AMENDMENTS: Study 139: One of the studies referenced in this review (study 13 - doi:10.1152/ajpregu.1985.248.1.R120) indicates greater fat deposition insulin was administered. However, if you look at the blood values of glucose (as one example), the animals’ blood values are significantly lower (half) of the non-insulin treated animals. So, I would argue the insulin is just depositing the blood values of nutrients into the fat tissue, but that does not act as a proof against the Conventional Model (as claimed in the review). It’s merely a re-compartmentalization of the nutrients from the blood to the fat tissue, which falls in-line with the Conventional Model, as well as the Insulin Model. Study 142: This re-analysis did address the energy expenditure issues with the Hall analysis (study 141), but ignored the bodyfat loss data, which showed the results are about equivalent on either diet. So, it only rebutted half the criticism. For access to the studies for your own eyes, see the description - there is a link to a document with the DOI numbers for all main studies mentioned.
Question for you, Dr. Nic: so, I'm 57 now, and was well over 400lb in my 30's. Low carb, fasting, and weight training have been my only sustainable path. I can't help but draw a half-baked analogy: if I tell someone "lifting weights is healthy," after a couple of weeks, the only thing someone would feel is....sore.😆 The benefits are only seen and felt after weeks. I feel like the insulin model is more viable simply by nature of the mechanism, but it seems like something that would only be evident after weeks of correcting insulin response. Am I off-base?
I was constantly, painfully hungry on a standard diet (not full of processed food...mostly vegetables). On keto /low carb I'm rarely very hungry, I feel better, and no more brain fog. I don't know if it's for everyone but I'll never go back to lots of carbs.
I've tried both diets too the book. A low carbohydrate for me works 3 times as fast for weight loss. This is great information, but it just comes down to what works for you.
I think yes, it's individual. I tend to get hungry from carbs, my father for example needs carbs to feel full. But that's just my theory. Or maybe it's the simple carbs that make one mor hungry.
@@stellasternchen you're right, there's definitely individual variance on that. I just caution people against confusing weight loss with fat loss. BTW, Kevin halls brand new study showed higher ad libitum cal consumption on low carb (on average) vs low fat, check it out!
@@emailjwr Water yes, muscle, depends. Are you on gear? Are you consuming 1g/lbs of mass to maintain and build? How do you train? (hopefully heavy with variable resistance and TUT) Too many unmentioned variables to definitely claim you lose more fat on low fat vs low carb.
@@emailjwr "Low fat diet". Sure, enjoy your binge eating disorder goals. " Youre only losing water and muscle." Really? I thought it was just a matter of creating a calorie deficit.
Great analysis of carb insulin model in the world of keto only videos trend. Thank you, it is amazing how you get time to make videos after researching and appreciate you continue to enlighten common people like us as a public service! Keep up your good work. 👍
In my 20s I was active duty, and worked out 6 days a week including things such as unit PT (calisthenics & running mainly), bodybuilding weight lifting, sprints & long runs, and combatives training, plus leading other exercise sessions. I was around 15% bodyfat and ate anything and everything only really ensuring that I ate a lot of protein. Weight management really wasn't an issue for me, and my annual physicals were always great. Now in my 30s, post-military with a variety of injuries and long-term gut damage from an infection that resulted in food allergies, I have found that a low-carb/keto/carnivore styled diet in conjunction with an intermittent fasting/time-restricted eating routine of roughly 16:8 has made things much more manageable. My various health issues (nerve damage, disc damage, chronic pain, IBS, acid reflux, headaches, and mood related things) are much better managed and are largely mitigated, and I feel better on average than if I stray from these practices. So far my bloodwork has shown positive results as well, so it seems fine for me at least. I was frustrated for some time with weight management, but this has been a positive on that end as well.
I lost 50 lbs and went to a normal A1C from a diabetic A1C. Low carbohydrate life style was the key for me. Low carb helps me with appetite control and satiety, therefore I can eat less and not be hungry all the time.
Your voice is like hot chocolate, so soothing. As someone who is lyrically trained, I appreciate how well rounded and integrated the registers are. VERY HOT VOICE!
The contrast between the two models is often over emphasised and the agreements minimised, in much of the literature. Eg almost everyone agrees overeating is the proximate cause of obesity and also that insulin is a key piece of the puzzle. The real question should be more about WHY people over eat - Ie about hunger / satiety. Dieting is dead easy except for hunger! Which is why metabolic ward studies are meaningless for real world strategies. Carbs are definitely part of the problem for many people - leading to excess hunger (everyone agrees low carb diets often work well) but evidence also shows other reasons why modern foods increase hunger. Eg see Hungry Brain by Guyenet. The focus should be on why we get hungry unnecessarily rather than on false dichotomies between different metabolic processes.
Agree: I wonder if fat cells produce leptin which communicates to the brain that we are full, Is the leptin within the fat cells consumed destroyed in the gut or does it survive and get absorbed? I have also read that processed carbohydrates are absorbed faster in our guts than protein and fats. Seems there may be something in the time delay of nutrients.
So we are probably better off by eating less, whatever it may be, and moving more? But eating less is more important than moving more? Is that the basic idea in a nutshell?
When you were talking about how closely one of the studies followed expenditure of calories, a thought occurred to me that I've never heard mentioned before (and perhaps for good reason ). Since Ketones can be excreted through urine and breath, is that taken into account in these studies? I agree that's likely not enough to make any real difference, but I was just curious if anybody had actually quantified the excretion as, perhaps, a ratio of ketones in the blood or some other measure so that it could at least be accounted for. Sorry if that's an annoyingly simple question, but in the dozens of these sorts of research videos I've heard on the topic, I don't recall ever having heard about that.
Hi, excellent review, thanks! Just a side note, would you consider posting the DOIs of the papers in the description of each upcoming video? That would help make it a great deal easier to look up those references.
My understanding is CIM model the partitioning towards fat happens because we have limited glycogen stores depending on the persons height, weight and musculature and excessive glucose gets shoved into fat cells. After an intense workout glycogen stores get depleted and you can consume carbs to replenish them stores without gaining fat. I am no expert and curious if glycogen stores and physical activity was mentioned in the papers.
What you didn't add to the carbohydrate-insulin model, and I appreciate that you had a lot to get through. is the double lock. When blood glucose is high, your insulin needs to rise as high as it needs to be to park that glucose to the liver or to your muscles. When these cannot take any more glycogen, the insulin parks the rest in fat cells. This leads to higher insulin level in the bloodstream on a chronic basis, which also locks the cells so that they cannot burn fat until the insulin levels have receded. If you eat regular carb meals during the day, your body may not have any opportunity to burn fat. As an individual case study I can tell you that I failed consistently on calorie controlled diets but have lost more than 25 lbs in a few months on a low carb diet. So for me, low carb has worked. I don't really care how the science stacks up because I am way healthier and slimmer now than I was.
So insulin resistance may be the starting to understanding hormone resistance in general and we may be prudent to avoid situations that cause hormone resistant states.
Bingo. Insulin resistance is really what brings the carb-insulin model to life. Individuals with a flexible/healthy metabolism will not see extreme increases in insulin after a high carb meal nor will the insulin spike last very long. Insulin resistant individuals will have higher fasting insulin, and see higher spikes that last longer. This high insulin drives down glucose in the blood but also prevents fat cells from releasing their stored lipids which leads to the the cravings for more carbs. It could take 3-5 hours for insulin to return to fasting levels in an insulin resistant person and in that time they’ve already consumed another high carb snack or meal. The cycle continues throughout the day and they stay in a high insulin fat storage mode all day long day after day only getting relief during sleep assuming they don’t snack late at night before going to bed.
As a sugar and food addict, a low carb diet is the only salvation for me. It is the only diet where I can forget about food and get on with my life. Carbs may not affect everyone, but for me create cravings all day long. Limiting carbs and sticking to low carb veggies (lots of lettuce and green leafy vegetables) I never feel hungry ultimately reducing calorie intake overall too. No mood swings, no tiredness, lots of energy... resulting in more success with keeping my weight under control. For me it's really about psychological effect of not feeling hungry and feeling balanced.
I can vouch for appetite control strategies as a critical part of weight loss. Fat is a powerful satiating macronutrient. When you lose fat, you need to rearrange your macro-nutrient intake to allow for more fat. As I've lost weight, and still in a deficit, I shifted from 50% carbs, 20% fat 30% protein to 35% carbs, 30% fat 35% protein. This ratio has helped keep my appetite down because it replaces the needed fat my body needs for satiety, while still keeping my calorie count in a deficit.
Just a simple first principles example. Whenever I do fasting or low carb - I lose weight. It happens consistently and always. Whenever I eat a " balanced" diet, despite my best efforts and to the big surprise - weight always creeps up. Always. And after a half a year I have to do low carb/keto again and then weights goes off effortlessly, however with the maximum effort on balanced diet it always goes up. This just shows that one theory works and other doesn't, and the goal of science should now be to elucidate why that is. TBH I really don't think that effort or will has anything to do with that. In other areas of life I am highly succesful, earn 2 standard deviations more than median in my country, but in this metabolism paradigm despite big effort with "conventional" approach - it doesn't work. So maybe the approach is wrong ? Maybe people are not physical machines? I know for sure, that CIM is correct, I'm just not sure why, and it is funny to see the other side imploding from their wrong assumptions.
Are there studies that show that it’s just different for different people? Like dividing by blood type or some sort of metabolic measure that points to one or the other?
Bro! All things being equal, the obesity epidemic and dramatic increase in major cardiometabolic issues(i.e., NAFLD, T2D, HBP, CVD Risk, etc.,) is the result of overconsumption of highly palitable foods and overconsumption of junk food in the way of fast food. Plain and simple regardless of which diet tribe you belong to, and regardless of whether you believe in carb-insulin model or energy balance model.
So before i watch this video my answer is we gain body fat by consuming mass and that mass ratio and makeup influences hormones that facilitate less satiety and/or more hunger and more fat gain
Carbohydrate-Insulin model? I'm late to the party, but this seems a little strawman-ish to me. I think the smarter model is Hunger-Metabolic Rate (Hormonal, which includes TR/DR/CR) vs CICO. I'll ask M Jordan, "Should I watch this video?" All do respect to both. But I don't want to listen to arguments between The Earth is a Circle vs Earth is Flat if I already know that it's a colloidal sphere. Thx
Hey Nic! Wouldn't you say that carb-insulin is a subset of the conventional model? Why are they even arguing? I'm sure there's more to it than carb-insulin, but it's definitely part of the problem. Also, what do you think about epigenetic mechanism and even transgenerational effects? The onset of highly processed foods is also accompanied and even preceded by the onset of chemical industry and wide spread exposure to epigenetics altering agents?
I agree, el. I actually don't think the Conventional Model mentions insulin doesn't have the effects it does, but the difference is if the fat cells suck up all the nutrients or if its pretty evenly distributed. That's a point of debate considering the Insulin model predicts the fat cells will take up all the nutrients, causing greater hunger signaling, but that doesn't really stand up to the research (as far as I can see). So, yes, insulin is still a major driver, just not the only one. It's certainly possible to get a different epigenetic profile passed on from your parents, as well as differences due to epigenetic altering agents, but I haven't looked into it much, beyond one video on Dr. Rhonda Patrick.
I think most overeating occurs when people get too hungry and they binge. They make bad choices that don't get them full. Protein and carbohydrate will fill you up quicker than protein and fat, but all 3 will fill you up the quickest and is the most thermogenic. Stretching the stomach causes pain that is addictive too, so you need to stretch it more each time. Of when I talk carbohydrate I am talking of whole carbohydrate and not excessive starches and sugars. Isnt low muscle mass and to some degree obesity the major cause of insulin resistance
I haven't read the study, but I was wondering if concerning the study showing differences between high GI and low GI foods on all those the dependent variables, part of the researchers point for why this supports their "insulin-model" is that high GI foods spike insulin more than low GI foods and that therefore insulin might mediate this effect. I don't know if they even measured insulin and tested whether it mediated, I suppose not otherwise you probably would have mentioned it, but there is evidence that high GI foods spike insulin more than low GI foods, right? But even if that is the case, I agree that it doesn at all show that insulin causes any of the effects.
I believe it depends also of your microbiome in the gut. Some people are able to use fiber every well for energy. So they have also consider the calories of fiber.
Rodents can starve to death with body fat intact if they eat a pure carb diet. Humans seem to run a later version of the mammalian software which makes them better at processing stored fat despite dietary macros.
I would also fall somewhere in the middle of these two approaches. I believe both have insights into the actual mechanisms, But both are missing key information. Calories do matter. Hormones also matter, such as insulin, grellin, leptin, etc. Lowering carbohydrate intake is a sure way to affect your hormones, as with the carbohydrate insulin model. This makes it MUCH easier to under consume a calories, while also preserving lean muscle mass in most situations. The lower insulin and other hormones allows your body to burn more fat instead to make up the difference. The largest issue I feel that is missed in both models is how seed / vegetable oils affect both systems. From a calories in calories out model, vegetable and seed oils stimulate the endocannabinoid system, which leads to overconsumption of calories. The carbohydrate insulin model often neglects the long-term metabolic effects of over-consuming the fat linoleic acid, on mitochondrial function, and other factors which affect metabolic health, insulin, and the other hormones.
I predict that if these studies split the participants by age, we would see a statistically significant difference between the low-carb and low-fat diets for older adults. For example, one group is 18-35 years old and the other is 45-62. When in college (18-35) my observations would have informed me that the calories model perfectly described me and my peers. Now in mid-life, the carb-insulin model is much more explanatory. Personal observations by themselves are not important to the scientific community, but they are often the reason that research is done. Something changes as we age that is not shown as a factor in either model. It happens to most of us in the 35-45 year old range. Some presume this to be related to insulin resistance.
That's what I think, as well. Might just be the very early onset of insulin resistance. I mean...that process slowly starts to happen a good decade before you would first notice chronically high morning blood sugar or such (from what I understand). At that point (30-40s), people have usually been eating a very high carb diet for decades and at the same time, started to be less physically active. So then their cells slowly start to become insulin resistant and conventional diets (counting calories) suddenly don't work as well anymore. Or just feel plain miserable, because your cells (or your brain?) can't utilize glucose as well anymore and keeps storing rather then burning it.
I just eat in a deficit. Get 0.8g of protein per pound of bodyweight and then just fill in the rest with whatever (But preferring carbs cause fat is high calorie low volume and leaves me starving) and it's worked wonders for me. Not sure why people make it so complicated
I think they'd argue it does make a difference. For example, leading to increased food consumption and modulating our behaviors. Possibly through some direct brain mechanisms, as well.
@@Physionic I prefer to follow the carbohydrate/insulin model particularly for health reasons. With regards to fat loss, I have had success with both models, especially when exercise is introduced, but I find it much easier to follow the low carb for weight loss and my overall experience is better. That said, I find this argument much like the climate change argument... There is a bunch of evidence supporting both claims and we must choose what evidence is real... Unfortunately in the process of choosing, too many people lose focus on the broader picture. In the case for/against climate change, the undeniable fact is that pollution has risen and that alone has serious consequences. In this case, it's far more important to look at overall health and the rise of diabetes which is undeniably linked to high sugar/high carb diets. I eat a keto diet over the Winter season when high sugar/high carb foods wouldn't be traditionally available to my ancestors. I lose weight, and my fasting BGL drops significantly. In April, I go back to a moderately high carb, lower fat diet. I've been doing this for well over 10 years and it seems to work well for me.
Cortisol stimulates gluconeogenesis (making of new glucose inside the body) which results in increased insulin - so I'd imagine they view it as a high carb diet 🤣😭
I was fasting on chemo and my blood sugar was normal around 80, but they were injecting me with dexamethasone (a glucocorticoid), which has similar action to cortisol and my sugar was going to 250 without even eating anything
I guess in that sense if you're chronically stressed you could be frequently converting your glycogen reserves in your liver and muscles into fat, indirectly through insulin...
Also, shouldn't the fact that type 1 diabetics without any insulin treatment literally can't put on any fat no matter how much they eat be a point in favor of the carb-insulin?
Yes, that is a point, but it is explained in the Conventional Model, as well. I don't think either model is saying insulin doesn't matter - it definitely does, but it isn't the only factor, according to the CM.
They also die without any insulin within a short period from DKA so insulin is essential for everyone. I personally was low carb for ages, got pretty lean, but am now eating 300g of carbs a day and only 50g of fat and am leaner than ever (200g of protein also) plus my fasting glucose is 79 versus 93 when I was low carb. Energy balance model is the winner from my experience.
Seems that there is evidence that both models are true with different environmental circumstances (ie diet). Both models agree that there is generally overconsumption with a western diet and I think that most people will agree that activity level has generally decreased with modern life. The fact that humans can survive with vastly different diets may speak to the ability of humans to spread globally. Perhaps trying to pick one model over the other is missing the evidence that both models have viability. I also wonder about what observations we can learn from animal observations such as herbivores needing to graze continuously and carnivores that may need to go some time between meals. Makes sense that humans as omnivores would have mechanisms to survive both dietary situations.
The carb-insulin model is just too fringe in their oversimplification/reduction to insulin and insulin to carbs (which really is also weird because healthy high cabs diet is best for insulin control). As you said the conventional model do not negate the effect of carbs on insulin (and on the rest of the cascade) it just include other known mechanism.
The graph shown at 15:23 is quite intriguing. If insulin didn't cause excess weight gain but increased adiposity under controlled feeding, it would suggest some of the protein ingested was burned or stored as fat instead of growing muscles. The term Sarcopenic Obesity comes to mind.
Maybe, Mario. I actually failed to mention something related to that. I'm a little frustrated with myself that I forgot, but in that study, the blood glucose and nutrient levels were much lower in those animals while the non-insulin treated animals had something like double the serum nutrient levels. So, my educated guess is that insulin causes fat gain, but no added weight gain (in this context), because the animals are having their nutrients compartmentalized to fat tissue as opposed to the serum. Yet, the total nutrient amount, across the body (compartments bedamned) is equal (therefor no added weight gain). However, if the researchers had given them too much insulin, they would have died, because too many nutrients would be in fat tissue and not enough in serum. This interpretation could be seen as a plus to the Insulin Model, but I consider it an argument for both, because the CM model still acknowledges nutrients go into the fat cells when stimulated to (insulin, for example), just not preferentially (like the CIM states).
@@prettybirdbeenlpeacock6592 correct, but that is exactly the problem. The subjects maintained the weight while lossing muscle and increasing fat, quite the opposite you want for good health.
There is a lot of rcts that compares low fat vs low carb equating protein and calories and theres no differences in fat loss. It funny because low carbers love quote mice studies when they try to proove anything in favor of lc but they dont use the human data available because disproove their point.
Good points, Juan. I didn't cover those, although I probably should have thrown that in here, too - like the metabolic ward studies. The one pushback offered by the CIM researchers on those studies is the fact that they're short term studies. Additionally, many of those studies are included in the meta-analysis discussed. That said, on a personal note, I agree with you 100%.
Sure satiety matters, but they explain that if you eat highly processed carbohydrates, no matter the amount of calories, you will get fat because you are spiking insulin and that's have been disproven many times. I believe low carb diets are a valid tool to lose weight because it could induce a calorie deficit is not due to insulin spikes or any other idea ludwig creates after his model is disproved so he changes it again.
Did the study subjects exercise regularly? Seeing that insulin sensitivity, energy partitioning, and ketone formation can be heavily influenced by exercise, the effects they found now might be reduced to effect size zero in a more active population. Just a guess. Anyhow, I do not think the effect sizes found are worth overhauling one's diet and scientific models for. I mean: Some foods/nutrients, like caffeine, grapefruit, green tea, and ginseng, etcetera, have been found to have similar effects on metabolic rate in some studies so little seems required to slightly increase calories burn per day.
For the meta-analysis, it doesn't distinguish, but generally the answer is no. That's a great point. I think the researchers would come back and say "why not use all of those methods and then you get a noticeable difference?". Additionally, before this analysis, they had claimed levels around 400 kcalorie increase, which is pretty dramatic. Ultimately, they settled on lower values, as you saw.
You need simple carbohydrates . You cant live without them. From the earliest times, man was eating highly processed refined carbohydrates. The complex carbohydrates found in natural sources such as leafy greens were simply unavailable. Snacking on all the goodies all day long has contributed to abnormally low amounts of insulin in peoples blood . Because of the abnormally low amounts of insulin in peoples blood Americans enjoy the lowest numbers of inflammatory diseases such as cancer and diabetes and a host of other auto immune diseases. Now we are the healthiest nation on planet earth. Long term diets of other countries and their cancer and other disease rates simply do not hale in comparison to our short term studies.
![Carbohydrate-Insulin Model vs the Conventional Model. [Study 138-143 Analysis]](/img/logo.svg){kind=logo}
