Red Meat Dilemma 2 – Hormonal Obesity XXVII

By Jason Fung, MD

Devotees of the low carb approach faced the red meat dilemma.  Meat was supposed to be non fattening because it was not a carbohydrate.  However, some large studies questioned this assumption.  The fascinating study “Changes in Diet and Lifestyle and Long- Term Weight Gain in Women and Men” demonstrated a rather large correlation between red meat and obesity.  Since proteins could be equally good at stimulating insulin, meat was not nearly as benign as once imagined. The experience of countless Atkins acolytes reinforced the trial results.  Millions of dieters in the late 1990s and early 2000s tried the Atkins low carb, high protein approach.  For some, the approach worked.  However, for many more, it didn’t deliver the promised weight loss.  Poplularity waned. Another interesting tidbit from that study involved the utility of exercise.  Overall, there was a beneficial effect of exercise on weight gain.  No surprise there.  Breaking down each dietary group to quintiles of exercise, you can see that within each dietary group, there is benefit with more exercise.

Comparing the effect of exercise, it is clearly much less beneficial to changes in diet, though.  This, too is not new.  The overwhelmingly important factor in weight gain is diet.  Exercise is secondary.  As we mentioned previously, diet is Batman, exercise is Robin.

The risk of type 2 Diabetes, closely related to obesity was also examined in relation to red meat consumption. “Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis” looked at the same cohort as the previous study.  Analyzing the result separately for processed and unprocessed meat, there was a strong correlation between diabetes and both types of meat.  However, the hazard ratio was only 1.19 for 100 grams of unprocessed red meat compared to 1.5 for 50 grams of processed meats.

Putting that into plain English, it means that for every extra 100 grams of unprocessed meat (steak, pork chop etc), there is a 20% increase in risk of diabetes.
For every extra 50 grams of processed meat (bacon, luncheon meats etc) there is a 50% increase in the risk of diabetes.

As we saw in the case of carbohydrates, the toxicity lies not predominantly in the food itself, but in the processing of the food.

Numerous other studies have shown a difference between processed and unprocessed meats.  A systematic review “Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes: A systematic review and meta-analysis” showed that there was NO association between unprocessed meats and diabetes, heart disease or stroke, but a 42% increased risk with processed meats.

Results from the European experience was published in “Meat consumption and mortality–results from the European Prospective Investigation into Cancer and Nutrition.”  Increased mortality and cancer risk was seen predominantly with processed meats.  The effect was much weaker in unprocessed meats and was not statistically significant.

This is yet another body blow to the Atkin’s diet.   The advice to skip the bread and eat all the bacon you wanted was not good.  Sausages, luncheon meats, bacon and other processed meats were not a whole lot better than the processed carbohydrates they were meant to replace. The toxicity is in the processing.
This really makes a lot of sense.  Our bodies evolved to eat many different types of foods without health problems.  Some ancestral diets were very high in meat and fats – such as the Inuit.  Others, like the Kitavans and Okinawans, were heavily carbohydrate dependent.  Yet both traditional diets were associated with good health.  You notice, though that neither one included large amounts of processed food – whether they were processed meats or processed carbohydrates.
Looking at our construct for the hormonal obesity theory, we can add the effect of animal protein to the protein raising effect.  This comes with the understanding that there are also protective effects of the protein on satiety and reduced stomach emptying.  Consider the major macronutrients – fats, proteins and carbohydrates.  Both protein and carbohydrates stimulate insulin to differing degrees.  Dietary fats have to least effect in this regard.  However, over the past 4 decades, we have, at the behest of nutritional authorities reduced our intake of dietary fats.  This left us with trying to increase protein or carbohydrates in the diet.  Yet no matter which way we turned, we were doomed to failure.

Thus we can see where the confusion with calories comes in.  Since it appeared that all macronutrients were the same, we imagined that all foods, regardless of nutritional content could be measured in a common unit – the calorie.  We initially tried to follow a low fat, high carbohydrate diet.  When that failed, the Atkins approach of low fat, high protein was tried.  That failed as well.  Now we grope along without any idea about what is happening because we have no framework to understand the underlying aetiology of obesity.

One of the most important points here is that both proteins and carbohydrates come with protective factors.  With carbohydrates, there is the protection of fibre.  Unprocessed carbohydrates contain large amounts of dietary fibre.  Traditional societies often ate upwards of 50-100 grams of fibre.  The standard, highly processed (removes fibre) North American diet trudges along with 15 grams.

With dietary proteins, we are protected by the incretin effect and the slowing of gastric motility.  Dietary protein increases satiety so that we will feel more ‘full’ and eat less at the next meal.  In years past, large meals full of protein would be followed by long periods of fasting in order to ‘digest’.  To a large extent, this does not happen any longer.

While we may indulge in a large meal, such as Thanksgiving, we are paranoid to skip the next meal because we irrationally fear that missing the next meal will ‘wreck’ our metabolism.  We see this in children all the time.  When they are not hungry, they will not eat.  We also see this in wild animals – lions, tigers, snakes etc.  Years of training have prepared us to ignore our own feelings of satiety so that we will eat when the time comes, whether we are hungry or not.  So, we circumvent the protective effect of the incretins by rigidly scheduling our meals 3 times a day, come hell or high water.  You may not be hungry, but by god, you will eat!

There are no intrinsically bad foods, only processed ones.  The further you stray from real food, the more danger you are in.  Should you eat protein bars?  No.  Should you eat meal replacements? No.  Should you drink meal replacement shakes?  (horrified) No.  Should you avoid processed meats and carbohydrates?  To the extent that you can.  It is difficult to completely remove these from our diets.  Therefore we have evolved over the centuries other dietary strategies to ‘detoxify’ or ‘cleanse’ ourselves.  These, dietary strategies too have been lost in the mists of time.  We will rediscover these ancient secrets soon, but yes, it is a cliffhanger.  For now, stick to real food.

Continue here with The Benefits of Vinegar – Hormonal Obesity XXVIII
Start here with Calories Part I – How Do We Gain Weight?
See the entire lecture – The Aetiology of Obesity 3/6 – Trial by Diet

By The Fasting Method

For many health reasons, losing weight is important. It can improve your blood sugars, blood pressure and metabolic health, lowering your risk of heart disease, stroke and cancer. But it’s not easy. That’s where we can help.

Jason Fung, MD

By Jason Fung, MD

Jason Fung, M.D., is a Toronto-based nephrologist (kidney specialist) and a world leading expert in intermittent fasting and low-carb diets.

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