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Why the carbohydrate-insulin model of obesity is probably wrong: It was fun for me to work with two researchers who I respect tremendously. And he has done as much as anyone else to help us understand how this hormone works in humans.
In this paper, Ludwig and Ebbeling lay out their argument for the carbohydrate-insulin model CIMas they refer to it. This is nearly identical to the model Gary Taubes advocates: According to this model, high calorie intake and low calorie expenditure are a result of expanding fat tissue, not its cause.
Ludwig and Ebbeling focus particularly on glycemic load, which is the degree to which diet impacts blood glucose. In my view, this review paper is the strongest defense of the model currently available. While Ludwig and Ebbeling had ample space to develop their arguments, we were limited to 1, words and 8 references.
This post reflects my views and not necessarily those of Hall and Leibel, who were not involved in writing it. What I think is very unlikely to be correct is the hypothesis articulated by Ludwig, Ebbeling, and Taubes: They may also be particularly useful for managing diabetes, although long-term outcomes remain uncertain.
I started my fellowship in and was immediately indoctrinated into the idea that there is an adiposity control system. What I was working on was considered way out of the mainstream at the time.
Schwartz and others in his field proceeded to spend 30 years debunking this assumption. This field is the very reason the Conventional Model has lost steam over the last three decades.
This is the field that discovered leptin and satiety hormones, showed that hormones and specific brain circuits regulate appetite and body fatness, and overturned the notion that body fatness is just about how much we happen to decide to eat and move note that this is perfectly compatible with the prevailing view that when calorie intake is held constant, all foods are similarly fattening in humans.
Growing evidence suggests that obesity is a disorder of the energy homeostasis system, rather than simply arising from the passive accumulation of excess weight. The Endocrine Society statement presents a third model, not mentioned by Ludwig and Ebbeling, that is neither the naive and oversimplified Conventional Model nor the CIM.
It happens to be widely supported within the scientific community.
If Ludwig and Ebbeling want to convince the scientific community that their model is better than what currently exists, they should be arguing against the prevailing model, not a straw man that has been obsolete for quite some time. Dietary fat can be fattening This is a simple observation that is hard to reconcile with the CIM.
Researchers have known for decades that adding fat to food tends to increase body fatness in animals. I have seen Olympics-worthy intellectual gymnastics to try to rationalize away this fact, but as I will show, the conclusion is impossible to escape.
Here is a quote from a review paper on this topic 4: In my own research, we used refined diets that were 60 percent fat and 20 percent carbohydrate to induce obesity in normal rats and mice— and they were very effective! The weight and fat gain on these diets is rapid, massive, and unmistakable.
In their paper, Ludwig and Ebbeling suggest that only the CIM can explain the phenomenon of fat gain without increased calorie intake in rodents, but this is clearly not the case— my field has been aware of this in the context of high-fat diets and brain lesions for a long time.
Aha, you may say! The refined carbohydrate is why the diet is fattening, not the fat! Researchers have already tested that supposition by comparing this diet to a low-fat version in which the fat is mostly replaced by refined carbohydrate. Here is a graph from a recently published study by Matthew Dalby, PhD, and colleagues, comparing fat mass gains over 8 weeks of free access to unrefined low-fat blackrefined low-fat blueand refined high-fat red food in mice 9: There was no difference between refined and unrefined low-fat diets, but the refined high-fat diet led to rapid and marked fat gain.
This finding has been replicated independently, including in rats How about in humans? So far, two controlled overfeeding studies have compared diets rich in fat vs. Both studies reported that overfeeding with a high-fat diet produced the same, or even slightly greater, body fat gain than overfeeding with a high-carbohydrate diet of equal calories.
Clearly, an excess calorie of fat gets into fat tissue as effectively as an excess calorie of carbohydrate, regardless of their effects on insulin.
Under these conditions, volunteers offered a high-fat diet tend to overeat and gain fat, just like in the animal studies discussed above 131415 Historically, many cultures ate high-carbohydrate and high-glycemic-load diets and were lean This is another simple observation that is difficult to reconcile with the CIM.
More precisely, it is a collection of many observations, because there have been, and continue to be, countless lean high-carbohydrate cultures. The quality of data vary across observations, but some are quite high.Aug 20, · Six Parts: Sample Reports Selecting your Topic Researching Your Topic Prewriting for Your Report Writing Your Report Finalizing Your Report Community Q&A.
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