[ericabiz]

Here's an anecdote the other direction.

One of our employees decided to cut out fast food completely. Total weight loss in over 6 months of doing this? 0 pounds.

Why? Because his at-home diet was still full of sugar and carbs (and he admitted as much..."I'll never give up bread!")

Meanwhile, I did a low-carb "lazy Keto" diet where all I did was keep carbs under 20g net per day. I continued to eat fast food at least a couple times a week (I ate a lot of burgers with no buns.)

Total weight loss? 25 pounds over 8 months, and have kept it off. I started the diet December 1 of last year, so it's now been almost a year.

It really is the carbs and sugar that do you in, no matter how organic or home-cooked/homemade those carbs may be.

[Fnoord]

The million dollar question is: "Did you (w/your N=1) try the exact same calories as your keto diet, but then with more carbs?" No, you did not, and because it is hard to eat foods which adhere to the keto formula you lose weight on a keto diet.

What people also fail to mention with their anecdotal evidence is their age and gender. It is relevant because young bodies and brains are still growing, increasing calorie demand compared to a middle age adult.

> It really is the carbs and sugar that do you in, no matter how organic or home-cooked/homemade those carbs may be.

It really is the calories that do you in, no matter what type of calories or how you restrict yourself otherwise. All the diets are just some kind of abacadabra (or facade or placebo effect if you will) to make you focused on your calories intake, for example with specific rules about having to avoid certain products or ingredients which make it difficult to follow so that e.g. the subject cannot snack in between meals.

If you take in a lot less calories than the amount you require, you'll burn fat quicker. You'll lose weight quicker as well (although if you also start exercise, muscles weight more than fat). A lot more calories leads to building up fat quicker and gaining weight quicker. Both, eventually, until you are on the level of your calorie intake.

It furthermore also stands to reason that something with sugar is more difficult to limit than keto products because the former is more tastier. From an evolutionary PoV it makes sense because the sugar from fruits was a quick way to give us energy.

Furthermore, you should ask yourself whether the ingredients of the high carb food are needed. You'll find that you don't need them in the first place, possibly not in the amounts you eat them, but if you eat one cookie with the coffee in the evening that doesn't suddenly "ruin your health" because it is high on sugar. It doesn't "ruin your diet" either. The problem is that people cannot stick with one cookie in the evening with coffee. They snack far more, between meals. Yeah that adds up. Look on the packages and do the maths.

All the bad stuff is on the packages as well, very convenient: saturated fat, sugar, and salt. What a coincidence that our governments demand this being listed!

[cpymchn]

Carbs increase insulin. Insulin increases the level of lipoprotein lipase (LPL) in your body. LPL dictates how much energy you store as white fat. No carbs --> low insulin --> low LPL.

So FWIW @ericabiz is correct "It really is the carbs and sugar that do you in".

You also responded to @kichuku regarding sugar being sugar:

> The natural in sugar is irrelevant. Sugar is sugar; as in fructose is fructose, and glucose is glucose.

Not exactly. Fructose doesn't initiate an insulin response in the body... so it doesn't increase LPL... there are other problems with fructose but the 'natural' in the sugar shouldn't be dismissed.

[Fnoord]

> So FWIW @ericabiz is correct "It really is the carbs and sugar that do you in".

Its not. The people who are obese mostly [1] consume too much, and often carbs are the culprit. If they reduce their calorie intake, they lose weight. It doesn't matter if they use a keto pseusoscience with that, go to a dietist to follow a raw food pseudoscience diet, or diet solo without a dietist limiting caloric intake on sheer willpower (a proven method based on decades of science). Even people who don't get into a "state of ketosis" because they diet on raw food or willpower lose weight. The thing they all have in common is: limiting the caloric intake.

[1] "Mostly" as there are some diseases which are exceptions, an example could be thyroid problems. I'm not gonna comment on this, not familiar with all the English terms on the exceptions.

> Not exactly. Fructose doesn't initiate an insulin response in the body... there are other problems with fructose but the 'natural' in the sugar is important.

Cane and beets are natural sugar as well. All sugar is natural, except artificial sugar, but then we call it artificial sugar. The term sugar doesn't tell us which sugar (e.g. glucose or fructose or lactose) but neither does the term natural sugar.

Its akin to denoting to stating "[..] fruit apple [..]". An apple is always a fruit. There is no need to underline that.

[cpymchn]

"keto pseudoscience" is loaded phrasing for a mechanism that has been understood and uncontroversial for 200 years.

If you are unfamiliar... the core insight is that obesity is an endocrine disorder; your hormones — not your caloric intake nor the amount you exercise — is the primary reason you gain or lose fat.

Here is a short explanation as to why this is:

* [enzymes] whether you store fat or not is determined by enzymes — specifically hormone sensitive lipase (HSL) and lipoprotein lipase (LPL)

* [hormones] production and inhibition of those enzymes is controlled by your hormones — including insulin, adrenaline, cortisol, estrogen and others.

* [diet] the easiest way to control your insulin levels is to keep your blood sugar low; the easiest way to control blood sugar is to eliminate carbs from your diet.

As I mentioned above... this can be simplified as...

No carbs —> suppressed insulin —> maximum HSL production.

'limiting the caloric intake' -- as you suggest -- is a blind alley when discussing this mechanism. It is a necessary but not a sufficient condition to lose weight. Your body won't draw on your fat reserves if it doesn't have to. i.e. it will happily extract the energy it needs from your gut all day long, provided your gut is full. That means you are partially correct; if LPL is low and if you are in a deficit then the body will draw down on your reserves and you will lose weight. But the opposite isn't true. If LPL is high, irrespective of your deficit or your willpower, then you won't lose weight. Conversely 'eating too much' isn't a diabetes risk... provided your hormones are in order.

If you have any sources that contradict the endocrine hypothesis, I would be keen to see them.

[Fnoord]

> "keto pseudoscience" is loaded phrasing for a mechanism that has been understood and uncontroversial for 200 years.

Certainly not 200 years, and also certainly not "understood and uncontroversial". Atkins/keto goes against the conventional science of dieting from the 20th and 21st century because it doesn't follow the caloric intake affecting weight loss premise (though it can have that effect, like almost every diets can). It goes against the convention that saturated fats are unhealthy, and should be severely limited. Finally, we should remember that transfats were only in recent decades found unhealthy, mostly due to research in 00s by M. Katan. Your Atkins diet during its hype in 70s didn't exclude transfats.

> not your caloric intake nor the amount you exercise

I didn't claim the amount one exercises significantly matters in weight loss. In fact, I wrote throughout the thread that muscles increase weight.

However, having more slightly more muscles than the default 9 to 5 job (lack of muscles) helps with doing tasks like grabbing your bicycle to do a grocery, assembling an Ikea wardrobe, carry your toddler around, that type of activity. Being fit allows endurance. Both are arguably useful motivators.

The Atkins hype is recent (and the keto hype is more recent), not 200 years old. Its also not established by our governments (the equivalents of NHS, Voedingscentrum, etc).

Voedingscentrum has this to say in summary: "Het Atkins-dieet levert gewichtsverlies op, omdat de voeding in totaal minder calorieën bevat. Uiteindelijk gaat het erom de gezondheidswinst die dit oplevert vast te houden met een gezond, gevarieerd en volwaardig eetpatroon.

Diabetes-patiënten en mensen met een gestoorde nierfunctie kunnen dit dieet beter alleen volgen in overleg met hun arts en onder begeleiding van een diëtist." [1]

Which boils down to: "The Atkins diet achieves weight loss because the diet contains a total of less calories. Ultimately, it is about retaining the health gain that results in a healthy, varied and full-bodied eating pattern.

Diabetes patients and people with impaired renal function are better off only following this diet in consultation with their physician and under the guidance of a dietitian."

Compared with various other diets they're not even that negative about Atkins. Many alternatives are worse established.

If you got any sources where government organizations like the ones I mentioned recommended 200 years ago the Atkins or keto diet I'd love to read about that. Or perhaps sources where they actively recommend it to this day, including the theory behind it. Any government health service sources supporting it, also welcome. The burden of proof lies at you.

And of course there are tons upon tons of articles which suggest Atkins/keto don't work, complete with test subjects losing weight at start, finding diet not practical, and a yo-yo effect. Here's a quote from one of the many [2]: "[...] These observations led Sacks et al. to conclude that behavioral factors rather than macronutrient composition are the main influences on weight loss [...]" Recommend reading entire article.

[1] http://www.voedingscentrum.nl/encyclopedie/verzadigd-vet.asp...

[2] http://www.nejm.org/doi/full/10.1056/NEJMe0810291

[cpymchn]

Small point first… eating the same amount but exercising more equals a caloric deficit in the same way that exercising the same amount but eating less does. I am not following your point about muscles specifically but I think we can let that go provided you agree that being in a caloric deficit needn’t mean you eat fewer calories. That is all I was trying to say regarding exercise.

Second point… confusion is not the same as controversy. Even though people might be confused how the mechanisms and pathways work doesn’t mean they are controversial. Hormones dictate weight gain and weight loss. See pregnancy or puberty or menopause. (You even mentioned Thyroidism.) It’s not controversial. Calling it pseudoscience seems over the top. See the green house effect (first argued in 1824) for an analog.

Third point… my claims pertain to the biology not to the marketing behind certain diets. I don’t believe that the atkins diet is ketogenic… nor do I think the Voedingscentrum is correct in saying the diet has a ‘varied and full-bodied eating pattern’, but I also don’t care. As you say… it is hype. But if your counter-examples have no explanatory power, then they are just as worthless. More on this below. In the very least don’t equate the hormone hypothesis with an endorsement for Atkins.

Fourth point… I concede that my rhetoric is not iron clad. Since science is a process and certainty is always a question… it is hard to ever win an argument about this stuff… as Katan points out doing double-blind studies is near impossible so that makes claims in nutrition science doubly fraught. Having admitted that… I stand by my statement that the hormone hypothesis is not controversial. Yes the lipid hypothesis had sway in American culture in the mid 20th century but evidence to back it up was never produced. If any controversy existed, I would say it lay with the lipid hypothesis not with the endocrine one.

As to the bonfides for sugar induced obesity I would point to Jean Anthelme Brilliat-Savarin (writing in 1825), Alfred Moore (writing in 1860), John Harvey (writing in 1861) , and William Banting (1863). Their accounts were accepted by medical schools in the US and the UK, with varied levels of understanding, through to the 20th century… where Thomas Cleave and John Yudkin were their antecedents. Does that make my 200 year claim iron clad? Not really but I think it is good enough for arguments sake.

Last point… you haven’t made a case for an alternative to the hormone hypothesis. The links you included don’t do it. Your examples don’t do it. The Katan article doesn’t say that low carb doesn’t work… let alone provide an alternative mechanism for losing weight. As I wrote above… caloric reduction is a associated with instances of losing weight… but it doesnt CAUSE you to lose weight. Hormones do.

[projektir]

Another anecdote: I'm in the "I'll never give up bread!" camp; I have never been on any kind of specialized diet, and I have never been obese. At one point I wanted to lose 10 LB, and I just counted calories, and it worked, albeit slowly.

Given that bread is a fairly old food, while the obesity problem seems recent, something seems off with the idea that we should all be on a keto diet.

[jm2721]

I think sugar is really what pushes societies from healthy and slightly stout to obese and diabetic, since those diseases are issues of insulin resistance. If you eat too much sugar, your insulin resistance will go through the roof because excess fructose (which makes up ~50% of sugar) leads to a fatty liver, which leads to insulin resistance. The liver is the only organ that can process fructose. Bread, on the other hand, will get metabolized into glucose (oversimplifying a bit here) and every muscle in your body can use glucose for energy, so it's a lot more evenly distributed.

If you're in the "I'll never give up bread!" camp, I would encourage you to try and find sugar-free bread. I tried doing that, and let me tell you, it is extremely difficult. Even your healthy looking whole grain, multi-seed, organic superfood bread usually has a ton of sugar. But it can be done :)

[Evgeny]

low-carb "lazy Keto" diet where all I did was keep carbs under 20g net per day

Looks like a strict keto to me, anything under 30g net carbs per day will put you into ketosis.