NuSI study backfires on Gary Taubes (Carb-Insulin obesity link debunked)

[FitBeforeFifty]

Following the success of Gary Taubes' books claiming carbs cause obesity, he founded NuSI (www.nusi.org) to raise money for reasearch. NuSI along with NIH funded a study intended to prove/disprove Taubes' carb/insulin/obesity link. The study has been complete for some time but hasn't been published. One of the principal investigators in the study presented some of the findings at the 2016 International Conference on Obesity earlier this month.

Some money quotes:

“The loss of fat mass slowed down on a low-carb, high-fat diet.”

“…it took the full 28 days of a ketogenic diet to lose the same amount of fat as was lost in the first 15 days of the normal carbohydrate diet.”

Dr. Hall’s conclusion: no metabolic advantage to a ketogenic diet. Carb-Insulin theory of obesity falsified.

Here's an interview with Dr. Hall at the conference:

https://youtu.be/MiUyjMjuLl0

[betpchem]

Good to know @FitBeforeFifty. I always like to hear what the science says.

[JohnRi]

I personally thought the high fat diet was bad for a number of health reasons.  Interesting study that showed a high fat low calorie diet took longer to lose the same amount of weight as the a low calorie high carb diet.

I will love to read the paper when it comes out. 

I've been running a low caloried diet 20%-25% protein, 20-25% fat, and 45-55% carb diet for 8 months.  I've lost 61 lbs.  So as far as I'm concerned a balanced diet will cause weight loss great weigth loss... 

If you ever see a link to the paper on the study, please post an new update with the link.

[FitBeforeFifty]

Here's one of the posters shown in the background of the video. If you look at the body weight/fat mass graphs you can see that when switching to low carb there is a dramatic drop in body weight but very little fast mass. During that transition to low carb (time 0 on that graph) the body is presumably consuming glycogen and lean muscle for fuel until the transition to ketosis is complete. Afterwards, the rate of fat loss seem to match that of the high carb diet (the shaded blue area).

The other thing you'll see is the energy expenditure does go up during the transition but levels off after transition to ketosis and is approaching 0. 

The huge drop in insulin (C-peptide graph) is not correlated at all with fat loss. 

Of course many of Taubes supporters will probably claim the study was flawed but the study was initially proposed by Taube's himself and was partially funded by NuSI (the organization he founded).

[emili]

I lost over 60 pounds being a huge fan of carbs. Still a huge fan of carbs and haven't gained an ounce. Of course not all carbs are created equal- that's where smart choices and understanding nutrition comes in. Thank you for sharing...

[Dominique]

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@FitBeforeFifty wrote:

Following the success of Gary Taubes' books claiming carbs cause obesity 

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Taubes is the Trump of nutrition: appealing to masses by blaming "big government" or the "big food" lobby for making people fat. The truth is: overeating is what makes people fat (regardless of what they overeat), and it’s not like anyone stuck a gun in their back to force them to overeat.

[OCDOC]

The data you show is from a poster presentation on preliminary data; the final results are not published. It's too early to say whether there are any 'flaws' scientifically. However, just look at the results in pink..all GOOD!! (ETA...the '21-Day Fix' people would be THRILLED with the 21-day results in pink 🙂  )

One key thing he mentions verbally is that the keto group have 'only' RAISED their EE by about 100 cals per day despite losing weight, then drifts to baseline. IT DOES NOT DROP!! The problem with 'eat less move more' is that EE drops like a rock. This 'by the way' is huge. It's why people plateau and rebound within a year. Here's K Hall himself re 'standard' dieting:

"During restriction of food intake there is a reduction in whole-body EO, due in part to the reduction in body mass that follows the lowered calorie intake. This can be accounted for by reductions in REE secondary to loss of lean and fat mass, reductions in AEE due to reduced amounts and costs of activity, a decrease in TEF due to lower EI, mostly caused by reductions in protein turnover and its associated energy cost. In addition to the passive compensation described above, there is evidence for an active reduction in REE during calorie restriction whose magnitude is dependent on the degree of calorie restriction"

 ncbi.nlm.nih.gov/pmc/articles/PMC3302369

You might also recall that the think-tankers resolved that if every overweight person had a 100 calorie deficit per day that over a decade obesity numbers would plummet. Well, there's your 100 calories...EE RISING despite losing weight during the 28 day keto diet, and never drifting below baseline. (Note the lead-in period in blue). If the EE doesn't drop over the ensuing 12 months (28 days is 28 days), then the difference is massive.

Again, who knows why he did the interview with only preliminary data. K Hall does good work..puzzling.

[FitBeforeFifty]

If you look at EE at the end of the high carb diet you'll notice it hasn't "dropped like a rock", it's at baseline. If you then look at EE at the end of the low carb diet, it looks to be about 25 calories above baseline. For someone trying to lose weight and create a 500+ calorie deficit, 25 calories is really meaningless.  At least it would be meaningless to me ... I'd much rather lose weight eating a balanced diet without any restrictions and deal with a 25 calorie delta.

Of course this isn't really a study designed to evaluate drops in EE (adaptive thermogenesis) because the deficit is relatively small.

While adaptive thermogenesis does indeed occur, I'm not aware of any studies that show low carb mitigates adaptive thermogenesis. Calorie cycling and/or deficits created with exercise instead of diet have been shown to mitigate it.

I know from my own experience, I never had any signs of adaptive thermogenesis. I do believe it exists and causes some people to plateau, but I think it mainly applies to people restricting calories too dramatically and not creating deficits via exercise. Instead of eating less and less as I lost weight, I ate more and more. I ate at a sedentary maintenance level and used progressively increasing exercise to create a deficit. I kept a constant 500 calorie deficit from TDEE but kept increasing TDEE each week and each month. My carb intake the first week of weight loss was 169 grams. The last week of weight loss I was up to an average of 252 grams of carbs per day.  

[OCDOC]

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@FitBeforeFifty wrote:

If you look at EE at the end of the high carb diet you'll notice it hasn't "dropped like a rock", it's at baseline. If you then look at EE at the end of the low carb diet, it looks to be about 25 calories above baseline. For someone trying to lose weight and create a 500+ calorie deficit, 25 calories is really meaningless.  At least it would be meaningless to me ... I'd much rather lose weight eating a balanced diet without any restrictions and deal with a 25 calorie delta.

Of course this isn't really a study designed to evaluate drops in EE (adaptive thermogenesis) because the deficit is relatively small.

While adaptive thermogenesis does indeed occur, I'm not aware of any studies that show low carb mitigates adaptive thermogenesis. Calorie cycling and/or deficits created with exercise instead of diet have been shown to mitigate it.

I know from my own experience, I never had any signs of adaptive thermogenesis. I do believe it exists and causes some people to plateau, but I think it mainly applies to people restricting calories too dramatically and not creating deficits via exercise. Instead of eating less and less as I lost weight, I ate more and more. I ate at a sedentary maintenance level and used progressively increasing exercise to create a deficit. I kept a constant 500 calorie deficit from TDEE but kept increasing TDEE each week and each month. My carb intake the first week of weight loss was 169 grams. The last week of weight loss I was up to an average of 252 grams of carbs per day.  

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Actually, the EE is exactly what keto is about. There are a zillion studies showing that standard calorie reduction and exercise demolish the BMR (eg see the recent 'Biggest Loser' fiasco re long-term damage to BMR).

His poster should be screaming 'EE DOESN'T DROP WITH KETOSIS!!'. Huge.

We won't know until/if/when there is a study at 6, 12, and 24 months into a keto diet vs an isocaloric Standard American control group, but believe me, the data Hall presents is exciting as heck..hardly a 'backfire' 🙂

[FitBeforeFifty]

I'm glad to see you are excited about 25 calories while ignoring the fact that, according to Dr. Hall, "it took the full 28 days of a ketogenic diet to lose the same amount of fat as was lost in the first 15 days of the normal carbohydrate diet." He also commented that the Carb-Insulin theory of obesity was falsified by the study because as you can see there is no correlation between fat loss and insulin.

If this was so exciting, I wonder why the co-founder and President of NuSI left at the end of 2015 ?

[OCDOC]

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@FitBeforeFifty wrote:

I'm glad to see you are excited about 25 calories while ignoring the fact that, according to Dr. Hall, "it took the full 28 days of a ketogenic diet to lose the same amount of fat as was lost in the first 15 days of the normal carbohydrate diet." He also commented that the Carb-Insulin theory of obesity was falsified by the study because as you can see there is no correlation between fat loss and insulin.

If this was so exciting, I wonder why the co-founder and President of NuSI left at the end of 2015 ?

Sorry, I don't like mixing gossip into discussions of science. I do like gossip in general tho 😉

Here's Michael Eades discussing Hall's poster/data. I'm not convinced of Eades 'protein' position, but he pretty much says everything there is to say about Hall's video interview. Enjoy and take care 🙂

proteinpower.com/drmike/2016/05/06/contradictions-and-cognitive-dissonance-the-kevin-hall-effect/

[OCDOC]

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@FitBeforeFifty wrote:

"Of course this isn't really a study designed to evaluate drops in EE (adaptive thermogenesis) because the deficit is relatively small."

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Oh the irony....here's the actual title of the actual abstract of the actual presentation:

T2 : S10 : 17 Energy Expenditure Increases Following An Isocaloric Ketogenic Diet In Overweight And Obese Men

Hmmm...sounds like it IS "a study designed to evaluate 'drops' in EE" afterall...  best!  Rob 🙂

[FitBeforeFifty]

Nothing ironic about this, you just don't understand the scientific terms discussed.

What I said is that it wasn't designed to measure adaptive thermogenesis. Adaptive thermogenesis is a behavioural and biological response to a sustained caloric deficit. They didn't design the study to have a caloric deficit and thus they didn't intend to measure adaptive thermogenesis.

It was designed to measure difference in energy expenditure and fat mass between 2 different diets. They intended to keep calorie intake constant after stabilizing. The reason they have a deficit is because they based their baseline EE on the metabolic chamber and it turns out (not surprisingly) energy expenditure was higher outside the chamber. The deficit was an accident and not design, therefore it wasn't designed to measure adaptive thermogenesis. Of course once they realized this it would have been too late to adjust, so they had to stick with their baseline calorie intake.

Having said that, there is no indication there is any adaptive thermogenesis at the end of the high carb diet and there is only a 25 calorie advantage to the VLCD.

You can have your 25 calories and I'll keep my bread  

[Tina31S]

"The reason they have a deficit is because they based their baseline EE on the metabolic chamber and it turns out (not surprisingly) energy expenditure was higher outside the chamber."

Taubes and others should be talking about this (instead of Taubes making vague remarks that the studies he funded are 'difficult to interpret' and making ambiguous statements that they are 'encouraging but ambiguous'). 

The NuSI study said that the energy expenditure outside the metabolic chamber on average was around a few hundred calories per day higher compared with inside of it and as high as about 500 calories per day in some people.  This a large amount of extra energy expenditure (what could be called a 'metabolic advantage') for what could be considered a fairly minor environmental change (the test subjects were trying to keep their energy expenditure due to physical activity constant for both environments).  It's an order of magnitude greater than the 25 calorie metabolic advantage of the low-carb diet which was tending toward zero with time as the body adjusted to the low-carb diet which required a very large macro-nutrient composition change from a higher carb diet, a change that may be difficult for most people to achieve and maintain on their own.

Such a phenomenon may have relevance in free-living conditions; for example, the effect on expenditure of working all day confined in a small office cubical compared with being in an open-floor plan.  It could be used as an impetus for another study that examines the effects of a person's living environment on energy expenditure.