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How the world's heaviest man lost it all (2017)

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Re: How the world's heaviest man lost it all (2017)

#21

Post by lhl »

1_player wrote: post #14
ravenstine wrote: post #8

Earlier quoted context omitted.

I hope someday this concept of a healthy diet goes by the wayside because even just a cursory investigation makes it obvious how flawed it is. It's like people think that a food is "healthy" as long as it's not pizza or ice cream, and even most GPs don't totally know better (they're not stupid, it's just that they're not as educated in that subject). A reasonable diet isn't even that complicated. Control the sugar an…

Re: fructose. I was reading recently some interesting theories about fructose possibly being obesogenic, I'm about to leave so I can't do a proper Google search and link the studies. The theory makes sense evolutionarily: fruits were mostly available for a couple months a year, so the body tries to store fruit sugar as fat, for the long cold winter days, instead of using them immediately as short term energy in the f…

There's lots of research on negative metabolic effects of high fructose consumption, particularly on the liver. Here's a couple recent reviews as a starting point for those that are interested:

Mai, Brandon H, and Liang-Jun Yan. “The Negative and Detrimental Effects of High Fructose on the Liver, with Special Reference to Metabolic Disorders.” Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 12 (May 27, 2019): 821–26. https://doi.org/10.2147/DMSO.S198968.

Jensen, Thomas, Manal F. Abdelmalek, Shelby Sullivan, Kristen J. Nadeau, Melanie Green, Carlos Roncal, Takahiko Nakagawa, et al. “Fructose and Sugar: A Major Mediator of Nonalcoholic Fatty Liver Disease.” Journal of Hepatology 68, no. 5 (May 2018): 1063–75. https://doi.org/10.1016/j.jhep.2018.01.019.

And some interesting evolutionary speculation on why effects of fructose might be so powerfully conserved:

Johnson, Richard J., Peter Stenvinkel, Peter Andrews, Laura G. Sánchez-Lozada, Takahiko Nakagawa, Eric Gaucher, Ana Andres-Hernando, et al. “Fructose Metabolism as a Common Evolutionary Pathway of Survival Associated with Climate Change, Food Shortage and Droughts.” Journal of Internal Medicine, October 17, 2019. https://doi.org/10.1111/joim.12993.

BTW, beyond mechanistic research, I think one of the most interesting recent trials was this elegant study done recently in obese children (n=41) where it was shown that over 10 days of isocaloric (calorie-matched) swapping of sugar for starchy carbs resulted in a halving (!) of liver fat, a 68% decrease in DNL (de novo lipogensis = fat produced by the liver), and improved insulin kinetics across the board, showing that fructose was not only uniquely bad from a metabolic perspective even vs glucose, but that the response to removing the fructose was a dramatic and immediate improvement in health markers:

Schwarz, Jean-Marc, Susan M Noworolski, Ayca Erkin-Cakmak, Natalie J Korn, Michael J Wen, Viva W Tai, Grace M Jones, et al. “Effects of Dietary Fructose Restriction on Liver Fat, De Novo Lipogenesis, and Insulin Kinetics in Children with Obesity.” Gastroenterology 153, no. 3 (September 2017): 743–52. https://doi.org/10.1053/j.gastro.2017.05.043.

Re: How the world's heaviest man lost it all (2017)

#22

Post by delusional »

staticassertion wrote: post #18
delusional wrote: post #13

Earlier quoted context omitted.

You're giving away the differentiator right in your comment. You've never heard anyone talk about "oversmoking" because there's no such thing as "the right amount of smoking" (or rather, that amount is zero. No smoking is the _correct_ amount of smoking). I agree that obesity is terrible. I even agree that the "oversugaring" is probably a large portion of the cause side of the obesity problem. I'm just pointing out t…

What is the right amount of sugar? What are the health benefits of sugar? Your body does not require it at all, it is strictly negative impact unless you're literally starving or trying to gain fat to avoid starvation. You're making this weirdly personal. No one is saying you're a bad person for eating sugar or "as bad as" a smoker. There's no pedestal.

> What is the right amount of sugar? What are the health benefits of sugar?

I don't have to answer your questions and it's not like you'd care about my answers anyway. The guy I'm responding to said "over-sugaring" which implies there's an amount of sugar that's not too much. I would expect something like eating an apple would fall under his definition of "not too much" but I wouldn't know.

What's the point of the rhetorical questions? I feel like you're trying to "own" me in order to put me into some Ben Shapiro youtube clip. If you want to make an argument, just make it.

> No one is saying

That's an odd point to make for someone just entering the discussion. I'm telling you what impression it leaves on me. Just saying "well your impression is wrong" is not really an interesting observation. Communication is a two-way street where we collaboratively create the impression we want. If you want to leave a different impression, then communicate differently.

Re: How the world's heaviest man lost it all (2017)

#23

Post by tejohnso »

1_player wrote: post #14
ravenstine wrote: post #8

Earlier quoted context omitted.

I hope someday this concept of a healthy diet goes by the wayside because even just a cursory investigation makes it obvious how flawed it is. It's like people think that a food is "healthy" as long as it's not pizza or ice cream, and even most GPs don't totally know better (they're not stupid, it's just that they're not as educated in that subject). A reasonable diet isn't even that complicated. Control the sugar an…

Re: fructose. I was reading recently some interesting theories about fructose possibly being obesogenic, I'm about to leave so I can't do a proper Google search and link the studies. The theory makes sense evolutionarily: fruits were mostly available for a couple months a year, so the body tries to store fruit sugar as fat, for the long cold winter days, instead of using them immediately as short term energy in the f…

Peter Attia has some great podcasts on this. Here's one [1] about how fructose drives metabolic disease.

[1]: https://peterattiamd.com/rickjohnson2/

Re: How the world's heaviest man lost it all (2017)

#24

Post by jjgreen »

ravenstine wrote: post #8
1_player wrote: post #5

"He had a proper dietary routine now, he said. [...], made oatmeal for breakfast, ate a banana as a snack, had a salad or PB&J for lunch, and some pasta for dinner." Ah yes, the proper diet of carbs and sugar, little protein and even less fat. PB&J for lunch for a diabetic, seriously? We're still a few decades away before the common populace and your GPs learns that sugar, especially fructose, is one of the biggest c…

I hope someday this concept of a healthy diet goes by the wayside because even just a cursory investigation makes it obvious how flawed it is. It's like people think that a food is "healthy" as long as it's not pizza or ice cream, and even most GPs don't totally know better (they're not stupid, it's just that they're not as educated in that subject). A reasonable diet isn't even that complicated. Control the sugar an…

During WWII, a nutritionist called Magus Pike worked at the UK Ministry of Food, post-war he became something of a TV "boffin", called on whenever food was in the news. I saw him once on how to eat healthily: "Eat what you like, try not to get overweight".

https://en.wikipedia.org/wiki/Magnus_Pyke

https://en.wikipedia.org/wiki/She_Blinded_Me_with_Science

Re: How the world's heaviest man lost it all (2017)

#25

Post by Broken_Hippo »

sbierwagen wrote: post #7
ravenstine wrote: post #4

> He was all too familiar with that precarious balance. In 2008, he had tried to commit suicide by taking enough codeine to kill two people, but he'd woken up the next morning with only a headache—his body had absorbed it all. I am nearly speechless. Suicide is no joke, but assuming the story here is true, it's kind of remarkable that a person's morbid obesity saved them from death in such an ironic way. If he was at…

Drugs for children are dosed in mg per kg, with calculators to suit: https://reference.medscape.com/calculator/650/weight-based-m... Adults are usually about the same size, so it's less of a problem there. Usually. https://www.nytimes.com/2018/06/08/well/drug-dose-weight-siz...

Drugs for children aren't only dosed per kg: Sometimes children have different bodily functions than adults [1]. Children might not clear out medicines like adults, for example, and it means they need a lower per KG dose. This is also a concern when giving children vaccines, though it is more due to the way a child's immune system operates differently than an adult's.

[1] https://www.msdmanuals.com/professional/pediatrics/principle....

Re: How the world's heaviest man lost it all (2017)

#26

Post by Broken_Hippo »

ravenstine wrote: post #4

> He was all too familiar with that precarious balance. In 2008, he had tried to commit suicide by taking enough codeine to kill two people, but he'd woken up the next morning with only a headache—his body had absorbed it all. I am nearly speechless. Suicide is no joke, but assuming the story here is true, it's kind of remarkable that a person's morbid obesity saved them from death in such an ironic way. If he was at…

"I could swear I've heard that the thing about body mass affecting the effectiveness of medication was a myth, but I'm not sure where I heard it."

It definitely affects it: This is part of the reason they ask you for your weight before you get an MRI with contrast (The amount of contrast changes on your weight) and IIRC, they change the dose of IV morphine depending on your weight. Realistically, this is also the case for some drugs - a small person generally gets drunk faster than a large one.

But it doesn't matter as much for some drugs than others: Two adults can generally take the same amount of ibuprofen because the differences aren't really all that large. Extremes are going to change this, though.

Re: How the world's heaviest man lost it all (2017)

#27

Post by tejohnso »

delusional wrote: post #11
weq wrote: post #9

Earlier quoted context omitted.

Totally. Sugar is the Cigarettes of our time, no doubt. My mother's gastric bypass at 50 saved her life. She took artifical sweateners for 20yrs thinking they would help her control her weight but in reality all they do is keep you conditioned to the rush. She regained weight after her initial surgury but has finally been able to kick the sugar and has kept it off long term - now 67. She has the same problems with sk…

> Sugar is the Cigarettes of our time, no doubt. People have been saying this for the past 15-20 years, yet it keeps not being true. The difference is pretty obvious with just a little thought. Sugars are part of a balanced diet, it's perfectly healthy to consume some amount of sugars during a normal day. Cigarettes have NO health benefits, they only serve to kill you. Cutting out all cigarettes is a pretty minimal s…

The saying can be improved dramatically by prepending one word: added.

There's absolutely NO health benefit to having any added sugar in food products.

Manufacturers know that it is harmful, they know that they are encouraging addiction, and they know that consumers are suffering as a result. And then there's the advertising, especially to children. Ninety percent of the breakfast aisles in most grocery stores should absolutely be illegal and people should be ashamed to be poisoning their children with products like these[1].

It's this combination of addiction, harmfulness, and advertising that are so similar to the cigarette industry.

[1]: https://www.metroparent.com/parenting/advice/kids-cereals-su...

Re: How the world's heaviest man lost it all (2017)

#28

Post by lhl »

pid-1 wrote: post #20
ravenstine wrote: post #8

Earlier quoted context omitted.

I hope someday this concept of a healthy diet goes by the wayside because even just a cursory investigation makes it obvious how flawed it is. It's like people think that a food is "healthy" as long as it's not pizza or ice cream, and even most GPs don't totally know better (they're not stupid, it's just that they're not as educated in that subject). A reasonable diet isn't even that complicated. Control the sugar an…

As someone who is successfully reversing* prediabetes for the past year, the most important takeaways for me are: - You must think about the insulin index of your whole meal, not individual components. It's fine to eat a banana if you mix with high fiber stuff. That's also why you should eat greens in your meals. They're high in fiber and will lower the insulin index of your dishes. - If you're exercising before or a…

Great work improving your health! While there is some controversy on what constitutes "reversal" vs "remission," I think you'll be happy to know that the idea that T2D is a chronic and progressive disease is pretty outdated (although sadly, still commonly believed not just by the general public, but also by clinicians/practitioners that don't know better), especially when you deal with it earlier like you are doing (I did the same a few years ago) as most people have a beta cell functional decline of 50% by the time they get an official T2D diagnosis. (For those that want to track these things, personally, I recommend adding a fasting insulin panel (even out of pocket, $5 more than getting just A1c and FBG tested), and tracking MetS markers).

Here's a bit of the more recent research suggests that full "reversal," which includes normalization of beta cell function and normal glucose tolerances/insulin sensitivity is totally possible:

Taylor, Roy, Ahmad Al-Mrabeh, Sviatlana Zhyzhneuskaya, Carl Peters, Alison C. Barnes, Benjamin S. Aribisala, Kieren G. Hollingsworth, John C. Mathers, Naveed Sattar, and Michael E. J. Lean. “Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent upon Capacity for β Cell Recovery.” Cell Metabolism 28, no. 4 (October 2, 2018): 547-556.e3. https://doi.org/10.1016/j.cmet.2018.07.003.

Lim, E. L., K. G. Hollingsworth, B. S. Aribisala, M. J. Chen, J. C. Mathers, and R. Taylor. “Reversal of Type 2 Diabetes: Normalisation of Beta Cell Function in Association with Decreased Pancreas and Liver Triacylglycerol.” Diabetologia 54, no. 10 (October 2011): 2506–14. https://doi.org/10.1007/s00125-011-2204-7.

BTW, exercise without a doubt increases your insulin sensitivity and is a good glucose sink, and meal mix is a good thing to point out too (there's actually plenty of fascinating research on how now just what you eat, but food consumption order actually affects your incretin/insulin response too!) and if what you're doings works best for you, by all means, keep doing it, but I'll just mention that there are many ways to go about improving your metabolic health and I think for most people, sorting out their diet first (basically, cutting out sugar, reducing processed foods) is going to be the more important thing, as exercise also tends to increase appetite, and takes more time/energy to do. Personally, I also found TRE/IF (16:8) to be one of the more initially daunting, but ultimately most effective methods when I was getting started. The way I tend to frame it is that you have a ~100g glycogen fuel tank that's your liver. How you empty/fill it is up to you, but you just want to keep it from overflowing (since when you go above that, you're going to get DNL and all the nastiness that ensues).

Re: How the world's heaviest man lost it all (2017)

#29

Post by 1_player »

delusional wrote: post #11
weq wrote: post #9

Earlier quoted context omitted.

Totally. Sugar is the Cigarettes of our time, no doubt. My mother's gastric bypass at 50 saved her life. She took artifical sweateners for 20yrs thinking they would help her control her weight but in reality all they do is keep you conditioned to the rush. She regained weight after her initial surgury but has finally been able to kick the sugar and has kept it off long term - now 67. She has the same problems with sk…

> Sugar is the Cigarettes of our time, no doubt. People have been saying this for the past 15-20 years, yet it keeps not being true. The difference is pretty obvious with just a little thought. Sugars are part of a balanced diet, it's perfectly healthy to consume some amount of sugars during a normal day. Cigarettes have NO health benefits, they only serve to kill you. Cutting out all cigarettes is a pretty minimal s…

> Sugars are part of a balanced diet

Citation needed. Only two things are necessary to live: protein and fat. Carbohydrates are decent fuel. Literal sugar (as added fructose/glucose to regular food for taste) isn't required for a diet to be called balanced or healthy any more than alcohol is (both are considered fuel for the metabolic system).

Thankfully the body is quite resilient and can work with reasonable amounts of sugar or alcohol in the diet, but to say it's part of a balanced diet is a bit of a stretch.

Re: How the world's heaviest man lost it all (2017)

#30

Post by staticassertion »

delusional wrote: post #22
staticassertion wrote: post #18

Earlier quoted context omitted.

What is the right amount of sugar? What are the health benefits of sugar? Your body does not require it at all, it is strictly negative impact unless you're literally starving or trying to gain fat to avoid starvation. You're making this weirdly personal. No one is saying you're a bad person for eating sugar or "as bad as" a smoker. There's no pedestal.

> What is the right amount of sugar? What are the health benefits of sugar? I don't have to answer your questions and it's not like you'd care about my answers anyway. The guy I'm responding to said "over-sugaring" which implies there's an amount of sugar that's not too much. I would expect something like eating an apple would fall under his definition of "not too much" but I wouldn't know. What's the point of the rh…

Jesus Christ you're touchy.
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