Category Archives: Weight Loss

New Evidence Supports Extreme Carbohydrate Restriction in Type 2 Diabetes

Low-Carb Spaghetti Squash With Meat Sauce

Diabetes is a disease of carbohydrate intolerance. Doesn’t that suggest to you that diabetics should reduce or avoid dietary carbohydrates?

The new study at hand was done in Indiana, involving 262 folks with type 2 diabetes. Characteristics of the study subjects:

  • average age 54
  • 66% women
  • BMI 41 (very fat)
  • average Hemoglobin A1c 7.6%

The authors don’t use the term “ketogenic diet,” preferring instead “a diet designed to induce nutritional ketosis” (I’m paraphrasing). For most folks, that’s a diet with under 30 grams of carbohydrate daily, according to the researchers. The study lasted for only 10 weeks.

The drop-out rate was about 10% (25 participants), which is not bad.

Results:

  • Hemoglobin A1c (a test of diabetes control) dropped to 6.5%, a move in the right direction and equivalent or better than that seen with many diabetes drugs.
  • Average weight loss was 7.2% of initial body weight.
  • No severe symptomatic hypoglycemic events.
  • Number and dose of necessary diabetes drugs were reduced “substantially.”

What’s not to love? Why isn’t this the standard of care?

Click the link below to look for details of the Virta Clinic program used in this study.

I put together a Ketogenic Mediterranean Diet for my patients with diabetes. It reduces dietary carbs to 20-30 grams/day. There’s a free version, but consider the low-cost version that includes recipes and extensive initiation and management advice.

Steve Parker, M.D.

McKenzie AL, Hallberg SJ, Creighton BC, Volk BM, Link TM, Abner MK, Glon RM, McCarter JP, Volek JS, Phinney SD
A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
JMIR Diabetes 2017;2(1):e5
DOI: 10.2196/diabetes.6981

low-carb mediterranean diet

Front cover of book

6 Comments

Filed under Carbohydrate, Drugs for Diabetes, Weight Loss

How Walter White lost weight in “Breaking Bad”

Raw Brussels Sprouts, one of many low-carb vegetables.
Photo Copyright: Steve Parker

In 2014 Howard Stern interviewed Bryan Cranston and asked how he lost weight so quickly for his role as Walter White on Breaking Bad:

“Stern: When you had chemo and was getting sick playing the part of Walter White, in order to go through rapid weight loss you deliberately didn’t eat for 10 days? True or false?

Cranston: False.

Stern: How’d you lose all that weight?

Cranston: No carbohydrates. I just took out all the carbohydrates.

Stern: How much weight did you drop?

Cranston: 16 pounds, in ten days.

Stern: Painful?

Cranston: No. The first three days are really hard, ’cause your body’s changing and craving sugar and wants, you know, and then you deprive it of the sugar and it starts burning fat.”

Source: How Walter White lost weight in Breaking Bad, it wasn’t chemo – High Steaks

h/t Tom Naughton

Leave a comment

Filed under Carbohydrate, Weight Loss

Exposure to Cold May Help You With Weight Management

Well below room temp here

Should be well below room temp here

David Mendosa found a 2016 research report suggesting that cool temperatures may help with weight management by activating our brown fat, which burns more calories. Heat generated by brown fat is derived from glucose and triglycerides. Keep in mind as you read further that a comfortable environment temperature for a clothed human is about 23°C or 73°F. Those temps don’t stress our bodies by requiring us to either generate or dissipate extra body heat.

David writes:

Researchers have discovered that when we get mildly cold, which they define as being cool without shivering, our bodies burn more calories. As a result, managing our weight can be easier.
This is the conclusion of a recent review that two researchers at Maastricht University Medical Center in the Netherlands published in the November 2016 issue of the professional journal Diabetologia. The title of their article, “Combatting type 2 diabetes by turning up the heat,” puzzled me at first.

The title confused me because the study is about turning down the heat in the room we’re in. But then our bodies compensate by turning up their internal heat production.

When our body does this, its energy expenditure increases, ratcheting up our metabolism. Being mildly cold revs up our bodies’ brown fat, which unlike white fat, burns calories instead of storing them.

It’s not quite clear how much cold exposure it takes to turn on your brown fat. From the link above:

Cold acclimation by intermittent exposure to a cool (14–17°C) [57–63°F], or cold (10°C) [50°F] environment resulted in significant increases in NST [non-shivering thermogenesis or heat production] capacity. A 10 day cold acclimation study with 6 hour exposure to 14–15°C [57–59°F] per day was enough to significantly increase NST by 65% on average. A 6 week mild cold acclimation study (daily 2 hour cold exposure at 17°C [63°F]) also resulted in an increase in NST together with a concomitant decrease in body fat mass. The latter two studies also revealed significant increases in BAT [brown adipose tissue] presence and activation. All in all, cold-induced BAT activity is significant in adults and parallels NST. The actual quantitative contributions of BAT and of other tissues (e.g. skeletal muscle) to whole-body NST are, however, not elucidated and await further studies. Furthermore, more information is needed on the duration, timing and temperatures to find out which treatments are most effective with respect to increasing NST.

Furthermore, cold exposure over the course of 10 days increased insulin sensitivity in T2 diabetics by 43%. Eight study subjects, probably in the Netherlands, were exposed to temps of 14–15°C [57–59°F] but I don’t know for how many hours a day. Increased insulin sensitivity should help keep a lid on blood sugar levels and reduce the need for diabetes drugs.

In case you’re elderly, obese, or have type 2 diabetes, be aware that the activation of brown fat by cold exposure is not as robust as in others.

On the other hand, I found evidence that higher ambient temperatures (above 23°C) [73°F] may also help with weight management, regardless of what brown fat is doing. Science is hard.

Steve Parker, M.D.

PS: Check out my books for more ideas on weight management.

 

Leave a comment

Filed under Weight Loss

QOTD: E.E. Blaak on the Ideal Diet

Full-fat cheese

Full-fat cheese

Overall, energy restriction is the primary factor producing weight loss, and it is increasingly understood that distinct macronutrients may vary in energy yield and effects on satiety, also based on individuals’ phenotype and genotype. Although an overall healthy diet, either Mediterranean or a low-fat, high-complex CHO [carbohydrate] diet may be effective in diabetes and cardiovascular prevention, insight is increasing that dietary prevention or treatment may require more personalized approaches to become most effective.

     —E.E. Blaak, in a review of effects of dietary carbohydrate in body weight control, glucose homeostasis and cardiovascular risk

In plain English, Blaak is saying:

  • weight loss depends on calorie restriction
  • proteins, fats, and carbs provide different amounts of energy and have different effects on hunger
  • your response to proteins, fats, and carbs depends on your genes and how you look
  • the healthiest diet for you probably isn’t the best for everyone else

 

Steve Parker, M.D.

1 Comment

Filed under Quote of the Day, Weight Loss

Gastric Bypass Surgery May Increase Risk of Suicide

according to an article at MedPageToday.

Steve Parker MD, bariatric surgery

Band Gastric Bypass Surgery

Self-harm emergencies rose by 50% after gastric bypass surgery in the Canadians in this study.

Folks on my diets lose weight without an increase in suicide risk, as far as I know. Click on my name for the diets.

Steve Parker, M.D.

PS: If you’re thinking about killing yourself, please please please call the National Suicide Prevention Lifeline or some other reliable source for help!

Comments Off on Gastric Bypass Surgery May Increase Risk of Suicide

Filed under Longevity, Weight Loss

Overweight Women Lose More Weight If Main Meal Is Lunch Rather Than Dinner

Conquer Diabetes and Prediabetes, Steve Parker MD

It may not matter whether you eat this particular low-carb meal at lunch or dinner

They say that to lose excess weight, you should eat breakfast like a king, lunch like a prince, and dinner like a pauper.

A recent study tested whether weight loss in dieting women was more effective by making lunch rather than dinner (evening meal) the main meal of the day. Over the course of 12 weeks, dieters making lunch their main meal lost 4 lb (2 kg) more than the other group. Furthermore, the lunch eaters had better improvement in their insulin resistance (as measured by HOMA-IR)

From the abstract:

“Background: The association between the time of nutrient intake and health has been described in a few studies. To our knowledge, no study has evaluated the relation between high energy intakes at lunch compared with at dinner on weight loss in overweight and obese subjects.

Objective: We compared the effect of high energy intake at lunch with that at dinner on weight loss and cardiometabolic risk factors in women during a weight-loss program.Design: Overweight and obese women [n = 80; body mass index (BMI; in kg/m2): 27–35; age: 18–45 y] were asked to eat either a main meal at lunch (LM) or a main meal at dinner (DM) for 12 wk while in a weight-loss program.

Conclusions: The consumption of higher energy intake at lunch compared with at dinner may result in favorable changes in weight loss in overweight and obese women after a weight-loss program of 12 wk. The consumption may also offer clinical benefits to improve insulin resistance.”

Source: Beneficial effect of high energy intake at lunch rather than dinner on weight loss in healthy obese women in a weight-loss program: a randomized clinical trial

I don’t have the full text of the research report, so I don’t know what kind of diet the women were on. The researchers seem to be based in both Iran and Great Britain. I don’t know the nationality of the women participating. The metabolism of Iranians may be different from Brits.

Steve Parker, M.D.

 

1 Comment

Filed under Weight Loss

What’s the Average Weight Gain Around the Upcoming Holidays?

MB900446412

MNT has the details:

“Around the world, weight gained from holiday feasting takes months to lose, a study found.

Christmas Day in particular is a holiday that appears to pack on the pounds: in a study of some 3,000 individuals in three countries, Americans showed an average 0.4% weight gain from 10 days before Christmas to 10 days after; Germans gained 0.6% more weight; and the Japanese 0.5%.

U.S. participants packed on 0.7% more weight in total during the full Christmas-New Year holiday season, but the Germans had us beat with a 1.0% weight gain, according to Brian Wansink, PhD, of Cornell University in Ithaca, N.Y. and colleagues.”

Source: Holiday Feasts Take Months-Long Weight Toll | Medpage Today

Those percentages aren’t very helpful, are they? In real life, if you weigh 180 lb (81.8 kg) and gain an extra 0.7%, you’re all the way up to a whopping 181.26 lb (82.4 kg). But if you do that—1.26 lb—every year for 20 years and fail to lose the weight, you’re up to 205 lb (93.2 kg) and now you’ve got diabetes and high blood pressure.

Here are a few tips to avoid the weight gain:

  • On the day of the major feast, just eat two meals, and make one of them small
  • Don’t  snack or graze; just eat at mealtimes
  • Work in some extra exercise
  • Minimize the alcohol that weakens your discipline

Steve Parker, M.D.

Pro Tip: Read one of my books before you make your annual New Year’s weight-loss resolutions.

PPS: Click for the research report in NEJM.

1 Comment

Filed under Weight Loss