Red Meat Dilemma – Hormonal Obesity XXVI

Our dilemma here is that there are really two opposing effects of meat and other animal proteins.  One is to raise insulin which tends to cause weight gain,  The other is to slow gastric emptying, increase satiety and tends to cause weight loss.  Which is the stronger effect?

One of the largest association studies of the recent past has come from analysis of the data by combining three very large cohort studies – the Nurses Health Studies I and II as well as the Health Professional’s Follow Up study.  Looking at this combined data, comparison was made between specific foods and and the risk of obesity.  While this was not a randomized trial, it still contains vast amounts of useful data.  “Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men” was published in the New England Journal of Medicine in 2011.

One of the most important things that the researchers did was to look at specific foods.  The past few decades had seen the rise in ‘nutritionism’ whereby foods were reduced to classification into ‘carbs’, proteins and fats.  However, that does not even begin to capture the complexity of food science.  An avocado, for instance is not simply 88% fat, 16% carbohydrate, and 5% protein with 4.9 grams of fibre.  But this sort of nutritionism is how avocados became classified as a ‘bad’ food for years due to its high fat content only to the reclassified today as a superfood.  (Useful online tool for this sort of useless thing here).  While kind of fascinating, there are hundreds of nutrients and phytochemicals in foods that affect our metabolism not captured by this sort of simplistic analysis.

This is the sort of useless thing, by the way, which goes into food labels which kind of explains why they don’t really make any difference.  I imagine that nutritionism really got going during the ‘low fat’ craze of the 1970’s where we imagined that we could explain the effects of all foods based on 3 macronutrients.  First, we thought that all fat is bad.  Then all carbs were bad.  The there were good carbs and bad carbs.  Then there were good fats and bad fats.  Next there will be good proteins and bad proteins (animal vs plant for instance).  The truth is that food resists such easy classification.  We also make this sort of artificial distinction for types of food – fruit for example.  Banana is a bad fruit and berries are a good fruit.  This was based on a notion such as the glycemic index, or the amount of fat, or the amount of sugar.

Following 120,877 men and women over 12 to 20 years, the researchers calculated the association between intake of specific foods and weight gain.  Overall the average weight gain over any 4 year period was 3.35 pounds – pretty close to the 1 pound per year that is often estimated.  While this may not sound like much, over 40 years, say from age 20 to age 60, that will result in 40 excess pounds transforming the 160 pound average person into a 200 pound pre diabetic patient.

It is important to remember that an association study like this cannot prove causation.  However, one of the strengths of this study is to be able to look at long term results – something that randomized trials tend not to do.  Because weight gain accumulates over decades, a short term trial of several years may not tell us what we ned to know.

However, it is still interesting to look at the data here.  It is easy enough to understand why potato chips and french fries may be fattening.  They are both highly processed carbohydrates that raise insulin and glucose significantly.  For the same reason, sweets and desserts, and refined grains are all highly associated with obesity.  Indeed, it would hard to find anybody who would argue  that potato chips, desserts and white bread are not fattening.

But there is also a strong association between processed meat, unprocessed meat and butter and obesity.  Since these are not carbohydrates, one may assume that they are not fattening.  But they are.  Once you realize that protein also stimulates insulin, it begins to make some sense that these foods may also lead to obesity.  But it is the meats and not the dairy so much that leads to obesity despite the fact that dairy proteins stimulate insulin to a much higher degree.  The problem here may be a quantity of meat versus dairy ingested as we explored in the last post.

There are also foods that are associated with a lower risk of obesity – for instance, nuts and vegetables.  This seems straightforward.  Both are low in sugars and very high in fibre.  Both effects will tend to lower insulin and protect against weight gain.  But whole grains and fruit are also protective.  A shock to Atkin’s enthusiasts, it appears that the high fibre in these foods may be protective.

Among beverages, sugar sweetened beverages and fruit juice are associated with obesity.  Not a surprise – both are very high in sugar and very low in fibre.  Skim milk may have a slight association, but whole milk does not.  The higher milk fat may be the protective agent here.  Diet soda is protective, but I have my doubt whether this is a true effect or whether it merely reflects that fact that these are people that are trying to lose weight.

It become much easier to understand the graph when you consider that all the foods that tend to cause weight gain tend to raise insulin.  Those that tend to protect against weight gain tend to contain protective factors – fibre, fermentation (yogurt), and fat.

Here then, may be the the clue to the final unravelling of the Atkin’s diet.  Originally envisioned as a low carbohydrate, high fat diet, it evolved into Atkins 2.0 in the 1990s.  While still low carbohydrate, the low fat craze turned the Atkins reboot as a low carb, high protein diet.  Atkins enthusiasts turned away from real food to Frankenfood creations like protein milkshakes sweetened with fructose, meal replacement shakes and protein bars.

Pharmaceutical companies, like Matt Taibbi’s vampire squid that jams its blood funnel into anything that smells like money, were only too happy to create new nutritional products to cater this new craze.  Boost.  Ensure.  Optifast.  Slimfast.  Have you ever read the ingredients of these meal replacements?  It would horrify you.  Milk protein, fructose, canola oil, soybean oil and a multivitamin.  Does this sound good to you?  Or check the ingredients of Atkins Nutritionals bar.  Chocolate flavour layer, peanut butter flavour layer, glycerin, protein blend, cellulose etc.  There is more friggin’ glycerin than protein!!!!

Not recognizing that not all carbohydrates are inherently fattening, they also turned away from many delicious and nutritious fruits and vegetable.  This made the diet hard to tolerate and sure enough, the compliance to the diet turned out to be very low.  This was not a diet that you could follow for life, despite what many claimed.  Dr. Atkin’s New Diet Revolution was finished.

Continue here with Red  Meat Dilemma II – Hormonal Obesity XXVII

Start here with Calories Part I – How Do We Gain Weight?

See the entire lecture – The Aetiology of Obesity 3/6 – Trial by Diet

2018-05-26T10:02:58+00:000 Comments

About the Author:

Dr. Fung is a Toronto based kidney specialist, having graduated from the University of Toronto and finishing his medical specialty at the University of California, Los Angeles in 2001. He is the author of the bestsellers ‘The Obesity Code’ and ‘The Complete Guide to Fasting’. He has pioneered the use of therapeutic fasting for weight loss and type 2 diabetes reversal in his IDM clinic.

Leave a Reply

avatar
  Subscribe  
Notify of
Liz
Guest
Liz

It’s been a month or so since a friend alerted me to your blog and I have been following each new post with interest. They have been straightforward and easy to understand but this one leaves me puzzled. You begin by noting meat’s propensity to both raise insulin and provide satiety and pose the question: Which is the stronger effect? I’ve read the post several times and fail to find a clear-cut answer. You note that perhaps it has to do with relative portion sizes, but don’t really state a portion size for meat that might cause the problem. If… Read more »

kfacwpup
Member

Hi Liz – thanks for the kind words, and I appreciate your thoughtful commentary. Next week is “Red Meat Dilemma 2” which will answer the question of the stronger effect. It actually depends upon the incretin stimulated – GLP1 vs GIP. To clarify, I don’t believe the Low Carb approach to be unhealthful. My main objection is eating a majority of our foods as processed foods – whether carbohydrate or even meat. The toxicity lies not in the food, but in the processing. I think Dr. Atkins did the world a large favor by focusing on carbohydrates, but I don’t… Read more »

Debbie
Guest
Debbie

Naturally any diet that includes lots of “frankenfoods” is not likely to be healthful! But that hardly means the Atkins Revolution is finished. Anyone who follows the diet sensibly is well aware that frankenfoods are not generally good for weight loss, and the heart of the true Atkins diet is whole, natural fats, proteins and veggies – very similar to what you propose! Except that for your fasting days, if one experiences hunger, you say “drink more, try to weight it out and let the cravings pass, etc” the same sort of advice the low fat, low cal people have… Read more »

Bernard P.
Guest
Bernard P.

Dr. Fung, what’s so special about red meat (beef) to explain the emphasis on it in so many studies? What about fish, chicken, pork? Is lamb classified as red meat? Even after reading part XXIII (Insulin Index) in this series, these questions remain.

Having greatly reduced carbs consumption, especially processed carbs, my wife and I are facing a conundrum if meat is also added to the list of problematic foods. At some point, one has to eat something…

kfacwpup
Member

Yes, that is specifically why it is controversial. Some vilify meat, and others (Atkins) allow for virtually unlimited consumption. Originally red meat fell out of favour due to its saturated fat content. The short answer is that meat is OK in moderation. Avoid processed meats – salami, lunch meats etc.

NS
Guest
NS

Dr Fung,

Do you have any opinion on nutritional yeast? The poisoning is in the refining, yes. But for some of us who try to limit our meat intake for various health reasons, it is not so easy to find proper/suitable protein sources. There is a whole world of hellish inflammation issues – unknown to doctors and absolutely invisible in the literature – for so many people and many, like me, cannot tolerate legumes and even some nuts.

http://selfhacked.com/2014/05/04/elimination-diet-safest-foods-people-sensitive-everything/

Incidentally, you may be interested in the indicated blog overall. Along with yours, it has been among the very few that are quite helpful.

http://selfhacked.com/2013/06/15/the-resistant-starch-diet-the-most-effective-diet-for-weight-loss/

http://selfhacked.com/2014/02/22/high-fat-diets-got-popular-healthy-altenative/

trackback

[…] Continue here to Hormonal Obesity XXVI – Red Meat Dilemma […]

erdoke
Guest
erdoke

While I tend to agree on most points, this is still just a bunch of associations. Let’s take butter for example. Butter is 80-82 % fat, so it should be one of the least insulinogenic real food (for me most green leaves and wheat straw do not count). How can it be unlinked from bread, potatoes and meat for example, while butter is almost exclusively consumed together with …bread, baked potatoes and steaks? It is a typical confounder. Well, except for butter munching types like Jimmy Moore. 🙂 I myself mostly have it with nuts. Meat is also something which… Read more »

kfacwpup
Member

Agreed. Association data, unfortunately, is often all that is available. What i am doing is hypothesis generation, not proof by a long shot. However, I think my hypothesis generated, that protein is also insulinogenic fits the available data far better than the current hypothesis – only carbs generate insulin and therefore protein and fat get a ‘free pass’. Remember that fatty foods also generate insulin. Also, protein comes with the protective incretin effect. To ignore completely the insulin effect of whey or meat, I think is foolish. One of my favourite blogs, http://www.dietdoctor.com is a low carb, high fat advocate.… Read more »

erdoke
Guest
erdoke

No objections on my side to your hypothesis at all. On top of that I have my own n=1 experiment confirming it. On the other hand starting a weight loss journey on a kind of (whole foods) Atkins induction phase can be still very effective. Protein, especially together with some fat and fibers, is the most satiating (macro)nutrient and intake usually ends up at a level not higher than before the diet. We can consider this kind of “high” protein diet (high in energy ratio, not higher in absolute terms than in a SAD otherwise) as an LCHF, just the… Read more »

kfacwpup
Member

High protein diets can still work. While meat increases insulin, it also decreases gastric motility and therefore causes the highest levels of satiety, which has been repeatedly shown experimentally. If we start to ignore satiety signals, say, by eating constantly through the day, it doesn’t work. I’m not convinced that an Atkins, highly processed meat diet works, though.

erdoke
Guest
erdoke

Oh yes, I have even added “whole foods” in the previous post. You need to be very smart with processed foods, as there might only be 10 % fitting human needs and amount should still be limited. Best is to test them with a cat or dog…

Troy
Guest
Troy

glucagon is secreted when eating protein. What does it do to insulin?

erdoke
Guest
erdoke

Not concerning this post, but to your kind attention:
Biologically Inactive Leptin and Early-Onset Extreme Obesity
http://www.nejm.org/doi/full/10.1056/NEJMoa1406653

kfacwpup
Member

Thanks. Personally though,I think that Leptin is given far too much importance even by smart people like Stephen Guyenet. It’s all about leptin resistance, not leptin deficiency. Same as type 2 diabetes – it’s all about insulin resistance, not insulin deficiency. So these cases of rare leptin deficiency, I think, have little bearing upon common obesity.

erdoke
Guest
erdoke

It is a very good and simple example though how obesity is hormonal. Even deficiency in a “lesser” hormone easily gives the undesirable result. Something very similar happens when one disrupts his/her hormonal balance over years. I have been thinking about how deficiencies can potentially contribute to obesity. My question addressing this is what happens when somebody is only deficient in some vitamins and minerals? How does the body try to compensate, i.e. make us consume enough of those lacking micronutrients? Could this contribute to overeating calories? It could be a reasonable assumption made by our regulating systems that if… Read more »

kfacwpup
Member

Certainly possible, but I think that micronutrient deficiency has been over-hyped. We are always looking for the magical missing ‘silver bullet’ that will suddenly make us thin. First, we all needed calcium supplements, then it was Vitamin E, then it was Vitamin C, then it was Vitamin D, then it was omega 3, then it was Vitamin B-12, then it was chromium, then it was magnesium, now it all about the gut microbiota. Every time these get tested in a rigorous trial, these vitamins fail. Even when you randomized people to multivitamins it does no good.

erdoke
Guest
erdoke

I am not searching for a magic bullet, just considering a role for overeating caused by deficiencies. What exactly happens when you are deficient in nothin else, but vitamin D and magnesium? As it happens in the majority of Westerners.
Regarding vitamins, I would separate D from the others, as it is difficult if not impossible to get enough even from real foods between October and March above 35 degrees latitude. When sunshine is not sufficient in the narrow spectrum of UVB, extra fish and/or supplementation is a necessity. Of course sunshine is the perfect source, providing much more then cholecalciferol.

Troy
Guest
Troy

what about glucagon? you did not mention it. It plays a big role in this protein business, yes?

trackback

[…] פוסט זה מוגש כשירות לציבור. הזכויות על התוכן שייכות לכותב של הפוסט המקורי. את הפוסט המקורי ניתן למצוא בכתובת הזאת. […]

Brennan
Guest
Brennan

I just want to point out you are completely ignoring the powerful effect that fat has on insulin resistance. It is well documented and researched that free fatty acids inhibit insulin action on the liver and muscle cells. Therefore the total macronutrient composition of your diet vastly affects your insulin resistance, which obviously then affects your levels of insulin and whether or not you gain fat. If you combine the high-fat meal with sugary or starchy carbs, it will both raise your glucose AND your insulin AND your insulin resistance. This trifecta is what creates obesity over time. If you… Read more »