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In this episode, episode 78, I do something a little different as I review the fantastically interesting book, “The Obesity Code: Unlocking the secrets of weight loss”, by Dr. Jason Fung. Full disclosure, there’s no real relationship to anesthesia and critical care, just some really interesting insights into the obesity epidemic and what can be done about it.
CME: https://earnc.me/JvYiZY
I acknowledge that I am leaving this comment without having read the book but exercise increases insulin sensitivity and HIIT training is the exercise version of fasting. You alternate high and low intensity training so that your body doesn’t adjust to it. The other thing is SLGT2 inhibitors decrease your glucose transcription threshold in the kidney so your peeing out tons of the sugar you take in. Similarly, type 1 diabetics who have no insulin, as their BG exceeds renal reabsorption levels, they pee out thousands of calories per day and lose tons of weight. That is due to loss of calories. Insulin is of course an anabolic hormone and increases lipogenesis and constant increased levels lead to resistance but there are other metabolic derangements that occur along with that in T2DM like the inappropriate release of glucagon simultaneously with insulin after eating and leptin resistance which regulates appetite and storage vs burn. I used to fast for 3 days occasionally and I do think it is a healthy addition to weight loss programs but I think the he is oversimplifying the insulin/glucose thing and downplaying the important role of exercise to increase insulin sensitivity counteracting resistance. If you eat 5000 calories per day of fat and protein, you will be fat. Also, a lot of the food people are eating is devoid of nutrition. Thank you for including a discussion of diet and nutrition on your podcast. It is not discussed enough unless as a promotion for some fad diet.
Above should say SGLT2 inhibitors decrease glucose reabsorption threshold…stupid autocorrect.
Good points, thanks for the comments!
I realized it would be delinquent of me to not provide some references for the above comment.
Int J Sports Med. 2000 Jan;21(1):1-12
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269649/
http://bjsm.bmj.com/content/44/14/i9.2
https://www.ncbi.nlm.nih.gov/m/pubmed/29270126/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4148933/
Thanks Jodi for that. Totally agree with the HIIT analogy. I would love to read the book, but got a newborn and new house, so being realistic for now.
Can you take a bit about fluids during fast? Also regarding fluids, based on the message of this book, drinking the right fluids must be a huge part of weight loss as almost anything non-H2O has sugar or substitute.
Also, have you heard of the documentary What the Health? It’s the opposite message and down right wrong in terms of some the physiology explanations. Any thoughts about meat vs non-meat related to the book you ready, Jed?
Thanks! Great podcast.
Hey Josh,
Congrats on the newborn and new house! The book mentions that some people choose to fast completely (no fluids in addition to no food) but Fung doesn’t recommend that as it’s obviously associated with dehydration and other issues. He recommends water, coffee and tea (with no sweeteners at all) and bone broth for fluids. Definitely nothing with sugar or sugar substitutes. I have not heard of What the Health, but I’m not surprised to hear that it has it all wrong. Remember, it’s been more than 50 years that the entire country has had it all wrong so it’s still pretty pervasive. Fung doesn’t weigh in on benefits of avoiding meat completely but he does say that limiting protein is a good idea. It seems like what he’s getting at here is that an all protein diet (like lean meat for every meal) is not a good idea. Some protein is fine; he doesn’t quantify it. Certainly saturated fats including animal fats, have lots of benefits and basically none of the downsides that they were said to have for a long time.
Great website/podcast you may be interested in.
Found my fitness website by Rhonda Patrick, Ph.D.: she interviews current researchers in nutrition and longevity and review recent publications or ongoing research. She also summarizes/reviews the literature into a concise short lecture.
https://www.foundmyfitness.com/episodes
The following videos are on her website too, but here are the YouTube links.
Satchin Panda: time restricted eating
https://youtu.be/qPpAvvPG0nc
https://m.youtube.com/watch?v=-R-eqJDQ2nU
Valter Longo: fasting mimicking diet
https://m.youtube.com/watchv=d6PyyatqJSE
Dr. Guido Kroemer on Autophagy, Caloric Restriction Mimetics, Fasting & Protein Acetylation
https://youtu.be/Gm626MgpveI
Dr. Eric Verdin on Ketogenic Diet Longevity, Beta-Hydroxybutyrate, HDAC Inhibitors & NAD+
https://youtu.be/9qOQGBVedAQ
NB: I do not recommend the ketogenic diet to people unless they have done a DNA analysis (23andMe) (no financial disclosures on my part) and look for SNPs in the PPAR-alpha or PPAR-gamma genes. Polymorphisms in those genes can lead to worse outcomes in those attempting a ketogenic type diet.
Jason Fung: two compartment model
https://m.youtube.com/watch?v=tIuj-oMN-Fk
Free Fasting and meditation apps: zero and oak
https://www.kevinrose.com/applications
Dr. Fahey: Nrf2 pathway, sulfurophanes, Moringa
https://m.youtube.com/watch?v=Q0lBVCpq8jc
Books you may be interested in:
Genius Foods by Max Lugavere
Missing Microbes by Martin Blaser, M.D.
The Epigenetics Revolution by Nessa Carey
Fat for Fuel by Joseph Mercola, D.O.
Death by Food Pyramid by Denise Minger
Wheat Belly Total Health (the second book) by William Davis, M.D.
Food by Mark Hyman, M.D.
Total Recovery by Gary Kaplan, D.O.
The great cholesterol myth by Stephen Sinatra, M.D.
Brain Maker by David Perlmutter, M.D.
Great resources, thanks!
Just finished reading the book after listening to this episode of the podcast. It was an excellent and eye-opening read! I would recommend it to anyone. It’s always fascinating and disheartening to see how failed approaches (such as calorie restriction) are still so entrenched in medical education. I thoroughly enjoyed your book review. If you were to do more episodes like this in the future, I would listen with eager ears.
Thanks Tyler, glad you enjoyed the episode and the book!
I love weight lifting and am always trying to maximize muscle growth; does this book give any direction on the best way to increase muscle mass with diet?
Hi Steven. Not much. He talks a bit about how supplements like creatine and whey protein are pretty useless or even harmful and how intermittent fasting protects muscle mass but that is not the focus of his book.
You may be interested to read “How Not to Die” by Dr. Michael Gregor for a little different perspective on the role of diet and health. https://www.amazon.com/How-Not-Die-Discover-Scientifically-ebook/dp/B00Y7USB14/ref=sr_1_1?ie=UTF8&qid=1535331671&sr=8-1&keywords=how+not+to+die
He also has a website (https://nutritionfacts.org/) with many videos reviewing the literature in nutrition and health. Check out the year in review videos too (https://nutritionfacts.org/video/how-not-to-die/)
The nutritional rabbit hole goes deeper indeed…