Topic: Mr. Body gets insulin shots and then does whatever the hell he wants

[jt512]

I find it funny that I’m on a high carbohydrate/low fat diet and I think (correctly) that I ‘run’ mainly on fat, and you’re on a high fat/low carbohydrate diet and think you ‘run’ mainly (or should run mainly) on glucose.

We all pretty much "run" on the macronutrients we consume in close proportion to the proportion we consume them.  That is, the respiratory quotient (RQ) is overall close to the food quotient (FQ).

Only if you’re using them shortly after you’ve absorbed them.  If the macronutrient is stored in a different form, such as excess carbohydrate being stored as fat and then burned, the the respiratory quotient would be closer than that of fat than that of carbohydrate.  And excess amino acids can be converted to glucose or ketones when there’s insufficient glucose, so they’d be burned as such (although, in that case the amino acids are actually are being burned almost the same time as they’re absorbed - so you’re partly right in this case; an excess of protein would be burned in proportion to its excess in the diet, but not in proportion to its absolute amount).

That's why the RQ is "close" to the FQ, and not exactly equal.  It's close because in normal mixed diets de novo lipogenesis is a minor metabolic pathway in humans.  In humans, the response to carbohydrate intake is overwhelmingly to increase carbohydrate oxidation, not to convert it to fat.

What about my case?  I’ve just had ‘lunch’, my first meal of the day, at 4 pm, which included 250 g of carbohydrate or around 1,000 kcals.  Some of it is going to top up glycogen stores but some of it is also going to be converted to fat to be burned later.

According to the studies, I've seen very little of the 250 g of carbohydrate you consumed will be converted to fat.  Almost all of it will be burned either short-term or later after having been stored as glycogen.

I argue that the respiratory quotient is a crude measure of which macronutrient is being burned.  How would you know whether with a RQ of 0.8 it’s just protein being burned or some mixture of the 3?

Usually, the protein burned is calculated from nitrogen excretion and excluded from the RQ, so the RQ (or more precisely the NPRQ) is an accurate measure of the non-protein fuel mix burned.

[bachfiend]

I find it funny that I’m on a high carbohydrate/low fat diet and I think (correctly) that I ‘run’ mainly on fat, and you’re on a high fat/low carbohydrate diet and think you ‘run’ mainly (or should run mainly) on glucose.

We all pretty much "run" on the macronutrients we consume in close proportion to the proportion we consume them.  That is, the respiratory quotient (RQ) is overall close to the food quotient (FQ).

Only if you’re using them shortly after you’ve absorbed them.  If the macronutrient is stored in a different form, such as excess carbohydrate being stored as fat and then burned, the the respiratory quotient would be closer than that of fat than that of carbohydrate.  And excess amino acids can be converted to glucose or ketones when there’s insufficient glucose, so they’d be burned as such (although, in that case the amino acids are actually are being burned almost the same time as they’re absorbed - so you’re partly right in this case; an excess of protein would be burned in proportion to its excess in the diet, but not in proportion to its absolute amount).

That's why the RQ is "close" to the FQ, and not exactly equal.  It's close because in normal mixed diets de novo lipogenesis is a minor metabolic pathway in humans.  In humans, the response to carbohydrate intake is overwhelmingly to increase carbohydrate oxidation, not to convert it to fat.

What about my case?  I’ve just had ‘lunch’, my first meal of the day, at 4 pm, which included 250 g of carbohydrate or around 1,000 kcals.  Some of it is going to top up glycogen stores but some of it is also going to be converted to fat to be burned later.

According to the studies, I've seen very little of the 250 g of carbohydrate you consumed will be converted to fat.  Almost all of it will be burned either short-term or later after having been stored as glycogen.

I argue that the respiratory quotient is a crude measure of which macronutrient is being burned.  How would you know whether with a RQ of 0.8 it’s just protein being burned or some mixture of the 3?

Usually, the protein burned is calculated from nitrogen excretion and excluded from the RQ, so the RQ (or more precisely the NPRQ) is an accurate measure of the non-protein fuel mix burned.

JT,

And then I’m going to have my evening meal 2 hours later containing a similar amount of carbohydrate, so I’m eating 500 g of carbohydrate or 2,000 kcals virtually in one meal.  Glycogen stores aren’t large.  When I was running marathons I read somewhere that the maximum is around 150 g.

The RQ might be very close to the FQ in a person taking frequent small meals matched to physical activity throughout the day.  Not so close for people who have 1 or 2 large meals each day (not everyone has fallen for the Kellogg myth that breakfast is important).  Intermediate for people who eat three meals plus or minus snacks.

[jt512]

And then I’m going to have my evening meal 2 hours later containing a similar amount of carbohydrate, so I’m eating 500 g of carbohydrate or 2,000 kcals virtually in one meal.  Glycogen stores aren’t large.  When I was running marathons I read somewhere that the maximum is around 150 g.

Acheson et al fed 2000 kcal of carbohydrate to subjects in a single meal and de novo lipogenesis was negligible. Whole-body glycogen stores in an adult male are around 800 g. [1]

The RQ might be very close to the FQ in a person taking frequent small meals matched to physical activity throughout the day.

Carefully conducted studies show otherwise.

Ref:
1. Acheson KJ, Flatt JP, Jéquier E. Glycogen synthesis versus lipogenesis after a 500 gram carbohydrate meal in man. Metabolism. 1982 Dec;31(12):1234-40.

[bachfiend]

JT,

Well, Acheson et al found that the respiratory quotient approached 1.0 after a large meal containing almost 500 g of carbohydrate, which is consistent with mainly carbohydrate being burned (which is hardly surprising).  They surmise that the rest was stored as glycogen, for which they had no evidence.  Having 800 g of stored glycogen sounds a little high.  The Wikipedia article claims that skeletal muscle contains as much as 400 g and liver as much as 120 g in a 70 kg man, with a little in other tissues, which is about how much carbohydrate I eat in 2 hours (and I’m not 70 kg, or anywhere near it).  And would have to assume that I was completely carbohydrate depleted before the meal.

[jt512]

JT,

Well, Acheson et al found that the respiratory quotient approached 1.0 after a large meal containing almost 500 g of carbohydrate, which is consistent with mainly carbohydrate being burned (which is hardly surprising).  They surmise that the rest was stored as glycogen, for which they had no evidence.

They didn't measure glycogen directly, but I wouldn't say they have no evidence. They accounted for everywhere else the glucose could have gone including the free glucose pool and even the urine. 

But regardless, they showed that there was essentially no net conversion of glucose to fat, even after a massive dose of carbohydrate.  Subsequent studies have confirmed this, and I'm not aware of any that have contradicted it. In healthy humans, the acute effect of carbohydrate intake is to suppress fat oxidation nearly calorie for calorie.  There is negligible net conversion to fat.

[fred.slota]

How's this, then.


Our given said that Mr. Body had a 2,000 calorie a day intake and was gaining 6.2 g a day.  With his 900c of C, 700 F, 400 P, his body needs were 1952 cal.

To this normal regimen, we're adding additional insulin.

We're not changing his caloric intake; he's still taking in 2,000 calories a day, still as 900/700/400 C/F/P.

Wait, what? We are wondering what would happen if someone were to follow you around and give you a shot of insulin after each meal.

Suppose, as I believe, that one of the side effects would be increased appetite and increased consumption and increased calorie intake.

How can we arbitrarily take that response off the table?

We're not changing his energy usage; his basal metabolism, the caloric cost to digest 900/700/400 C/F/P, and the calories for his general activity and exercise all remain unchanged, 1952 cal per day.

Again, adding insulin removes energy available in circulation. In addition to increased hunger and consumption, the insulin will also lead to low blood sugar which also leads to lower energy expenditure, so not we cannot take that effect off the table.

Therefor, Mr.  Body will still have a net imbalance of 48 calories/day, 6.2g/day, 5 lbs/year.

We can't arbitrarily decide that there is no effect when we're trying to see what the effect is.

What will happen is that feedback loop of homeostasis of insulin's control of blood glucose, fatty acid and amino acid levels will have an initially faster response, with a higher undershoot, and slightly more 'ringing' oscililation before damping out overnight, provided we aren't injecting more insulin than can be processed in 24 hours.  A faster, bouncier see-saw, that will still end up averaging to the same daily 48 calorie average, roughly.

Except that's not what would happen in this experiment.

I'm not 'arbitrarily taking that response off the table."  I'm holding everything equal, except for the one variable, extra insulin.

Obviously, if he gets hungrier and eats more, he now gets extra calories on top of his already-met metabolism, and would thus gain calories.  That then becomes a no brainer to explain to anyone.  But that would happen on top of a base response.

I view it kindof like the "diet soda makes you gain weight" storyline.  Anecdotally, people who replace a sugary soda with a diet soda often end up gaining more weight than those who stay with the sugary drink, rather than the expected losing/slowing weight gain.  But, the diet soda contains no calories.  What appears to happen is that people tend to decide "I saved 150 calories, I can eat an additional 150 calories", which would end up neutral, and instead they eat more than 150 calories and gain weight.  The anecdotal weight gain is not saccarine becoming fat, is not aspartame lowering metabolism, the weight gain was not 'caused' by the diet soda.  The weight gain was correlated with the diet soda, it was caused by the increased eating.  This is the same case. Increased insulin does not directly become fat.  Increased insulin does not make the food you initially ate contain more calories, does not catalyze the digestion of the food you eat reducing the energy needed to digest it. 


Now, your comment about "the insulin will also lead to low blood sugar which also leads to lower energy expenditure" is an avenue to discuss.  I have several questions.
I thought basal metabolism was essentially fixed.  If you eat total calories under your requirements, the body will raid stores to be able to burn the fuel you need, lowering fat stores and even robbing from muscle protein if needed.
There is available fuel and there is necessary work.  The basal metabolism is a need.  If blood sugar is low, and insulin is low, and immediate driving of glucose into the cells is low, don't forget about what happens next.  Low insulin also pulls more glucose from glycogen, raising blood sugar, eventually raising insulin, and driving glucose into the cells at a higher rate.  See-saw.  Oscillation.  Lower push, higher push. Long term average essentially unchanged, as the long term average is driven with trying to match the overall glucose availability and use to the overall need, which has not changed.

[CarbShark]

Gluconeogenesis doesn’t occur only when there’s excess protein (which would mean that on Western diets it would be occurring all the time), just when glucose is in short supply (in ruminants it is turned on all the time though).

Sort of. When the liver has protein and is not processing a lot of glucose, gluconeogenesis begins.

Insulin is always bound to at least some insulin insulin receptors everywhere.  You never have a situation where a cell with insulin receptors doesn’t have some of their receptors bound.  It’s the number of bound receptors that determine whether the cell carries out the specific action insulin causes in the cell involved.

Yes, of course, and the number of cells with receptors in contact with insulin.

I find it funny that I’m on a high carbohydrate/low fat diet and I think (correctly) that I ‘run’ mainly on fat, and you’re on a high fat/low carbohydrate diet and think you ‘run’ mainly (or should run mainly) on glucose.  If you’re making a positive claim that glucose + ketones is the best fuel for the body, then it’s your responsibility to prove it.  I’m not required to prove a negative.

If you're on a high carb diet you're mainly running on carbs.

[CarbShark]

I'm not 'arbitrarily taking that response off the table."  I'm holding everything equal, except for the one variable, extra insulin.

We are trying to determine the effect of that one variable. You're keeping equal two of the most important effects.

Obviously, if he gets hungrier and eats more, he now gets extra calories on top of his already-met metabolism, and would thus gain calories.  That then becomes a no brainer to explain to anyone.  But that would happen on top of a base response.

If that's an effect of doubling the insulin then we've answered part of the hypothetical.

I view it kindof like the "diet soda makes you gain weight" storyline.  Anecdotally, people who replace a sugary soda with a diet soda often end up gaining more weight than those who stay with the sugary drink, rather than the expected losing/slowing weight gain.  But, the diet soda contains no calories.  What appears to happen is that people tend to decide "I saved 150 calories, I can eat an additional 150 calories", which would end up neutral, and instead they eat more than 150 calories and gain weight.  The anecdotal weight gain is not saccarine becoming fat, is not aspartame lowering metabolism, the weight gain was not 'caused' by the diet soda.  The weight gain was correlated with the diet soda, it was caused by the increased eating.  This is the same case. Increased insulin does not directly become fat.  Increased insulin does not make the food you initially ate contain more calories, does not catalyze the digestion of the food you eat reducing the energy needed to digest it. 

Increased insulin causes more of the calories you've eaten to be partitioned in fat storage and unavailable for metabolism, thus reducing the number of calories you can burn.

Now, your comment about "the insulin will also lead to low blood sugar which also leads to lower energy expenditure" is an avenue to discuss.  I have several questions.
I thought basal metabolism was essentially fixed.  If you eat total calories under your requirements, the body will raid stores to be able to burn the fuel you need, lowering fat stores and even robbing from muscle protein if needed.

I don't believe basal metabolism is fixed at all. I believe it is a number derived from an rough average with a lot of individual deviation and deviation between individuals.

There is an underlying minimal energy expenditure, but it's probably significantly lower than the calculated BMR. And it's well understood that Resting Energy Expenditure varies significantly between various diets.

There is available fuel and there is necessary work.  The basal metabolism is a need.  If blood sugar is low, and insulin is low, and immediate driving of glucose into the cells is low, don't forget about what happens next.  Low insulin also pulls more glucose from glycogen, raising blood sugar, eventually raising insulin, and driving glucose into the cells at a higher rate.  See-saw.  Oscillation.  Lower push, higher push. Long term average essentially unchanged, as the long term average is driven with trying to match the overall glucose availability and use to the overall need, which has not changed.

I believe it's only liver glycogen that raises blood glucose when released. Glycogen in lean tissue is used for metabolism in the tissue.

[fred.slota]

Internet hiccupped, Lost my response.  Will get back soon...

[fred.slota]

Apologies, I'm going to stop replying to five parts of a post at a time.  I wanna keep a pending response list in my replies as a reminder, but I'm not completely motivated to do it at the moment, maybe later.  I'll discuss the multitude of points, but not at the moment.


This is a hypothetical.  We control what we control.
I arbitrarily partitioned equal calories to the three meals.  We don't sit here and quibble about "Mr. Body would be hungrier at breakfast, and less hungry at dinner, so he's gonna shift the proportions" mid hypothetical.
I specified that he partakes in some exercise, but not when.  We don't decide he'll be hungrier after that, so the following meal will be larger.
It's a hypothetical.

If Mr. Body feels hungry, he waits for his meal.
If Mr. Body feels hungrier because of the insulin, he still waits for his meal.

That's how you determine what the effect of added insulin would be.

If you allow Mr. Body to snack in response to hunger in response to lower blood sugar in response to added insulin, then you are allowing Mr. Body to vary his intake, and thus you are testing with two variables, not two effects.  You are testing "What are the effects of added insulin and ad libetum snacking", not "What are the effects of added insulin".

You can say "That's not realistic", to which I reply "It's a hypothetical".


Eating in response to hunger is a want, not a need.

Added insulin forces the reduction of elevated blood sugar.  That is involuntary.  That needs to happen.
Added insulin does not force you to eat.  That is voluntary.  That wants to happen.

If adding insulin produced a hunger hormone that transformed a portion of your femur into a Hershey bar, or a granola bar, or a string cheese, and thus added new calories into the system, then there you have an insulin-driven snack worthy of inclusion in the hypothetical.
If adding insulin produced a behavior-altering fungus that forced Mr. Body to, against his will, walk to the pantry and eat the leftmost item on his eye-level shelf, I would possibly include that.

But saying "He feels hungry, so he voluntarily alters his intake", no, that's answering a different, compound question.

[CarbShark]

This is a hypothetical.  We control what we control.

Well, you are controlling what you want to control.
 

I arbitrarily partitioned equal calories to the three meals.  We don't sit here and quibble about "Mr. Body would be hungrier at breakfast, and less hungry at dinner, so he's gonna shift the proportions" mid hypothetical.
I specified that he partakes in some exercise, but not when.  We don't decide he'll be hungrier after that, so the following meal will be larger.
It's a hypothetical.

Nobody is questioning any of that.

If Mr. Body feels hungry, he waits for his meal.
If Mr. Body feels hungrier because of the insulin, he still waits for his meal.

That's how you determine what the effect of added insulin would be.

If you allow Mr. Body to snack in response to hunger in response to lower blood sugar in response to added insulin, then you are allowing Mr. Body to vary his intake, and thus you are testing with two variables, not two effects.  You are testing "What are the effects of added insulin and ad libetum snacking", not "What are the effects of added insulin".

You are testing the effects of added insulin, which include hunger, satiety snacking and meal size.

You can say "That's not realistic", to which I reply "It's a hypothetical".

To which I reply it becomes meaningless and point less.

Eating in response to hunger is a want, not a need.

Eating in response to hunger is a survival behavior.

Added insulin forces the reduction of elevated blood sugar.  That is involuntary.  That needs to happen.
Added insulin does not force you to eat.  That is voluntary.  That wants to happen.

But the point of the hypothetical is to see the result of adding insulin. If that includes changes in behavior we shouldn't ignore that.

Particularly since that's probably the most important effect. If there's no effect on hunger or satiety, it doesn't reflect reality.


 

[fred.slota]

If I had said we were testing the effects if Mr. Body changed from a 2,000 calorie diet to a 2,500 calorie diet, would you be saying "Mr. Body now feels full and bloated, so he decides to switch back to 2,000 calories a day"?  No, we'd be talking about the biological adjustments in what get burned and what gets stored, and that he would be gaining about a pound of body fat a week.

If I had said we were testing the effects if Mr. Body changed from a 2,000 calorie diet to a 1,500 calorie diet, would you be saying "Mr. Body feels hungry, so he decides to switch back to 2,000 calories a day?"  No again, we'd be talking about the biological adjustments in what gets burned and stored, and that he would be losing about a pound of body fat a week.

If we wanted to compare Mr. Body eating his 900/700/400 CFP diet with his twin, Mr. Body Double, who eats a 600/1000/400 CFP diet, would you be saying "Mr. Body Double feels greasy, so he gives some of his Crisco to his dog, Mr. Dog, under the table and sneaks a Snickers bar at night"?  No again.

If we wanted to discuss Mr. Body going full-on vegan, would you be saying "Yup, he's vegan,  But once a week he runs through the McDonalds drive in because Big Mac attack."?  Once more, no.


Yes, when people decide to eat more, many revert back to their old portions.
Yes, when people decide to eat less, many revert back to their old portions.
Yes, when people change diet proportions, many revert back to original patterns.
Yes, when people eliminate some foods, many cheat or slip back.


He feels hungry.  Fine.  That's an effect.  Then measure the effect.  Have Mr. Body report his hunger levels while we're monitoring his blood glucose and taking his weight.

IF the question is "Will Mr. Body stick with eating 900/700/400 C/F/P when receiving additional insulin?", then dietary modifications due to hunger is an acceptable things to allow and monitor.

But when our question was "What happens to Mr. Body, eating 900/700/400 C/F/P, when he receives extra insulin", the hunger stops at hunger.

Answering "Mr. Body eats a snack" means we are now answering the question "What happens to Mr. Body, eating 1000/700/400 C/F/P and receiving added insulin."

[CarbShark]

If I had said we were testing the effects if Mr. Body changed from a 2,000 calorie diet to a 2,500 calorie diet, would you be saying "Mr. Body now feels full and bloated, so he decides to switch back to 2,000 calories a day"?  No, we'd be talking about the biological adjustments in what get burned and what gets stored, and that he would be gaining about a pound of body fat a week.

If I had said we were testing the effects if Mr. Body changed from a 2,000 calorie diet to a 1,500 calorie diet, would you be saying "Mr. Body feels hungry, so he decides to switch back to 2,000 calories a day?"  No again, we'd be talking about the biological adjustments in what gets burned and stored, and that he would be losing about a pound of body fat a week.

If we wanted to compare Mr. Body eating his 900/700/400 CFP diet with his twin, Mr. Body Double, who eats a 600/1000/400 CFP diet, would you be saying "Mr. Body Double feels greasy, so he gives some of his Crisco to his dog, Mr. Dog, under the table and sneaks a Snickers bar at night"?  No again.

If we wanted to discuss Mr. Body going full-on vegan, would you be saying "Yup, he's vegan,  But once a week he runs through the McDonalds drive in because Big Mac attack."?  Once more, no.

This is all nonsense. We're not talking about any of those things, if we were I wouldn't be interested enough to continue and if I did those are not anything like what I would have said.

Yes, when people decide to eat more, many revert back to their old portions.
Yes, when people decide to eat less, many revert back to their old portions.
Yes, when people change diet proportions, many revert back to original patterns.
Yes, when people eliminate some foods, many cheat or slip back.

None of that is relevant to this hypothetical.

He feels hungry.  Fine.  That's an effect.  Then measure the effect.  Have Mr. Body report his hunger levels while we're monitoring his blood glucose and taking his weight.

Eating more or eating less is not a variable. Those are potential outcomes. (And pretty important outcomes at that).

But, what do you think the possible outcomes of the hypothetical are? What are you trying to measure?

IF the question is "Will Mr. Body stick with eating 900/700/400 C/F/P when receiving additional insulin?", then dietary modifications due to hunger is an acceptable things to allow and monitor.

But when our question was "What happens to Mr. Body, eating 900/700/400 C/F/P, when he receives extra insulin", the hunger stops at hunger.

No. What happens is his behavior changes. He eats more. Maybe just a little more. Maybe just 50 calories per meal, that's the difference between large fries and medium fries. That's less than the difference between a small coke and a medium coke.

Answering "Mr. Body eats a snack" means we are now answering the question "What happens to Mr. Body, eating 1000/700/400 C/F/P and receiving added insulin."

What?

[bachfiend]

Fred,

The hypothetical was that Mr Body consumes a fixed 1952 kcal/diet with a fixed proportion of macronutrients long term with fixed levels of exertion, and asked what would be the metabolic consequences if he was also given an insulin injection before each meal equal to that produced by the meal, possibly doubling the amount of insulin in the system.

If it’s a hypothetical, then it is certainly reasonable to assume that certain events that might actually happen in the non-hypothetical real world wouldn’t happen.  He might in the real world eat more because he feels hungrier, so he’s eating more than 1952 kcals a day.  Hypothetically, he might prepare his meals in advance, putting them in the fridge, and pulling them out and consuming them at the meal time, and eating nothing more because that’s all that’s prepared.  He might in the real world do less physical activity because he has less energy (there’s less circulating glucose).  Hypothetically, he might have a certain number of tasks he has to do each day regardless accounting for all his physical activity, so physical activity is hypothetically fixed too.

Now what would be the metabolic consequences of the insulin injections?  I think you’ve already given the answer.

[CarbShark]

Fred,

The hypothetical was that Mr Body consumes a fixed 1952 kcal/diet with a fixed proportion of macronutrients long term with fixed levels of exertion, and asked what would be the metabolic consequences if he was also given an insulin injection before each meal equal to that produced by the meal, possibly doubling the amount of insulin in the system.
 

That's actually not what the hypothetical was. That was the "baseline" energy intake. To refer to something as "baseline," as it was in this hypothetical, indicates it could change. It wasn't presented as "fixed" until later in the discussion, and I immediately objected.

In Lustig's hypothesis he indicated he thought both energy intake and energy expenditure would change (up and down, respectively).