livedarklions

Every weight loss diet has something else in common--they don't work for the vast majority of people. The problem isn't losing weight, almost all of them get people to do that initially, it's that the gimmick isn't enough to sustain the weight loss. People really do vary widely in their metabolisms and how their bodies handle different combinations of macronutrients and levels of activity.

But I recognize some of the truth in what you say here--when I first started my massive weight loss, I gave up grains and starches as well as any refined sugar. To this day, I don't know whether I succeeded because I changed my diet that way, or because those strictures made it virtually impossible to find anything to snack on while I was out in the world--not a lot of fast food or convenience snacks that meet those criteria. That also made the calorie counting a lot easier.

livedarklions

That article also exposes something consistent with my experience--when I was fat, I had high bad cholesterol. As I was losing weight but still obese, I was being very strict with my diet such that I'm sure my cholesterol intake went way down, but my cholesterol levels didn't budge. When I started working out and dropped the additional 40-50 pounds, I also increased my protein intake, primarily by increasing the amount of meat I eat. Definitely jacked up the consumed cholesterol by a lot. Guess what? I ended up with textbook perfect bad/good cholesterol levels.

The research is all showing pretty much the same thing--cholesterol levels are almost completely unrelated to the cholesterol content of the foods you eat, which makes sense since your body makes 80% of the cholesterol, and only 20% comes from the foods. It's much more related to weight and activity level.

I was offered statins when my cholesterol was borderline high at one point, btw. Very glad I didn't take them.

WizardOfBoz

I'm on solid engineering ground when I say that if you burn or excrete more calories than you ingest, you'll lose weight. There's no way around this.

But there are effects of what you eat, when you eat it, and when you exercise. Effects on hunger, satiety, fat storage and use, etc. A guy I've worked with over the years (Kevin Hall) is a tenured researcher at the NIH and does obesity research. One of his points is that we've evolved over many thousands of years to be able to process almost any energy source to use to fuel our activities. That said, we've not evolved to swig "Big Gulps" full of highly refined high fructose corn syrup, or sucrose. When we do that sort of thing, it can muck up the body's feedback loops. And we tend to eat more calories if we eat highly refined foods.

An overview of some of Kevin's points in the context of other's views is here.

To the OP: any exercise will burn fat. It's pretty much impossible to "target those problem areas" as fad programs claim. You are genetically pre-programmed to store fat where your body wants to store fat. If you want to get rid of belly fat, work to lose adipose (fat tissue) mass in general.

My take-away is this involves
1) Eat a healthy diet that includes a lot of fresh vegies
2) Avoid or at least minimize hyper-refined foods. Yes, that means pretty much all soda pop. Lower your use of oils. And so forth.
3) Get a good amount of aerobic exercise
4) Do strength training to built your lean muscle mass. This mass will help you burn calories, and has other benefits.
5) Get enough sleep

If you really want to have a smaller gut, do the above. If you want a six pack (or if you want to have better general health) make sure your strength training includes core muscle exercises.

As Kevin says, this isn't rocket science. We know what is required. Just have to do it.

WizardOfBoz

For some people, some statins have a negative effect. I was offered a "natural" statin: red rice yeast. Had horrible effects - leg pain and such. But there are other statins. Switched to Pravachol, which works great with few noticeable side effects. For most folks with high non-HDL (bad) cholesterol, statins have allowed them to avoid heart attacks, strokes, incapacitation, and death.

What is very dangerous is for folks to read someone here state negative views about a class of drug, and to conclude that they're bad for everyone. Statin's aren't. If your non-HDL cholesterol is high, you have an increased risk of heart attack or stroke and death and incapacitation. Certainly its great if you can lose enough weight and change your lifestyle to get the cholesterol numbers down to where they're not a risk factor. But some people have hypercholesterolemia due to genetic factors, and other just aren't able (or willing) to achieve the diet/exercise/lifestyle changes to lower cholesterol enough. For these people, statins can save their life.

I'm not an MD, but I currently do research on hypertriglyceridemia and hypercholesterolemia. If you have lab work showing that your lipids profile puts you in a high risk category, CAREFULLY CONSIDERING FOLLOWING THE ADVICE THAT YOUR DOCTOR SUGGESTS. If that includes a statin regimen, do it. Do research on the web, ask your doc questions, sure. Report any side effects you notice, absolutely. But its' kind of their job to be able to offer you EXPERT medical help in the context of your health situation. I mean, it's not like they spent 4 years in pre-med getting excellent grades, and years in med school, and more years in practical training. And it's not like they're familiar with how drugs affect different people differently. And gosh, they haven't done a physical exam and an interview with you to get your specific situation. And they haven't ordered specific tests and reviewed the results... Oh, wait a minute...

I don't ask my doc for the proper torque values for my stem clamp. Don't make the mistake of depending upon a bunch of bikies (me included) for advice on modulating a specific thing (cholesterol) in a complex system.

kansukee

You can easily go crazy with all the information out there these days. For me at least it's always been about portion control and exercising and boy do I like my desserts! I have maintained my weight of 148-150 since I started cycling and working out in my late teens; there's no need to overthink it.

WizardOfBoz

Dwight Eisenhower had the same philosophy, kansukee. When his weight went up, he just ate less. Not everyone has your (or his) willpower or genetics, though.

That's why I have a job! I write math models of all this stuff to see if we can get insight and not insanity from all the data. I let the computer "overthink it".

livedarklions

I actually had done my research on this when I gave my answer, and it was offered to me as a choice. As I said, my LDL was only mildly elevated at that point, and my parents are both in their late 80s, so I don't think I was fitting anyone's definition of high risk. What I had read, and you can correct this if I'm wrong, is that there is no evidence that a mildly elevated LDL is a risk factor worth risking the side effects of statins to reduce. In other words, I would likely have put myself to more risk by taking the statins than just living with the risk imposed by the mildly elevated LDL. What I didn't anticipate, and what's really made me happy that I chose as I did, was that my LDL came down to normal levels and stayed there within a year of that decision, a result that almost certainly would have been incorrectly attributed to the statins, and I would probably still be on them unnecessarily to this day.

Sorry, but I've worked in the medical field, and I've seen enough doctors make bad calls that I'm not willing to just defer to any advice they throw out. Given your condescension at the end of your post, I rather enjoy the fact that if I had acted in the way you recommend , I clearly would have been worse off.

Last ride 76 

This:


"I mean, it's not like they spent 4 years in pre-med getting excellent grades, and years in med school, and more years in practical training. And it's not like they're familiar with how drugs affect different people differently. And gosh, they haven't done a physical exam and an interview with you to get your specific situation. And they haven't ordered specific tests and reviewed the results... Oh, wait a minute...


I don't ask my doc for the proper torque values for my stem clamp. Don't make the mistake of depending upon a bunch of bikies (me included) for advice on modulating a specific thing (cholesterol) in a complex system."


With one important caveat, in the form of a riddle... Q: What do you call the person who finished last in their graduating class at med school? A: Doctor... Just like in any other profession, skill, or endeavor, some are better at it than others. Sometimes, it's not very important to have the best Doc available. There are times when having the best you can find can make a difference.

When I was 16, a GP altered the course of my life. Finding the right Doctors has kept my daughter's life from being substantially changed for the worse.

Regards, Eric

Last ride 76 

Alert: This is a load of garbage masquerading as science. While it may be technically accurate to describe them as all working by "creating a caloric deficit", the way this is achieved is NOT the same and has very different potential outcomes, and potential SIDE-EFFECTS, not all of which have been studied in a truly systematic scientific way.


Just one example... Putting one's body into a state of ketosis actually is a very radical proposition. The process is an evolutionary adaptation, to help us SURVIVE and continue to function in times of extreme food stress. Roughly speaking our bodies need carbohydrates to effectively process proteins and fats.
Thus, if there is no carb intake , those other calories are not absorbed very well.
So in order for the organism (you) to survive and continue to function, the body starts to use the energy stores available to it. Yes, the body's stored fat. But this is not a "normal"event, It takes a few DAYS of zero carbohydrate intake before the body will trigger this response. Not a condition we are designed to just slip in and out of. Again, there have not been sufficient truly scientific studies done to know what the consequences might be either short or long term.



Intermittent fasting seems to hold a lot of promise. Original studies were done on mice. There are very few controlled studies, and no large scale ones that I am aware of. Apparently part of the hypothesis is that it is in line with our evolutionary patterns, our biorythms. Unlike the idea behind having 6 small meals spread out over the course of a day, it seems that perhaps it is better to let our gut biome have some down-time. Relatively new stuff, with limited published research, as of this winter.


Don't believe the hype...

Regards, Eric

ksryder

Oh well since you used an eyeroll emoji I'm convinced.

WizardOfBoz

livedarklions: Didn't mean to sound condescending, but my motivation is to address people posting opinions and results that are uninformed by a broader perspective and that are based upon a very small sample (themselves, n=1). So when someone says
"I took Cureitall and it made me itch all over and didn't help my problem - don't take Cureitall!"
there's the issue that these results are unique to the individual, and that others (who might signficantly benefit from the therapy without any adverse effects) will overgeneralize and use the n=1 sample of the person posting, and not the epidemiological results from a pivotal clinical trial (what is called Phase III, which is what the FDA uses to approve drugs) or post-marketing surveillance (which is sometimes called "Phase IV"). Further, a good physician will know most of the key side effects and who is most susceptible to them.

By the way, did you notice that this discussion has the same flavor as our helmet discussion? We have an issue that is affected by many factors. Which factors are most important? How much should we consider other factors? This is why I like my math models: all of the factors are integrated quantitatively. You can test for sensitivities to see what influence are strongest.

Statins can have significant, serious side effects in some people. Or none, in others. It sounds like you informed yourself and at least considered statins as they were offered by your physician. Did your physician weigh in on this? What was that discussion like? I have some weird stuff going on in my legs, with significant weakening. First noticed it when I took statins, but I chose to go off of statins for several years and the weakening continued. My LDL-C was high enough that it was a risk factor, so I chose to go back onto statins. Also, my neurologist, who's a world expert, said "It doesn't do me any good to figure out your leg issues if you die...". No adverse effects so far, will get a blood test in a few weeks. I'll see if my CPK (an enzyme indicating tissue, like muscle, breakdown) goes up. For the overwhelming fraction of folks with high non-HDL cholesterol, which is a significant risk factor, statins are safe and effective.

Eric, There is no doubt that doctors come in a range of competencies. And (when you look at the news these days) a range of moral character levels. No doubt. I've had to fire doctors who did not demonstrate sufficient competency and responsiveness. When you are 16, you don't feel that you have much choice. Still, the guy that has the worst grades in med school still had to have superb grades just to get into med school, and had to have acceptable scores to get through med school. And their scores in med school were better than mine (because I don't have any). And they do have exposure to a lot of different patients.

What does this mean in terms of action? Some thoughts
1) Do research on your doctor. Use patient reviews like Yelp, but with a grain of salt. I find that asking my GP and all of the nurses I meet "Which specialist would you go to?" or "What is Dr. Smith like" to be helpful.
2) Do research on your malady. Read stuff, but again realize that some of the more extreme cases will be what you are reading about, because the extreme case people are more motivated to do so.
3) Have a discussion with your doc. This means you get to ask the questions formed in your mind when doing your research.
4) When a medication is proposed, I always ask "Is the benefit of this drug worth the risk to me?" Often docs can come back with "Well, the adverse effects you asked about only occur in about 1.3% of patients, all of whom have a different profile than you".
5) For seriously powerful therapies, it sure as hell doesn't hurt to have a 2nd or 3rd opinion.

I have some spinal degradation, with some pain. This is a separate issue than my leg nerves and muscles. Physical therapy allows me to function pretty normally, with minimal pain. I went to see two surgeons, and a non-interventional doc to check out next steps. One surgeon suggested an injection. The other surgeon and the non-interventional guy both suggested that I was probably best off as is. Given the effectiveness of my PT, the non-interventional guy told me "If I were evaluating you post-surgery, and you had the function and minimal pain you have, I'd rate the surgery as a success". And my personal PT (who happens to be my wife) strongly discouraged any treatment that involved sharp things like scalpels or needles near my nerves or spinal cord. Or any poking that could cause an infection.

But I made my decision after discussions with trained professionals who were able to address my questions and concerns in the context of their broader experience, and with knowledge (imaging etc) of my personal situation.

WizardOfBoz

Not sure that I can correct you. In fact the data support what you are saying. I found this graph and thought it was interesting. This is from a pretty large study, and it gets to my point about understanding risk in the context of the responses observed in large populations. Look at the change in the rate of deaths due to cardiovascular and coronary heart disease. There does appear to be a sight increase in CHD and CV deaths with increased LDL-C, but even in the borderline high range (see table) the slope is pretty low. The incidence of stroke actually goes down with LDL-C, and then back up. What is really weird is the "all-causes" deaths which are very high at low LDL-C. That was unexpected. What the hell is up with THAT?

This is observational data (you just look at what happens). I wanted to find data for a prospective study on statins. That would be a larger group of volunteers who were randomized and separated into study arms, some of which received a placebo and some of which received statins at various doses. This would answer the question definitively. Couldn't find that in a quick search. If you're interested, I did find this:

"Is the use of cholesterol in mortality risk algorithms inclinical guidelines valid? Ten years prospective data from the Norwegian HUNT 2 study", J. Eval. Clin. Practice, 2011, Petursson, et al.
This states the the effect of LDL cholesterol on cardiac risks seems to be overstated. No time to review, cited here if you're interested.
https://sphweb.bumc.bu.edu/otlt/mph-m...terol-risk.png

Last ride 76 

Rather than attacking my use of an emoji, READ my post critically for it's content, not emojis, style or typos, and understand why that chart is misleading, at best. Then if you have something more cogent to say, please do so. Otherwise don't bother.


PS Food for thought: Pseudo-science is not science. Just because the word science is present, does not make it actually "science".


PPS I do not mean to be insulting or sound arrogant. I do mean to be emphatic. People who practice endurance sports, should be careful about extreme dieting.

When in a state of ketosis, one long hot day on the bike, with or without a little dehydration mixed in, can put a body in an unhealthy state.


If I offended ksryder or anyone else, my apologies. My only goal was to counter the false equivalencies and prevent misunderstandings which that chart promotes.

Ride well, Eric

Paul Barnard

https://www.nutristrategy.com/caloriesburned.htm

I don't know. Moderate to vigorous cycling seems to rank pretty high.

Paul Barnard

Hello my friend from the 'fire. Keep up the good work.

Paul Barnard

Dang brother, reading this and a recent post where you described the distances you ride, you have my respect! Well done.

Paul Barnard

I have watched a lot of people head down the path of weight loss. I have been able to predict those that would succeed and those that would not based on that singular factor.

Too much pain, too much austerity or simply doing something you don't enjoy will just about guarantee failure.

KraneXL

It sounds so simple when you put it like that. Yes, lose weight, but the point is to lose fat. So CICO does not tell the whole story; and one reason why I consider a weight scale a "dumb" measurement of weight loss. You don't know whether you're losing fat, muscle, or water.

Having read through most of the comments here, its not so much that they're wrong, rather, incomplete or just partial truths. Is "calories in, calories out" true? Yes, but again its more complicated than that. The body can absorb different types of foods at different rates at different times. So timing is also important.

Do carbs cause you to gain fat and are bad for you? Yes, but simple carbs, and only in excess. Carbs of the complex variety are beneficial in so many more ways. Which is also true with any macro-nutrient. The thing about carbs that makes them seem bad, is that they typically come in forms that makes them so much easier to over-consume (you can literally eat donuts and cookies all day) However, few people will eat a pound of brown rice, or 10 potatoes in a day.

Overall, the biggest deciding factor on feeding and weight management is determined by your genetics. That's the main reason why some people can eat all the bad foods in abundance and still not gain any fat.

WizardOfBoz

KraneXL, I agree that a few 1000 word posts in a bike forum thread can't begin to address the complex issues of weight gain or wasting, muscle gain or wasting, etc. Use google scholar and search for "obesity". You get 2.8 million citations!
Further, people are different. The regimen that might benefit a 20 year old who's overweight or obese might kill me. Or be counterproductive. So, when I write a diabetes model I might use 1000-1400 literature citations. And knowing what's important and what's not, and which research group does good work and which ones publish errr, clap, becomes a pretty tall order.

People want to have a magic pill. "Can I lose tummy fat?" And its not that simple.

But enough good food (lots of vegies, especially green ones), enough water, enough sleep, and enough exercise, both aerobic and resistance, is probably going to be better than a regimen missing one or more of those ingredients. And this is true whether your genetics are John Candy or Arnold Schwarzenegger.

Jim from Boston

I have recently described myself mainly for fitness.

Over the past few years I have developed a personalized training regimen based on Relative Perceived Exertion and Cadence (link), as a cheap and simple version of Power Meter with the basic intent

livedarklions

Two things--I think we actually approach these issues in pretty much the same way (probabilities and math), and I reacted to the "doctor knows more than you do" perhaps a bit defensively. Actually, the doctor I was talking to about it couldn't refute my reasoning and actually didn't try to argue me out of it. I've seen her notes on it, and she actually pretty much took down what I said word for word without much comment. She actually offered me statins as a question--"do you want to take?"

Other thing--I think there's an issue of what counts as success for statin intervention. It's definitely effective in lowering LDL, but it's not clear that it's actually leading to better long-term outcomes. As your sources indicate, the connection between LDL levels and heart attacks tends to be overstated (and look at that flat line for strokes!), so it stands to reason that the effects of moving that number marginally may not be very large at all. I would probably take statins if I had a chronic LDL level, but I don't think it's a slam dunk for me.

Just as an aside--I'm guessing the effect at the very low LDL levels is probably because that group includes a disproportionate number of malnourished people, whether through cachexia, anorexia or malabsorption issues. As I'm sure you know, those conditions create all sorts of cardiac issues. BMI and longevity has a similar spurious correlation (which is why it's such an inadequate measure) because there's a higher rate of mortality for people who are slightly "underweight" vs. "normal" and "slightly overweight". Slightly overweight is actually the longest-lived category. This occurs because the underweight category catches people who have lost weight or can't keep weight on because of illness, and the slightly overweight category catches people with larger muscle masses than average. So I'm guessing something like that is going on with this curve.

livedarklions

You're wildly overstating the differences between complex carbs and sugars. White flour is primarily a complex carb, as is white rice. People eat a lot of french fries, potato chips and large quantities of mashed potatoes, and a baked Idaho potato can weigh quite a lot, and people eat those all the time. The collapse of the food pyramid basically occurred because the assertions that complex carb calories were affecting blood sugar significantly different from simple sugars and were less likely to get converted into fat were simply not true, and that the pyramid was recommending an amount of starch that was actually disastrous for weight loss and maintenance.


Whole foods and grains are healthier for you not because their carbs are somehow different, but because they contain other things that your body needs like fiber and protein. The starches in white rice and brown rice are, by definition, identical, but the same quantity of brown rice will have fewer carbs and calories than white because of the proportion of other stuff in the bran that's left on. I don't know, however, of any reason you can safely assert that people won't eat as much brown rice as white. I can easily binge on either.


I agree that genetics play a huge role, but I think they also play a large role in how people should balance their macronutrients in order to sustain or achieve a body weight, as well as the level of physical activity they can maintain.

CICO is true at a very abstract level, but people live and eat in a complex world for of all sorts of variables that are hard to balance, so it's a bit like saying "the key to human-powered flight is to balance thrust, drag and lift." The devil is in the details.

WizardOfBoz

livedarklions,

Enjoyed reading your last couple of notes. As you likely know, the FDA has taken up this line of reasoning in approving new drugs in this area. Just proving that your new drug lowers cholesterol won't cut it: you have to prove that it improves mortality/morbidity statistics.

I was looking at this issue this morning. An interesting review meta-study* was done showing that in the elderly, LDL-C was inversely correlated with cardiac and all-causes deaths in the elderly. Hmmmm.

To your point about normal and slightly overweight folks having mortality/morbidity advantages one could see how we evolved to be optimal at a point where we have a little (but not a lot) of reserve energy on our frames. So I'm really, really optimal! Yay!

One aspect of this I don't like: all of the studies are observational/retrospective. There are some serious problems that this can cause and its easy to misinterpret these things. You may recall the issue when until recently the common wisdom was that there was a u-shaped curve for mortality/morbidity with respect to alcohol consumption. Folks looking at retrospective data noted that non-drinkers had a slightly higher incidence of disease/death than did those having one or two belts a day. The theory was that a single drink a day was actually beneficial. When they looked at the data a bit more carefully, they realized that the non-drinkers included a significant number of folks who were recovered alcoholics, and for whom years of drinking had taken their toll. When this was accounted for, it was shown that no amount of alcohol consumption is safer than zero consumption. Fortunately for me, that slope (risk vs average number of drinks/day) is very low, too, until you get to the 3 or 4 drink level** at which point the curve starts to head North. Still searching for a prospective study done on statins effect on cardiac and cardiovascular, as well as all-causes death.

I wonder about the all-causes deaths at low LDL-C. I also wonder how survival affects the LDL-C vs Mortality/Morbidity question.

I agree about the genetics point. Two things. First, as my friend Denis Noble has pointed out, and as the field of metagenomics has shown, genetics occupy an important, but not a privileged place in phenotype. That is, your weight and health state depends upon genetics as well as life-style (diet, exercise, mental and spiritual outlook, etc). A related point is this: one has the genetic hand that one was dealt. If one throws up one's hands and says "Oh dear! Oh my! My genetics are horrible! I'm gonna die young!", it is probably so. If one says "I have some control over my health, and I'm gonna exercise that control", one can optimize to some extent one's health. And, in the case of biking, you at least get to enjoy the ride too.

Wiz

* Ravnskov, et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review
BMJ Open, 2015

** My brother was sitting in a bar with a colleague many years ago and they agreed that the term "alcoholic" was much too harsh a term for them. They felt that they merely had "Too much to drinkism". Interestingly, the CDC recently published data to suggest that there is a level of high alcohol consumption that is not alcoholism. They were right!
https://www.cdc.gov/pcd/issues/2014/14_0329.htm

WizardOfBoz

My expert friend Kevin Hall would argue that its easier to consume mass calories when the food is hyper-refined. A 32 ounce big gulp will have about 150 g of carbohydrate, or about 600 calories. To put that in perspective, a normal healthy diet might have about 2500 calories more or less. And you don't get vitamins, fiber, protein, or fat (we need some fat in our diets).

To add another point, consider: your body has about 5 liters of blood. Fasting plasma glucose is about 90 milligrams per deciliter, or about 900mg/liter. So you have about 1350 mg, or a gram and a half of blood suger at fasting conditions. IF you're not diabetic, this goes up to maybe 4 g or so after a meal. So with a Big Gulp one is drinking, in highly absorbable form, about 30-100 times more sugar than your blood can absorb. This is a huge hit. Our bodies can handle this once in a while, but constantly pounding one's metabolism with this stuff is really detrimental. Especially so with high-fructose corn syrup which doesn't stimulate the body to produce insulin as effectively as glucose. Seems to me to be a recipe for "How can I induce overweight and diabetes in my body?"

I don't even drink soft drinks anymore.

El Gato27

A few years ago I decided I had gained a few too many pounds and decided to start exercising more and “dieting”. I lost about 15 pounds and then eventually plateau even though I would exercise a decent amount on a regular basis. I started to do some research and came to realize that losing weight is approximately 80% diet related and 20% exercise related. I decided to start tracking my calorie intake and to my surprise I was consuming way more calories than I thought I was consuming. Stuff that I thought was “healthy” was really not—a quart of Gatorade, granola bars, etc…

I was consuming ~3000-3500 calories a day without realizing it. I slowly started modifying my diet and then I started to lose more weight. No specific designer diet, just less food. I lost 30 pounds over ~2 years and now have a good feel on my calorie intake so I don’t track everything I eat.

I would suggest tracking your food intake for a few months to understand where you’re at, it might surprise you.

There’s a few sites, I used to use the Livestrong site and then switched over to MyFitnessPal after they upgraded the Livestrong site.

Good luck.