The idea that the carbohydrate-insulin model (CIM) has always stated that it takes >2 weeks for changes to hunger and metabolism to occur is a major goal-post shift. Let's discuss...
The mechanisms proposed by the CIM involve known *rapid* actions of insulin, within hours after meals containing carbs insulin acts to suppress lipolysis and stimulate fat uptake and storage in adipose tissue. Insulin thereby traps fat in the "One-way Calorie Turnstile"
The CIM goes on to suggest that these established rapid actions of insulin on adipose to sequester and accumulate calories is the cause of increased hunger, overeating and slowing metabolism because anabolic adipose starves non-adipose tissues of fuel.
Lowering insulin quickly mobilizes fat from adipose, raising blood fatty acids, thus CIM predicts alleviation of "internal starvation" of non-adipose. The alleviation process could take weeks, but CIM originally suggested otherwise! Phase1 of the 'Always Hungry?' diet says <2 wks
'Always Hungry?' page 150: "...big declines in hunger sometimes from as early as Day 1. As fat cells calm down and begin to release their excess calorie stores back into the body, your brain will register...that it has enough fuel to run your metabolism in optimal mode..."
"Since your body will be burning more fat, your need for external calories will decrease. You'll fill up with less food and stay full longer." So, consistent with the known rapid insulin effects, the CIM circa 2016 predicts rapid effects on hunger, energy intake, and metabolism.
Here ~4:30, @davidludwigmd claims, based on the CIM circa 2016, that Biggest Loser folks could have avoided weight regain because "These biological responses that fight against weight loss can be reversed in potentially as little as one meal or one day" wgbh.org/news/2016/05/1…
But then experiments revealed many of the predictions of the CIM did not materialize after many days and weeks. Rather than acknowledge the CIM was incorrect to claim rapid effects, goal-posts were shifted and these studies were deemed "weak" and safely ignored as irrelevant.
Taking the CIM seriously and devising experimental tests that are summarily dismissed and goal-posts have constantly shifted is even more exhausting than these debates on Twitter! @MichaelMindrum aptly described it here:
And if you made it this far and are worried that I'm describing a "straw man" version of the CIM, see the thread below:

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More from @KevinH_PhD

17 May
I hadn't expected @davidludwigmd to criticize the recent perspective in @ScienceMagazine with @JohnSpeakman4 on the basis that it presents a "straw man" version of the carbohydrate-insulin model (CIM) of obesity. We tried to faithfully represent his version of the CIM. Thread.
Dr. Ludwig's description: “a high-carbohydrate diet … produces postprandial hyperinsulinemia, promotes deposition of calories in fat cells instead of oxidation in lean tissues, and thereby predisposes to weight gain through increased hunger, slowing metabolic rate, or both.”
This was also described as "the fat cell theory of obesity" in Always Hungry by where @davidludwigmd describes insulin as the "fat cell fertilizer" that acts as "The One-Way Calorie Turnstile" trapping fat in adipose tissue and leading to increased hunger & slowing metabolism.
Read 8 tweets
6 May 20
Just submitted our latest manuscript entitled "A plant-based, low-fat diet decreases ad libitum energy intake compared to an animal-based, ketogenic diet: An inpatient randomized controlled trial". I'm looking forward to all constructive comments!
osf.io/preprints/nutr…
20 adults without diabetes were admitted as inpatients to the NIH Clinical Center and randomized to consume ad libitum either a plant-based, low-fat (PBLF) diet or an animal-based, ketogenic, low-carbohydrate (ABLC) diet for 2 weeks followed immediately by the alternate diet .
The PBLF diet was 75.2% carbohydrate, 10.3% fat, 14.5% protein and had a non-beverage energy density of 1.1 kcal/g. The ABLC diet was 75.8% fat,10.0% carbohydrate, 14.2% protein and had a non-beverage energy density of 2.2 kcal/g. Subjects consumed as much or as little as desired
Read 17 tweets
5 Sep 19
I have some thoughts on a recent video posted at NutritionFacts.org by @nutrition_facts called “Keto Diet Results for Weight Loss” that relied heavily on our research to criticize ketogenic diets: nutritionfacts.org/video/keto-die…
The video cites our 2015 @Cell_Metabolism paper that didn’t investigate a keto diet. We even refused to call the diet “low carb” because the calorie restriction achieved by selectively cutting carbs resulted in a diet ~30% of total calories from carbs. ncbi.nlm.nih.gov/pubmed/26278052
Our study was NOT an efficacy study as portrayed in the @nutrition_facts video. Rather, it was designed to investigate the physiology of selective restriction of carbs vs fat &the effects on insulin secretion and body fat. The body fat differences were clinically meaningless!
Read 8 tweets
11 Feb 19
Our latest RCT paper was just submitted for peer review and now available as a @NutriXiv preprint: "Ultra-processed diets cause excess calorie intake and weight gain: A one-month inpatient randomized controlled trial of ad libitum food intake". osf.io/preprints/nutr… 1/7
We investigated whether ultra-processed foods affect energy intake in 20 weight-stable adults who 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. 2/7
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. 3/7
Read 7 tweets

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