Given the amount of discussion we have here about a calorie being exactly the same thing to every person I thought thiswould be of interest - a doctor is researching, due to his personal experiences, if in fact prediabetic conditions might lead to the weight gain that we currently believe cause diabetes.
I couldn’t watch the whole thing because the streaming keeps stalling for me-- but I’m having trouble understanding what the real point of this is. And why it’s even on TED. Forgive me if I’m missing something.
It’s great that Attia is being contrite about his past prejudices towards his patients. Is anyone really going to argue that doctors don’t need to foster compassion for patients?
It’s great that he’s telling people to challenge the status quo. Think outside the box. Great.
But what is he trying to prove? What is he saying that’s so groundbreaking? A crappy diet and low activity are unquestionably linked to diabetes. You can’t just flip cause & effect and claim a new theory. Should we also re-examine the link between UV exposure and melanoma? Maybe the cancer is causing people to forget their sunscreen!
It’s about behaviour. People shouldn’t be made to feel ashamed for bad choices, but they do need to be responsible for them.
I’ll note that he has started several diet-related businesses, the latest of which is “The Eating Academy.” Let’s just say I’m skeptical.
If you’d been able to watch the whole video you would have seen that despite a reasonable diet and a regular exercise routine he developed insulin resistance and began to gain a substantial amount of weight. His theory is based upon his own experiences.
He’s also set up a group of researchers who all believe different things so they can test together and constantly question results. The one thing they agree on is that what we think is fact about the obesity epidemic is probably not.
During my year or so of undiagnosed, untreated diabetes, I lost about forty pounds. Diabetes definitely didn’t cause weight gain for me. But my case is odd, and I suspect he’s talking more about type II anyway, so I would discourage anyone from listening to me.
You mean this?
Okay, I’ve poked around a bit more and I think I understand what’s going on. He’s a big fan of the ketogenic diet. That’s fine. He seems to be building something of an empire based on his passion, which is also fine. But I’m not convinced he’s bringing anything new to the table. Unless you’d count, “Atkins was right all along!”
I don’t believe he’s a prophet with all the answers but I’m encouraged by the fact that people are still looking for answers.
I don’t think we know everything about the way the body deals with food and other substances and I think we need to know more.
That is an interesting theory. Another theory I’ve heard (I’m not sure if there is a name for it) is that both obesity and insulin resistance are tools of a metabolism designed to survive famines and neither causes each other. Obesity gives you extra energy stores during periods of famine, insulin resistance allows glucose to be taken up only in cells that truly need it like in the brain. People with high insulin sensitivity on a low calorie/low glucose diet could see their glucose taken up by muscle tissue before it has a chance to feed more important organs like the brain. Supposedly someone naturally thin like Lance Armstrong, if he eats a ton of calories will see that energy taken up by the muscles. So he will be able to exercise for extended periods of time. A person designed to survive a famine will see it stored as fat. I was reading an article I think by Gary Taubes on the subject of exercise and energy, he claimed it could be reversed (instead of exercise leading to thinness, thinness leads to exercise). Instead of exercise leading to weight loss, it could just be that people who are bad at storing fat are ‘forced’ to burn excess calories as they come in, which would give them higher stamina for endurance activities.
Which brings me to my history of low carb diets. I’ve lost weight about 3 times in my life. Twice with low carb (about 10% of calories), once with high carb (about 60% of calories). Both times I lost weight with low carb I gained back three times as much weight. It is a nightmare, and I’m never doing it again.
However when I lost weight with high carb, I only gained back a little more than I started with. Granted that is still not good, I’m getting fatter. But for whatever reason, I didn’t gain back 3x more weight with high carb diets as I did with low carb diets.
Again, the theory I’ve heard is that on a very low carb diet the body becomes insulin resistant so the little amount of glucose available can go to organs and tissues that truly need it like the brain. I don’t know if that is why low carb diets have screwed me up so badly or not. All I know is I will never do one again. If so, then finding ways to become more insulin sensitive could be something I really need to look into. However my blood glucose levels are normal and I take no diabetes medications (ie I am not diabetic or pre-diabetic).
Good for the doctor for thinking outside the ineffective moral judgments we usually have about obesity and thinking of the biology of it instead.
Yep type 1 is very different to the insulin resistant diabetes. I wish they had different names..:mad:
TL;DNW
Going by the summaries posted here however it sounds like he is stating part of what every medical scientist knows, only part of it, handling it as some brilliant epiphany, and then going off on unsubstatiated recommendations from that that happen to make him money.
Type 2DM is caused by the combination of insulin resitance and the inability of the pancreas to keep up with increased demands for insulin caused by that resistance. There are many factors that contribute to insulin resitance: genetic predisposion; lack of exercise; low grade inflammation; nutritional factors; excess energy intake and its direct consequence, obesity. No expert believes that excess energy intake/obesity is the only contributor to Type 2DM.
There is no question that excess energy intake/obesity contributes mightily to insulin resistance. This is not based only on human corralative data but on animal models. Make an animal obese either by overfeeding or by genetic models that cause overeating and insulin resitance commences. The key issues here are that excess energy, whether it is available as glucose or especially as free fatty acids, is a potent trigger for insulin resistance, and that adipose tissue, which grows with that excess energy, sends off messengers that drive more inflammation that increase the resistance as well.
There is also no question however that some can be very genetically prone to develop insulin resistance, so prone that the trigger of overeating and obesity is not needed to set it off - there are those who are metabolically obese while normal weight for example.
Those with insulin resistance for whatever reason are indeed often more likely to gain (more) fat, especially centrally, and that fat, especially that central fat, will drive more insulin resistance. The key issue here is the mismatch of degree of insulin resistance in different tissues and the level of insulin produced and a variety of other messenger levels. Have X amount of insulin floating around and have insulin resistance muscle >insulin resistance fat > insulin resistance liver? More energy stored in liver (as fat, causing liver damage and greater pancreatic dysfunction), than in fat tissue, which still picks up more energy than does muscle, growing more fat mass and sending out more free fatty acids which drives more insulin resistance … And we haven’t even thrown in brain receptors yet! This is the aspect that highlights the importance of exercise: it alters that mismatch. Exercise decreases muscle insulin resistance most of all.