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What Is Metabolic Flexibility, and Why Is It Important? J. Stanton's AHS 2013 Presentation, Including Slides
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February 8, 2014
8:34 am
Glen Nagy
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Great presentation, it ranks right up there with my other all time favorite series "why are we hungry"

I think one of the biggest changes that happened in the 80's is snacking and meal frequency. When I grew up in the 70's my mom would never give me an after school snack as it would "ruin my dinner". We were too busy playing during the short morning recess at school so we didn't snack then either, it was breakfast, lunch and dinner most days. Now it seems kids are constantly snacking. Every time my son's have an afternoon play date there are always snacks.

Do you think that eating low fat, high carb meals every 3 hours can reduce our ability to use fat as a fuel since we are using mostly glucose all day? If we are not using the metabolic machinery that burns fat all day I would think our bodies would reduce the resources going into that pathway. I think this is the another difference between the SAD high carb diet and the kitavans and Okinawan high carb diets that no one talks about. I'm sure the okinawan's didn't come in from the fields to snack every couple of hours and they worked hard. This forced them to keep their metabolic flexibility and use stored body fat between meals.

I believe that snacking has played a huge roll in the obesity epidemic. Not because it added calories so much as it changed our metabolism, affected our metabolic flexability and made us hungry all the time. Once you start snacking it creates a cycle that makes you hungry so you snack more. But once you start eating like a predator your urge to snack stops and your hunger normalizes.

February 8, 2014
2:01 pm
tam
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How does bad fat oxidation lead to bad glucose handling?

February 8, 2014
4:54 pm
v
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JS,

This is off topic- sorry. I originally followed Art De Vany Paleo or 'Evolutionary Fitness'. He subscribes to no dairy of any kind except a little cream in your coffee and a little cheese as flavor in your salad. But as a 48 year old perimenopausal woman, I am worried about this. I hear that after menopause women rapidly lose calcium and we have to build up our stores before menopause. My blood work on no/little dairy shows my serum calcium at 8.5 mg/dL (2013) , 8.7 (2011), 8.5 (2010). I went Paleo in August of 2009 and in May of 2009 before Paleo I was 9.1. The reference range is mg/dL 8.5 - 10.6. I remember Art De Vany simply saying that I should remember to eat my leafy greens. The Chinese don't traditionally eat dairy, but they have bone broth soup regularly. I am not lactose intolerant, but I lose more weight dairy-free. Since I have gained weight this winter I am considering cutting out dairy, but I'm not sure it is the wise thing to do. Any thoughts?

February 9, 2014
12:47 am
neal matheson
Guest

"I think one of the biggest changes that happened in the 80′s is snacking and meal frequency. When I grew up in the 70′s my mom would never give me an after school snack as it would “ruin my dinner”. We were too busy playing during the short morning recess at school so we didn’t snack then either, it was breakfast, lunch and dinner most days. Now it seems kids are constantly snacking. Every time my son’s have an afternoon play date there are always snacks."
This is a consant rub with me and my children. If I am "lucky" the kids are given fruit but more often I end up being the ogre taking bisuits and crisps (cookies and chips) away.
Three squares is very much a modern invention.Medieval people generally ate two meals a day.

February 9, 2014
1:28 am
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Danny:

Yes, lifting heavy will tend to partition extra "calories" towards muscle growth (which is energetically expensive) instead of fat gain.  Especially if you're eating keto, it's very, very difficult for a healthy person to gain fat mass in that scenario.

 

Glen Nagy:

"Do you think that eating low fat, high carb meals every 3 hours can reduce our ability to use fat as a fuel since we are using mostly glucose all day?"

Yes, for several reasons. 

And yes, I therefore agree that the increase in carb-heavy snacking has contributed to obesity and MetS.  As I've shown in various installments of "No Such Thing As A Calorie" (e.g. part VIII), when you eat can affect both fat mass and health just as much as what you eat.

Of course, this is yet another case where the mainstream advice is not only wrong, it's actively injurious -- so I don't expect it to change for a long time.

 

tam:

As I mention in the speech, we're still not sure how that happens.  Petro at Hyperlipid has been doing some deep, grotty mitochondrial biochemistry that may elucidate the mechanism.

 

More soon!

JS

February 9, 2014
1:44 am
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v:

If you're consuming bone broths, you've got plenty of calcium coming in, so that won't be your problem.  Besides, the problem with calcium isn't usually under-ingestion, it's under-absorption and under-utilization. 

Calcium requires adequate vitamin A (not beta-carotene) and vitamin D3 in order to be absorbed, and adequate vitamin K2 to be deposited in bones and teeth (where you want it) instead of arteries (where you don't).  This is why calcium supplementation famously does nothing for osteoporosis, and often increases heart disease. 

K2 is a tricky one to get, because it's mostly available in grass-fed dairy and grass-fed organ meats.  It's actually one of the few supplements I take: this is my preferred form, and the most cost-effective.  (Yes, it's expensive, but the bottle will last over two years at 1 drop/day: the suggested dose of 15 drops is ridiculous.  Also make sure they send you the K2-MK4 only: there's a combination K2/D Thorne sells that some people have been sent...which is worth about 1/3 as much but whose packaging is very similar.  Verify that you got the K2-MK4 when you get it.)

 

neal:

These days it's more like one square meal (dinner) and eight snacks, some of which are passed off as meals (e.g. breakfast).

 

I'm finally caught up!  Thank you, everyone, for your support...especially those who bought a copy of TGC or a DBTT T-shirt.  And it's finally dumping rain and snow here in Tahoe after an extended drought, so I'm going to take a well-deserved day off and go ski it.

JS

February 9, 2014
5:15 am
v
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what about natto for vitamin k2? i have just started to eat it and found that it cured my constipation that had recently started up from going lower carb higher protein. i tried to search how jaminet feels about it and tofu, but i didn't find anything with a quick search of his site. i would be surprised if the PHD were against fermented soy since japanese women are the longest lived with Hong Kong women coming in second. i lived in taiwan 7 years and the consumption of tofu was quite high.

what is another good source of A outside of eating liver, which i can't stand. lastly, do you know of any situation where the body would actively block the absorption of vitamin d? thanks!

February 9, 2014
6:12 am
v
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from jenny ruhl:

"An interesting side note to the issue of high serum phosphate is the finding that rising serum phosphates will lower Vitamin D production as Vitamin D is one of the regulators of blood phosphate levels. (Discussed HERE). If you have abnormally low Vitamin D levels when not supplementing Vitamin D, this could be pointing to the fact that your serum phosphate level is unhealthily high."

I am a teacher, so I have the summers off, during which time I try to be outside a lot. I am always tan. So in July when I had check-up bloodwork done, I was surprised that my Vitamin D was 25.4 Low out of a reference range of ng/mL 30.0 - 100.0 Since Vitamin D is also a major player in bone health, that is why I am mentioning this finding here. I take no supplements at all because I want to get all my nutrients from food. Once I have a clear symptom of a vitamin deficiency, I can take a supplement and more clearly see if it does what it is supposed to do. The problem with this strategy is by the time a symptom shows up (a broken wrist from significant bone loss, etc), it might be too late to do something about it. But thankfully my health is fairly good. I had one three day cold during which I took no medicine and I recovered quickly while many of my students and fellow teachers have gotten uncomfortably sick (fevers, throwing up, losing days of school). I don't take any medications. I have diabetes in both parents and can run high blood sugars if I eat like most people, but I control what I eat so I'm OK that way. Anyway, I'm focusing on bone health right now since I am approaching the magic age on menopause, so any insights you have into the above would be much appreciated.

February 9, 2014
6:20 am
v
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sorry for the double posts. here is the link to the jenny ruhl post mentioned above:
http://diabetesupdate.blogspot.com/search?q=vitamin+d

Enjoy your skiing!

February 10, 2014
9:04 pm
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v:

Natto is a source of K2-MK7.  We think that MK-7 ought to have the same beneficial effects as MK-4, which we get from animal products, but the studies are all on MK-4, so that's what I take.  And if you can stomach natto, you're a stronger person than I!

Foods containing actual vitamin A (not beta-carotene, a precursor which is inefficiently converted, and in some cases, not converted at all) include grass-fed butter, egg yolks, liver, organ meats (especially eyes) and shellfish.  Fortunately, most of those are the same foods that contain K2-MK4.  Keep in mind that the US government permits beta-carotene to be labeled as "Vitamin A" on nutrition labels…

Ruhl's posts confirms the biochemistry: too much vitamin D and calcium, with too little vitamin A and K2, can cause all sorts of problems since the calcium is absorbed but not deposited where it needs to go (bones and teeth).

The problem with getting D3 from sun is that during the winter in high latitudes, the sun barely gets high enough in the sky to be of sufficient intensity to produce D3 in our skin!  Then there's the cloudy day problem.  I, too, try to get as much sun as possible, but I take D3 when I can't.  (Note that too much D3 is immunosuppressive…for me, 2000 IU is fine, but 4000 can be a bit over the line.)

JS

February 11, 2014
1:15 am
pam
Guest

nice article. thanks for making complex things simple.

also kitavans live in a tropical island? yes? so they may get more sunshine. + they probably don't snack all day long.

cheers,

(i have ordered a shirt.)

February 11, 2014
11:43 am
rs711
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Before I can think of an intelligent question I simply wanted to say:

this piece is clear, concise, doesn't go out on wild tangents, makes verifiable claims, is well supported by a lot of evidence of different types, & openly attempts to reconcile conflicting evidence rather than ignore contradictory findings.

This is a stand-out example of superlative scientific argument-building and communication. Bravo!

PS: You've temporarily restored my faith in humanity [1hr ago I read "Dr." David Katz's ad-hominem attack on Gary Taubes' recent NYT article]

February 11, 2014
7:17 pm
v
Guest

Thx for the reply, js. but you missed the vitamin d point. I should be getting plenty of D from sunshine in NJ in the summer, so why am I testing low in July when I'm out all the time and have a tan? that brought in the point about phosphates that jenny ruhl was making.

on another topic, i don't get why you think the perfect health diet is so great. the safe starches jaminet recommends spikes my blood sugar for quite a while. he should advertise it for anyone BUT people with blood sugar problems/relatives with diabetes. and what's with him trying to scare people off from eating meat and green veggies saying this causes glucose deficiency and he got scurvy and diverticulits gall stones etc from eating this way. what a joke. did his wife have all of these side effects he mentions? i think this guy is cuckoo cuckoo. and as for diverticulitis- how does he know he didn't have it before the low carb diet? what he should have done is said all that crap in his book and then told people with diabetic relatives to eat to their meter and stay at a minimum under 140 one hour after a meal and 120 two hours after a meal. with the stuff he recommends, i don't think i could do that. i had 20 carb grams of corn tortilla chips (about 16 pieces) and my blood sugar went to 135 in an hour. before paleo my A1c was a pre diabetic 5.9. after a year it was 5.6 (2010). last year with more biking after eating, it was 5.3- without his 'safe starches'.

February 12, 2014
5:28 am
La Frite
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@v
Just so you know, the more tanned, the less vit D your skin produces with the same amount of UVs. I know it because I am a southerner (North-African) and tan super easily. Since I live in higher latitudes, I need to be outdoors A LOT during summer. My wife (northern-european) would fry in 30mn, while I can stand hours as long as I have developed the tan.

But yeah, I don't pretend to know why your number was low, I was just mentioning a thing that definitely bit me in the past.

February 12, 2014
5:35 am
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pam:

Thank you!  I do my best.

And yes, the little I've seen about Kitavan dietary patterns indicates that they eat one big meal a day, with the rest of their calories coming as "by-the-ways" during work.  They also smoke like chimneys.

 

rs711:

Thank you!  Sometimes I feel overwhelmed by the Big Picture that I'm just beginning to see and understand, and wonder if I'll ever be able to communicate it to others.  I'm glad I've been able to bring this part of it into focus for you.

Yes, the nutrition field is full of hypotheses that don't account for observed reality, and are therefore prima facie bankrupt.  Furthermore, it's become clear to me that most pathologies for which people are chasing brain-based or endocrine-based explanations are actually caused by failures of energy production at the cellular level.  Brain and/or endocrine dysfunction is a downstream consequence: they're just trying (but failing) to maintain a broken homeostasis.  I expect the greater medical and research community to understand this in about 10 to 20 years, if we're lucky.

 

v:

I don't know enough about Vitamin D metabolism to know why that might be the case.

Re: Perfect Health Diet, obviously someone who has a major disorder of glucose metabolism (diabetes) should be cautious with their glucose intake!  And no, I wouldn't advise anyone to eat in such a way that it dramatically spikes their blood sugar, no matter whether they are technically diabetic or not.  You'll note that I said in my review "…there are clearly some people with metabolic issues around carbohydrate (even “safe starches”). And not all VLC issues are caused by insufficient starch or solved by more starch."

However, given their exhaustive treatment of the nutrients required for humans to survive and thrive, I still believe that, as I said, "The Perfect Health Diet is the new baseline from which all future attempts to determine the optimal human diet must be argued and measured."  I don't know of any other single source that comes close to providing such a baseline, let alone recommend both specific foods and patterns of consumption that best satisfy those needs.  So, yes, everyone should feel free to deviate from that baseline as necessary.

JS

February 12, 2014
5:55 am
v
Guest

for people who DON'T know that they need to measure blood sugar and have inherited problems using glucose , like me before about 2011, the perfect health diet is DANGEROUS. my fasting blood glucose was always good. that is the last thing to deteriorate. he should preface his book by saying ANYONE with diabetic relatives needs to get a cheap relion meter from wal-mart and measure their post prandial blood sugar after eating a serving of his safe starch. i think my caveat would be extrememly helpful to people like me who have stealth prediabetes/diabetes. in other words, i would have liked the above in your review.

February 12, 2014
5:59 am
v
Guest

ps the crux of the issue is how prediabetes/diabetes is commonly diagnosed. many people have glucose processing issues and don't know it. this piece is MISSING from high profile bloggers like you, de vany, sisson. thank god i learned about it from jenny ruhl.

February 13, 2014
8:40 am
ChrisM
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In the email you sent out announcing the publication of this article online you mentioned that the readership of your least popular article far outstripped the number of people who watched the 2012 AHS video.

For my part, I far prefer reading this kind of technical information rather than watching a video. While reading I can pause, reread, and ponder a point that I might miss entirely in a video.

Tom Naughton, does excellent, informative, and entertaining videos that I enjoy watching, but they aren't nearly as technical or in depth as your work. I would encourage you to publish the written version of your 2012 presentation and any other such work you may have.

Modern technology has given us the means to produce amazing audio/visual presentations, but sometimes nothing can beat the written word.

February 13, 2014
9:18 am
tam
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How much is DHA/omega-3 a factor in fat oxidation?

February 13, 2014
11:31 am
v
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i posted this over at wooo's site who wrote in her latest post that you are the only paleo blogger she has any respect for:
my only problem with j.stanton is that he endorses the prefect health diet without enough of a warning to people with potential glucose processing issues. i just wrote this to the creator of that diet on his website the perfecthealthdiet.com:
after a google search i see that your diet is not recommended for diabetics:
you say: “Our “regular” diet is not specifically directed at diabetic or metabolically damaged persons. We have a basic diet that is designed for healthy people (represented in the apple – food plate) and we recommend modified versions of the diet for various health conditions – including diabetes.”
but i did not see that caveat in the book i borrowed from my public library published in in 2012. i looked in the index for all references to diabetes. actually, you have a testimonial from a diabetic in your book on page 391:
“I am down from 341 lbs. to 272 lbs. doing mostly Paleo, but modified with some safe starches per your book. Just so you know tis is not just about weight loss for me, I was a type 2 diabetic with full metabolic syndrome and most importantly, I had popping capillaries in my retinas that were leading to blindness. All is better now, no pills, etc. -J. Hippman”
Also, I did not see the modified version of you diet for diabetics on your site that you say you recommend. could you please link to it for me?
lastly, a person does not need to have diagnosed pre diabetes or diabetes to stay away for safe starch. i have neither at the moment, but i have two parents with diabetes. i ate 100 grams of a traditional taiwanese porridge made from white rice and sweet potato. that is a small amount which i measured on a food scale. my fasting bloos sugar upon waking was 95. one hour after eating the porridge of ‘safe’ starch my readings were 145/151. not very safe. i should say i usually eat low carb, so you might make the case that i would not have such alarming readings if i carbed up, however i don’t know if i would really drop that much, especially if i ate your recommended daily intake of a pound of safe starches. my husband, on the other hand, ate the same amount of safe starch as I, and his blood glucose actually dropped from a fasting level of 91 to 79/70 one hour later. so how an individual reaches to safe starch is very individual. my recommendation to you is to strongly recommend that any people thinking of starting your diet who have diabetic relatives should test their blood sugar before and 1 hour after eating your safe starch. if they get readings of 140 and above, your regular diet is not for them. they can buy cheap relion meters from walmart without a prescription. i think it would be irresponsible if you did not do something similar to what i recommend.

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