EAT LESS THAN A 100 CARBS A DAY IS BEST FOR FAT LOSS

Much of our beliefs about insulin and no sugar diet fat gain were fabricated myths over the past few years. We blamed insulin and carbohydrates for obesity in the western world. If you read an article about the effects of insulin, it will many times mention that insulin is a fat-storage hormone. Insulin is more than a storage hormone; it’s a nutrient-partitioning hormone.

Besides increasing fat storage, insulin can increase muscle glycogen synthesis, increase muscle protein synthesis, and reduce muscle tissue breakdown. The theory of insulin-induced obesity is:

HIGH CARBOHYDRATES > INCREASE INSULIN > INCREASED FAT STORAGE = OBESITY.

The Carbohydrate-Insulin Model of obesity suggests high carbohydrates elevate insulin, suppress fat mobilization from adipose tissue, and lead to obesity. It hypothesizes that increased carbohydrates result in increased hunger, decreased physical activity, and excess calories, resulting in weight gain. Unfortunately, the recent work of leading experts in nutritional science has debunked the notion that carbohydrates cause obesity based on large-scale epidemiological studies.[1]

Kevin Hall, Ph.D., is one of the leading obesity researchers in the country and has adapted The Energy Balance Model of Obesity. This theory proposes that obesity is caused by changes in the food environment (i.e., consumption of energy-dense, ultra-processed foods). First, it has been found that compared ultra-processed foods result in increased appetite, increased calorie consumption, and increased body weight and body fat.2 Contrary to this, whole food decreased the appetite-stimulating hormone ghrelin and increased the appetite-suppressing hormone PYY.[2]

In a detailed review of the literature by Kevin Hall, Ph.D., he concluded refined carbohydrates might lead to increased caloric consumption leading to obesity, but this can’t be attributed to the carbohydrate-insulin model.[3]He detailed the flawed logic of using carbohydrates as the sole contributing factor to obesity.

IS A LOW CARB, NO SUGAR DIET BEST

A later review by the same researcher found no differences in body weight with low carb, no sugar diet or higher carbohydrates when calories were matched. Over 32 controlled studies were examined, with dietary carbohydrate intake ranging from 1–83% of total calories and dietary fat ranging from 4–84% of total calories.[4]

Despite the wide differences in the ratios of fats and carbohydrates, there was no difference in body weight change in favor of higher or lower carbohydrate intakes when calories were similar. It made sense that if you follow a low-carb/keto diet, fewer carbs are consumed, and less insulin is produced, leading to less fat storage. The problem is that none of this occurs if you are in a caloric deficit; only when you are eating in a caloric surplus will carbohydrates and fat contribute to increases in body fat.

LOSE WEIGHT ONLY EATING RICE? HIGH CARB FOR WEIGHT LOSS

In contrast to the low carb, no sugar diet, the popular Rice Diet developed by Dr. Kempner documented severely obese patients losing weight by eating 95% of their diet from fruit and rice. The diet was less than 1,000 calories per day. Is this diet optimal for losing body fat? No! They also lost a considerable amount of muscle, but it emphasizes that carbohydrates do not cause increases in body fat unless in a caloric surplus, much like fats.

In a cross-sectional study of 212 subjects, there was no association between white rice and obesity factors. Also, the Okinawans, who have some of the largest numbers of centenarians (i.e., people that live over 100 years old), eat a diet rich in sweet potatoes, vegetables, legumes, and other low-energy foods. Their diet comprises 85% carbohydrates, yet they have a calorie-restricted diet of about 1800 calories per day.[5]

The diet community was rocked when a 2018 study compared healthy low-carb and low-fat diets for 1 year. The study had over 600 participants, and both groups gradually reduced their calories. Both groups consumed similar protein but varied carbohydrates and fats depending on what diet condition the two groups were assigned. Despite the low-fat group consuming more carbohydrates, there were no changes in insulin secretion.[6]  Another meta-analysis of 22 studies concluded that a high-carbohydrate diet or an increased percentage of total energy intake as carbohydrates did not increase the odds of obesity.[7]

CAN I EAT CARBS AND STILL LOSE WEIGHT?

No diet can be considered superior as long as protein is at a higher rate; it does not matter whether it comes from carbs or fats. When participants adhered to either an ad-libitum (i.e., the diet is always available) high-carb, low-fat diet (75% carbohydrate, 10% fat) for two weeks or a low-carbohydrate, high-fat diet (75% fat, 10% carbohydrate) before alternating diets, both groups lost an equal amount of weight when protein was similar between the groups. The low-carb groups dropped weight faster, but the weight loss was similar at the end of the study.[8]

Interestingly, the body fat changes were better for the low-fat group compared to the low-carb group. Researchers divided subjects into four conditions: high vs. normal protein with low or normal carbohydrate content. The researchers found that the success of low-carb diets is not due to low carbohydrates but rather high protein. Lowered carbohydrate intake per se did not affect the decrease in body weight and fat mass during energy restriction. In contrast, daily elevated protein intake promotes body weight and fat mass loss during weight loss.[9]  Protein is the key ingredient for optimal body composition changes.

Caloric Restriction is the Key to Fat Loss.

CAN YOU LIVE WITHOUT CARBS?

Others have found that baseline insulin levels or insulin resistance did influence subject’s ability to lose weight. [10]  If insulin were the key contributing factor to obesity, one would expect the protein to cause increases in body fat because protein can also raise insulin. Fitness competitors and diets can’t go a day without having a whey protein drink, yet whey protein is more insulinogenic than bread. [11]

THE STUDY

Whey protein has consistently been beneficial for preserving lean mass and decreasing body fat while following a calorie-restricted diet. Whey protein has a higher insulin response than tuna, turkey, or egg. [12]  In another study, beef had a similar insulin response as brown rice, and fish had an equal response to grain bread. [13]  Some have suggested that the ketones produced from high-fat diets enhance fat loss. In a 2021 study, subjects were assigned to a low carb (< 50 grams per day) high protein diet (.7 grams per pound of body weight), a low fat/high-carbohydrate diet (i.e., consumed 259 grams of carbohydrates per day), or the low-carb diet with a ketone drink. Ketone drinks will significantly increase circulating ketone levels.

Results

At the end of the study, despite the ketone drink elevating ketone levels beyond the low carb group, the elevated ketones did not alter the magnitude of weight loss or fat mass. [14]  Other studies have found no differences in appetite between those with high and low ketone levels during weight loss. [15]

Insulin and carbohydrates are not the demonizing dynamic duo causing obesity. When protein is controlled, you can choose the ratio of carbohydrates or fats that best fits your diet needs. You can lose weight and fat with both low and high-carb diets successfully; it’s a matter of choice. The carbohydrate-insulin-mediated theory of obesity should no longer be a topic of discussion of obesity.

NO SUGAR DIET KEY POINTS:

• You can lose weight with both low and high carbohydrate diets; calories is key
• When protein intake is similar between groups, long-term weight loss studies have reported similar weight loss with low and high carb diets.
  

  REFERENCES

  1.         Hall KD, Farooqi IS, Friedman JM, et al. The energy balance model of obesity: beyond calories in, calories out. The American Journal of Clinical Nutrition 2022.

  2.         Hall KD, Ayuketah A, Brychta R, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab 2019; 30(1): 226.

  3.         Hall KD. A review of the carbohydrate-insulin model of obesity. Eur J Clin Nutr 2017; 71(3): 323-6.

  4.         Hall KD, Guo J. Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition. Gastroenterology 2017; 152(7): 1718-27 e3.

  5.         Willcox BJ, Willcox DC, Todoriki H, et al. Caloric restriction, the traditional Okinawan diet, and healthy aging: the diet of the world’s longest-lived people and its potential impact on morbidity and life span. Ann N Y Acad Sci 2007; 1114: 434-55.

  6.         Gardner CD, Trepanowski JF, Del Gobbo LC, et al. Effect of Low-Fat vs. Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial. JAMA 2018; 319(7): 667-79.

  7.         Sartorius K, Sartorius B, Madiba TE, Stefan C. Does high-carbohydrate intake lead to increased risk of obesity? A systematic review and meta-analysis. BMJ Open 2018; 8(2): e018449.

  REFERENCES

   

  8.         Hall KD, Guo J, Courville AB, et al. Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake. Nat Med 2021; 27(2): 344-53.

  9.         Soenen S, Bonomi AG, Lemmens SG, et al. Relatively high-protein or ‘low-carb’ energy-restricted diets for body weight loss and body weight maintenance? Physiol Behav 2012; 107(3): 374-80.

  10.       de Luis DA, Aller R, Izaola O, Gonzalez Sagrado M, Conde R. Differences in glycaemic status do not predict weight loss in response to hypocaloric diets in obese patients. Clin Nutr 2006; 25(1): 117-22.

  11.       Salehi A, Gunnerud U, Muhammed SJ, et al. The insulinogenic effect of whey protein is partially mediated by a direct effect of amino acids and GIP on β-cells. Nutr Metab (Lond) 2012; 9(1): 48.

  12.       Pal S, Ellis V. The acute effects of four protein meals on insulin, glucose, appetite and energy intake in lean men. Br J Nutr 2010; 104(8): 1241-8.

  13.       Holt SH, Miller JC, Petocz P. An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods. Am J Clin Nutr 1997; 66(5): 1264-76.

  14.       Buga A, Kackley ML, Crabtree CD, et al. The Effects of a 6-Week Controlled, Hypocaloric Ketogenic Diet, With and Without Exogenous Ketone Salts, on Body Composition Responses. Front Nutr 2021; 8: 618520.

  15.       Gibson AA, Seimon RV, Lee CMY, et al. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obesity Reviews 2015; 16(1): 64-76.

  16. Brown, R. C., Cox, C. M., & Goulding, A. (2000). High-carbohydrate versus high-fat diets: effect on body composition in trained cyclists. Medicine and science in sports and exercise, 32(3), 690–694