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Tampilkan postingan dengan label Metabolic Rate. Tampilkan semua postingan
Tampilkan postingan dengan label Metabolic Rate. Tampilkan semua postingan

Jumat, 13 Desember 2013

The NEAT part about Moving More

Random Bump!



Original publish date:  4/21/12

In writing up a post on metabolic rate and weight loss, I couldn't help but come across a ton of stuff I had in my draft bin and hard drive vis a vis exercise, lean body mass and metabolic rate.  This got me thinking about the usefulness of ELMM = Eat Less Move More as a strategy to flip the CICO balance along with other things we can do.  

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Selasa, 18 Desember 2012

It's official. Jimmy Moore & Co. aren't interested in solving metabolic mysteries after all

UPDATE 9/14/13:  I am in the process of deciding exactly how to deal with one Dr. William L. Wilson, discoverer of the imaginary CARB Syndrome.    This appears to have been the only post of mine he links to in his unsolicited diagnosis of yours truly with this made up mental illness.   Further he offered treatment in the the form of his Carb-22 supplement.  

My purpose for this update is that some have -- rightfully, IMO -- taken him to task for making this bizarre diagnosis on the internet, of someone he has not only not met in person, but apparently knows very little accurate information about based on skimming a few blog posts.  After the fact he emailed me a link to the post, and posted one on another post on this blog.  He is busy answering many challenges to his post on his FB page at the moment.  

Rather than re-evaluate the prudence of his actions, he seems to be digging a hole.  One way he is doing that is claiming I am some public figure and it's fair game for everyone to diagnose me ... oh, and because in this post I essentially did the same thing with Jimmy Moore.  Now, this would not justify his actions, especially since as a licensed and practicing physician he is clearly subject to laws that I, a mere blogger, am not.   But let's clear a few things up anyway.

In his post he wrote:  
You might wonder how can I possibly diagnose someone with a disease who I have never personally met? Yes, to some extent I am speculating, but in medicine we often speculate about possible diseases in patients we have never seen when discussing cases with our colleagues in “curb side” consults. CarbSane even does this herself when she speculates that Jimmy Moore has Klinefelter’s syndrome and she doesn’t even have an MD behind her name. Over the years I have successfully treated thousands of patients who fit the CARB syndrome pattern and in my opinion CarbSane clearly falls into this category. After 35 years of clinical experience, my diagnostic skills are very sharp.
On FB he's written:
Out in the world physicians and every Tom, Dick and Harry speculate what might be wrong with public figures like CarbSane. Physicians do this all the time on TV and in the media. Even CarbSane does this when she speculates whether Jimmy Moore has a genetic condition.
You call my analysis of CarbSane “mean spirited”, yet she suggests that Jimmy Moore has Kleinfelter’s syndrome. Perhaps she was trying to give Jimmy information that would help him but I doubt it. Klinefelter’s syndrome is a genetic disorder you really can’t treat. If CarbSane really does have CARB syndrome, it is a reversible disorder that is quite easy to treat. If she doesn’t want to deal with it, that’s her choice and it’s fine with me. If she is interested in checking out, I have information that might be helpful to her.
There are more, perhaps I edit them in, perhaps not.  In any case, I can see how he thought that ... my wording is not always crystal clear, this is a blog after all, and I don't proof, edit and consolidate nearly as much as I would like to if I had infinite time.  But as it turns out, I did not.  Here are the exact words:

It has come up in comments here of late that Jimmy might have Klinefelter's syndrome which is one cause of hypogonadism.
Klinefelter's was raised by someone in comments  here (no I do not have the time nor desire to track a link down).  I also recall that I said at least once that I do not believe this to be the case.  A chromosomal condition like that is usually diagnosed early on.   However, there are many other causes of hypogonadism and he displays enough symptoms that if he were getting proper comprehensive care, this would at least have been addressed.    So let's be clear, I did *speculate* that this may be an issue for him, I did not diagnose him.

I did not wish to get Regina any more sneers aimed at her at the time so I didn't quote her post I linked to, but I will now.   Not to bring her any belated headaches, but because folks like Wilson are apparently too lazy to click through links and read the content that has stirred me to write what I do here.  I don't write this blog in a vacuum.  In this post, Regina wrote:
Since it is the endocrine system which largely controls our weight and hunger, it needs to function well for weight loss and maintenance. Yet, there are some endocrine issues which a diet alone cannot resolve - they are genetic - and Jimmy has, we've learned through his posts, hypogonadism.
Simply understood, that's where you, if male, have low testosterone, elevated LH and/or FSH, and often it leads to high serum ferritin (iron).

Jimmy has shared with readers that he has this condition - and it's something, that after reading up on it last night, one cannot change with diet alone. Now this isn't an excuse - but a reason that helps explain why Jimmy's appetite is such that he's driven to eat more than he requires. Those with hypogonadism are often insulin resistant, suffer abdominal obesity and gain weight easily.
Frankly, Regina stated this in far more definitive terms than I would have chosen.     Does he have hypogonadism?  I do not know.  But the point of the title of this post is that on some level, apparently, he does not care.   He is seemingly in a constant search for answers with blinders and very deep shades on in a darkened room.  He does not want to see.   For the time being the NuttyK was working for weight loss -- nevermind the worsening lipids, the stubborn UTI he had early on, the protein and crystals in his urine or anything else.  Mr. Healthy LC Diet was losing weight again.   

She also wrote:  
If nothing else, Jimmy is a prolific blogger - he's got websites, podcasts, YouTube videos, a forum, twitter and facebook - and this leaves us with a lot of information to ponder about his weight maintenance, gains and losses.
Yes he is.  And for those that don't know, I have a freakish memory and I remember a lot.  Especially numbers, images, dates, phrases, etc.etc.etc.  I see, hear and write a lot.  This reinforces it.  This may come off as obsession when it is not.  Jimmy used to blog daily about what he ate along with notes.  Routinely discuss struggles and ask for advice.  As he became more dogmatic and those offering advice kept giving him advice he didn't want to hear, he got mighty testy at times.  I vividly recall him asking for thoughts on a topic and when someone responded with their thoughts they were rudely shot down with a "nobody asked you".   I used to be one of those people who tried to help him.   Others remember me.  I remember them.  Eventually, Jimmy just started censoring any "advice" he didn't like ... and the pot shot posts at his "nasty" critics started insinuating all manner of bad behavior.  NEVER. HAPPENED.   

Regina, one last time (in response to Jimmy's comment in a post to which she was responding to:  "Was it the keto-adaptation or the calorie-cutting that has worked in producing the weight loss success I’ve seen? If you ask me, I say WHO CARES?!"):
Well, I care - not only about Jimmy as a person and friend, but also for those within the low-carb community, who despite doing everything seemingly right, fail to lose weight or gain and will do anything - even something extreme - to lose the weight.
So then, what has been going on?

What context might explain Jimmy's weight gains and losses?

And more importantly, why are those important considerations for anyone ready to jump on board the nutritional ketosis bandwagon and do what Jimmy's doing?
When Jimmy embarked on this extreme nutritional ketosis experiment seemingly everyone jumped on board.  I know not everyone, but enough.  Even a 100 lb perfectly healthy woman did.  Thankfully she had the common sense to stop before she harmed herself.   Three years ago now Jimmy went on an eggfast.  The following year on his lead a woman engaged in one.  Face went tingly, passed out.  Stuff like that.  I have highlighted here how SO many are stuck or weigh more than they ever did.   How so many see their insulin sensitivity worsen, their body composition and fat distribution change unfavorably.  For crying out loud one low carber had to cut her hair because too much was falling out  -- and still she advocates for the "healthy" diet.  There's more at stake than just money, but wasting money is enough of a bad thing, no?

I do NOT mock their looks or weight.  I do NOT attack them personally.  I DO think it is pertinent information that an advocate for a diet be honest in their delivery.  If a diet is not working for you, you really have a lot of nerve promoting it to anyone.  Period.  That Jimmy Moore is too mired in dogma to alter his diet ... Well, many have tried.  I may not have the friends Regina has in the LC community, but I do not want to see people potentially harm their health taking advice from charlatans ... even if many of those people don't particularly like me.

I provide my readers with the science here.  I'll occasionally share *my opinion* and clearly state it as such for people to consider as they see fit.   I think that on the whole Cholesterol Clarity will do far more harm than good and that it deserved at least one honest appraisal on its merits.   Jimmy Moore can't even be honest with himself any more what is going on with his health and it is evident throughout the book and the quotes he chose so selectively to entwine with his biased narrative.  






Original Publish Date:  12/18/12

I would like to give props and offer my support, though she probably doesn't really want it, to Regina Wilshire of Weight of the Evidence blog.  By the time I had found the LC community in 2009, her blogging had apparently tapered off and I had not really come across much bearing her name other than the occasional picture.  Oh ... and the post on Jimmy's now defunct and deleted menus blog identifying her as a "heavy low carber".  It was that post that caused me to mention her in a post of my own (2011) addressing the topic, hence due to Jimmy's inclusion of her in his post, her name got included in mine.   I also named a few of her low carbing friends, and the rest, as they say, is history.  I hope in retrospect, some of these folks are able to see that I meant no harm or ill will in merely highlighting what I did.  It's pretty obvious, to everyone except the low carbers it seems, that on the whole advocates of the lifestyle are more overweight or obese than advocates of other lifestyles.
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Minggu, 02 September 2012

The Hadza Hunter Gatherer Energy Expenditure Study

I've been asked by a few people to weigh in on a recent NYT article, Debunking the Hunter-Gatherer Workout, that discusses the following study (free full text):  Hunter-Gatherer Energetics and Human Obesity.  I didn't have a whole lot to say until I wrote this, and now it's rather long ... so I guess I did have quite a bit to say after all ;-)   But first, a little link love for Colby Vorland of nutsci.org who discussed this back in July:  Westerner energy expenditure compared to a hunter-gatherer population is equivalent.  In addition, Colby had discussed Energy expenditure and physical activity level are not higher in developing countries compared to industrialized.  I encourage reading both.

So from the NYT article:
We found that despite all this physical activity, the number of calories that the Hadza burned per day was indistinguishable from that of typical adults in Europe and the United States. We ran a number of statistical tests, accounting for body mass, lean body mass, age, sex and fat mass, and still found no difference in daily energy expenditure between the Hadza and their Western counterparts.
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Kamis, 28 Juni 2012

A Modest Proposal for Peer Review Research

With the advent of, and inexpensive nature of online sharing of information, I propose that all peer-review research should include (anonymous) raw data for each subject.  At the very least, there should be scatter plots presented for the individual data points for the main outcomes.

I frequently teach statistics, and one of the first things we discuss in that class is sort of the "first purpose" of it all.  Because before we can analyze data, first we must summarize and present the data in such a way that the "consumer" can readily glean information.  In one classic stats text -- Triola -- this part is given the acronym CVDOT.  C = Center, V = Variation, D = Distribution, O = Outliers and T = Time.  So we go through the various ways we can convey the center of a data set, it's variability, distribution, etc.  In most of the studies we discuss here, data is presented as a mean value +/- either the standard deviation or standard error (C +/- V in the acronym).  And further statistical analysis compares these means between groups for statistically significant differences.   If I have 20 subjects in a study, I can provide you with a table of all results sorted by subject number assigned randomly.  This tells you very little.  If all I do is sort the data ascending or descending, you can now readily pick out the range and "center" of the data.  Perhaps if data is of a more rounded nature, you might be able to pick out the most frequent or common values.  Outliers will jump off the page.  
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Senin, 30 April 2012

Rapid Weight Loss Tanks Metabolism? The TBL Study

Thanks to Yoni Freedhoff of Weighty Matters blog for providing me with the full text of this one.  Check out his take on the results.  Update 11/11/13:  Full text now available free HERE.
Context: An important goal during weight loss is to maximize fat loss while preserving metabolically active fat-free mass (FFM). Massive weight loss typically results in substantial loss of FFM potentially slowing metabolic rate.
Objective: Our objective was to determine whether a weight loss program consisting of diet restriction and vigorous exercise helped to preserve FFM and maintain resting metabolic rate (RMR).
Participants and Intervention: We measured body composition by dual-energy x-ray absorptiometry, RMR by indirect calorimetry, and total energy expenditure by doubly labeled water at baseline (n = 16), wk 6 (n = 11), and wk 30 (n = 16).
Results: At baseline, participants were severely obese (×± sd; body mass index 49.4 ± 9.4 kg/m2) with 49 ± 5% body fat. At wk 30, more than one third of initial body weight was lost (−38 ± 9%) and consisted of 17 ± 8% from FFM and 83 ± 8% from fat. RMR declined out of proportion to the decrease in body mass, demonstrating a substantial metabolic adaptation (−244 ± 231 and −504 ± 171 kcal/d at wk 6 and 30, respectively, P < 0.01). Energy expenditure attributed to physical activity increased by 10.2 ± 5.1 kcal/kg·d at wk 6 and 6.0 ± 4.1 kcal/kg·d at wk 30 (P < 0.001 vs. zero).
Conclusions: Despite relative preservation of FFM, exercise did not prevent dramatic slowing of resting metabolism out of proportion to weight loss. This metabolic adaptation may persist during weight maintenance and predispose to weight regain unless high levels of physical activity or caloric restriction are maintained.

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Selasa, 24 April 2012

Random Thoughts: Obesity, Weight loss, Metabolism, Diet & Exercise

In the interests of saving a bit of time and gathering thoughts, I thought I'd jot down some would-be comment replies in a blog post instead.  First, so we're all (newer readers especially) on the same page, I did no formal exercise during the active weight loss phase and long plateau from sometime summer 2007 through spring 2009.  This was not really by design, but more out of fear as the last time I low carbed I experienced the racing heart mostly when doing rather short periods of pilates and such.  So I kept meaning to up the activity level a bit but never really managed to get around to it.  In 2009 I did start doing concerted cardio -- walking and biking -- and later some more cardio-like exercise DVD's.  As for strength training, the only formal training I have done was that 100 pushups thing that was popular in 2010.  I got to 100 "girlie" pushups and was on my way with the regular ones when I pulled something in my side that made rolling over in bed painful!  So for me personally, regular exercise is a sporadic thing at best ... something I am trying to dedicate myself to just never seems to stick.  That said, I am very active.  Initially this was just doing the "parking far away at work" thing and such, but has progressed to deliberate short bouts of exercise like walking around the yard when I bring the garbage out, always running up stairs, just going up and down stairs for the heck of it, etc.etc.  Additionally, we go through a lot of wood with our fireplace to heat part of our home and I do pretty regular "workouts" transporting/stacking, chainsawing, etc. wood.  
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