The necessity of eating; hunger and body weight regulation. Pt 1 - The Scribble Pad: Food is not evil

The Scribble Pad: Food is not evil; the necessity of eating; hunger and body weight regulation. Pt 1

Pt 2 to come.
A few days/weeks ago I wrote a blog series regarding the controversial topic of trouble with ketogenic diets. (I have now created a separate tag for this post series and may update them in the future; although I intended to do so with the Guyenet series which I largely abandoned. That reminds me, I really need to get back to work cataloging guyenets' lies as well! This is a service to humanity!)

The cornerstone idea of my "trouble with ketogenic diets" blog is that an overwhelming majority of complaints pertaining to ketogenic dieting is not specifically related to the diet makeup itself; it is more accurately described as the result of rapid prolonged body fat oxidation w/o adequate insulin stimulation of fat tissue (i.e. fat growth) thus better attributed to a chronic prolonged negative fat cell energy balance. It is the expected result of failure to consume enough dietary energy and micronutrients to restore endocrine milieu to a fed state. They are not intrinsic ketogenic eating risks, these are weight loss dieting risks.

It is extremely important people recognize that calorie adequate ketogenic diets are a pleasure to maintain, with absolutely none of these signs/symptoms of starvation being present when consuming a ketogenic diet rich in micronutrients and eucaloric to prevent body fat atrophy. It is important to shout this from the rooftops because of the incredible clinical efficacy of ketogenic dieting for a variety of conditions ranging from the most well known metabolic problems (obesity and blood sugar complaints) to neurological issues such as migraines and seizures and mood and anxiety. Many of us irratioanlly feel we are stuck between choosing the benefits of a VLC or ketogenic diet, vs choosing the "fed state" and its benefits (warmth, sleeping easily, fertility, energy). This is not a choice one ever needs to make, because the "fed state" is possible with a ketogenic diet, assuming one actually eats food.

I also propose the widespread myth that ketogenic diets are bad for women is just as false, and the result of eating disordered, eating dysfunctional, body image disturbed females using ketogenic diets to STARVE THEMSELVES, with a very expected outcome : starvation symptoms. Starving yourself on a ketogenic diet is absolutely no different than starving yourself on a high carb diet so I fail to see why people are surprised they feel poorly several months eating 1200 calories and losing substantial subcutaneous fat.

 Well, I suppose body fat loss is much more effective following a ketogenic diet (due to more calories of protein and constant body fat oxidation/insulin inhibition suppressing fat tissue growth, body fat loss more efficient and muscle sparing is promoted; ironically this superior loss of body fat with a ketogenic diet also triggers and intensifies the starvation symptoms such as infertility/hair loss at higher calorie intakes and higher body weights due to a specific bias of fat cell atrophy/body fat oxidation).
Men do not have these problems in ketosis because they are more likely to eat normally than women; out of any number of men and women adopting a ketogenic diet, dysfunctional and abnormal restrictive eating is expected to be overrepresented amongst the females simply because such behavioral problems are overrepresented amongst females. I've never met a female eating an adequate calorie intake of a ketogenic diet reporting these bizarre starvation symptoms. (If you know of such a person, please email me for $$profit$$)

This "ketogenic diet intolerance" is not an inherent, biologically sex based difference: this is a psychopathological difference, with relatively more women having dysfunctional eating and electing to restrict life giving caloric energy so as to whittle their fat tissue to some arbitrary size. To say ketogenic diets are bad for women, because some women follow them to starve themselves, is like saying alcohol is bad for men because some men happen to binge drink into a coma.

When it comes to starvation, the fat cell rules the day. 
The endocrine stimulation of adipocytes control your brain, metabolism, feeding behavior, and every other endocrine axis in your body. I.E. Guyenet is wrong. I've a whole archive with many arguments and anecdotes illustrating this, the child level intuitive logic required to deduce Guyenet's food reward theory is bogus. Evolutionarily speaking, your fat tissue controls your entire future. Your fat tissue is your reproductive potential, your growth potential, your LIVING potential. His facile, foolish "hedonism" theory can only make any semblance of sense in modern post industrial america where food calories are ubiquitous. Such a concept can only be born of the industrial/tech revolution, with no relationship to the evolutionary pressures shaping our genetics and anatomy/physiology, where minimum caloric nutrition was the concern, i.e. fat cell growth trends. Logically our fat tissue must control our brain, not reverse.  Appetite and feeding never exists in a vaccum; over a long term continuum it is always in service of the fat tissue and representative adipokines. In a pathophysiological feedback loop, insulin drives fat tissue growth drives appetite.

Fat tissue adipokines certainly can modulate our brain and nervous system to promote further weight gain, and indeed when leptin sensitivity is absent (e.g. VMH injury, other brain injury) people will gain weight progressively, seemingly non-terminating with a variety of neuroendocrine derangements purely the result of abnormal leptin signalling. Guyenet has been putting fourth the argument that fat growth is secondary to the brain, and the brain is controlled by our reward centers hijacked by modern hyperpalatable hyperrewarding meals. He has a managerie of loosely understood/referenced animal models and anecdotes to substantiate such wild speculation.

To assume the point of origin defect is in the brain, simply because we can produce animal models (or observe natural examples) where brain level knockout of leptin sensitive neurons produces this phenotype of severe obesity, is what I would call obtuse , perhaps purposefully or unintentionally. But that is the great question of guyenet, that originally incited his fury on hyperlipid: is he really this f'n stupid, or is he pretending just to have his way with his shot at fame?  How on earth can one take a rodent model like ob/ob leptin deficient mouse, and conclude its obesity is a brain disorder ? It's beyond apparent the cause of the obesity is a lack of fat tissue feedback indicating a fed state; abnormalities in the brain secondary to lack of leptin are but one of many defects promoting severe obesity.  Or, you can take a rodent that has sustained hypothalamic damage, rendering it in a similar position as the leptin deficient mouse although the difference is leptin injections fail to work in this case. How on EARTH can one call themselves reasonable or intelligent and purport to say the brain is of superior hierarchy to the fat tissue in controlling long term feeding behavior and appetite and reward / pleasure / hedonistic response to food? To make the brain produce obesity, it nearly always requires damaging substructures or neuron clusters that detect either adipocyte signals or downstream actors of adipocyte signals.

 The CNS perceives and reacts, it never acts, at least not in isolation of input from other organs and the world at large. This is common sense. Our eyes sit on our face right below/next to our brain. Behind our eyes is a nerve stalk feeding right into the brain. Do you think this configuration is incidental? The most primitive rudimentary eye is a cluster of light sensitive cells, evolving and selected spontaneously in response to the presence/pressure of light. The brain naturally complements eyes, and all of our sensory organs. The fat tissue is a sensory organ, at least in terms of detecting and responding to nutrition threat. What kind of moron fool or imbecile would argue our brain tells our fat tissue what to do, without any other feedback directing the brain in such a fashion?

Oh, I forgot, "REWARD" is directing our brain to direct our fat tissue toward growth. Seeing as reward is subjective and not consistent, that's rather like assigning an effect as a cause. Why do starving people find garbage "rewarding" to eat? Why do I almost never feel hungry anymore after gaining 10 pounds? Question oh questions.

Yes, whether SG is stupid or lying will remain the great mystery of the paleosphere. Except, of course, to teh paleo insider mafia, none of which:
1) work with obese clients
2) have controlled obesity in even an n=1 case
3) work on a patient/practitioner level in medicine at all.

Harris is a radiologist. He looks at films. He writes what down what he sees in xrays or visualizes in various isolated organs. He can look at a pair of lungs and give his medical opinion that there is no evidence of infiltrate, merely atelectasis. He can look at a bone and tell me if the fracture is new or old, or present at all, and how the fracture looks (...is it a compression fracture? How did the pt likely sustain such injury? Etc)

He has NO IDEA about consulting with a diabetic patient and observing their progress or monitoring their blood sugar reactions and how it responds to various diets. He is not even a GP. He barely should call himself a physician; he works with films not people. It's grossly misleading to his readers who assume he has any experience treating or counseling or understanding patients. I suppose that's why he's so comfortable with his flights of fancy and absolutist thinking and extreme paradigm shifts every few days. Real doctors know never to speak in absolutes and to allow for exceptions / individuality in patient needs, responses. Also, many different issues can produce similar symptoms. Harris doesn't work with patients. Lungs either do or do not have infiltrate, understand me? The bone IS, OR IS NOT broken. This is the archevorian world. Patients just dont' belong in it.

As for McEwen, Carb"sane", et al?  Zero medical education but they love to pretend.
Krieger is a nutritionist; some of the most dogmatic unscientific faith based thinking has been promoted by nutritionists and dieticians.  Their job is largely to sell government agricultural products and create diet plans to sell industrial medical nutrition supplements such as glucerna, ensure and other dietary supplements.


Pt 2 to come.