these (natural) struggles explain much of the frustration and desperation around weight loss and why it's a field so ripe for misinformation and marketing
'a new diet that delivers effortless weight loss' is the ultimate marketing tool
ok, back to the science
one of the most popular ideas to emerge over the last couple decades was the carbohydrate-insulin model of obesity
according to it:
*carbs/insulin CAUSE fat gain and increase appetite*
**weight loss REQUIRES cutting carbs and lowering insulin**
numerous best-selling books put forward this interesting idea
it's now been tested in significant ways. the results haven't settled the issue completely but are informative and fascinating
Kevin Hall's team put obese subjects on 2 weight loss diets (both 30% lower in calories than baseline)
in one group the cals came from fat, in the other from carbs
acc to the carb/insulin model, only cutting carbs should deliver weight loss
the low-fat group lost significantly MORE fat than the low carb group
the diff was statistically significant but small. take home msg is that both diets resulted in comparable weight loss
C-peptide levels were lower on low carb, indicating lower insulin levels (as expected)
this does not rule out the carb/insulin model
(individual studies almost never settle an issue)
but it's a significant blow
carb/insulin reduction was not necessary for fat loss. if anything cutting fat & leaving carbs worked better. the opposite of what the model predicts
ofc when you're looking at a longer study, on a free-living population, you have more questions regarding adherence (see 'no perfect experiment' comment above)
the National Lipid Assoc. led a comprehensive review of the literature in 2019 and concluded that
"Low- and very-low-carbohydrate diets are not superior to other weight loss diets"
One take home msg from all this is that macronutrients (fat/carbs/etc) are probably not crucial for weight loss (unlike what 99% of marketing will have you believe)
then what IS?
ultraprocessed foods seem to be
they can lead to more calories eaten and more fat gained even if macronutrients are matched
calorie density may play a role. fiber. microbiome. etc
shooting for unprocessed, whole foods with low calorie density and a good amount of fiber is a good long-term bet for weight and health alike
additional factors:
- sleep affects metabolism and appetite. harder to lose fat if sleep deprived
- weight vs fat loss. losing water weight or muscle looks good on the scale but it's not what you want. keep adequate protein intake and consider a weights workout
geez and I said 'short thread'... got out of hand 😁
peace
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this indicates that 2 populations with the same ApoB level would have different risk depending on what type of ApoB particles are elevated (LDLs? VLDLs? both?)
NO. the study shows all these ApoB particles are atherogenic but points to TG-rich lipoproteins as being even more so *particle for particle*. most people have many more LDLs so the risk attributable to those will still predominate
Re: heart disease in particular, we can find heterogeneity in the literature. Some studies point to a signal of risk for eggs, others find no stat sig effect.
One of the main differences between science and Social Media content is how they deal with heterogeneity.
Social Media feeds you polarization. One FB forum argues eggs are poison, and shows you only the studies reporting risk.
Another argues eggs are a perfect, risk-free superfood, and shows you only favorable studies.
over 2 months, he lost 27lbs. his BMI came down to the normal range
his LDL-C dropped 20%. his triglycerides, 39%
his anecdote illustrates a couple points:
▶️we can lose weight on almost any type of food, as long as we cut calories enough
▶️ some foods make it easier to cut calories. calorically concentrated junk food makes it easier to overconsume calories, so for most people they're not ideal. most people won't achieve the precise control on a day to day basis that the Prof exercised in his experiment
Does high ApoB still raise risk if I´m “metabolically healthy”?
The evidence indicates it DOES.
(thread)
The idea that cholesterol level is completely irrelevant has largely subsided.
As the public is exposed to more scientific evidence, it has become increasingly obvious that blanket denial is not realistic.
So a more nuanced idea emerged.
“it´s about context”
According to this idea, high cholesterol/apoB increases risk in “sick” people (e.g. insulin-resistant/obese/diabetic) but is harmless for the insulin-sensitive & lean