLC diet. There were positive associations among the magnitude of changes in FPG, fasting insulin, and triglycerides for the diets analyzed. However, stratified analysis indicated that the increase in triglycerides was insignificant when accompanied by energy intake restriction.

Here's another supposedly isocaloric comparison of the two approaches with a hypocaloric twist. This was much smaller; 55 subjects, who were identified as obese, but otherwise healthy. When both groups concurrently practiced CR, the results were less dramatic, but the HFLC group still prevailed in decreases in TGs, CRP, and increases in HDL and adiponectin.

Consuming a hypocaloric high fat low carbohydrate diet for 12 weeks lowers C-reactive protein, and raises serum adiponectin and high density lipoprotein-cholesterol in obese subjects
http://www.sciencedirect.com/science/ar ... 9513002230

Results
The age range of subjects was 21–62 years. As a percentage of daily calories, the HFLC group consumed 33.5% protein, 56.0% fat and 9.6% carbohydrate and the LFHC group consumed 22.0% protein, 25.0% fat and 55.7% carbohydrate. The change in percent body weight, lean and fat mass, blood pressure, flow mediated dilation, hip:waist ratio, hemoglobin A1C, fasting insulin and glucose, and glucose and insulin response to a 2 h oral glucose tolerance test did not differ (P > 0.05) between diets after 12 weeks. The HFLC group had greater mean decreases in serum triglyceride (P = 0.07), and hs-CRP (P = 0.03), and greater mean increases in HDL cholesterol (P = 0.004), and total adiponectin (P = 0.045) relative to the LFHC. Secreted adipose tissue adiponectin or TNF-α did not differ after weight loss for either diet.

It's very interesting to note that many of the advantages of the HFLC dwindle when compared to a hypocaloric LFHC diet. STILL, the evidence leans towards HFLC as improving IR and increasing HDL- BOTH of which have been implicated as important strategies in AD prevention- especially for E4 carriers. However, If that benefit comes at a cost of driving up LDL-C/LDL-P...we must carefully weigh our strategies. I see lots of very smart members here hedging their bets in both directions until more evidence becomes available.

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Re: Calorie restriction (CR)

Postby Russ » Fri Aug 22, 2014 3:49 pm

Julie, Ski, Gopod thoughts and agree. FWIW, I'll know I'm on to something interesting when I see my HDL move at all. I've been at 45 +/- 1 for over 3 years no matter what I do so far. Perplexing, and probably tells me something, but have no idea what? For now, I'm hoping to see it do something if I can get into deeper ketosis, but no reason to guess that it will.
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Re: Calorie restriction (CR)

Postby Tincup » Sat Aug 23, 2014 9:44 am

A couple of comments. A hypocaloric HCLF diet may be fairly LC when looking at absolute values rather than macro percentages. I think it is a lot more comfortable to do a hypocaloric diet. From Gary Taubes, "Good Calories Bad Calories"
The implication is that we will experience no hunger if we eat nothing at all—zero calories—and our cells are fueled by the protein and fat from our muscle and fat tissue. If we break our fast with any amount of dietary protein and fat, we’ll still feel no hunger. But if we add carbohydrates, as Drenick noted, we’ll be overwhelmed with hunger and will now suffer all the symptoms of food deprivation. So why is it when we add carbohydrates to the diet we get hungry, if not irritable, lethargic, and depressed, but this will not happen when we add only protein and fat? How can the amount of calories possibly be the critical factor?


My own "goal post" or end point experiments - fasting contrasted with "Carb Nite" show interesting results. All the 3 Carb Nites I've tested result in trigs off scale low - <50, HDL in the high 60's or 70's, lowered TC. Fasting results in trigs as high as 170, HDL in the 40's and higher TC and calculated LDL. Last Sat night was another Carb Nite. Results were typical for a Carb Nite on Sunday morning. Monday I fasted and then tested on Tuesday morning, so a 36 hour water fast. The trig spike wasn't as great (100) and the HDL's stayed high, in the 70's. Two things were a bit different from prior fasts. One, the Carb Nite was close in time and I may still have had some stored glycogen. Second, I did a super slow to failure strength workout on Monday afternoon. Either of these could have kept the HDL's up. In addition to home testing, I pulled an NMR test on Tuesday, but have not yet gotten the results.

If I were going only by traditional lipid tests as an indicator, I'd Carb Nite every night. Obviously not a good plan.
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Re: Calorie restriction (CR)

Postby Russ » Sat Aug 23, 2014 10:08 am

George,

Now that is very interesting. I am still intrigued by the Carb Nite concept, but getting back into ketosis after last one has been slow. I may go a little longer this time then carb up again and see what happens the next day.

Also sounds like I need to get one of these little home cholesterol meters - even if not completely accurate, sounds like it's giving you some consistency in changes. What brand do you use?
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Re: Calorie restriction (CR)

Postby Tincup » Sat Aug 23, 2014 11:05 am

Russ, I use CardioChek. It has separate strips for TC, TG & HDL. The hole you need to poke is much larger than needed for glucose or ketones. The strips come with a pipette with a line. The blood is taken into the pipette via capillary pressure. There are two air holes at the line on the pipette. To put the sample on the strip, you cover the air holes and then squeeze the bulb of the pipette.

Here are testing suggestions for accuracy http://www.testsymptomsathome.com/pol91_tips.asp I think one common error for getting low readings is to milk the blood. Getting the blood pumping first, then pressing from the hand into the finger minimizes this - otherwise you tend to mix the fluid with the blood & dilute the blood.

I don't worry about getting back in ketosis. I've been keto-adapted for 5 ish years. Nothing I've done has made me have to readapt. If I really wanted to, I'd just do a HIIT to burn up any excess carbs.

I had a serum ketone reading of 1.0 last Tuesday after my 36 hour fast. That would have likely been higher if I'd done the fast and tested with more days separating the Carb Nite and the fast. For example, my ketones were at 1.7 this morning and I had a normal dinner last night.

As I write this, it might be interesting to correlated ketone and lipid readings. The presence of ketones generally indicating a lack of insulin (except in Stavia's unusual case).
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Re: Calorie restriction (CR)

Postby Gilgamesh » Sat Aug 23, 2014 2:10 pm

Russ, yes, I knew about the upcoming Taubes work. CAn't wait to see the results. (Taubes spoke at the most recent CR Society conf. at the Buck institute. Great guy.) And, wow, Julie, thanks! A couple very cool articles I had never seen, and that might really change my thinking. Might... And you know how much I've looked into and believe in CR. Maybe the CR Society mantra of "it's calories calories calories" needs modification (obviously, in non-CR conditions it would! But we're not talking about that). As you note, the one study is in diabetic subjects, and there are some other qualifications, so I'll need to read these papers carefully. Also, it's not just the isocaloric criterion that matters, but also the effective energy intake, gaged by resulting weight. (I wish all researchers were as CR-aware as Spindler. [1])

Re the idea that it's the lower abs. amount of carbs. Doesn't make a lot of sense to me: they're smaller people! Shorter, thinner boned -- not just skinnier. But it's certainly higher quality carbs. But then we should ignore the studies with low-quality carbs, just like part of hte HF movement's founding story begins with the history of flawed "Go grains!" research: it compared bad diets with fat (sugar and trans fats) to good carbs.


Russ, I can't listen to podcasts for a bunch of reasons, childish stubborness maybe, but mostly, I think, it's just the slowness compared to reading speed, which drives me up the wall. And I want to be able to right-click-Pubmed/-google stuff. (Google Now is almost there, of course.)

Anyone know of a podcast player that plays at faster speeds and has good pitch readjustment? BeyondPod?

OK, I've been warned that 60 mg. of prednisone can make someone short-fused, to put it mildly. Shouldn't interact with people in any way socially. Will be a hermit for another couple days. And pardon typos.

GB

[1] I want to see language like the following in all diet studies. I think: OK, here's someone who knows what he's doing. (Weirdly, BTW, Spindler does NOT think CR will extend maximum lifespan much in humans!!)

http://online.liebertpub.com/doi/abs/10 ... .2012.1386
"The control and treatment groups were iso-caloric with respect to one another. A 40% calorically restricted and other groups not reported here did experience life span extension. Body weights were unchanged relative to controls for all but two supplemented groups, indicating most supplements did not change energy absorption or utilization."

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Re: Calorie restriction (CR)

Postby Tincup » Sun Aug 24, 2014 7:23 am

Stavia,

Thanks! I've never done 23andMe, so ordered a kit and signed up for the diet analysis. We'll see if it times out right for a free analysis.

Russ,

I did another Carb Nite last night and tested with the CardioChek again this morning. Results were in line with previous ones. TC 169, TG <50, HDL 65 LDL calc 94 Blood Sugar 96. The fasting sugars after a Carb Nite can vary greatly - 70 on up. My normal fasting BG is 70's & 80's.
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