Is the carbohydrate-insulin model of obesity dead? - Interview with Dr. Ted Naiman
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- เผยแพร่เมื่อ 28 มิ.ย. 2024
- A recent editorial by NIH researcher Kevin Hall claims CIM is dead. And Dr. ted Naiman tweeted that he agreed. But how doe this conclusion fit with the research from Dr. David Ludwig and the books by journalist Gary Taubes? Could it be that carbs and insulin are still vital to the concept of weight gain and loss, even if the full CIM may not apply? And how string I the research for and against CIM? We address these questions in this video with a bonus interview with Dr. Ted Naiman at the end.
Table of content:
0:00 Dr. Bret Scher on the recent CIM claim
7:03 Interview with Ted Naiman, MD
23:44 Closing by Dr. Bret Scher
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I have tried every diet under the sun. Keto worked... but only to a point. I hit a very long stall and found that when I reduced the dietary fat I was finally able to burn my own fat stores. Increasing the protein (rather than fearing gluconeogenesis) is helping me feel strong and and vital in my 70th year.
What you are doing is still keto. Misinterpretation of macronutrient composition numbers is very common, is reality protein is low limit and fat is high limit, you should limit fat consumption to stay under this number, consume less when you can. I guess it should be made more clear. Gluconeogenesis is a demand driven process, consuming more protein doesn't kick you out of ketosis.
I had the same thing happen- I did not lose weight on a ketogenic diet. Restricting calories and engaging in strength training are the only thing that has helped me lose weight. Just keeping track of calories has helped me be more conscious of what I am eating, and the strength training helps keep my metabolism higher. I'm not doing anything extreme, just working out with dumbells a few times a week, something just about anybody could do. Even yoga or tai chi could be useful for this in elderly people.
Fat is a rich source of energy, and the body is very reluctant to waste that energy it has stored up. Epileptic kids and adults on medically supervised ketogenic diets don't lose weight just because they are eating alot of fats. If they did, the diet wouldn't be remotely acceptable.
I remember in one episode of Asra Conlu’s carnivore TH-cam channel, she did mention that once you hit around 60 and beyond, your body needs greater percentage of protein than fat.
Its all about if you’re on a caloric deficit or not. Nothing beats a healthy balanced diet in conjunction with structured exercise.
I think the fat vs protein percentage is very personal. I think younger women need more fat, as you get older and have less estrogen the percentage may shift slightly. Its very individual.
I lost 60 pounds, 30 year old excema gone, no more joint pain, depressive thoughts gone!
I dont need mouse studies, i m my own study!
👌🏾👏🏽👏🏽👏🏽😃 100% agreement
I think their model, if you would call it such, improves upon and is more complete than the carbohydrate insulin model, which is only part of the picture.
This can be expanded further to the mitochondrial metabolic dysfunction models which incorporates all these, which I speak of in another comment.
The parable of 3 blind men and the elephant really applies here.
look in the mirror....you never know...
I lost 50 of 80 total pounds while recovering from shoulder surgery, 18 weeks. I started keto and did nothing as far as exercise. I cut out the carbs but ate very well while not keeping track of calories. Once I was able to get around the weight fell off even faster. Been over two years, still keto, still at goal weight, still not counting carbs, working out every other day and feel amazing.
I'm jealous
@Jeff C clearly, i guess he would have been much healthier being 80lbs overweight...
5:05 I don't know about the other blue zones, but the Okinawa inclusion into that high carbohydrate, low protein, low fat category is based on dishonestly reported data taken right after WW2 when their pig stock was decimated. The Okinawan diet is traditionally relatively meat heavy (specifically pork), and remains so to this day. I've been living in Japan for 4 years and studying Japanese language/culture for much longer and can attest to this. Likewise, while it's difficult to find this information in English-language sources because of the aforementioned widely disseminated misconception, meat consumption in Okinawa is approximately 30% higher on average than in mainland Japan (90-100g/day as opposed to 70g/day).
According to Wikipedia: “Pork is highly valued, yet eaten very rarely. Every part of the pig is eaten, including internal organs.”
False?
@@Seanonyoutube Definitely false. The meat consumption numbers I referenced were also taken directly from data from domestically conducted research.
Edit: the part about every part of the pig being eaten is true, however. This is true of not just Okinawa, but Japan in general, where many more parts of the animal are considered not just edible, but desirable, than in the West - especially liver, heart, intestines, and connective tissue (depending on the animal).
@@MildlyLinguistic how often would you say the older generation Okinawans eat pork?
They consume a great deal of SPAM
@@Seanonyoutube my mother in law is Japanese and lived in that area for a long time, she mentioned to me the same thing, they eat a lot of pork and fish there, this vegetarian thing is a myth
When I keep carbs low my appetite control is dramatically improved. An occasional 48 hour fast just isn't a big deal. I for one am never going back. I wish I knew how easy this was 20 years ago when my weight started to creep up.
I'm sure that the magic bullet is in the fasting, and LCHF is an essential pre requisite.
🙏 you for sharing and congratulations.
10:08 Dr. Ted Naiman says 'I like the controversy and I don't have all the answers'
..19:13 Dr. Ted Naiman's false argument against the carb insulin model is - he fattens animals with refined fatty oils (vegetable oils?) that have high satiety. But the key to health is to eat NATURAL dark meats and eggs, not processed fats and oils.
Thanks Robert, I’m wondering what the reason is for the 48 hour fast? I think I should try one but not sure why.
It seems that the elephant in the room, diabetes, and the promotion of conventional diet wisdom which has a direct relation to the diabetes epidemic in society is constantly being ignored. Follow the money and you'll find the cause of everything.
Stephen Rankin, I WISH I thought you were wrong, but the current dietary/medical advice from too many “ Nutritionists,” Doctors, and Government Officials (despite THE REAL SCIENCE of this whole question) as well as the terrifying and growing numbers of people with screwed-up carbohydrate metabolism, PROVES HOW RIGHT YOU ARE! 😱😢
@@Sforzatheforcer YOU ARE A THOUSAND PERCENT ( and tragically) CORRECT! 😱😢
@@Sforzatheforcer OR they feed it to livestock (along with antibiotics) and ruin THAT part of the food supply as well. 😣🤬
True 😢
@@Sforzatheforcer And over 99 percent of those crops are sprayed with very toxic pesticides.
He didn't clarify that it's seed oils (Omega 6 rich PUFAs) that are used to fatten lab rats, not coconut, olive or other mono or saturated fats. I have no doubt that if humans ate only PUFAs, they'd get fat.
The doctor being interviewed is so far the least credible person to be featured on diet doctor. Along with what you said about toxic seed oils; this guy is dismissing the carb-insulin hypothesis. I feel the model is not wrong, just incomplete.
Seed oils might still be satiating but they inflame and oxidise the body. Saturated fats like coconut are safe.
Well, it is combination of sugar + saturated fat where the saturated fat is potentiating the effects of the sugar. Yet it is not the SFA what is the problem but the sugar(fructose) which overwhelms the mitochondria so that this cannot cope with the SFA which *then* makes things worse.
But this is far away from sayng SFA are bad...
Yeah, his explanation was not sound or thorough. PUFAs in large quantities are a no no, and he didn't address it.
For years ate the toast and orange juice I was hungry all the time.
Eating meat and animal and coconut oil and butter and lard. Defo keeps my hunger at bay. I eat some green veg. But white carbs are my enemy so to highly processed junk food. So I think I will be sticking to the low carb insulin lowering idea.
Those on type 1 diabetes have poor blood glucose control. As soon as they go on a low carb diet, their blood glucose normalises, their requirements for insulin drops, joint pain goes, some women get their periods back. Carbohydrate Insulin model seems to work.
Thank you Azim
reducing carbs for someone with T1D enables them to stabilise blood sugars and insulin so they can dose more accurately and get off the blood sugar/insulin roller coaster. optimisingnutrition.com/how-to-optimise-your-insulin/
In a Type 1 diabetic their pancreas doesn't produce any insulin at all. Insulin is the mechanism the enables glucose to enter cells for fuel. This means that the glucose stays in their blood and can't enter their cells and be used as fuel. Their body uses their fat and muscle to get fuel and that's why most type 1's are skinny. Glucose in your blood stream is toxic and as it builds up their health declines and they eventually have organ failure and die. Before synthetic insulin was developed the ketogenic diet was prescribed for them but their blood glucose never 'normalised.'
I used to believe I could turn off my pancreas (like my wife, who has T1D) by swapping carbs for fat. Turns out I can’t. I need to reduce body fat to reduce the insulin required to hold my stored energy in storage. To that, I need to prioritise foods that are more satieting.
@@martykendall5111 That's a very interesting observation of the other major role of insulin. So would it be correct to say that heading towards your personal fat threshold is an additional driver of basal insulin, just as is consuming carbs beyond your body's individual carb tolerance is a driver of intermittent insulin spikes?
I think where keto/LCHF went off the rails is when folks started chugging a bunch of BP coffee with 800 calories of nutrient free MCT and such in it. There are "empty calories" in the carb world and there are empty fat calories as well. This doesn't mean we have to start eating carbs again, it just means that we need to re-focus our sights on nutrient density. Carnivore, in my experience, is the easiest and best way to do this. As a carnivore I am still in ketosis and still ultra low carb but I'm eating real food with high nutrient density and thus high satiety.
Hear, hear! 🐑🐮🐟
Hi Robin,
I agree, but who can afford $120 for a pastured turkey that might have been eating food contaminated by pesticide drift?
And GMO alfalfa has been legal since the Obama / Biden administration. They tacked it on a bill on Sunday morning with Monday being a holiday so no one would know.
@@LR-je7nn Pesticide drift happens directly in plant "food" crops. In animal feed, it is less dangerous because we have the animal doing the detox for us. Ruminant animals are better at this than the mono gastric ones such as pigs and poultry. Who is eating $120 turkey? Not me. There are lots of ways to make carnivore affordable including purchasing in bulk.
@@LR-je7nn are we fat because of politics, especially the democrats? Maybe we should be communist, chinese are thin on average.
@@roywalker7512 I am in favor of a wise benevolent dictator probably with term limits to replace our current corrupt government.
Singapore is doing pretty good with theirs.
I want to hear Ben Bickman’s views on this.
Bikman believes it's all about insulin toxicity, but misses the fact that energy toxicity (driven by low satiety foods) is the upstream issue driving insulin toxicity.
@@martykendall5111 why don't we let Ben say what he believes
Sure. That’s just my summary based from listening to everything he’s published. I think many people miss managing the basal insulin (which is the vast majority of the insulin produced to hold energy in storage). To reduce basal insulin you need to focus on satiety and nutrients rather than micromanaging the blips in your blood sugar or insulin only after meals. I think Ben is more active on Instagram rather than YT comments.
Agree, hopefully it can happen!
@@TH-camr-ep5xx I meant specicially to Marty's take on his view
Lost my weight by going healthy keto ....cancelled refined carbs and added salads and vegetables daily. Eats as much healthy fat as I want. 2 years holding. Protein did not change.
Meanwhile, I just lost 2.4Kg after a week of no carbs with high fat and protein in my diet... 🤔
Yeah I think the point is you can use moderate protein and high fat/low carb or a moderate protein low fat/high carb to lose weight. You can always sub carbs with fat and still lose weight if it’s the same amount of calories, they are interchangeable in regarded to weight loss. Too much ketosis can put your body into high high cortisol issues 5+ years down the line, such as in my case. After 5 years there are hormone problems for me on high fat carnivore and I cannot function anymore with zero carb. It takes a long time to wear down on it though for me at least
I ate mostly plants and limited my processed foods for decades. I was constantly hungry and constantly gaining weight. If you can fix yourself that way, fine but I got the talk from my doctor every year until I went keto and lost 27 lbs. I have kept it off for 3 years now and feel fantastic. I'm still 15 to 20 lbs overweight but I'll take it over obesity.
Berberine is a great supplement to reduce hunger and increase insulin sensitivity. It also has benefits for digestion. Apparently it doesn’t have to be taken forever if you are on Keto . I found it gave me a real boost that Keto didn’t quite achieve.
A lot of that might be just lose skin.
Just as the population is getting clarity on obesity and disease the researchers have to come in and confuse everyone with nuance.
Clarity? only until the next lot of experts come along
Science changes or is updated when it is challenged by new evidence. Fortunately, it’s not religious dogma. LOL
Where does his funding come from, total B.S.?! AN MD... #KETO4LIFE
His tweet was too simplistic! Saying that the "CIM is dead" failed to express the nuance of his specific point. As a result, Dr. Bret Scher had to clarify the confusion created by broad imprecise language. 🤦
The the trip right ry
I'm glad someone addressed this issue. The controversy is confusing people. The carb insulin model makes sense, and low carb is saving lives. There's nothing gained by trying to prove that you're too cool for keto, a la Ted. He is not helping people who need clarity around this subject, and whose lives can be saved by the low carb model. Throwing shade is not serving anyone, but maybe a few science nerds who just find it interesting on a theoretical level. Practically speaking, low carb works when nothing else does. Period.
Well articulated LV Richardson.
Well said, in addition I am following the high protein Diet Doctor plan with less fat more protein 20g of carbs 24lbs down since the end of November and 24 to go.
This is more of a geek episode… but is factual in every sense.
Well said, he is just trying to be controversial to sell his over priced book. That throws more confusion in a very confusing issue for most people.
@@davidhealey75 Ted is cool… he basically is saying introduce more protein cause it is satiating. And more fat (in huge amounts) is not always the answer. I am glad he shone another light in the keto space
I'm sure we all agree that drinking 2,000 calories of canola oil a day instead of eating food is bad. That doesn't show that the carb insulin model is wrong. I expected more detailed science and data.
Thank you for this very professional look at this topic! I ate a very low fat very high carb whole food plant based diet for a few decades and was slim, energetic and healthy (mesomorph body type). Then came peri-menopause, me/cfs and inability to exercise from my illness. I continued to eat that way but was driven to over-eat as I never felt full and put on fat pounds for the first time in my life-about a 15-20% increase in weight, all fat. I tried CICO with same diet plan and lost nothing and was constantly hungry! I then realized I probably had damaged myself and was now insulin resistant, so moved to a low carb diet about 6 weeks ago. Finally feeling full, getting energy back and slowly losing fat weight. I am able to exercise too. I plan to stay on this way of eating for the time being, until I reclaim my former physique & health at the very least!
Everybody is so different, my patient came to me because she has lost only 3 pounds in 3 weeks. I realized she was eating way too much fat. Starting keto, she increased her energy consumption from 1300 kcal a day to 2500 kcal a day. She is just 5 feet tall. What impressed me is that she still lost 3 pounds!! And yes, she wasn’t losing more because of her more than 200g of fat consumption a day… There were some adjustments to make… 💫
it is interesting how he only mentions "refined fats" as bad and not natural fats....anybody that knows anything about keto diets avoids "refined fats". Diet Doctor should have asked further on the "refined fats bad" concept and what he meant by it because I get most of my satiety from natural fat. Much more than protein.
He lost me when he said it’s all about calories which I know from experience doesn’t explain it all. He assumes that everyone started at a good weight, ate too much, and then gained weight, but some people have issues with insulin from the beginning, and some people were overweight as young children eating the same number of calories as the people who followed the standard trajectory that he envisions. I tried both approaches and keto and intermittent fasting are the only things that actually worked for me, and I counted calories meticulously and exercised at least six days a week before learning about keto and intermittent fasting, only to be stuck at a plateau and to sustain injuries from overtraining. I blasted through that plateau doing keto and intermittent fasting, and the only exercise that I did was walking, because that’s all that I could do with my injuries.
In 18 months I reversed my NAFLD with NASH and F3-F4 fibrosis, and lost 65 pounds in the process. All with a low carb/high fat keto lifestyle. In my experiment of N=1 the insulin carbohydrate model is valid.
thx for mentioning the time u needed to reverse NAFLD....it isnt a magic spoof,which unfortunately many afflicted with NAFLD seem not to know !
And that's All u need!!!
It could be that the same thing isn’t true for every body. I know what I’ve tried and what’s worked and what’s failed, and the insulin model has worked for me and the conventional wisdom and standard advice has failed miserably, so I’ll continue with the insulin model. But, I recognize that that may not be true for everyone. I’m just glad that people are out there talking about alternative options so that every individual can find out what’s actually effective for them.
its not the calories when you add oils to the rats food is the refined oils, use animal fats lets see what happens, but make sure those rats are not eating carbs. make it a diet of animal proteins and fats verse carbs and refined oil with the same calorie levels ill bet you will see a real difference. that will determine if its the calories or what you eat.
this is the thing. The issue with rat studies are that they are not all that close to us digestively. The cancer studies on rats, especially on 'red meat' or 'protein' causes protein were always without the associated animal fats. Then one study fed rats the normal chow, beef and bacon... normal cheap fat still on the bacon. These rats did have cancer and which rats did the best? The ones fed the supposed more carcinogenic food, bacon. Obviously this must mean that ICAR overturned their ruling that cured red meats are a class 1a carcinogen right? not with authors of vegan and vegetarian cook books dominating the panels it won't.
@@scottw2317 i agree, their are no good studies especially when they come from biased sources but i don't need studies to determine what history has shown us from tens of thousands if not millions of years. it's a crazy world that looks at science and ignores history.
@@yanostropicalparadise755 Well 'science' does show we had very high nitrogen 15 levels in our cartilage, with a level similar to or even higher than top tier predators, unlike herbivores that have high nitrogen 14 instead. We wouldn't evolve cancer weakness to these foods but not introduced trash like seed oils and high sugar intake.
@@scottw2317 i agree with you on all. but we didn't need science to know this. all you have to o it walk thru any wild area and try to find anything to eat. after searching these areas all over the country you will find that if you don't hunt animals, birds or fish you will starve to death, their is not enough wild plant foods to eat to keep even a small child alive. even if you happen to get lucky and find a few fruit trees its seasonal and you'd die in time.
@@scottw2317 just look at all the fruit trees in my yard, you can see them on the videos in my channel, id starve to death if i tried to survive on those.
I wish you teased out what he considers a "refined oil".. my assumption is he is talking about seed oils.. but it would have been nice to actually define it, or give examples, as it seems central to his argument. I am assuming he is not talking about fats such as beef tallow.
Yes. Oils are usually from seeds. Saturated fats like butter, lard, beef tallow and coconut oil are all solid and stable at room temperature and are therefore not oils.
@@asarcadyn2414 he considers all of those (butter, coconut oil, mct oils etc) as refined fats.
@@jenniferv3219 He is right on MCT oil of course, but I don’t think he could believe butter, lard or tallow is refined. Maybe ghee could be considered refined butter? It depends on how you buy coconut oil whether it has been refined or not.
First of all thank you for all the clarifications from Diet Doctor. I have been a member for number of years and have always found the discussions useful. Things change as science progresses and understanding improves. I appreciate that the site also reflects those changes. “All models are wrong but some models are more useful than others.“. This makes a lot of sense to me and I have lost some 70 pounds and improved my metabolic status using the CIM model as a guide. Since I’m thinking that weight gain/obesity and loss is multifactoral I guess I am persuaded that more nuance is coming our way as we gain more experience and more research and open inquiry is supported. I am pleased to see that (I hope anyway) that these discussions are not putting the low-carb community in any kind of serious opposition to each other. Disagreements are precursors to further research and N of 1 studies as it were. .As one of the low-carb nutritionists has put it there seems to be a continuum of diets that work for people and nuance and specific circumstances should always be taken into account. The Question “what is the goal“ or specific outcomes that need to be addressed in the context of a low-carb approach has to be considered. This is not to say that other approaches don’t work (for a time I lost weight following an Ornish diet) just that low carb seems to have a better track record overtime. The PE diet seems to offer some new approaches but I suspect that over the coming years that also will become somewhat more nuanced and tweaked depending on the needs of the specific individual. This will likely vary over metabolic conditions as well as age. Thanks again for this discussion.
Same old calories in vs out arguments from Nieman. 1000 calories from sugar and 1000 from butter should have the exact same effect on weight loss so long as you don't eat anything else. Anyone believe that?
CICO should be Control Insulin Control Obesity.
CALORIES are NOT edible.....why do we insist on making them a bio-marker?
Calories are burnt lab food numbers in practice.....jump to calories in your body with NO regard for NUTRIENT rich foods...
CICO is 5th Grade Math.....disguised as a health practice.
Yeah.... morbidly obese people do 😄
even the values for individual fat types have variation so while many of the polyunsaturates burned at a higher energy value monos and especially saturated burned with lower values yet fat is given the poly value of 9 where the value can go as low as around 6.
I've been obese and I've been extremely lean. I've lost 100 lbs. twice. I eat keto now, which is high in fat. I don't count my calories and I'm NOT over weight. Plus, while over weight I acquired Diabetes2. That has been completely eradicated with the keto diet, as well as several other related health issues. Improved health is my goal, so I will stick with what I'm doing for now.
Hi Maggie,
That's a good plan that's working for you. I did it similar, but I grew up down the street from Monsanto's chemical plant in Sauget IL and no food can defeat that.
@@LR-je7nn 💔
Lost 55lbs on very low carb/keto in first 2.5 months and have maintained new weight at bmi 19 for 18 months keeping very low carbs and 20/4 IF. Blood work very good - and got rid of BP medication as well. Never felt better and will keep going as it's easy.
I’ve lost 54 lbs eating meat cheese eggs and olive oil.
I wouldn't trust the olive oil. Studies have been done of the last couple of years on in store purchased brands of olive oil and avocado oil including ones claiming 100% of said product 100% organic and found that up to 85% of the product itself can be 'cut' (substituted) with seed oils like canola etc. The fats that plant oils do oxidise at a higher rate than animal ones and the common shelf life of these oils before purchase then people would be better off not eating these oils and definitely not cooking with them.
I don't know, but I wonder how many patients Dr Ted works with who are Obese, Diabetic, etc and that he walks them through the weight loss process for months with success and then follows up with them for the next couple of years. The real world of eating carbs is very addictive and taking this mediocre path that he seems to take misses out on the 90% of folks who regain their weight because of this addiction. I know the conversation was about the CIM but his answers seems to imply his rejection of carbs as the major cause of weight gain.
I totally agree. It also looked to me like Dr Sher wasn’t comfortable to really push him to properly clarify and explain his statements. Was almost a bit uncomfortable watching Dr Sher’s facial expressions towards the end of the video...
Keto
You can tell that Brett's heart is breaking with every word that Ted speaks.
This Naiman guy is criticizing the carbohydrate-insulin model by describing what happens during the process of weight gain, but he's completely ignoring what happens in the process of weight loss/maintenance.
Clear as mud. Thank you.
It’d be really helpful if Diet Doctor continued explain this issue and had more interviews about it with someone like Dr. Benjamin Bickman. I just don’t find this consistent with my experience. I find lean foods like chicken and vegetables satisfying. I can eat and eat them until I can’t eat any more and be hungry again in a few hours. I’d really appreciate more content about this.
i am the same way. lean sources of animal protein and fiber veggies are not as satisfying as when I add fat
Same here. I’ve been trying higher lean protein instead of fat and am starving all the time. I even started snacking inbetween my meals again which I haven’t done for nearly 2 years on high fat keto. This definitely isn’t working for me unless I want to be hungry all the time...
Maybe snack on cheese in between?
I have heard Ted talk about this before and do get his point. However, personally, I think we have so skewed our bodies with bad diets each generation that most of us now have to do low carb to correct this as against my great-grandparents who probably managed on 2-3 good meals a day of natural foods and did not get fat.
My biggest problem with Ted's approach is that there is too much focus on weight factors. For me there is also a significant mood factor as well not just weight loss. Lean meats leave me dissatisfied and unable to switch off hunger. Good animal fats make me happy, content and grounded. How my mind feels is also integral to my daily life.
If you add personal carbohydrate tolerance and personal fat threshold the model holds. Also the fat you "eat" from your stores counts in your calories but are not available to those with high insulin.
insulin resistance actually makes it easier to lose weight once you find a way of eating that gives your body what it needs without excess energy from fat and/or carbs. optimisingnutrition.com/ted-naimans-dam-fat-storage-insulinographic-explained/
Step 1 is to prioritize protein.
Step 2 is to control carbohydrate
Step 3 is to balance fats to satiety understanding that too much fat will limit weight loss or cause weight gain.
PS your graphic makes it appear fat and carbohydrate are equivalent in their insulin stimulation but fat is the least likely to stimulate insulin...why the desire to promote confusion?
Rodents in labs are fattened up with 45 percent sugar, 45 percent oil and 10 percent proteins -lab formula
and it just so happens that our modern food system is optimised to a very similar formula to maximise profit margin and drive us to eat more. optimisingnutrition.com/why-our-food-system-is-screwed-in-charts/
Exactly. Combining carbs with fat is the real issue.
Yes because eating two competing energy sources - fat and carbs is a poor idea. Carbs are energy now, fat is energy later. If you have energy now (carbs) you store the energy for later. This isnt rocket science. The issue is eating fat and carbs together - eg douts and baked goods.
@@michaelolofsson8558 what about milk ?and nuts ? And any food combo where food has both energy sources ..say egg and bread 🍞? Are carbs n fats from rice n eggs are bad when eaten together? Or it’s only bad when it’s junk food fats and carbs together ? If fats are carbs are to be eaten separately..how far separate from each other should one eat both macr nutrients ?fats take 4 to 5 hours to digest ..
@@thepoet456 Obviously the amount matters. Milk is a minuscule amount when it comes to a serving, whereas a couple of donuts is quite large in terms of energy.
Look at how much energy there is and how long it takes to spend it. Theres no hard and fast rule, when us in the high protein keto community do PSMF we limit our fat to 20 when we eat carbs for refeed.
Its that adage, dont blame the bread for what the peanut butter is doing, a serving of peanut butter is 120 calories, mostly fat, most people would have close to 4 servings (80g or so) then blame the 100 calories of bread for the damage, reality is, its the combination of both then a sedentary lifestyle meaning that energy is not used.
I'd love to hear Ted talk more about how weight loss takes a back seat to healing in a subset of metabolically unhealthy people. Siobhan Huggins has theorized (and there is some anecdotal evidence) that for certain very unhealthy people, such as obese women who have serious endocrine problems and inflammation, eating more fat and less protein -- at least for awhile -- seems to be the only way they can keep insulin low enough to permit lipolysis from their very unhealthy fat tissue and begin shedding some of their excess weight. Sometimes I feel there is too little attention paid to how men and women can be so different in how their bodies regulate weight gain and loss.
I love the way you sum up the information in the video at the end, it really makes listening to the video more valuable.
Low carb diet is the only thing except starvation that works for me, Basically i did a 1000 kalorie diet for a month and walked almost daily a 1-2 hour walk. Did lose a few hundred grams of fat in a month, which to me was really depressing, Then i did the low carb diet. And i lost 10 kilos in a month, This diet works 100% for people like me with insulin resistance.
I was the same. Haven’t lost as much as you did. But for the first time in my life i have been able to lose weight without starvation. AND i now have the energy I need to work out. 😃
Time-restricted eating would probably also work for you...
Thank you. Great discussion
As others have pointed out here in comments it is the combination of carbs and fats that cause the issues. Having gone through several years of low carb to keto to carnivore to ketovore I have done the big weightloss, got all my blood markers where I wanted but I am never satisfied so I keep reading including dr Naiman’s P:E book. Which was good. My struggle as a senior weightlifter now is getting the necessary protein without over doing Energy macros. And since trying Naiman’s approach, that is not fearing carbs as I have for years now, I find my E is too high and have seen some weight gain. Not a lot so nothing to panic over but also not seeing the body composition moving in the right direction either. I will probably go back to strict LC if I don’t see a change in the current trajectory. So n=1, jury is still out but not seeing the P:E approach working as well as strict LCHF.
I found this video very confusing? What does this mean for actual people???
Our goal is always to keep low carb simple. You may find this reassuring.
www.dietdoctor.com/high-protein-diets-are-an-option-but-not-the-only-option
@@dietdoctor You keep posting that link, but "reassuring" isn't really the word. Simplified, yes.
great work guys! understanding insulin as the break that holds your fat in storage is critical. unless someone is chasing you with an insulin pen to inject excess insulin (which will shut off the release of stored energy), satiety and nutrient density is where it's at if fat loss is your goal.
I lost 45 pounds on keto but I never ate that much fat...no fat bombs, not exageration in putting more butter or mayo...Always add some but normally...I am often on OMAD during the week , easily with absolutely no hunger... I only eat whole food, meat, veggies, yogurt, cheese eggs. Occasionally berries like a treat ... I not only lost weight,....I lost 20 years of age ! No more joint's pain or tiredness ....I feel SOOOOO good...I will never look back again...bye bye carbs !
No doubts about it !
This makes so much sense. I have PCOS. From what I can tell I may have had insulin resistance for years even before I had to deal with infertility and two ivf cycles. I went on a vegan diet last year and lost 35 pounds and my A1c came down from 6.4 to 5 within months then I slipped back to bad eating habits and gained all of it back. I started doing keto a month ago and down 12 pounds already. One thing was consistent both times. I stayed away from any kind of processed food. We got our ingredients locally and cooked all the meals ourselves. I like keto better as soon as I started it my joint pains went away. I still have high blood sugar in the morning, which worries me ( I never had high blood glucose before even with high A1c, every time my doctor did a test Bloodborne glucose was in the normal range. ) I decided to be brave 😂 and stick with keto. My skin and joints love my new diet. Last week my weight loss stalled. Watching this I understand maybe it's because of the keto peanut butter cups I used as a snack. I am going to stop that and eating nuts. I will stick to eating real foods. Thanks for doing this channel. It's hard to find good resources about low carb diet, specifically the metabolic side how it affects different conditions.
So ultimately we’ve gone full circle. In the past we solely focused on calories, then we said calories don’t matter as long as insulin eg carbs are low, and now it’s back to just the calories again... #totallyConfusing
PS. It’s sad to hear Dr Naiman saying that he isn’t “taking this super seriously”. As someone who used to be very metabolically unhealthy and has turned my health around this topic IS super serious!
This is how science works. Apposing, conflicting, and supporting hypothesis must be reconciled. Progress is being made.
I believe he said he doesn't take it PERSONALLY. Totally different.
He said he doesn't take it personally. In other words, he doesn't feel personally insulted if his favorite scientific model is invalidated.
@@borissman , instead of lowest calories, I prefer nutrient dense. But perhaps our goals are similar.
@@borissman I think the truth is that our bodies are itself, and are full of, independent living organisms that can't be distilled down to any one answer for all or even for a majority. :)
What's his point? He should have a knockout argument to 'kill' a successful model which explains so much and helps so many. He's arguing a darker shade
of a nuance
Same here, there’s been enough studies and anecdotes that show lowering insulin via lowing carbohydrates works period.
@@Sforzatheforcer Diet Doctor is slowly losing his credibility.
@@Sforzatheforcer wish I'd never heard of Ted Naiman. It seems that when I reduced my fat intake my body held on to body fat and I ended up eating junk carbs to get the quick energy I found I was now lacking. And so I gained all the weight I lost from 4 years on keto. Eating a higher fat to protein ratio seems to be the answer for me both for my physical and mental health.
@@wifetojafa2285 um he demonizes both refined carbs and fat. you totally missed the point. eat more protein, not more refined carbs. why would you eat more junk carbs that have terrible satiety per calorie? utterly stupid. sounds like you went too extreme in lowering fat.
@@SkyZer0 I didn't miss the point. What I'm saying is that I felt I lost control as there was no satiation. I was perpetually hungry until I ate fast burning carbs. My guess is that I need a much higher intake of fat than Ted Naiman advocates. And, thank-you for being so very polite.
“Those people just don’t understand how insulin works...”. How insulting is that?!
but true! optimisingnutrition.com/how-to-optimise-your-insulin/
Excellent nuanced conversation Bret and Ted; thank you so much for the enlightening exchange -- outstanding! #gratitude! Anuruddh
Interesting discussion. The question for me is: is satiety increased more by nutrient-dense food, regardless of its macros? It may be different for different people. For me, when I got used to intermittent fasting I learned to be satisfied skipping breakfast. Now, when I occasionally have breakfast, I sometimes feel bloated. Satiety changed for me.
I agree when the guy says that insulin moderates the fuel flood gates, but I don't agree when he says vegetables have a high satiety. I can eat a very large amount of veg, but a moderate amount of fatty meat will fill me up. Your body knows when it's got enough nutrients and energy (on a whole unprocessed food diet).
@@jhaley2439 Indeed, you've defined it quite well.
When I'm satiated on fatty meat, my stomach isn't actually full. There's more capacity but I don't feel like eating.
My old carby diet was horrible, I'd want to eat more even when I could feel my stomach stretch. That's how stomach aches occur.
I regret eating white rice, empty calories that caused me prediabetes and digestive stress.
@@jhaley2439 exactly!!! lack of hunger without the belly pain
My question is how does one even begin to measure satiety objectively?
@@robinbeers6689 we me after eating this way I am not stuff but full. I feel satisfied I don't know how else to explain it. I feel different than when I would eat a burger and fries verses a keto bun/burger and homemaid sweet potato fries cooked avocado oil
@@aprilek6003 I agree but how does one quantify satiety? How do you say this food has more satiety per calorie than this other food? You and I have our subject experiences. So are they saying that this or that macro or food is more or less satiating based on opinion surveys?
Dr. Naiman's emphasis on satiety alone has a HUUGE blindspot when you take into account the metabolism breaking effects of modern industrial seed oils that are the one component of the modern human diet that most coincides with the prevalence of chronic disease all over the world but nevertheless he is a font of wisdom when it comes to protein. The PE ratio book is a complete steal and makes for a great read
Still, not eating carbs will burn fat. Eating carbs will not. Even Ted acknowledges that eating carbs turns off fat burning.
yeah and you're never going to burn your OWN fat if you're eating plenty of dietary fat.
@@SkyZer0 true. Thus the emphasis on protein.
@@SkyZer0 Well I did. N=1. Perhaps its better not to be omniscient and tell others "you will never". Just sayin'.
@@T-aka-T and people stall out all the time doing so. you clearly weren't exceeding your daily energy expenditure vs. food intake
Thank you Dr. Sher for this excellent explanation of the nuances surrounding this debate around insulin. Additionally, I appreciate the interview with the incomparable Dr. Ted Naiman, which further elaborates on these points.
What a nuance! Howevet, ,it appears that Protein has maintained its position of being "super" important.
Protein is king 👌🏻
the % protein in your diet is the biggest lever for satiety. it's not always about MORE protein, but rather less fat and carbs that leads you to eat less without constant hunger. optimisingnutrition.com/how-does-protein-suppress-your-appetite/
@@martykendall5111
Nice article.
Yes but notice how he only talks about "refined fats" in his answers and not all fats or natural fats.
@@marcelodim9762 I totally think some animal fats are essential, even for satiety.
Well, I'm confused now. I've been obese for at least the last ten years. I can remember back to the days before that, where I had a high carb, low fat, low protein diet and boundless energy. Since I've been obese, Dr Ted says I have MORE fat and glucose circulating - MORE energy in my bloodstream - well, it MAY BE circulating around, but I'm not getting access to USE it - these last ten years I tire physically, VERY quickly, every single time I go for a walk, use the treadmill, or just walk up a flight of stairs. With dogged, gentle persistence, going out for a 1km walk every day - IT NEVER GETS ANY BETTER - my fitness never improves - access to that energy never opens up. Countless times I have gotten to the 6 or 7 week mark and just thrown in the towel from f-ing frustration. If I have extra energy as an obese person, and I never get to use it, what's the point of it?
I could have written the same! I am going through that exact problem. I am also menopausal and wonder if that's why. I have been strict keto and the scales do not want to budge. I just started Dr Naiman's P:E approach and up'd my protein and lowered fat to keep my carbs and fat well below my protein totals and I am hungry all of the time and feel bloated. I am also frustrated and just feel like giving up!
Vegetables are satiating? I don't think so. Fat and protein are satiating and that has been proven for years. Naiman is wedded to the calories in calories out model which has been debunked and frankly he talked quite a bit on nonsense.
Great information thanks
Thank you for video.
Great content!
i think i saw that article posted in the facebook group. As far as i read into it, the topic as a whole is not dead.
Thanks Dr. Bret for trying to clear this up. Difficult to say the least. I fear this back and forth on if insulin is the reason you are fat and cannot lose weight will just keep more folks confused and sick. My hope is those with a weight issue will seek out Drs Tro, Lenzkes, Cywes, etc. And leave the always thin, metabolically voices in this space alone. Where we enter our health journey matters. Much love for you Diet Doctor!
@Papa F Jose Well, now, there's a global claim! A bit beyond the scope of your evidence, I suspect.
@Papa F Jose No, actually I've contributed a few things on this page and carefully said "n=1" when giving my own experience. Your ad hominem insult isn't appreciated. I take the topic seriously.
@Papa F Jose I think we may be wasting each other's time. I wish you well. Cheers, farewell.
I also feel more confident listening to experts who themselves have lived through the struggles of being overweight. Someone who has never been seriously overweight just doesn’t fully understand it. We may have studies which they always refer to but I have done my own n=1 study for decades now and some of the things they’re talking about just doesn’t apply to me...
The demonizing of insulin and the lack of any context to metabolic function of insulin has lead to many myths and blunders within the LC community. Instead of focusing on, for example, the dramatic blood sugar normalizing effects and the halting/reversing of diabetic complications for diabetics and pre-diabetics that LC offers, 'insulin' was named as the boogeyman. This lead to a disaster where protein (insulinogenic) was replaced with meals of fat...'LCHF'. If you were active in the keto online world tracing back to 2014 or so, you'd see people trying to drink cream to 'get the fat and ketones up' because 'fat isn't insulinogenic'. This stuff was ubiquitous and crowds would see an initial improvement but then plateau indefinitely. Good to see this nonsense is getting fixed. Dr. Naiman a hero for fixing these blunders. You cannot overemphasize the importance of protein nutrition and that is the context we want for insulin.
where do you buy the scale
Great Dr very helpful
My triglycerides were 93, but A1C was high at 6%, and I am severely obese and was never experiencing satiety. I felt hungry all the time and struggled to keep calories at 2400-2700 a day unless I spent hours on my exercise machine. Since I started intermittent 18 hour fasting 2 months ago, I feel so much better! My guess is that there may be receptors in the gut that influence satiety, because I now experience the satiety I remember as a kid for the first time in decades. My calories are under 2000, because eating is confined to a six hour period, usually less. I don't focus too much on food restriction. I eat high fat and keep carbs under 200g a day, often less. I don't like sugary foods and never have, but I was eating too much starch. I rarely touched alcohol or sugar, just never liked them. Been a vegetarian over 40 years, so cholesterol ratios are all optimal. The 18 hour fasting is the right option for my body, but there was so much negative messaging about it and muscle loss, that I avoided it. And there was so much positive messaging about eating small meals all day to keep blood sugar from crashing, I was always doing that and failing. I feel I should do this fasting forever and hope to feel up to introducing a 42 hour fast once a month.
To think that a diet, which works on an insulin sensitive lean person, would also undo the damage and lower the obesity of an insulin resistant person is misguided. Its like thinking that, if you want to make a car go as fast as a fighter jet, all you need to do is put jet fuel in that car's engine. Just because jet fuel works to make a jet go fast, doesn't mean it will do that with the car because a car's engine is not equipped with the machinery to use jet fuel effectively. Similarly, an insulin resistant person's physiology (i.e. machinery) is no longer equipped to use the jet fuel (i.e. carbohydrates) that insulin sensitive people use so readily.
Still learning!
A big problem has always been that people use the words sugar and carbohydrates interchangeably all the time. They also use “good carbs and bad carbs”. This confuses dieters that are beginning to learn nutrition science. Books are generally more specific than interview videos. If you are a beginner please don’t get confused and give up. Find a person’s view you like in the videos, then get their book and study it. Remember this “nutrition and diet are highly controversial because of their complexity.” Don’t loose the forest for the trees and also, everyone is pulling for you.
Just started LCHF ...am anxious to reduce statin, BP and antilipemic meds. Yay!
Has Ben Bickman addressed this latest study?
Intermittent Fasting (one meal a day) and low to no carb intake has done wonders for me.
The same for me.
Hello sir your explanation is so good but what is that disclaimer I'm fear about that disclaimer
Satiety per calorie does seem to be a good measuring stick.
yes indeed! if only someone would work out how to quantify that! optimisingnutrition.com/calculating-satiety/
@@Sforzatheforcer nice work! I've just tried to dive into this analysis to help myself, my family and other people that 'eat fat to satiety' doesn't work for in the long term.
@@Sforzatheforcer -- N= 1 from me (in agreement with you). Keto for several years was fine but shifted no weight. Gradually went up, up, up. Switched to carnivore with high fat and all the effects of the plant toxins disappeared, weight started coming off -- on definitely MORE calories, with no change to exercise. Never ate processed foods or seed oils, and I don't fall into the "carb addict" category. But I loved vegetables. Now, instead of my usual "some meat" and 5 vegetables or big salads, I have switched to (eg) a 250g or 300g porterhouse with salt and lots of butter, or a 400g ribeye, and an omelette with bacon, or liver and bacon, or a can of sardines (with the oil) for brunch/lunch. That's it -- and that's what has brought the results. I'm 20 years younger. Definitely not eating less.
It comes down to satiety....yes! I can eat a 1/4 pound of brisket and a side of veg and be full for a day. Give me a bag of potato chips and I can’t seem to eat enough to get full during the day.
1/4 pound...that's less than 125 g of meat...how can you be full for a whole day??
@@angiesrecipes it does keeps me full compared to any carb loaded meal, however I do eat twice a day. If I eat a carb heavy breakfast I am hungry in a few hours and seem to never get enough to eat. If I eat protein heavy meal early in the day I don’t ever think about food until dinner.
@@cassieb1860 but 100 g of meat just 30g of protein...that's not a protein heavy meal. I eat 100-120 g of protein per day.
@@angiesrecipes ok I was not being specific enough, I guess. I eat upwards of 160 g of protein a day for my 5’10” frame. I was only implying that with a little protein and veg a person will not be hungry from that like they would eating a carb heavy meal. I follow Dr. Naiman’s advice from his book.
@@cassieb1860 I see. 160g of protein is good. Sometimes I was trying to eat less than 100g, and I would feel hungry. So I was really surprised when you said that you wouldn't be hungry eating just 125g of MEAT.
I wish you had challenged him on 1) is refined oils/fats same as what is normal in keto diet 2) isn;t natural fat higher satiety content vs refined oils 3) just focusing on satiety is not a very practical way to eat. nor accurate for weight loss or glucose control
I can appreciate that the carb/insulin model that makes one fat is not going to be the same that fixes obesity because of the problems that metabolic syndrome creates when one has become insulin resistant or pre-diabetic/T2D. Chronically high glucose with chronic high insulin seems to be problem #1 - at least for me. Lowering refined or starchy carbs to practically 0 gm along with moderate (higher for me) protein, and moderate fat (less that the typical LCHF recommended of 70%), seems to work better for lowering glucose and improving satiety and wt loss. But insulin is not as easily measured outside the lab. Intermittent fasting every day with occasional full fasting of 1-2 days each month, seems to give me the best success so far. Some days OMAD works fine but on others I add a large salad with a chopped egg (and/or tuna) & avocado for dinner if it doesn't. Keeping the calorie range between 900 - 1200/ day.
fantastic, you guys are my favs…🙋🏻♂️💪🏻👊🏻😀
How is satiety per calorie unlike CICO?
You summed up it up well at the 5:00-ish minute mark -- change is needed, calories decrease, this can be done with changes in glycemic index, fat intake, etc. As you alluded, the CIM is part of energy balance and changing your metabolic state. One aspect that is not included is education and looking at eating nourishing is a skill... The insulin question at 11:50-ish is stated nearly binary -- when endocrinology and insulin is a 'dimmer switch'. The insulin shift over time is that the 'thermostat' and fuel sensor changes to the circulatory environment -- as mentioned by Dr. Naiman.
wonderful video!!! 👏👏
to me what Doc Neiman said about satiety per calorie look like: “insulin does mean nothing, it’s all about calories in calories out!”
and at the end… i really really agree with that!! 😉
What is the "Ideal" caloric range to be eating?
That is very individual. It’s not the amamentar every person. Lifestyle, height, muscle mass all plays into it.
Here's the guide to calories on our website.
www.dietdoctor.com/low-carb/calories
All I know is what actually works best for my body and without a doubt it’s the carbohydrate-insulin model. When I keep my carbs and insulin super low, I loose weight, my appetite is controllable and my body and mind have more energy and I feel great. If someone can find a scientific way to explain how that works besides using the insulin model, good for them, but I’ll keep doing what works for me. Also, my HDL keeps going up and my triglycerides keep going down and the last time I had my vitals taken my blood pressure was 116/80 and my resting heart rate was 60. So I’m good with that.
Sir, are you saying that dr.jason fung & dr.cywes is wrong?
I NEED MORE! It is sorta still hangin'...inconclusively! Maybe I'll play it again...
This guys got some good information but there are some huge gaping holes in what he’s saying. Look at Dr. Benjamin Bickman‘s research, it is about insulin. There’s a lot of research out there that he seems to be ignoring.
But the big question remains unanswered i.e. what is causing all the diabetes?
Isn't it likely that eating too much of the foods that spike insulin the most, and eating them too frequently, are in some way related to the growing number of diabetics?
It's mostly sugar, because that is how it is suppose to work. Sugar is a signal in the nature (occuring in the late summer/in the fall) to go into insulin-resistance to spare energy for the winter to come.
However this is unrefined sugar. Refining potentiate the effect of the sugar and chronically leads to a severe insulin-resistance.
It's caused when somebody reaches their fat threshold. This means they have no more fat storage and the glucose in the bloodstream has nowhere to go. This constant high blood glucose leads to diabetes sooner or later.
@@francisvlatko2834 You are wrong, because you aren't even trying to ask yourself why would be so much glucose in the blood stream in the first place.
Glucose doesn't lead to diabetes but high insulin. And high insulin is caused by insulin resistance which in turn is caused by sugar(fructose) in the diet.
14:25 Ted literally answered this in this video
Interesting perspective…
This well known guy, being also an MD talks b@llsh!t about the carbohydrate-insulin model, which he does not obviously understand. Yes Mr. Naiman if you are insulin resistant and then get really fat, you eat homongously and in a little time you starve, you are not hungry you are starving. I have seen it in many of my acquaintances that are really obese to overeat and after an hour or two to be desperate for food. Also, pour oil... on what? on carbs? yes they get fat and the model explains it. This "protein-calories" guy is in total darkness about the carbohydrate-insulin model.
For the life of me I don't understand why people overcomplicate what to eat. Any advice telling you not to eat fruit or potatoes (too much sugar, or too much insulin) is ridiculous. Eat 3 balanced (protein/fat/carbs) home cooked medium sized meals per day nothing processed, just actual food and make sure to stay active, just walk more. Carbs are not the enemy - eating a boiled potato with meat and salad is not going to make you obese or diabetic. Snacking on berries and nuts is not going to make you fat ! Eating a tub of ice cream after a XL pizza with buffalo wings followed by McDonalds for dinner and M&Ms for desert will ! Is it really so complicated? Are we not just deluding ourselves when we say an obese person became overweight by eating too much fruit and boiled potatoes? My entire family has consumed carbs with pretty much every meal (cooked from scratch of course). My partners family is the same. None of us are overweight. I very much doubt we are a scientific anomaly. Just eat 3 home cooked meals a day people..
My insulin always high ,but now I’m gonna work hard to lower it and eat healthy,, cut carbs thank everyone sharing this video 👍
Can you look into the research done on AMY1 genes and obesity, please?
breakdown the oils you are mentioning, the Bad omega6s!
The carbohydrate-insulin model (CIM) has some nuances that are not often discussed. I have been trying to troubleshoot a hard stall in my weight loss (for 3 years) after initial success with keto. I eat
Listening to this trying to understand Lipedema.
I've already reconciled theses models in r/ketoscience. The more obese and insulin resistant you are the more the CIM applies. The lower your insulin and fat mass CICO applies. Easy peasy
What is CICO?
@@Knaeben Calories In, Calories Out. The "eat less and move more" school of thought.
Kaeben Calories in, Calories out
Well no, because CICO directly impacts your insulin sensitivity.
I like your conclusion. Of course calories count. Of course, eating carbs puts you on a blood sugar roller coaster, and that makes you hungry. The key issue is eating in a way that provides nutrition while keeping hunger at bay and allowing your body to metabolize your stored fat.
Isn't this just the how the Randle Cycle works?
Does dr. Naiman ever differentiate between refined fats? Seed oils vs. Butter for example.