Author Topic: The Hypothalamic Hypothesis of Obesity  (Read 10152 times)

Offline Todd Becker

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The Hypothalamic Hypothesis of Obesity
« on: November 26, 2011, 12:36:24 AM »
I just put up a new post on the blog, entitled "Obesity starts in the brain".  In part, it was inspired by difficulties I came across with the Carbohydrate / Insulin Hypothesis (CIH).  While I greatly admire Gary Taubes, Michael Eades and others who have provided powerful arguments for reducing insulin levels through carbohydrate restriction, there are a number of facts about obesity that CIH cannot explain, and the casual mechanisms proposed may not be correct.  I've also been intrigued by the Food Reward Hypothesis (FRH) as advocated by Stephan Guyenet.  Stephan's Whole Health Source blog is one of the best in sources of new ideas and research in the field of neurobiology as it relates to fat regulation, obesity and health.  While many of Stephan's posts are individually compelling, I find the FRH to be somewhat of a "catch-all" theory that is either circular or has the causality backwards.

So this latest post is my best attempt to make sense of the full set of data, while shifting the explanatory framework to focus on the brain's control system -- the hypothalamus.  There is a lot of remarkable research, some of it quite dramatic, showing that the hypothalamus is in fact where obesity originates.  Part of the frameshift was also realizing that obesity is not a single disorder -- but two very different conditions:  subcutaneous obesity and intra-abdominal obesity.  Once this distinction is made, a lot of the puzzles about the causal roles of leptin, insulin, and insulin resistance appear to be resolved.

The Hypothalamic Hypothesis is a brain-centric theory of obesity, but a different one than the Food Reward Hypothesis.  That is borne out also in the different dietary recommendations I make.  Stephan takes the FRH to indicate we should eat a blander diet consisting of less "rewarding" foods.  My conclusions, based upon the HH, are quite different and focussed on avoiding two specific food ingredients:  fructose (and it's common disaccharide sucrose) and certain pro-inflammatory fats.  There are also some recommendations regarding intermittent fasting and exercise.

I'd be interested in feedback, both confirmatory and critical.

Offline Anima

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Re: The Hypothalamic Hypothesis of Obesity
« Reply #1 on: November 27, 2011, 10:18:10 PM »
Your theory makes more sense than anything I've ever encountered.

You made a few dietary suggestions.  What traditional diet do you think is most conducive to staying lean?  I was glad to read that rice and potatoes may not be a problem like the low-carb/paleo enthusiasts lead us to believe.  A paleo diet may be super healthy, but I think it's impossible to sustain.  I think the 4HB slow carb diet would be easily sustainable if all those beans could be replaced by rice or potatoes.

I wonder if you could say more about how alcohol fits in with your theory.  My experience has been that if I drink a lot I get fat quickly and if I abstain I lose weight quickly.  I don't think it's just the calories, though they are substantial.  My alcohol intake is still far above moderate, but I have been able to lose weight by switching from beer to red wine.

BTW, I have tested your theory in regards to the Shangri-La diet.  I stopped worrying about the flavor-free window with my oil.  I still take it on an empty stomach, but I often brush my teeth or vape my electronic cigarette or drink tea before or after.  I haven't noticed a change in its efficacy.
« Last Edit: November 27, 2011, 10:32:07 PM by Anima »

Offline Todd Becker

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Re: The Hypothalamic Hypothesis of Obesity
« Reply #2 on: November 28, 2011, 08:37:39 AM »
Thanks for the feedback, Anima.

The impetus for my post was to put together the logic and evidence for the HH theory of obesity. Regarding specific and practical dietary prescriptions, I must admit I'm still on a learning curve. But I'm thinking about what I eat in a new way.  Rather than focus on factors like energy content (calories in, calories out theory), flavor (FRH theory), hormonal effect in muscle and fat tissues (CIH theory), I'm thinking more about: how does this food, dietary practice, exercise, etc. affect my brain?  And that includes whether it inhibits access to the brain (e.g. fructose -->triglyceride "fouling" of the blood brain barrier) or inflammation of the POMC neurons), upregulating or downregulating brain receptors, etc.  So it gives me a new model for trying to optimize what I eat and how I exercise.

I'm still researching (and self-experimenting) what foods are most compatible with the HH theory. So I can't give you a complete run down, but perhaps I'll share a few thoughts that partially answer your question.

At first, I did not understand Robert Lustig's emphasis on restricting sugar (sucrose and fructose) vs. carbohydrates in general.  But for the reasons laid out in my post, I now I think I have a basis for that distinction. So I tested the theory over Thanksgiving. I ate more potatoes and yams (high in glucose, no fructose) than I would have previously, while cutting back on desserts (high in fructose) and nuts (high in linoleic acid). Of course, I ate a lot of turkey, green beans, salad etc. too. I found that I filled up readily and stayed satiated for much longer.  I also lost slept great, even better than usual. Perhaps my hypothalamus was getting the insulin it wanted?!  Most odd of all, I actually lost a few pounds over Thanksgiving!  I laughed when I first read about the guy who lost weight eating mostly potatoes, but now it doesn't seem so silly. (And from his website, it looks his potato diet worked quite well for weight loss and reduced triglycerides and cholesterol). So I will try adding back some potatoes and rice (within reason) while cutting back on sugars and certain fats (including those in nuts) to see what effect this has on my body fat.

One interesting additional consequence of the HH theory is that foods that are most satiating should also be those that help with fat loss. That's because the POMC/CART neurons, when activated by insulin or leptin, have the dual function of not only suppressing appetite, but also increasing metabolism and fat burning. That's a wonderful two-for-one effect!  So I will be testing that out.

Your question about alcohol is very interesting.  A lot of the research says that alcohol raises triglycerides, which suggests it should be avoided.  However, on my post I provided a link to one study indicating that moderate alcohol consumption does not raise triglycerides and may actually lower them.  I think it may come down to the status of your liver.  If you have a healthy (non fatty) liver, and if you are in a fasted state, then your liver will probably easily metabolize one or two drinks without raising triglycerides or causing inflammation.  But beyond some minimum amount, you'll start to gain weight, particularly if the alcoholic beverage has extra calories (like beer) or you consume it with a lot of food.

Todd
« Last Edit: November 28, 2011, 07:05:57 PM by Todd Becker »

Offline Jbird

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Re: The Hypothalamic Hypothesis of Obesity
« Reply #3 on: December 02, 2011, 06:02:06 PM »
All very interesting, Todd, and re: what you said about potatoes filling you up, are you familiar with the satiety index? Here's some info http://www.mendosa.com/satiety.htm. Of the foods tested, potatoes were far and away the most satiating.
« Last Edit: December 02, 2011, 06:13:06 PM by Jbird »

Offline Anima

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Re: The Hypothalamic Hypothesis of Obesity
« Reply #4 on: December 03, 2011, 01:50:28 PM »
I found an old article that suggests a fructose index to replace the glycemic index: http://www.topnews.in/health/potatoes-pasta-rice-may-be-relatively-safe-compared-table-sugar-2158

I've been trying to eat with the HH in mind, and I have noticed that I don't just get full; I get satisfied.  I usually have to say to myself, "You're full, stop eating," but when I eat like this I enjoy the food without being tempted to overeat.

Another thought I've had since reading about the HH: I was very lean in college, despite a super high carbohydrate diet.  I was a vegan and a poor student, so I lived on starch.  Typical meals were beans with rice and burritos made with flour tortillas.  I ate tons of pasta.  According to the low-carb enthusiasts, I should have been fat and starving, but I was thin.  I always thought that maybe my metabolism was just better back then, but now I think it's because I was inadvertently on a low-fructose, low-fat diet.

ETA:  Okay, Todd, you found a way to enjoy food and lose weight, now find a way to drink copious amounts of alcohol whilst remaining lean and healthy.  I know you can do it if you put your mind to it  ;).
« Last Edit: December 03, 2011, 01:57:21 PM by Anima »

Offline Todd Becker

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Re: The Hypothalamic Hypothesis of Obesity
« Reply #5 on: December 04, 2011, 11:17:52 AM »
Jbird -

Thanks for the link to Holt's satiety index. There is a lot of food for thought there.  I've excerpted a few statements from the analysis that I think are interesting:

Quote
Holt found that some foods, like croissants, are only half as satisfying as white bread, while boiled potatoes are more than three times as satisfying, easily the most satisfying food tested. But potatoes in a different form—French fries—did not score well.

This mirrors my own experience getting very full eating potatoes (and gives me some impetus to cut way back on croissants).

It is quite noteworthy that adding the step of frying in oil made potatoes significantly less satiating.  That proves that neither calories nor carbs can alone account for satiety.  Nor can bulk and fiber explain this effect.  Clearly, the oil or frying process must be altering how the glucose from the potato starch is interacting with the brain.

I think it is also interesting that not all starch is the same. The "safe starch" concept advocated by Paul and Shou-Ching Jaminet (which seems reasonable to me), would suggest that potatoes and rice are both about the same - since both consist of starch (polymerized glucose) and no fructose.  But the satiety index suggests they are different.  For example, both white and brown rice scored satiety indices between 130 and 140, versus boiled potatoes at 323.  Brown pasta (188) is evidently more satiating than white pasta (119)

Oatmeal (209) looks quite good, but I wonder what happens when you sweeten it or mix in raisins, nuts or other toppings...

The satiety index can be criticized on methodological grounds, and there is probably some variability in how different individuals respond.  But some of differences between apparently similar foods are so pronounced that something real is going on here.  There is probably more to the potato that differentiates the satiety effects of potato starch from the starch found in rice or wheat.  It bears looking into.

Thanks for posting this!

Todd

« Last Edit: December 04, 2011, 12:22:30 PM by Todd Becker »

Offline Todd Becker

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Re: The Hypothalamic Hypothesis of Obesity
« Reply #6 on: December 04, 2011, 12:08:15 PM »
I found an old article that suggests a fructose index to replace the glycemic index: http://www.topnews.in/health/potatoes-pasta-rice-may-be-relatively-safe-compared-table-sugar-2158

I've been trying to eat with the HH in mind, and I have noticed that I don't just get full; I get satisfied.  I usually have to say to myself, "You're full, stop eating," but when I eat like this I enjoy the food without being tempted to overeat.

Another thought I've had since reading about the HH: I was very lean in college, despite a super high carbohydrate diet.  I was a vegan and a poor student, so I lived on starch.  Typical meals were beans with rice and burritos made with flour tortillas.  I ate tons of pasta.  According to the low-carb enthusiasts, I should have been fat and starving, but I was thin.  I always thought that maybe my metabolism was just better back then, but now I think it's because I was inadvertently on a low-fructose, low-fat diet.

ETA:  Okay, Todd, you found a way to enjoy food and lose weight, now find a way to drink copious amounts of alcohol whilst remaining lean and healthy.  I know you can do it if you put your mind to it  ;).

Thanks for posting the article, Anima.

I will think about your challenge of how to drink and be merry without getting a stout belly...Hmmm.

Todd

Offline Jbird

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Re: The Hypothalamic Hypothesis of Obesity
« Reply #7 on: December 04, 2011, 07:32:32 PM »
Todd, I wonder if resistant starch factors in somehow? http://en.wikipedia.org/wiki/Resistant_starch. We don't know how the boiled potatoes were consumed. If they were room temperature rather than hot, then maybe that helps account for their satiating effect. I also wonder if boiled potatoes retain more moisture than potatoes prepared in other ways, like the French fries. Barbara Rolls has conducted some interesting experiments that indicate foods that are higher in water help satisfy appetite better than calorie dense foods. She created the Volumetrics Diet based on her findings. Oranges are also high in water and were highly satiating. I think fiber probably accounts for the difference between whole wheat pasta and white. I wish we knew more about how Holt's testing was done, and I wish the testing had continued with more foods. In the meantime, I suppose any of us could test the effects of different foods eaten alone on ourselves.

Offline Anima

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Re: The Hypothalamic Hypothesis of Obesity
« Reply #8 on: December 05, 2011, 11:24:00 PM »
Quote
Barbara Rolls has conducted some interesting experiments that indicate foods that are higher in water help satisfy appetite better than calorie dense foods. She created the Volumetrics Diet based on her findings. Oranges are also high in water and were highly satiating...

I wonder about her definition of "satiating."  According to the Volumetrics theory, a meal of two oranges and an apple should be highly satiating, but I can't imagine that if one had such a lunch that he or she wouldn't be craving fat and starch later (if not immediately).

A diet with lots of raw fruits and veggies might be characterized as satiating by some definition (though not by any I would consider credible), but I don't know anyone who would consider it satisfying, and I think it's fair to say that there is a distinction.  Even people who like salads want dressing (i.e. fat) with them.  No amount of water and flavor can substitute for fat and starch - the two components that make food genuinely satiating, IMHO.
« Last Edit: December 05, 2011, 11:38:21 PM by Anima »