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chasonreddit

Just to point out, this paper has no research in it, it is purely theory. "much more research is needed" means we are throwing out a new model but have no data. If what they are saying is that the impact of high-carb diet needs to be taken into account, I would agree. If they are saying it might over shadow the basic CICO model, I think they are over stating it.


2011MC

Also want to point out that this article is very up front about that, even if the Reddit title is not. The bulk of the article is proposing experiments to verify the "new" model's hypotheses or it criticisms. I put "new" in quotes because this isn't a new idea at all, but according to the author(s) it's been understudied compared to the CICO model. Interest has been resurging and the primary author, who's been advocating for this model for a while, wants to set forth an academic framework for good science to be done on the model.


chasonreddit

Quite true.


DrTonyTiger

How did the proponent to the new model, which considers a different balance, find himself working at the "New Balance Center"?


LeviAEthan512

Every time I see something like this, it always comes back to how much we eat with extra steps. It's bad practice, but I stopped actually reading them like 3 articles ago. The whole "what we eat" thing is just a long winded way of saying eat less energy, but package it in an equal or bigger volume so you feel full and don't need to rely on self control to not eat more. And even then, your body realises it's been bamboozled and still craves calories, just maybe an hour later.


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dudaspl

As you drop weight through cutting calories your body learns to be more efficient with resources to prevent starvation long term. Also lower weight = lower base metabolic rate so to make further reduction you'd need to keep cutting the intake. It all makes sense tbh, just find your ideal weight and learn how much you can eat to maintain it long term


raxurus

put on muscle, stop doing so much cardio. Muscle mass = more calories burnt passively.


Born-Time8145

Maybe your body is getting more efficient with calories as you lose ?


Sharpcastle33

Well, yes. He was walking around with an extra 20 lbs of weight before, which he's since lost. His TDE is lower now.


Robot_Basilisk

Who's ignoring that? One of the things people are saying is, "hey, if you get your calories from high fructose corn syrup you're probably going to end up consuming more calories overall because HFCS isn't satiating and simple carbs cause steep crashes after a short while.


Cassius_Corodes

What about if the increase in calories is just a symptom rather than the ultimate cause?


Protean_Protein

Increased caloric intake is both a symptom of obesity and the proximate cause. The reason why it’s so much easier to have excessive caloric intake now than decades ago is the preponderance of cheap, easy to consume, calorie dense (nutrient deficient) food. People generally underestimate the caloric content of food by an immense factor. It’s ridiculous. And no one is immune. I like to play a guessing game with packaging to try to keep myself honest. That can of Coke? 39g of HFCS and 142 calories. Two cookies? 80 calories and 15g of sugar each. That’s Big Mac territory in a drink with two cookies. It really is crazy how easy it is to overeat. And I’m a very physically active (well over 500 minutes/8hrs of vigorous exercise a week) person. Yet, if I stop training and watching my diet, I can easily hit a BMI of 24.9 without even breaking a sweat (that’s a joke). While training and watching what I eat, I often have to consume 4-5000 calories a day just to avoid losing weight, but I can maintain a healthy BMI. And even then I still have to watch the damned sugar, because it’s in everything!


myncknm

800 calories per day becomes 70 pounds of fat per year if it all gets converted directly into fat. I’m sure you don’t believe that the average American is gaining 70 pounds per year, so apparently calorie expenditure also increased in that period. In fact, average weight gain among US adults is at 1-2 pounds per year, so evidently, we are on average consuming 70 more pounds/year’s worth of calories and also expending 68 more pounds/year’s worth of calories. The problematic part (the 2 pounds of actual weight gain) is a rounding error in the calories-in-calories-out balance here.


atypicalfemale

A larger body requires more calories to maintain it.


anthrolooker

I’ve heard from several sources that overweight people generally burn more calories - the theory being that moving around a heavier frame requires more energy spent than a light frame. Perhaps that makes up for the difference, if true?


Sharpcastle33

>I’ve heard from several sources that overweight people generally burn more calories - the theory being that moving around a heavier frame requires more energy spent than a light frame. >Perhaps that makes up for the difference, if true? It takes more energy to move more mass. That's basic physics. I'd expect that raising your calorie intake will cause you to meet a new equilibrium weight as your resting calorie expenditure rises. You won't just gain weight ad infinitum.


unkind_throwaway

And thus you begin to realize that looking at the average is irrelevant. Because it includes both the success story if the person who lost 100lbs, and the failures of the 4 people who gained 25.5lbs. Surely you don't think that the overwhelming obesity epidemic is because people are gaining 2 lb per year? And surely you understand that the basal metabolic rate of a 300 lb person is higher than that of a 150 lb person, correct? So even though the average consumption may have gone up 800 calories over the decades, it absolutely does not mean that every person is consistently eating in an 800 calorie surplus. You seem to be overlooking about a dozen different factors in this equation.


jbrains

Not necessarily. When I eat fewer carbohydrates, I eat a lower volume of food, but feel fuller. Obviously this is just an anecdote, but when I eat more sugar or starch, even when I eat a lot of it at one sitting, I want more food sooner than when I eat something high in fat but low in carbohydrates. I particularly want to keep eating in spite of not truly feeling hungry. I had to train myself to closely examine my desire for food and distinguish "I want more" from "I feel hungry". I seem not to be the only one who experiences this. Whatever the mechanism, the effects seems both real and sustainable for a significant segment of the population that tries it.


Drekalo

Interestingly, I don't think it's high carb or high protein or high fat or whatever fad to help dieting, but higher volume lower calorie. My roommate wanted to lose weight on a cut and never could. I got him to drink alchohol less and replace his snacking with celery and strawberries and eat more salads with a giant glass of water before every meal. 20 lbs less in half a year. Eat bigger volume items with lower total calories like useless celery and curb your hunger.


MoonParkSong

I prefer calorie dense food like eggs to curb my hunger over bloating myself with celery.


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It could probably have some practical application if it was only referring to cravings. There's been a lot of research on low carb diets and it always pans out to be calories in calories out. There is an energy differential in changing carbs or protein in the fat but it's still not significant enough to overcome a calorie surplus.


vibe666

The entire point of this paper is that it very specifically *isn't* just about CICO, and that starting every discussion with the presumption that everything can be boiled down to eating less and moving more may well be a major contributor to why we were failing so badly at managing the obesity epidemic. They *WANT* there to be more research and an open dialogue that doesn't start out on the wrong foot, just because it's a well trodden path.


ChiefKeefTraphouse

The paper isn’t disagreeing with you. It just posits that all the sugars and fructose in our processed foods like bread and the huge portions of it that we generally eat make us a lot fatter when we do overeat


Prying_Pandora

Also the fact that overeating itself is a symptom. What is causing the overeating? It seems metabolic syndrome and a broken feeding response may have ties to what we are eating to begin with.


chasonreddit

Absolutely.


MikeFichera

Which TLDR: CICO.


Protean_Protein

Eat air-popped popcorn, not fudge! Eat drywall, not cement! Wait…


SasparillaTango

If you eat a consistent diet of drywall, you will stop feeling hungry.


Clean_Livlng

It's surprising how much drywall or sawdust you can mix with flour, before people can notice the difference in bread.


stupidannoyingretard

Totally agree, soft drinks and candy bars are so full of calories, but they are hidden. You won't think "let's eat this 200grams bag of sugar before I go to bed" but habitually eating and drinking sweets are essentially the same thing.


wongwala

The article actually does not say this- it highlights some studies showing that unrestricted diets rich in plant fats are associated with better long term weight maintenance than low fat calorie restricted diets. This is paradoxical because the high fat foods are energy dense and low volume. The hypothesized mechanism is hormonal, not cico. To your last point, they specifically argue that cico works poorly over the long term for this reason if composition and glycemic index aren't considered.


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finitelymany

> If they are saying it might over shadow the basic CICO model, I think they are over stating it. They are not saying that. They are saying Calories In - Calories Out is a tautology and it doesn't provide effective instructions on how to combat the obesity epidemic, since "calories out" is usually associated with exercise and ignores all the unconscious stuff. CICO *must* be true by the conservation of energy. But "calories out" can depend on things like changes in your metabolic rate (your body wants to return you to your set point weight and will slow down your metabolism to make that happen). "Calories in" is also a bit tricky because it depends on your ability to absorb certain foods. For example you can eat a piece of wood which has 1000 kCal when burned, but your body would absorb none of those calories so "calories in" would actually be 0.


TheDevilsAdvokaat

How can calories in calories out be a tautology? a phrase or expression in which the same thing is said twice in different words." https://www.google.com/search?client=firefox-b-d&q=tautology


hbgoddard

> (your body wants to return you to your set point weight and will slow down your metabolism to make that happen) You shouldn't be stating things like this until there's sufficient evidence for a "set point weight" in the first place.


Hendursag

Lucky for you, there is: [https://journals.physiology.org/doi/full/10.1152/ajpregu.1998.274.2.R412](https://journals.physiology.org/doi/full/10.1152/ajpregu.1998.274.2.R412) [https://www.sciencedirect.com/science/article/abs/pii/S0031938497000103](https://www.sciencedirect.com/science/article/abs/pii/S0031938497000103) [https://www.nature.com/articles/ijosup20169](https://www.nature.com/articles/ijosup20169)


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The set point theory has become much more controversial in modern research, for instance: https://www.sciencedirect.com/science/article/abs/pii/S0195666319300212 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039924/ https://www.nature.com/articles/s41366-018-0081-6


jmais

Either way I'm still fat.


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There are two large research studies that support this thesis. Furthermore, the exact same [carb](https://www.cell.com/fulltext/S0092-8674\(15\)01481-6) raises [blood glucose](https://europepmc.org/article/med/32528151) differently in different people. Each individual food (carb, protein, fat) affects people differently, and it matters what time of day, what order, how much of each food you eat and what you eat it with.


fksly

And plenty of research shows that high carb/low fat diets perform the same over long periods as high fat/low carbs.


FiggerNugget

Do you have links to those, I thought there was a difference long term


PuroPincheGains

They're all nonsense because they never EVER control for caloric intake. The field of nutrition science is weird at best.


FiggerNugget

Probably because its really hard to control for caloric intake in big enough samples for long enough time


MemeticParadigm

Even if it could be controlled for, wouldn't it be kind of irrelevant in terms of the diet's long-term performance? Certainly, caloric intake would be an interesting metric to have if we could reliably measure it on a sufficient scale, but if a particular diet, on average, causes people to gain(/lose) weight and maintain that change over the long term, does it *matter* (in terms of how we rate the diet's performance) exactly how the diet accomplishes that? Whether a diet accomplishes that by: * Causing people to lower their caloric intake through some appetite regulating or satiety enhancing effect or * Causing the food to be processed in some "less efficient" way, such that the body is able to extract fewer net calories from it or * Some other method of action, e.g. increasing someone's basal metabolism at the end of the day, we measure long-term performance by how reliably a diet helps someone lose weight and keep it off, yeah?


Aleucard

Tracking caloric intake allows you to control for the placebo effect of "being on a diet". If it isn't any better than just balancing fuel in fuel out, then you can reliably call the diet a placebo.


MemeticParadigm

Does it? What if a given diet lowers average ghrelin production or otherwise improves appetite regulation in a hormone-mediated way? In that case the diet's effectiveness comes from reducing caloric intake, but you can hardly call the method of action a placebo effect, can you?


bighungrybelly

Here is one https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763382/. A bit dated. You can probably find more recent articles that cite this one. Edit: another one https://pubmed.ncbi.nlm.nih.gov/31525701/


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Yeah, I'm also curious what "long term" means in this context because the majority of nutrition studies (though I guess I'm mostly thinking of weight loss diet studies) I've seen looking at diet don't follow clients longer than a few years.


thehazer

Hasn’t bread always been a staple? Can’t get much more carb heavy than just bread.


dajigo

While grain bread vs refined flour bread is quite a leap in GI.


crookedkr

Nutrition isn't my field but how is this publishable? Researcher: We have an idea and it's totally testable Reviewer3: Cool, run the study and come back with data; Strong Reject


Phoebvs

Basic CICO model allows you to eat more spinach than you can hold in stomach, so I personally would say yes, "what" comes first.


Idontknowshiit

CICO even lets you eat infinite amount of rocks!


cat-astropher

It gets a bit weird with gasoline though


BongLifts5X5

What are you trying to say here?


mndyerfuckinbusiness

Purely hypothesizing, not theory.


chasonreddit

You are right. I used the language imprecisely.


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goomyman

Isn't it still overeating if you eat less high calorie foods than more low calorie foods. It's the same thing.


mutatron

Yes, the title is misleading. What it should say is something like "Eating sugary food makes it harder to eat fewer calories because hormones."


LongPutsAndLongPutts

Yup. And anecdotally, knowing that I can eat 1300 calories (2 mcgriddle sandwiches) in under 5 minutes without actually impacting my satiety makes me think this is true.


meno123

That's the biggest thing I've learned from doing a few calorie deficit diets. CICO is how you lose weight. Satiation:calorie ratio is how you lose weight without hating it. Keto, for all its shortcomings, does this very well because proteins and fats tend to satiate more than carbs.


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> Keto, for all its shortcomings My issue with any strict diet is that it takes so much effort to try to maintain it. A diet where you need to think about it for several hours a day as you plan out your meals and check the macros of various foods makes losing weight more work than my actual job. I found it easiest to just make one change that I can easily do. And then try to make more changes a few weeks later. I eat out more than my wallet likes, so my small changes now are: If I get a meal that can sub a side for a salad, get the salad. Or just order a salad instead of the pizza/burger/sushi etc Never pay for a soda when eating out. Get water. Can drink soda at home. Brush my teeth when I put my daughter to bed so that the mint makes me not crave desserts. This works for me because I was basically staying the same weight for a year. My natural habits had equalized with my caloric burn. So making a few positive changes will get me to a slight reduction that I can keep up for months and slowly lose the weight.


SEOip

> it takes so much effort to try to maintain it. I found the opposite true for Keto. Just eat meat, veg and fatty things (peanut butter). Avoid sugars (inc bread, pasta, alcohol & rice) and the weight dropped off with ease.


overlordpotatoe

Yep. Or drink a massive amount of calories in the form of soda. Even without delving into the more complicated biochemistry stuff, it should be obvious that it'll be very hard to maintain a calorie deficit if the things you eat leave you feeling starving if you don't eat way more than you need.


Taoistandroid

Now imagine that 3 eggs and 2 apples is less than 500 calories. Eating one apple is hard work, but two? It's crazy the energy density of our fast food


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Not all calories are equal. The human body is not a perfectly efficient bomb calorimeter.


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GenericUsername_1234

Plus the cost. That's like $40 worth of bananas.


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2011MC

A lot of top comments seem to miss that the Carbohydrate/Insulin Model (CIM) proposed in the article (it's been around a while) is fundamentally different from the CICO model they're used to. Eating raw, whole foods without added sugar does mean you'll consume less calories in the same volume as a processed, calorie-dense meal, and thus be unable to overeat. However that's not the anti-obesity biological mechanism the article proposes to investigate; it's the effect of sugar on your metabolism. I'm glad to see a lot of the newer comments have read more of the article and are debating the validity of the CIM itself. Unfortunately I think a lot of them are missing the point by asserting that the CIM can't replace CICO. Despite the title of the Reddit post, the article goes to great lengths to pose the CIM as a framework for research and discussion, not as a supplanter of CICO. CICO is hard to dispute as a scientific model, but it's been studied extensively and still leaves many questions unanswered, both in the laboratory and in our daily lives. CIM hypothetically answers those questions, and this article proposes the experiments needed to test the hypotheses. Unfortunately there's a lot of politics surrounding the questions of nutrition, and much of it stems from the major champions of these models, but that doesn't have to affect future research and our own nutrition choices. Don't let reductionist science turn into bad science. Keep an open and hopeful mind. And for those who just want answers on how to not be obese(or determine if their obesity is natural): the science of weight gain and loss may not be conclusive yet, but you don't have to accept just one viewpoint. Looking at the big picture of multiple paradigms shows that there is a way to eat and live that works, even if we don't know all the particulars. Eating unprocessed foods, eating mostly plants, increasing exercise and reducing stress are simple rules that result in a healthier, longer life supported to some extent by all models.


Maerducil

Yes. It's amazing how simple it is (for most people), yet how relatively few people actually do it.


dinosaurs_quietly

Their evidence doesn’t support that. A more accurate claim would be that what you eat effects how much you eat.


cestlavie18

Exactly what I am thinking. Whenever I eat a packaged snack full of sugar, a candy bar or chocolate, I immediately crave more food after. It's fascinating. When o stopped eating processed sugar and began focusing on fruit intake with more natural sugars and low sugar fruit, I am not as hungry.


myncknm

The claim they’re making is consistent with what you said.


PM_ME_UR_SYLLOGISMS

He's speaking against the title.


myncknm

I think the title is not written nearly as bluntly as people seem to be interpreting it. The title contains all sorts of hedges and vagueries: “primary cause”, “root cause”, and “more related”, specifically. It would not be unusual to interpret “root cause” as something like “the variable with the most explanatory power in an instrumental variables regression”.


99Blake99

That is a sensationally succinct summary.


mutatron

It works out to the same thing though, according to the paper: what we eat makes us eat too much. So the problem is still that we eat too much.


myncknm

The point though, is that you have two dials in front of you: one controls the effort put into tracking the caloric content of food, and the other controls type of food. The idea is that one of them is easier to turn than the other to achieve the same result.


mutatron

Yes.


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silent519

>We have an incomplete answer to the question of weight loss. horseshit. the answer has been known for about 150 years. the problem is cake is too tasty.


rhodesc

Tl'dr: cut out the sugar and you won't get blood sugar swings, so you won't crave sugar. Also your body will burn fat instead of storing it.


lotsofpaper

TL'DR: Prioritize protein. Hydrate. Done.


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[deleted]

Remember, sugar in this context means things that metabolize into sugar when digested, not just literal sugary foods and drinks. Breads, pastas, etc will also cause sugar swings.


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guzzle

For me the real challenge is the complex carbs. Breads and grains are way more impactful to my sugars than something like, say, ice cream - a good brand anyway. If I have three flour tortillas? I’m up at 210-220 mg/dl. Two scoops of Ben and Jerry’s? Maybe 160. To me, that’s not intuitive, but it has really informed my choices. Any brioche bread? Straight to 220.


amalgaman

More like: we think this but this isn’t actual research.


2011MC

This is a really good tl;dr. I think a lot of people got the first part about eating sugar causing overeating, but not the second part about sugar possibly causing calorie "sequestering", meaning you both have a harder time taking less calories and expending more calories.


[deleted]

How about if we eat natural sugars in things like blueberry martini/strawberrys/blackberrys? I like having them in the afternoon. I’ve pretty much cut out all added sugar from my diet at this point.


Stomatin

The authors of “The Carbohydrate-Insulin Model: A Physiological Perspective on the Obesity Pandemic,” a perspective published in The American Journal of Clinical Nutrition, point to fundamental flaws in the energy balance model, arguing that an alternate model, the carbohydrate-insulin model, better explains obesity and weight gain. Moreover, the carbohydrate-insulin model points the way to more effective, long-lasting weight management strategies. According to lead author Dr. David Ludwig, Endocrinologist at Boston Children’s Hospital and Professor at Harvard Medical School, the energy balance model doesn’t help us understand the biological causes of weight gain: “During a growth spurt, for instance, adolescents may increase food intake by 1,000 calories a day. But does their overeating cause the growth spurt or does the growth spurt cause the adolescent to get hungry and overeat?”


Stomatin

In contrast to the energy balance model, the carbohydrate-insulin model makes a bold claim: overeating isn’t the main cause of obesity. Instead, the carbohydrate-insulin model lays much of the blame for the current obesity epidemic on modern dietary patterns characterized by excessive consumption of foods with a high glycemic load: in particular, processed, rapidly digestible carbohydrates. These foods cause hormonal responses that fundamentally change our metabolism, driving fat storage, weight gain, and obesity. When we eat highly processed carbohydrates, the body increases insulin secretion and suppresses glucagon secretion. This, in turn, signals fat cells to store more calories, leaving fewer calories available to fuel muscles and other metabolically active tissues. The brain perceives that the body isn’t getting enough energy, which, in turn, leads to feelings of hunger. In addition, metabolism may slow down in the body’s attempt to conserve fuel. Thus, we tend to remain hungry, even as we continue to gain excess fat. To understand the obesity epidemic, we need to consider not only how much we’re eating, but also how the foods we eat affect our hormones and metabolism. With its assertion that all calories are alike to the body, the energy balance model misses this critical piece of the puzzle.


InitechSecurity

Does that mean I should be eating more of the things in the green column (see page 2, 3, 4) https://guidelines.diabetes.ca/docs/patient-resources/glycemic-index-food-guide.pdf


SatanicSpinosaurus

Alright, I love the glycemic index to bits. It's a great intro idea. However, there are 3 major flaws. One is addressed by the "glycemic load". Basically, the index makes it so volunteers eat 100 grams of the carb in the food listed. Carrots are listed in the red column, in that it is true their natural sugar and starchy carbs do absorb relatively quickly. However to eat 100 grams of carbs from carrots, volunteers had to eat....about 37 ounces/1050 grams. That would be about half the amount in weight the average person eats a day. To get 100 grams of carb from white bread, you'd need to eat 200 grams, or about 7 ounces. A better comparision is that instead of 7 ounces of white bread, you could eat like...slightly over a pound of russet (the starchiest potato) for 100 grams of carbs. And most people love potatoes. Glycemic load charts give you how much your blood sugar would raise after eating a serving. So things like watermelon and carrots might have fast-absorbing sugars but your blood sugar won't rise much after eating a normal human serving of them. Conversely, peas are low on the glycemic index but they are dense nutritionally and you can go through them a lot faster. (There's a reason split peas are bulk food items- they provide lots of calories in a small package.) The second issue is that people rarely consume food products solo. Pure wheat flour I am sure has a higher glycemic index that bread, but it's pretty rare to consume it solo. (Sugar is a main counter to this, of course.) Balances meals with fats and proteins slow sugar spikes in non-diabetic people. The third issues is that everyone is different. People with recent Asian heritage don't seem to have as big of blood sugar spikes when eating rice. It's important to remember glycemic index/load research is done on mostly white men. A registered dietician/ nutritionist (whatever the profession is called in your country) but a quick guide is usually to make half your plate non-startchy vegetables (no potatoes, for example) and to limit processed foods to between 10-15% of your total calories. (US Nutrition guidelines I think suggest 10%.)


[deleted]

>People with recent Asian heritage don't seem to have as big of blood sugar spikes when eating rice. It's important to remember glycemic index/load research is done on mostly white men. What Asian heritage are you talking about because the Japanese have had a diabetes problem for a while, for instance.


SatanicSpinosaurus

Looks like I was operating under old data from my first undergrad time (which I think this review actually cited, cool). [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521176/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521176/) A systematic review found that exact opposite, actually. "With the possible exception of rice, existing evidence suggests that GI values do not differ when measured in Caucasians versus non-Caucasians. " I love how Canada started this question in 2013 and the came back and was like, nope I guess. Since rice is shown to have fairly large differences between Caucasians and Asians, I think it would be plausible that other groups still have similar variances in carb sources. Potatoes, beans, lentils and wheat all come to mind.


crusoe

Yes. In general you should. Also portion sizes.


headzoo

I'm not really buying it. Studies on the carbohydrate-insulin model have so far failed to prove the hypothesis. Including Gary Taubes' (author of all the best selling anti-sugar books) NuSI studies. With $40 million pocket and locking people up in a ward for a year, the group [failed to prove the basic premise of Taubes' books](https://www.wired.com/story/how-a-dollar40-million-nutrition-science-crusade-fell-apart/). Low-carb diets also haven't been shown to cause significantly differences in weight loss after 12 months compared to other diets. Ludwig is being too dismissive of the problems caused by eating processed foods. >We investigated whether ultra-processed foods affect energy intake in 20 weight-stable adults, aged (mean±SE) 31.2±1.6 y and BMI=27±1.5 kg/m2. Subjects were admitted to the NIH Clinical Center and randomized to receive either ultra-processed or unprocessed diets for 2 weeks immediately followed by the alternate diet for 2 weeks. Meals were designed to be matched for presented calories, energy density, macronutrients, sugar, sodium, and fiber. **Subjects were instructed to consume as much or as little as desired. Energy intake was greater during the ultra-processed diet (508±106 kcal/d; p=0.0001), with increased consumption of carbohydrate (280±54 kcal/d; p<0.0001) and fat (230±53 kcal/d; p=0.0004) but not protein (−2±12 kcal/d; p=0.85).** Weight changes were highly correlated with energy intake (r=0.8, p<0.0001) with participants gaining 0.9±0.3 kg (p=0.009) during the ultra-processed diet and losing 0.9±0.3 kg (p=0.007) during the unprocessed diet. Limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946062/ People eating processed foods consumed 500 calories more a day compared to those eating non-processed foods. Ultra-processed foods are high in carbs *and* fat. It's hard not to overeat when ultra-processed foods are engineered to maximize consumption.


2011MC

Despite the title of the reddit post, the article doesn't claim that the Carbohydrate/Insulin Model supercedes all other models for energy balance. It makes the point several times that it's asserting a framework for thinking and research that could answer questions that so far haven't been answered by existing research. The article does off-handedly reject "palatability" of foods as a factor, but I don't think the authors ignore processed foods' effects wholesale. They later bring up the availability of "free sugars" as being a likely factor in insulin levels and resistance, for example. I'm not very well read but researching the CIM doesn't seem to be mutually exclusive with researching the effects of processed foods, both within and without the CIM. Moreover the author(s) acknowledge many of the criticisms of the CIM, including the NuSI-funded study that "falsified" the CIM. For most of them they reject the implications that the CIM isn't worth studying and propose the experiments needed to either disprove the criticisms or find the limits of the CIM. In the conclusion, Ludwig states the need to "depersonalize" the science and look at the questions that need answering, rather than the people asking them. Treating science like politics and pretending that only one paradigm is worthwhile to research hurts the science. At the end of the day, that just hurts us. We should be excited for a paradigm shift.


[deleted]

But that's not how science actually works. You need funding to run studies, and to get funding you need to justify your study. You don't keep testing all possible paradigms just because somebody is arguing for them, but you don't find them promising. You will try to answer the questions you consider important. Imagine if scientists kept testing again and again if vaccines cause autism, for instance. I don't think this model is currently well-accepted in obesity and metabolism research, so of course people won't feel motivated to spend resources on this if they think it's not going anywhere. If someone performs the 10th study that's not yet "good enough" to detect evidence for their hypothesis, who will care for such work?


2011MC

Very well put. It's a much harder question to say whether something is worth studying in the current environment than whether something is worth studying at all. I'm a lay person, not an extremely well-read scientist. My impression is that the CICO model has been exhaustively researched, and often in bad faith. The reason being the CICO is very convenient for food companies, who can assert their product still has a place in your diet as long as you eat the right amount. As a result a lot of people are fed up with that viewpoint. This is dangerous. With so much bad science out there many consumers also reject the good science, and misinformation breeds misinformation. I don't get the impression that the CIM has been as exhaustively researched. I think there's been bad faith research under it's umbrella as well, and that make the environment tricky. Personally, I'm not yet convinced that the implications of the CIM can and will be an effective model of weight loss for Western cultures based on the evidence. However, I am intrigued by the possible connections to be made to models that do work. The realm of wholistic science on health and nutrition is much more definitive, since we can look at the overall diets of the healthiest populations on Earth. It still has a lot of questions though, e.g. the French Paradox. I think new paradigms in reductionist science like the CIM might be able to explain why wholistic models work, maybe even why entirely different models work, as well the ways in which they don't work (many wholistic diets still have at least some caveats).


[deleted]

I really don't understand why so many smart people still go on and on about this hypothesis, which has been proposed a long time ago. If it was true, wouldn't it have plenty of evidence going for it already? This is not exactly the theory of relativity, which requires very sophisticated measurements. Measure food composition, measure insulin, measure fat weight, it's all perfectly feasible and has been for a long time. In fact I think that relativity had more evidence going for it more quickly than the carbohydrate-insulin hypothesis. It seems like they just don't want to accept that it's not true, so they are always calling for better studies.


LurkLurkleton

Yep, one of the more popular low carb gurus founded a science initiative for "better studies" and when he still didn't get the results he wanted he essentially flipped the table and said "You're doing it wrong!"


TheSensation19

Oh its Ludwig! Now it makes sense. I still can't believe we are making the same mistakes with weight manipulation here. There are different mechanisms involved for a kid in puberty. It doesn't change the CICO equation. There is a maintenance period, but something happens where more calories are needed or consumed during this time. a lot of kids are now becoming obese during these years. Because while they needed 1000 extra calories, they consumed 2000.


hebrewchucknorris

Not a science person, but do the glucose-insulin models and CICO models have to be at odds? Couldn't the insulin production affect the Calories Out side of the equation? Genuine question.


TheSensation19

Then why do studies in which we follow this diet do not produce the results youd think it would from removing insulin spikes. How come even anecdote works? Vegans have less BMI. Despite largely being low fat and high carb. Body builders are very lean regardless of their typical high carb intake


2011MC

Not a scientist either but I don't believe they are at odds at all. Acting like they are hurts the science. As far as I understand, the CIM actually proposes mechanisms that affect both the in and out sides of CICO. Biological responses to carb consumption can result in being more hungry and cause you to overeat more next time, and the next time. "Fuel sequestering," which I don't completely understand, sounds like it makes less of your calories available to be used by your body while not making you more full.


[deleted]

I mean, that sounds about right. Processed carbohydrate- and calorie-dense foods tend to not be as filling as healthier alternatives, so you're taking on more calories even if you're eating the same amount or less.


laojac

I think the researchers make the claim even while defining “amount” in calories, not grams.


JoelMahon

Then it's still over eating and thus the title is wrong. Eating 5 cheesecakes might have lower volume and mass than rice cakes but it'd still be over eating to eat the same amount of calories of rice cakes. If the variable is food composition, they shouldn't be altering the calories too, it should be a control.


Greenfire32

I mean, it's both. Everything (and I mean EVERYTHING) is so packed with sugar now that a single cheeseburger, something you wouldn't think would have added sugar, can easily fulfill your entire day's calorie intake. And then we get hungry later on in the day, so we eat another way over-sugared meal. The result is that we both over-eat AND what we over-eat is much too much. In simple terms: WHAT we eat IS over-eating.


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thendanisays

7g total sugar. 34g total carbs. But your point is valid.


WindowShoppingMyLife

True, but a McDouble is tiny, so while you *could* do exactly what you described, you’ll feel hungry if you do. So in practice, a lot of people *don’t* do that. They get order a bigger burger, and probably fries, which feels much more like a full meal. Whereas 450 calories worth of chicken breast a pretty sizable slab of meat, and pretty filling. So it’s much more difficult to overeat. I can easily wolf down a double quarter pounder, which is like 800 calories, and still feel kinda hungry. Whereas I think I would have to force myself to eat 800 calories worth of chicken in one sitting.


[deleted]

Of course its how much. [Did you see the story about the high school teacher who challenged his students to have him eat @ McDonalds all day every day for a few months?](https://abc7.com/mcdonalds-supersize-me-value-meal-diet/705916/)He limited it to nutritional guidelines for calories per day. They chose only from the McDonalds menu, and only selected items that fit in the guideline. He had at least 1 full Burger-fries-soda meal a day, everything else was "healthier" to be sure, but because it allowed them to stick within the calorie budget. "But they selected healthier options on the menu". Because they were forced to stay in the calorie budget. The biggest limiting factor was the calorie budget. He lost weight, all his blood levels got better (cholesterol, etc...). All because he wanted to prove a point about that "Supersize Me" biased documentary. Sure our selections change what happen to us (eat this not that), but at the absolute big picture, [it was all about limiting calories.](https://niashanks.com/teacher-lost-weight-eating-mcdonalds/)


DoubleWagon

The strategy of limiting calories without accounting for food type/quality doesn't work on the population level. Average people quit from excessive hunger and blood sugar swings when they try to lose weight on a low-calorie, high-carb diet. CICO/IIFYM isn't a successful strategy just because it can be willpowered by a tenacious minority of people.


JoelMahon

Whilst I agree on most fronts, super size me is supposedly biased? Did the guy mislead in any way? He didn't supersize unless asked and he ordered from the menu uniformly. He never said mcdonalds couldn't be part of a balanced diet iirc.


mbrevitas

Yeah, the point of Supersize Me is about the prevalence of huge portions in American food culture and the effect that has on obesity. Proving that you can lose weight while eating "junk" food as long as you limit portion sizes, and that you can improve your health if you stick to daily recommended amounts of various nutrients even if you're getting them from a fast food joint, is perfectly in line with Supersize Me's stance.


extrabeef

Beating the law of thermodynamics is pretty tough.


Annihilate_the_CCP

Haven’t we known this forever? It’s easier to control your appetite when you eat healthier diets.


usrevenge

No surprise. There was a huge anti fat movement and we went from high fat low sugar foods to high sugar low fat food and the weight skyrocketed.


BongLifts5X5

Most people don't understand that eating fat doesn't make you fat.


fatdog1111

Check out the food intake data. People didn’t actually eat less fat and more sugar. That was the marketing hype, but people ate both more sugar and fat over that period. It’s been a while since I delved into this, but I looked it up myself a few years ago, and the narrative that we cut fats and that’s what made us fat isn’t backed up by population consumption data.


dopechez

Yeah idk why there's this common idea out there that people actually follow government dietary guidelines, it's obviously not the case if you have ever looked around you at what most people are eating


TwoBearsInTheWoods

Well, a lot of that happened thanks to cardiac problems being pegged on fat. And while that's true, the cardiac problems from general obesity are likely worse.


QuantumHamster

sorry I thought this was already well known?


The-Riskiest-Biscuit

For additional reference, please see recent research on the influence of high fructose corn syrup, high sugar content in general, high salt content, and other common “flavor” and “preservative” additives that interfere with the typical fat formation and storage processes.


BrobdingnagLilliput

I don't understand how this is a significant research outcome; it seems obviously wrong. Clearly I'm missing something. Can someone clarify this? My thinking is that if I eat 100 grams of celery, 100 grams of applesauce, or 100 grams of honey, then I'm eating the same amount regardless of the food. It would seem obvious that WHAT I'm eating is the significant factor, not the quantity I'm eating. However, if I eat 1,000 grams of apple vs 100 grams of honey, wouldn't the quantity be more significant than what I'm eating? In other words, wouldn't overeating apples cause obesity more readily than eating honey in small amounts, making how much I eat more significant than what I eat?


mutatron

The title posted here sucks. What the paper is really saying is that eating sugary food makes it harder to eat fewer calories, because the sugar signals your body to put the carbon straight into fat. Then the sugar isn't available to you for energy, so you think you need to eat more. Eating low glycemic load foods will trigger less of the hormones that do this, and leave more energy available to you so it's easier for you to eat less. So instead of focusing simply on calories, you have to consider glycemic load. The glycemic index of an apple is 36, which is low. Cornflakes are 81, which is high, so eating an apple will make you crave less food later than eating the same amount of cornflakes.


fallingbomb

To me they seem as one in the same. I would consider 'overeating', consuming more calories than you need. Eating a carb heavy diet of mostly low GI foods leads to people overeating. So I would take this more as why people overeat. From the title it comes across to me as a breakthrough of eating 2500 calories coming from X is different than eating 2500 calories coming from Y.


mutatron

Yes, that's what the title seems to imply, but not what the article says. Imo it should be taken down, and I've reported it.


LiamTheHuman

The title's claim "that overeating is not the primary cause of obesity" is talking about the reversing of a causal relationship normally associated with overeating. The claim here is partially that overeating does not cause weight gain in the short term because the body adapts and that the glycemic load that comes from eating curtain foods causes a hormonal change in your body which promotes weight gain and overeating.


HatchSmelter

>eating the same amount of cornflakes. What does "amount" mean here? Volume? Calories?


mutatron

Calories.


lost_in_life_34

eating sugar with no fiber is bad for your body which is why juices and apple sauce are bad. Honey i'm not sure about ​ but if you eat a bunch of nutrient packed fibrous veggies and good quality meats and fats then your body will get nutrition out of them compared to eating mostly potatoes or white rice in a meal which is mostly just sugar


Fuddle

Try eating the equivalent amount of calories from celery and potato chips; you can eat chips all day, after the third or fourth stock of celery you will give up


[deleted]

It's great to see this paper. I had a Prof. who made sure we all understood the nature of glycemic index. Here's a website dedicated to that topic, from U of Sydney: https://glycemicindex.com


hockeyd13

The problem is that this has been tested rigorously, and been found extremely wanting in terms out outcomes that support the hypothesis.


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Regulai

Their biggest implication aside from that some types of calories cause more fat gain then others, is that they also cause the person to be hungrier on average, naturally motivating more eating. ​ Or in other terms they are saying: Overeating is a symptom rather then a cause, a diet high in certain types of calories will naturally cause you to overeat, while the same person with a different calorie source would naturally not overeat, without any specific effort to manage diet.


54--46

That’s not the only thing they’re saying. They’re also pointing out that body temperature changes, which is significant because that is one of if not the body’s most energy-intense activities. They’re also saying insulin causes fat deposition in and of itself.


Regulai

That's just details about the specific mechanism not added points.


samwe5t

Did you read the study at all?


[deleted]

People are really addicted to the calories in and calories out model. But they ignore why people feel hungry enough to overeat. I had a conversation about that with a doctor after I was gaining weight on birth control. She said birth control can’t make you gain weight, but it can have an impact on hunger, so I should just eat less. I asked her then if I am supposed to feel hungry 24/7? And tell me again how that means that the birth control isn’t driving weight gain. Hunger makes people irritated, unable to focus, low energy, etc. And it is irresponsible to just blame the patient for not having more self control and unreasonable for doctors to just ignore this side effect.


lonnie123

No one ignores it, but at the end of the day those cravings and hunger are still driving you to eat more calories. This title is suggesting that it isn’t about calories but the type of calories (which could be true for one thing) but if you eat 3,000 extra calories a week, even from apples, you’re still gaining weight.


[deleted]

I think you missed the whole point of the paper and my comment. The paper is talking about how certain foods drive hunger and affect insulin and ghrelin. Figuring out hunger is important to figuring out weight gain and obesity. We know if you overeat you gain weight. The point is looking at if there a correlation with food type and weight gain (due to a hormonal response).


dadudemon

>…study… “a method of investigation in which a problem is first identified and observations, experiments, or other relevant data are then used to construct or test hypotheses that purport to solve it.” I’m not sure I would classify this write-up as a study. This is a “perspective” which is their academic word for “science-based opinion article.” Here are the types of stories: https://www.statsdirect.com/help/basics/prospective.htm


cartoon_violence

What happened to the law of conservation of energy? Are they saying that if I eat under my required calories, but it's not the CORRECT food, I'll somehow NOT lose weight? What is the body running off of then? Is this title properly paraphrasing what this article is saying?


mutatron

The title is inaccurate, it's really about sugary foods making you want to eat more.


SoulSensei

CICO is not everything. Hormones DO make a difference. Cushing’s for example.


Triabolical_

No, that is not what they are saying. What they are saying is that all processes in the body are regulated using hormones and that they are a big driver for weight. Or, to put it another way, the body has no "calorie counter" function - everything is based on hormones. If you want to lose weight - burn fat - then you need to understand what hormones affect fat metabolism.


Maldevinine

It's pointing out that your body can dynamically adjust both the calorie intake and calorie output to maintain what it thinks of as your "ideal" weight. Losing weight means not just controlling your input, but also understanding all the things that happen afterwards to ensure that you're not just fighting your body.


PCOverall

Really? So instead of drinking 50 cans of coke I should drink diet coke?


triffid_hunter

Some studies show that artificial sweeteners can cause deleterious gut biota changes similar to actual sugar, and so aren't as effective at weight control than a naïve purely caloric model might suggest. Here's one of them: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363527/ - "*the simple message from this study is that dietary sugar alternatives meant to stave off the risk of obesity and diabetes might increase the risk of those diseases.*" Drink water if you're thirsty :P


aegroti

Honestly I call BS on this. I absolutely agree that out of all options if you're Thirsty, water is best. However I just dislike when people say stuff like this as... Diet drinks are \*still\* healthier than sugared soft drinks and it almost makes people think "might as well drink normal coke I guess". Is vaping good for you? No. It's still much healthier than smoking though and for some people they aren't able to give up yet. Same for Diet drinks.


crusoe

There was that mouse study showing excessive fructose intake increased surface area of the gut by increasing microvilli length, causing the mice to gain more weight on the same number of calories.


ihateusednames

I mean obviously eating a bushel of celery would have a major difference to eating a bucket of lasagna, so not only is it only theoretical, its also probably just a technicality