Low Carb More Effective In Weight Loss Than High Carb?

[revenant]

Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial

Objective To determine the effects of diets varying in carbohydrate to fat ratio on total energy expenditure.

Design Randomized trial.

Setting Multicenter collaboration at US two sites, August 2014 to May 2017.

Participants 164 adults aged 18-65 years with a body mass index of 25 or more.

Interventions After 12% (within 2%) weight loss on a run-in diet, participants were randomly assigned to one of three test diets according to carbohydrate content (high, 60%, n=54; moderate, 40%, n=53; or low, 20%, n=57) for 20 weeks. Test diets were controlled for protein and were energy adjusted to maintain weight loss within 2 kg. To test for effect modification predicted by the carbohydrate-insulin model, the sample was divided into thirds of pre-weight loss insulin secretion (insulin concentration 30 minutes after oral glucose).

Main outcome measures The primary outcome was total energy expenditure, measured with doubly labeled water, by intention-to-treat analysis. Per protocol analysis included participants who maintained target weight loss, potentially providing a more precise effect estimate. Secondary outcomes were resting energy expenditure, measures of physical activity, and levels of the metabolic hormones leptin and ghrelin.

Results Total energy expenditure differed by diet in the intention-to-treat analysis (n=162, P=0.002), with a linear trend of 52 kcal/d (95% confidence interval 23 to 82) for every 10% decrease in the contribution of carbohydrate to total energy intake (1 kcal=4.18 kJ=0.00418 MJ). Change in total energy expenditure was 91 kcal/d (95% confidence interval −29 to 210) greater in participants assigned to the moderate carbohydrate diet and 209 kcal/d (91 to 326) greater in those assigned to the low carbohydrate diet compared with the high carbohydrate diet. In the per protocol analysis (n=120, P<0.001), the respective differences were 131 kcal/d (−6 to 267) and 278 kcal/d (144 to 411). Among participants in the highest third of pre-weight loss insulin secretion, the difference between the low and high carbohydrate diet was 308 kcal/d in the intention-to-treat analysis and 478 kcal/d in the per protocol analysis (P<0.004). Ghrelin was significantly lower in participants assigned to the low carbohydrate diet compared with those assigned to the high carbohydrate diet (both analyses). Leptin was also significantly lower in participants assigned to the low carbohydrate diet (per protocol).

Conclusions Consistent with the carbohydrate-insulin model, lowering dietary carbohydrate increased energy expenditure during weight loss maintenance. This metabolic effect may improve the success of obesity treatment, especially among those with high insulin secretion.

Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial

 

[JustAGuy]

With these studies I always wonder what the long term results would be. Anybody can lose weight on sheer willpower using stress hormones. The problem with this is that you end up rebounding because you feel bad all the time and you are in a “stress-debt”.

The important thing though is maintaining a lean state long term while feeling good. For me it seems to be the combination of hormetic stress bursts to be stress tolerant while maintaining a chronic low stress state (a non-stressful diet & lifestyle).

 

[rei]

The best way to stress the body is to eat carbs again before reaching fasting blood glucose and insulin levels. This keeps the body in a constant fat-accumulation mode and leaves no time for maintenance and repair. Low carb or intermittent fasting regimen gives the body time to do these important tasks and preserves the metabolic flexibility, which minimizes the stress response when switching from carbohydrate metabolism to fat burning.

I am slightly surprised about how clear the benefit was in this study because they certainly ate large amounts of PUFA and MUFA, if they mainly consumed SFA and some MUFA the result would be even more drastic.

 

[Hugh Johnson]

With these studies I always wonder what the long term results would be. Anybody can lose weight on sheer willpower using stress hormones. The problem with this is that you end up rebounding because you feel bad all the time and you are in a “stress-debt”.

The important thing though is maintaining a lean state long term while feeling good. For me it seems to be the combination of hormetic stress bursts to be stress tolerant while maintaining a chronic low stress state (a non-stressful diet & lifestyle).

Honestly, DNP+Clen+Trenbolone+T3 and eating no food what so ever would be ever would be even more effective for weight loss if we are to use the measures these people are using. But it might not be maintainable.

 

[Hans]

The best way to stress the body is to eat carbs again before reaching fasting blood glucose and insulin levels. This keeps the body in a constant fat-accumulation mode and leaves no time for maintenance and repair. Low carb or intermittent fasting regimen gives the body time to do these important tasks and preserves the metabolic flexibility, which minimizes the stress response when switching from carbohydrate metabolism to fat burning

A low carb diet, insulin resistance and hypothyroid makes you metabolically inflexible.
Insulin/carbs doesn't make you fat.
The thyroid regulates cell renewal. Thyroid hormones are even sometimes classified as catabolic hormones. Hyperthyroid individuals struggle to gain weight and are lean. How come they are lean and struggle to build muscle? Is it because the thyroid only burns fat and not regulate cell recycling/renewal hence little muscle mass?
Peat would surely be fasting if he thought that it is more important than proper thyroid function for health and metabolism.
Carbs and insulin keep the metabolic rate up to support thyroid function and the metabolism.

 

[rei]

You keep saying stuff, but the data disagrees. Why? I was merely reimagining the interpretation of the data. You claim effects completely contrary to the data without presenting alternative more credible sources.

And what if i told you that what you call insulin resistance is actually how a healthy response looks like? I fail to see how you can call it resistance when less insulin is needed to process same amount of food?

 

[Hans]

I posted a study in the hormones and fat loss thread that high carb was better than low carb for fat loss.
Insulin resistance occurs during low carb diet, and that is to prevent tissue from using the glucose yes, but that is what makes you metabolically inflexible. Eating a low carb diet doesn't make you metabolically flexible.

I fail to see how you can call it resistance when less insulin is needed to process same amount of food?

You mean, less insulin is needed to process smaller amounts of glucose? A certain amount of insulin is needed to deal with a certain amount of carbs. The more insulin resistant you are the more insulin is required. But as the amount of glucose decreases, as in a low carb diet, less insulin is needed. I don't see how that means better insulin sensitivity or metabolic flexibility.

 

[Zigzag]

Take ketogenic diet. It actually worsens insulin resistance.

 

[rei]

The issue is not the high or low carb. The issue is when you eat carbs before you reach fasting insulin. If you do IF and eat One Meal A Day then you want balanced macros. If you do 2 meals you want low carb. 3 meals = one of the meals better be ketogenic. This way you prevent insulin resistance since you start spiking insulin again only once you have reached baseline.

Insulin resistance does not happen from low carb diet.

One Day of a Low-Carb Diet Decreases Insulin Resistance, Study Finds. Eating three low-carb meals within 24 hours reduces after-meal insulin resistance by over 30%, while eating three high-carb meals maintains insulin resistance, according to a new study from the University of Michigan.Nov 18, 2016

Insulin resistance does not happen from fasting. It happens from too high insulin AUC.

AFAIK even Ray Peat has advocated sometimes skipping a meal or two. This could mean 18 hour fast on weekdays and feast on weekend. This is what i practise and is a quite common Intermittent Fasting protocol.

 

[Hans]

Insulin return to baseline rapidly when someone is insulin sensitive. Like within 2-3 hours. Few people eat every 3 hours. Glucose uptake, storage and oxidation are enhanced when you have good thyroid health and as insulin sensitive. Cortisol, PUFAs, serotonin, etc. increase insulin resistance. High blood glucose in the presence of excess ROS causes problems, hence the beneficial effect of lowering carbs. But that doesn't solve the problem. Lower cortisol, free fatty acids, ROS, LPO, etc. and insulin sensitivity increase regardless of glucose intake.

 

[JustAGuy]

I posted a study in the hormones and fat loss thread that high carb was better than low carb for fat loss.

Anecdotal but I have done every macro split to figure out which gives me the most energy per calorie and carbs are where it’s at by far for me, so I agree completely.
On a certain calorie intake from fats I would have 0 energy and would need to tap into adrenaline every single time to get anything done. Whereas with carbs I had more motivation/energy at exact same caloric intake and doing things was just much easier. This does not go around the calories in/out principle, just my body is in a less stressed state on x calories from carbs vs fats, hence it is easier to do more activities per calorie ingested from the carbohydrates rather than fats in my personal experience. Also getting much leaner was more possible since the stress threshold before my body burns out was greatly postponed.

 

[walker_in_aus]

You keep saying stuff, but the data disagrees. Why? I was merely reimagining the interpretation of the data. You claim effects completely contrary to the data without presenting alternative more credible sources.

And what if i told you that what you call insulin resistance is actually how a healthy response looks like? I fail to see how you can call it resistance when less insulin is needed to process same amount of food?

There is also a lot of data saying diets are only effective long term in about 3% of the the people, and everyone else eventually gains it back, or more.

 

[TeaRex14]

The problem is a low carb diet will increase cortisol, this is how you lose weight on the diet. Cortisol is the fat burning hormone, it just so happens to be one of the major stress hormones as well. You end up losing weight at the expense of stressing yourself out due to lack of glucose. To make matters worse, liberating all that store body fat will likely increase the PUFA and estrogen concentrations in your bloodstream as well. Losing weight a stressful way isn't necessarily healthy weight loss. Also, this is anecdotal, but when I was doing low carb several years ago I lost a good amount of weight but I think it was mostly muscle I lost. I couldn't put on any lean mass no matter how hard I tried. When I switch to a "Peatish" way of eating I didn't gain any fat, in fact I lost some. I also put on a few pounds of muscle without weight lifting. That was before I started supplementing aspirin and low dose of thyroid. I think supporting thyroid metabolism is the best and most healthiest way to lose weight. You may not lose weight quite as fast, but most of that quick weight shedding on a low carb diet is just fluid retention from your glycogen stores anyways, not fat loss.

 

[Hans]

Anecdotal but I have done every macro split to figure out which gives me the most energy per calorie and carbs are where it’s at by far for me, so I agree completely.
On a certain calorie intake from fats I would have 0 energy and would need to tap into adrenaline every single time to get anything done. Whereas with carbs I had more motivation/energy at exact same caloric intake and doing things was just much easier. This does not go around the calories in/out principle, just my body is in a less stressed state on x calories from carbs vs fats, hence it is easier to do more activities per calorie ingested from the carbohydrates rather than fats in my personal experience. Also getting much leaner was more possible since the stress threshold before my body burns out was greatly postponed.

Cool, me too. I noticed that the fatigue that carbs might cause, other than lowering cortisol, is that it might be converted to lactate, giving the feel of fatigue and heaviness. This can be prevented by vit B1.

 

[rei]

You fail in your analysis in the same manner as modern medicine fails when treating many diseases. The short-term "cure" most often actually makes it worse in the long term, this is most clearly documented with psychiatric medications and diabetes "treatment" using insulin.

Each IF study i have seen show them put on muscle and burn away fat without doing exercise. This is one of the key drivers of longevity according to Ray Peat. Fasting ramps up your anabolic hormones and metabolism to such a degree that the little you lost when not eating comes back in greater amounts when refeeding. Similar happens when you exercise. Hormetic stress.

I quoted a credible study from 2 years ago that shows dramatic improvement in insulin resistance just by limiting carbs. And again it was shot down with n=1 even when it supports the study of this topic.

In canada they recently did a pilot study with moderate to severe diabetics doing a 36hour fast 3 times a week. They did not need any insulin after 1-6 weeks and were essentially cured. If they understood to swap out PUFA -> SFA i bet they would be cured proper.

 

[Zigzag]

You fail in your analysis in the same manner as modern medicine fails when treating many diseases. The short-term "cure" most often actually makes it worse in the long term, this is most clearly documented with psychiatric medications and diabetes "treatment" using insulin.

Each IF study i have seen show them put on muscle and burn away fat without doing exercise. This is one of the key drivers of longevity according to Ray Peat. Fasting ramps up your anabolic hormones and metabolism to such a degree that the little you lost when not eating comes back in greater amounts when refeeding. Similar happens when you exercise. Hormetic stress.

I quoted a credible study from 2 years ago that shows dramatic improvement in insulin resistance just by limiting carbs. And again it was shot down with n=1 even when it supports the study of this topic.

In canada they recently did a pilot study with moderate to severe diabetics doing a 36hour fast 3 times a week. They did not need any insulin after 1-6 weeks and were essentially cured. If they understood to swap out PUFA -> SFA i bet they would be cured proper.

I'd like to see a comparison between regular KETO diet and PUFAs free KETO diet. This might be the ultimate "treatment" for diabetics.

 

[cyclops]

If you do IF and eat One Meal A Day then you want balanced macros. If you do 2 meals you want low carb. 3 meals = one of the meals better be ketogenic.

Pretty much everyone here, and Peat, are doing it wrong then.

 

[rei]

I hope you realize we are talking generalizations here and what is right for you is what produces results and feels right. The healthier and more physically active you are the more you can utilize carbs before your stores start to overflow and insulin resistance sets in. On this forum this is often erroneously taken to mean: if you want to get healthier consume more carbs.

The canadian study's authors said that the worse the patient's diabetes is, the longer the fasting duration must be to reverse it and 24 hours is only enough for mild diabetics to see quick recovery. So what is beneficial to the athlete is actually killing the average person.

 

[cyclops]

I hope you realize we are talking generalizations here and what is right for you is what produces results and feels right. The healthier and more physically active you are the more you can utilize carbs before your stores start to overflow and insulin resistance sets in. On this forum this is often erroneously taken to mean: if you want to get healthier consume more carbs.

The canadian study's authors said that the worse the patient's diabetes is, the longer the fasting duration must be to reverse it and 24 hours is only enough for mild diabetics to see quick recovery. So what is beneficial to the athlete is actually killing the average person.

People here usually follow Peat who is a proponent of consuming a relatively large amount of carbs. Peat has stated that he is quite sedentary and he consumes a relatively high amount of sugar. He believes this is what is healthy and correct. Of course he could be wrong, but that's how he rolls.