The carbohydrate-insulin model of obesity by David Ludwig

Is overeating driven by biology and not by a lack of self-control? David S. Ludwig, endocrinologist and researcher at Boston Children's Hospital, talks about the carbohydrate-insulin model of obesity, or metabolic disorder of fat storage. Eating less and moving more has guided obesity treatment for more than a century, but obesity rates keep rising. Dr. Ludwig explores this paradox. "When do we ask maybe it's not the public's fault, maybe there is something the matter with the advice?" Watch the video to learn more.
For more than 25 years, Dr. Ludwig has studied the effects of dietary composition on metabolism, body weight and risk for chronic disease - with a special focus on low-glycemic index, low-carbohydrate, and ketogenic diets. He is founder of the Optimal Weight for Life (OWL) program at Children's Hospital, one of the country’s oldest and largest multidisciplinary clinics for the care of overweight children. He also co-directs the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital.
🥗💡This talk was presented at the recent "Food for Thought 2023: Rising to the challenge of obesity and diabetes" conference held by Swiss Re Institute and @TheBMJ . Learn more: www.swissre.com/institute/con...
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#health #obesity #diabetes #overeating #insulin #type2diabetes #lowcarb #keto #carbohydratemetabolism

[@KenDBerryMD]

Brilliant presentation. Everyone needs to absorb the gold nugget that a scientific/medical model/paradigm can be very helpful, yet be completely wrong…

[@csmrfx]

- In my study of academic literature, it is 100% clear that #hyperinsulinemia aggravates problems with #ghrelin and #leptin metabolism, and then consequently any negative outcome from behavioral or nutritional problems an individual might have. Hormones command the human, not vice versa. David Ludwig brings you up to standard. This is what USA needs - 40% obesity prevalence. Carbs are not a required nutrient for human health, and refined carbs are detrimental according to diabetology. Simple as that. Only thing "provocative" is the Food #industry #corruption of scientific #research, and the society too #ignorant to consider it a problem. Keto and fasting can solve the obesity problem, f.ex. see UK PHCUK research, also on KZbin. Thank you.

[@kostar500]

Agreed with all your points. So, what’s gonna happen with the snack food industry? The ultra processed food industry? This is a social political paradigm that requires a lot of changing and tilting

[@northerncoloradotransparen1454]

Carbohydrates are by far the best form of energy for humans. Comparing refined carbs to complex carbs is like comparing an apple to eating a dead animal. Cmon use a little common sense. Want a processed food?? Eat meat it is highly processed even for those in denial!? Need some help understanding those facts about meat? It is clear that animal fats plug cells, digestion, and arteries in the body causing a multitude of metabolic issues. Once you remove the animal fats from your diet your body will absorb nutrients at a much better rate from real whole foods. Whole foods do not include bread, bagels, and orange juice!

[@fan1008]

Thank you Dr. Ludwig for the presentation!

[@gstlynx]

Fantastic presentation. Thanks Doc. And thanks to Nick Norwitz for the link.

[@JimSiverts]

What everyone is missing is the 800 pound gorilla sitting in the corner and that is protein. Please read Raubenheimer and Simpson Eat Like The Animals. People are overeating in their quest to get more protein. They came up with the protein leverage hypothesis. They show that protein is the primary driver of satiety. We were told to cut fat and eat more carbs and as a result we also cut protein. Thus our hunger is continually telling us to eat until the body gets what it needs most - protein. So we have both the problem of high insulin and low protein that both create a continuous cycle of hunger and overeating. Protein doesn’t even appear in the food pyramid and yet it is the most important of all.

[@JesusMartinez-mk6fc]

Truly excellent presentation by Dr. Ludwig, a major researcher in this area with impeccable credentials. Oddly, it's the first presentation I have watched by him other than a couple of interviews although I've seen his name listed on many research papers.

[@stevedow9076]

Has Lane Norton seen this?

[@JemyM]

We do not tell someone with fever that they have a "heat-regulation problem" is a pretty solid statement. I often said we don't tell someone with broken foot that they try to defy the laws of gravity.

[@szghasem]

His example of people with Edema during Q&A putts things into perspective. We need many more of such examples to bash circular reasoning.

[@headybrew]

So these two doctors were at a convention in a big hotel. One of the convention rooms was chock full, standing room only, and they couldn't get in to see what was going on. One of the doctors said, "Hmm... It's full because more people keep going in than are coming out." And he was right. But the other doctor asked, "Why do so many people keep going in and why do they not come out"?

[@Athenaikos]

I am very disappointed at the inability of CIM overtaking EBM as the prevailing guide for nutrition in the future. The high inertia exbibited by the status quo clearly points to politics and not science.

[@wmp3346]

I recognize Mr Taubes 👏👏

[@grahamedwards6824]

An excellent presentation Dr Ludwig, thank you. Perhaps more focused for medical professionals, than laypeople unless they have done some prior research. We have been having high fat / low carb, and normal protein, meals for over a year. We can now manage to eat one meal a day and not suffer extreme hunger towards the end of the day, or gain or lose weight. Initially we needed to become ‘fat adapted’, and Insulin sensitive, before we were able to do this, and that happened over a period of two or three months. If we need to lose some weight, we introduce some fasting into the equation. Say zero calories for thirty six hours. It’s not rocket science, but understanding how the system works helps enormously. Neither is it will power, but if I understand it properly, then I can control it appropriately according to our needs. We measure our fasting Glucose, and Ketones every morning which in my opinion is also necessary.

[@user-hh4in4ld7f]

Excellent presentation, great evidence from famous studies. Thank you.

[@warshipsdd-2142]

Outstanding, excellent and informative

[@sheilacollins9384]

Eat less, move more...I always laugh when I hear that bit. When I move more I get hungrier. After a 500 meter swim I can eat a horse!

[@mariomenezes1153]

Just an amazing presentation!

[@bruce8443]

Great talk!

[@eugeniebreida1583]

Great question from Taubes, I agree w/presenter, that fructose vs glucose (sugar vs processed/starch) study very much needs to be done. Having a very healthy lineage of omnivorous eaters equipped with ‘a sweet tooth’, my take is the white sugar may not be the enemy that round up sprayed powdered white flour is. And either is benefitted by diverse sides of plant fibers (leafy greens), natural fats (avo/seeds/egg yolks/fish etc), and protein.

[@csmrfx]

Please look at prevalence of T2 diabetes and fatty liver. From there, knowing fatty liver leads to T2, find out: "What two things cause fatty liver, if digested regularly?" Hint: ethanol is the other one. What is the other one? While glyfosate seems to be detrimental for you intestinal microbiome, and as a consequence of this *detrimental to your immune function, there the health outcomes are different (from metabolic disease such as obesity or NAFLD). As a consequence of this, which reasoning would one end up with? Finely ground flour does have a quite high GI and GL.

[@OIOnaut]

Yes indeed. Still the rageing lunatic Jack Kruse makes a point with the bioquantum properties argument. It tells a tale of light, differences in structured water aka low deuterium content in fructose in local fruit and non local ultra processed substrares by photo radiative barcoding. Quite substantially even. My bias is a 10 year carnivore lifestyle, optoelectric semiconduction research biohacking and having known all the names dropped in this lecture for some time. Have a nice day folks. I love you all.

[@user-gv5mo1rd2p]

That's what you got from this presentation? Both flour and sugar is carbs and the latter is in fact more dangerous as it will lead to even higher spikes than the ones shown in the slides. The key term is glycemic index.

[@olafkunert3714]

@@csmrfx "What two things cause fatty liver, if digested regularly?" Too simplistic. Fatty liver is mainly caused by positive energy balance, it does not matter whether you eat too much fat or carbs. Overeating is more prevalent in a high carb diet, but carbs are not the only contribution save ethanol. BTW: The shortest path to cause insulin resistance is with fat.

[@wocket42]

@@olafkunert3714 fatty liver from too much fat on a zero carb diet? I would like to see the study that shows that.

[@DrPetesKetoKlub]

Hello Dr. Ludwig: Its not a question per se of fructose equivalents because one must realize the activity of the polyol pathway in the face of rising glucose and its activation of Fru/UA with the change in metabolic state of the liver. The argument should not hinge on exogenous fructose but rather the glucose threshold that opens the polyol pathway driving the acute rise in UA, steep decline of ATP, with the activation of de novo lipogenesis, change in state of the mitochondria, increase in systemic inflammation, alteration in the regulation of NO, etc. Lets open a meeting where this biochemistry is presented along with your work and have a conversation about how compatible these models are.

[@BartBVanBockstaele]

"Is overeating driven by biology and not by a lack of self-control?" This is the wrong question. Self-control **is** biology. With that out of the way: if there is no self-control, there will be either overeating or undereating, most likely overeating, at least in our environment.

[@user-gv5mo1rd2p]

You can't become obese by eating too many cucumbers.

[@gruber1650]

So the bottom line is that high glycemic foods put on fat and low ones help to put on muscle, have I got that right?

[@MarilynRoper-ob1nj]

High glycemic foods put on fat and exercise plus protein ( amino acids) build muscle.

[@paulsalvaterra]

I would like bart kay to review this

[@Starchaser63]

Carbohydrates from whole foods will not cause health or weight issues unless in the presence of too much fat 😮. Fat and sugar/starch should be kept apart..😊

[@przemysawukawski4741]

Its exactly the vice-versa :) Carbohydrates as a whole, should be avoided if you want to stay healthy. We do not need them at all

[@Starchaser63]

@@przemysawukawski4741 I cannot find a study showing a diet if whole foods complex Carbohydrates causes diabetes, weight gain, metabolic issues etc. If you have such a peer reviewed study then please let me know..😃 🙂

[@suzannegarrett2246]

Type II Diabetes is carbohydrate intolerance. If I want to keep my body composition and blood glucose at normal levels I have to avoid carbohydrates including limiting vegetables. I was formally diagnosed after a stint with veganism in my early 30’s but had metabolic dysfunction in my 20’s as well.

[@Starchaser63]

@@suzannegarrett2246 there is no study anywhere in the world which clearly shows eating carbohydrates from real whole foods causing diabetes or weight gain...if you know of a peer reviewed large study showing this then please send me the link..its processed junk carbs thats great problem and years of eating both fat and sugar...a high caeb diet from real whole foods has never been shown to cause negative health issues 🙃

[@elinope4745]

I've been on a very low carb diet for close to two years now. I can feel the difference of eating even two or three grams of carbs. I can tolerate carbs from whole foods much better than in processed foods which really play one over on me and can have me feeling quite ill for a couple of days. But high carb foods also mess with me, even sweet potatoes make my joints ache. I do have a very high fat intake with fat making up between 60 and 80 percent of my total calories on any given day. Wildflower honey for some reasons does not mess with me, while apples and bananas do.

[@gordanshaw7747]

Yeah, but the first law of thermodynamics though…

[@js1mom]

The human body is a very open system, and we are not bomb calorimeters.

[@mihelbergel]

We need to blend the Energy Balance Model (EBM) and the Carbohydrate Insulin Model (CIM), and not pit them against each other. Please allow me to explain. I've used both the EBM and CIM to help many people lose weight and both work very, very well depending on the person. But there are advantages and disadvantages to both that we can blend. The EBM is difficult for weight loss because hunger is not satisfied by simply cutting calories and some will power is required to overcome the hunger. The CIM is difficult for weight loss because the carb addiction is not satisfied by simply eliminating carbs and some will power is required to overcome this. Many people give up and fail with both approaches because of these issues. On the flip side, the EBM is advantageous for weight loss because people do not have to give up all carbs and therefore can ween off their addiction. The CIM is advantageous for weight loss because people feel more satisfied and do not have to go hungry as much. The different approaches work differently for different people. So instead of thinking that only one way is correct why not blend them since they both have advantages and appeal to different people in different ways? For example, start a person off on a weight loss program that cuts a few carbs but still allows them to maintain their carb addiction temporarily while creating a slight calorie deficit (EBM), and at the same time increase their fat intake slightly (CIM) while creating a slight calorie deficit. Then progressively continue with this plan. After a few months of progress, the person will transition off the carb addicted diet and onto a fat adapted diet. Both models work extremely well for weight loss, but it depends on the person. Blending is a wonderful solution for long-term weight loss success.

[@stevedow9076]

Best treatment for an alcoholic: Stop drinking alcohol. Period. Same here

[@przemysawukawski4741]

You don't treat alcoholic by allowing him/her to drink just a little bit less every day :P Your point then is incorrect. People should firstly realize they are addicted to carbs, and then they just have to cut them out for good.

[@OIOnaut]

Having an insurance company of insurance companies is HUGE. Now🤫 listen and look to the bioquantum mechanics below all this what David says. Near IR, structured water earth negative charge in ”grounding”. POMC gene and the outcome of its cleveage is all deuterium physics. So even us the long time woken people will have to do a new paradigm shift. A true quantum leap. This is why I am a ghee eating carnivore who attends to his childrens funeral one day with my grand children.

[@wocket42]

Zero carbs for life!

[@martinzero3726]

If you provide timestamps for this video you will get a lot more views and likes ;)

[@mihelbergel]

I agree with everything right up to the Q&A where it is said that obesity is NOT a question of self control. I strongly disagree. It is definitely a question of self control. Yes, the biology is also changed, but it is still a question of self control. Before I knew about the biological impacts of ultra processed carbs, I had helped dozens of people lose weight exclusively with self control and I witnessed hundreds of others lose weight exclusively with self control. I have read dozens of studies showing that self control works very well for weight loss. It's not easy and it takes discipline, but self control works very well as a means to lose weight. Yes, fixing the biology while also exerting self control would be more optimal, but the implication that we take no responsibility for our weight gain is a sickness in itself. We must accept responsibility. As a society we want to make everything easier, but there is no substitute for discipline and self control. If we attempt to take discipline and self control out of the equation we will always create new problems. Instead, let's combine the two models. Why do we have to have only one or the other. Let's do both.

[@curtislavoie2242]

You used a lot of words to say keep doing what we are doing.

[@petercyr3508]

It is important to get all the carbs out of the house to be succesful.

[@thalesnemo2841]

A grossly mistaken understanding of basic biochemistry. Self discipline is not an actionable hypothesis! IT IS LARGELY THE AMOUNT OF CARBOHYDRATES! One has to find one’s own carbohydrates threshold and eat below that value . This LESS THAN 100 grams total per day . I’m less than 60 grams total/day ! My N=1 data shows IT IS THE AMOUNT OF CARBOHYDRATES-PERIOD! I’m down 23 Kg , No more arthritis, No more sinus issues, far less GI issues and far better physical endurance!

[@RBzee112]

Self control does work for weight loss. But not for weight maintenance. Not when you're constantly told carbohydrates are healthy and fat is not. It's been shown that carbs are equally as addictive as drugs. Sets off the responses in the brain.

[@sheilacollins9384]

If self control was the most salient factor then we wouldn't be seeing a global explosion of obesity and diabetes. What has changed since the mid 20th century? The massive consumption of ultra processed food - including sugar, refined carbs and toxic industrially produced seed oils. I doubt very much that the percentage of people unwilling to control themselves has exploded. I will add one caveat though: utra processed food are DESIGNED to encourage uncontrolled consumption. Basically, we are being poisoned by our food and we're getting fat and chronically ill as a result. It's not our native personal will that is flawed.

[@Bandybear]

I hope this video is actually helpful. I have watched so many of these videos on this channel trying to find some answers for things but these people and their buzz words are over the top another thing that makes them repugnant to us at the bottom of this ecosystem is how pretentious and out of touch with reality and their humanity . It’s frightening how important they think they are while they’re supporting their own nonsense . I’m not Einstein but let’s see if I learn anything from this video ?

[@MarilynRoper-ob1nj]

Much of the audience are medically trained individuals. I do my best to keep up- my lack of knowledge is not the speaker’s problem.

[@PublickStews]

Ludwig is a charlatan