Nick Norwitz Profile picture
Jun 14 10 tweets 6 min read Twitter logo Read on Twitter
1/10) 🚨NEW! #Keto for Anorexia🚨

We report on 3 patients who achieved remission from treatment-resistant anorexia using animal-based keto diet 🥩🍳

👉BMIs 10 - 13 kg/m2

👉Each gained ≥20kg

👉+Dramatic improvements in mental health

insulinresistance.org/index.php/jir/…

Read & Share🧵🙏 twitter.com/i/web/status/1… Image
2/10) Background 👇

Anorexia is a devastating condition that increases risk of death >5X and is associated w/ high rates of relapse

There is desperate need for more effective treatment options
3/10) Common knowledge posits patients w/ anorexia should be discouraged from practicing food group restriction

But anorexia can be framed metabo-psychiatric condition that may benefit from treatment w/ metabolic health interventions w/ neuromodulatory properties, i.e. #ketodiet Image
4/10) In this case series, we report on 3 patients who -- after having little success with conventional approaches -- went into remission with an animal-based #ketogenic / #carnivore diet Image
5/10) Patient 1 (female):
👉BMI low 10.7 kg/m2
👉 complicated by starvation hepatitis, osteoporosis, anorexia-induced blindness, and cardiac arrest
👉 Quote: "My high-fat #carnivore diet saved me, and I feel I can now do anything. I'm never going back to the way I was" Image
6/10) Patient 2 (male):
👉BMI 13
👉 complicated by anxiety, low T, neuropathy, osteopenia
👉 Quote: "But when I started a carnivorous diet, my life changed! My anxiety diminished... I steadily gained weight... I'll never go back."
👉Total testosterone levels ⬆ 6X & free T ⬆ 10X
7/10) Patient 3 (female):
👉BMI low 11.8 kg/m2
👉 Complicated by OCD, depression, self-harm
👉 Quote: "I feel 100% in remission and confident it will stick.”
👉Suffered for 3 decades with treatment-resistant anorexia, before starting #ketogenicdiet; now in remission for > 5 years
8/10) This case series suggest #ketodiet may have clinical utility for some patients with treatment-resistant anorexia, consistent w/ the perspective of eating disorders as “metabo-psychiatric” conditions that can benefit from neuromodulatory interventions, including ketosis
9/10) We hope these cases inspire further research and attract funding for much-needed clinical trials for ketogenic diets for a variety of mental health conditions, including eating disorders. Image
10/10) YOU can help support this line of research by RETWEETING this thread and sharing the link to the paper on your social media share this thread LINK: insulinresistance.org/index.php/jir/…

Special thanks to @Metabolic_Mind, @bschermd, @janellison and the Bazucki Group for their support

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More from @nicknorwitz

Mar 22
1/ NEW RCT shows that Fat-Sugar mix

👉 Alters reward circuits in human brain

👉⬇️ preference for lower fat-sugar food and ⬆️ response to milkshake

👉These changes were independent of changes in body weight or metabolic health

... A thread🧵
cell.com/action/showPdf… Image
2/ In this study, normal-weight participants were exposed to EITHER a high-fat/high-sugar snack OR a low-fat/low-sugar snack for 8 weeks in addition to their regular diet. The snacks were to be consumed 2x per day and were isocaloric. Image
3/ After the intervention, they first tested fat & sugar preferences & found, compared to baseline:

High Fat-Sugar intervention ⬇️ wanting for lowest but also highest fat food

Snacking intervention in general (both high-fat- sugar & low fat-sugar) ⬇️wanting for low sugar food Image
Read 6 tweets
Mar 11
1/ As time has passed and positions have evolved, I’d like to do another thread 🧵 on Satiety Per Calorie (SPC) covering:

👉 Utility vs. Limitations

👉 Issues w/ messaging, “evolutionarily normal” “open-minded”

👉 And to get at sense of prevailing opinions (Poll!)
2/ First, I’d like to say I’m not against SPC as a HEURISTIC and ABSTRACT concept

Reflecting on what food nourishes and satisfies you is a good exercise, in line with mindful eating. That’s the utility!
3/ However, once you start giving foods particular SCORES, you necessarily run into issues

I’ll review a few, and you can also see prior threads...

Prior threads/vids



Read 13 tweets
Feb 6
🚨Carbohydrate insulin model “dead,” OR is it misunderstood again? 🤥

1/ Doctor Tweeted “that the carbohydrate-insulin theory is completely dead” ☠️⚰️

I recently watch the interview with that doctor, and it was surprising the degree to which s/he got the facts wrong…
2/ The CIM does posit that a high glycemic load diet drives high insulin to glucagon ratio state… as a result energy available in the bloodstream is driven downwards in the late postprandial phase leading to “hormonal, hunger” & overeating…
3/ Doc said: “This whole process of fattening all the way down the line, you’ve actually got MORE fuel in your bloodstream… than someone who is not getting fatter.” ... the “decrease EA in the blood "has never been documented because it’s not really there!” Thus, CIM is dead!
Read 10 tweets
Feb 4
1/ How to poo 💩! Was listening to the new @hubermanlab with @DrGottfried this AM (at 3:37) on hormones and #constipation & was inspired to do a little thread on my top #6 tips for dealing with constipation ... hopefully this thread helps at least 1 silent sufferer
2/ This is a topic I'm interested in is bc as someone with a hx of proctitis + cecal patch (form of ulcerative colitis strongly linked to constipation), it's something I've struggled w/ at times. It's not fun & a far more prevalent problem than people realize 4 obvious reasons
3/ Let's start the list.

#1 tip has nothing to do with diet, but technique!

In normal seated position with knees at 90o, your puborectalis muscle strangles your rectum. If you squat with the assistance of a squatty potty (or 'toilet yoga') you receive this strangle-hold
Read 10 tweets
Feb 3
1/4) “Satiety score” score suggest macadamia nuts are more likely to promote weight gain and prevent weight loss than cheesecake?! (higher = more satiety) 🧐

Macadamia = 17
Cheesecake = 19

Battered fried shrimp = 35
Apple juice = 32
Fried zucchini fritters 27

#satiety
2/4) First, lest address the science. Do macadamia nuts cause weight gain?

In a 4 week interventional trial in which people were instructed to eat 40-90 grams of macadamia there was actually a net weight loss.

Try getting those results with cheesecake…
3/4)

Over past few days, I’ve gotten dozens of messages expressing disappointment in the new satiety scoring system

It’s a reasonable concept at best, but definitely not ready to be available as a public tool if it’s promoting cheesecake and apple juice over raw nuts.
Read 4 tweets
Jan 30
#Satiety Science, thread! 🧵

1/ It seems the new trend is talking about food "satiety" scores

Superficially the approach makes sense… prioritize foods that’ll keep your full and thus you will lose weight. Sensible, right?

Maybe, or maybe not...
2/ 1st, satiety is an abstract concept

The best one can do is try to operationalize by creating scores based on other variables

@DietDoctor does this
[combines] "factors that make a food more satisfying: protein percentage, energy density, fiber content, and a hedonic factor." Image
3/ However, such composite scoring systems have the problems. We know this from examples like the NPS that ranked lucky charms healthier than eggs!

Everyone was upset, right? Well, satiety scoring system presents a double standard Image
Read 10 tweets

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