Dr. Andreas Eenfeldt - 'Maintaining weight loss and T2 reversal - How sustainable is it?'

many people know that on a low-carb diet you can lose weight you may even reverse some diseases like type 2 diabetes but can you maintain that is that sustainable for many many years that's what I'm gonna talk about today but first the disclosures so me and our team like Chris mentioned we run the health company diet doctor it is the largest low-carb site in the world actually I'm curious how many people have visited quite a few Wow okay thank you so in case you don't already know we're funded by an optional membership section we take no money from an industry we shall we sell no products and we we have no ads so we're fully funded by the people and and actually we're a team of about 50 people now including 12 people here in Denver so including actually most of the amazing people in the back of the room who are doing all the hard work with a video and the live stream yeah cause for them so that's C Mon your goes unit on Matthias Harry Paul Morris and do you know I guess you've heard but you can actually if you miss any presentation you can go home and watch it online today or tomorrow pretty amazing right for free so we are also growing very fast at the moment we have 14 open positions that we are recruiting for so if you know of someone who would be perfect someone who's passionate about making low cups simple for people we need really writers we need recipe creators we need software engineers and many other roles feel free to to let them know and to finalize my disclosure I I do eat low carb I have eaten low Karpis yes so this is my my dietary bias I am I'm biased to believe that this is not gonna kill me I hope please not anytime soon so look at this short this is the growth of online searches for keto diet it is by far the most popular online sort of diet search at the moment so why is low carb and keto so popular here's a New York Times article from last year that may have something to do about it something to do with it it's about how low-carb could help you maintain a healthy weight so says that adults who cut carbs and replace it with fat they sharply increase their metabolism and this is of course the Ludwig study from last year he spoke earlier at the conference will we get back to that here's something else about low-carb as you know it can look like this is real food and you avoid food with a lot of carbohydrates and sugar so what do you eat or you could eat only bacon and you could drink only coffee with butter in it that's low-carb and some people might think that's how it's done it's possible but I don't think this is the most healthy or sustainable version of it fortunately a low-carb can also look like this it's a Caesar salad can be low-carb lasagna can be low-carb if you make it with eggs and cream cheese and this can be low-carb this can be low-carb and of course bacon and eggs for breakfast it can be low-carb I'm a point with all of this is that low-carb can be enjoyable low-carb can be varied and you don't have to be hungry you don't even need to count calories so this can be a long-term lifestyle compared to other perhaps shorter and less enjoyable diets this is actually something that you might be able to maintain and sustain for life if you like it and that's a good sign sign that perhaps the effect could also be sustained we're gonna look at the science for this but another point about this food first is that this is almost exactly the opposite of conventional advice right in many ways you're supposed to avoid fast you're supposed to avoid saturated fat you're supposed to eat lots of fruits lots of whole grains so in many ways this is completely the opposite but maybe maybe maybe that's a good thing because look at what has followed the conventional advice and there are many ways to start this story but I'd like to start it in 1984 this is the year that George Orwell wrote about his novel about Big Brother and in the same year the American government launched a campaign to teach the American people how to think about food and what to eat and they should fear fat they should fear real food like eggs or bacon or butter or meat this relieves a low-fat low-cholesterol diet and food companies went along with it producing low-fat foods right take away the fat and then quite often you add is that more more sugar and there is a lot of refined grains and refined they're a carbohydrates in there so these are foods that raise blood glucose levels and and the fat storing hormone insulin like less fat more sugar and here's what happened to obesity rates in America this is 1985 year after this campaign and the white states there are there is no good data about obesity because wasn't a big problem by John but the blue states have around a prevalence of about 10 percent of easy to say but one person in town has obesity meaning BMI over 30 so let's move ahead a few years and see what happened few years later 91 there is a new color dark blue states with over 15 percent obesity so quite a massive increase from 10 to 15 percent in just a few years 97 we get yellow states with over 20 percent obesity twice what it was just a decade before the massive increase in oh three we have a new color orange over 25 persons in o9 red states with over 30 percent obesity I think these are the red states and in 2015 we have these even darker states with over 35 percent obesity quite incredible do you think it's turned around you look at 2017 will it look better no just keeps getting worse every yeah so this is unsustainable because it's copy it's correlated with a lot of increase in indices right so obesity rates basically tripled in one generation you're looking at this short of different countries you can see that it has made America great pleased in size so the heavyweight champion of the world showing the way for the rest of us so sweet and I'm from Sweden it's way down here we way far behind why longer to only 12% obesity which means that 88% of Swedes still look like this it's not clear if it's a good thing or not but all jokes aside this is this is not good because it's correlated to a lot of disease let's look at for example diabetes in adults in the US and in the 60s and in the 70s was fairly low at 2% and then boom you get to Dietary Guidelines for Americans and it just shoots up people eat less fat and they eat more carbs and more sugar so of course correlation doesn't prove causation but I would say there is good evidence now that if you do exactly that it's more refined carbohydrates more sugar you increase your risk of diabetes and that's what people did when they were told to avoid fat because you have to eat something right and the reason we still say this we still advise people to do this is that there is still this ingrained fear of saturated fat and cholesterol but modern science now has shown us that this is actually this is wrong this is just not based on any good evidence so for example if you look at all the observational data where you we ask people how to eat and you you follow them for decades this is you know several hundred thousand people - taken together many many studies all taken together there is just no correlation even meaning that people eat a lot of out they don't get more heart disease people who avoid that they don't get less doesn't seem to have any you know effect and if you look at the much much better more expensive and more intensive studies experimental studies or cities then you get the same thing you take a group of people and you randomize them to either eat less fat or the same amount of that there is just no difference so people avoiding stopping eating when they stop eating saturated fat and replace it but with unsaturated they don't get healthier just doesn't work it's time to to just look at this and say well this has been a big failure let's stop doing it right and a lot of people know that so this is for example the cover of Time magazine a few years ago to the right says eat butter scientists labelled fat the enemy why they were wrong it's just wrong and a lot of people know that now and they don't care about fat anymore in fact they may even go on a keto diet so for example this is what Lance did and lost a lot of weight but not only that he's also controlling his epilepsy on a keto diet so he doesn't need drugs so he doesn't get the side effects of the drugs pretty amazing will be on weight loss and here's Kimberly also lost weight but the most impressive things for her was was the health benefits and the way it made her feel so of course these are just anecdotes right you can find people saying similar things perhaps about most diets so it's no good evidence so low-carb could be just another fad diet except it's not because there are studies there are studies the highest gold standard of nutrition research randomized control trials the most expensive and and best evidence available there are dozens of these comparing low carb diets to low fat diets and the result is very clear in fact the public health collaboration in the UK they made a review of all these studies and looked at you know how many studies have found that the low-carb diet actually results in significantly more weight loss and the answer is thirty one studies the best quality studies or cities and then they looked at how many studies have shown that a low-fat diet results in more weight loss statistically significantly more weight loss and they looked and they looked and they said okay never ever has that happened pretty amazing right so that seems like a very clear result and still you get headlines like this from last year saying that after another study is saying that a low-carb diets are no better than a traditional focus on fat this is actually quite a good study well done but if you look closer you can see that both groups were avoiding sugar and refined carbohydrates so both groups were on fairly healthy diets basically and if you look even closer you can see that the low-carb diet actually did lose more weight even though it's not statistically significantly more it's like a small advantage and if you look at what they studies you can also see that there are many studies similar studies where there's no clear winner they're a bunch of because these studies are hard to do and sometimes you don't get the very clear result so there are a bunch of studies showing there's a draw but when you can find a clear winner it's always no carb the way you really look at this in the most objective way possible is to combine all the studies into a systematic review and see what does it all say combined and this is a recent such review effects of low carb diets versus low fat diet diets on body weight and cardiovascular risk factors so is it true yes participants on low-carb diets experienced a greater reduction in body weight also improved risk factors in all kinds of ways except LDL cholesterol that went up by a very very frightening six milligrams per deciliter so then I guess the question for anybody is do I want to be overweight with bad blood pressure and HDL etc or do I want to raise my LDL by 6 milligrams per deciliter it's a good question I think it's quite an easy answer but depends on your perspective I guess but when it comes to weight loss anyway the the standing is is very clear low-carb is it's more effective so the question is more like why as you know that to lose weight you have to either eat less calories or you have to burn more calories right it says run more it's what people say at least so what is it because in these studies they're not told to eat less or run more most often they also to eat low carb so does low-carb result in people eating less or burning more calories what do you think did you say both let's see is that true here's the systematic review do ketogenic diets really suppress appetite looking at all the evidence individuals adhering to a ketogenic low-carb diet were less hungry and had a reduced desire to eat so the people who said it's that you eat less on low-carb they are right do you also burn more perhaps like in this study in British Medical Journal last year so people who are trying to maintain their body weight after weight loss were randomized to either low carb or low fat and they found that the people who ate low-carb they burned more calories without even trying so how many well at least 200 calories and depending on how you looked at it if you looked at the people with with high insulin like people with type 2 diabetes for example and people who really followed a low-carb diet you could actually get all the way up to 478 calories extra per day that's pretty enormous relief so the answer here is low carb diets result in more weight loss because at least partially because people tend to eat less because they are less hungry and at least under some circumstances people even burn more calories and I think that's great for a maintainable sustainable weight loss right you don't have to count calories and be hungry you don't have to exercise even though that's great you can lose you can have a healthy weight anyway weight and exercise would be a bonus so I think that's why we see these stories over and over this is a guy called Peter he lost a lot of weight and he reversed his type 2 diabetes this is Judy also off all her diabetes strikes on the keto diet this is another man called Peter who also reversed his type 2 diabetes on low-carb and here is Kenneth showing off some pretty amazing transformation there and finally here is a guy called Peter with type 2 diabetes who reversed it I don't know what it's about this guy's called Peter because this is a correlation not causation so someone should study it in a randomized form but anyway it sounded almost too good to be true is it is it too good to be true is it sustainable and if so how long so Eric Westman spoke earlier today he published a study that a decade ago that is six months long testing a ketogenic low-carb diet for people with obesity and type 2 diabetes and after six months they're quite a big increase improvement in blood glucose and body weight factors seems like it could work fairly well for six months Sarah Hallberg spoke earlier as well her studies 12 months long with some impressive improvement in not only blood glucose but also body weight you can see this nice short where there is no rebound just stays down there for the full 12 months there is 2-year data but it's not published yet so I can't show it apparently it looks really good it should be out very soon and this is the longest study that I'm aware of is actually sweetest article called Nielson who published data an uncontrolled trial on tap to people with type 2 diabetes on low-carb almost 4 years long and still quite a big improvement in body weight and blood glucose so it seems like it's working at least for a number of years however in most studies randomized stutters you see this kind of regain where people lose weight and then they try to resort to regain weight which leads to this idea that low-carb is sort of a satire anyway because it just works short term right what's the point it is only short term for example this study the scheie study from 2008 is two years of duration where they tried three different diets low carb is purple the low fat is red and Mediterranean is yellow and you can see in the first six months people lose a lot of weight on low-carb but after six months they start to go up again so question is did it stop working at six months what do you think interestingly they were told to eat about four percent carbs and then after six months they asked people what they were actually eating and they replied on average they were eating 41% carbs so seems like this is this is really a fad diet because if you stop doing it it stopped working right you actually have to do it if it's gonna work so unfair terrible turbo but should we really be surprised about that or is it just the same as any lifestyle intervention right like take for example smoking let's say you're you're a smoker and you have asthma and you hear that if you stop smoking you ask me I will improve and you think wow that's great I'm gonna try it you stop smoking you quit and then you ask me improves but then you start smoking again because that's very easy to do and then you ask my comes back would you then say that hey I tried that fad quit smoking thing but it's only a short-term fix you know it doesn't work long-term as soon as you start smoking the asthma comes back or let's say you go to the gym everyday and you get to really fit and your muscles get really strong and then you stop going to the gym and you're not as fit anymore and your muscles start to get weaker we do then say I tried this exercise thing but that's aside you know it's just short-term effects nothing worked long-term probably you wouldn't have the muscle example let's say you hear about this new thing called showering and you hear that what you're gonna get really clean if you shower and you try it Wow you get you get clean but then you stop showering and you're not so clean anymore and then you say well I try this fad showering thing but it's just a short-term effect doesn't work long-term we probably wouldn't because in all these are the cases we expect there to be you know you just have to keep doing it right and I think the exact same thing is true for any lifestyle intervention including any dietary change to make it work long-term you have to do it long-term and that should not be so surprising so let's look at this study where they actually kept losing weight for the full year they measure the ketone levels and they found that they were elevated the whole period meaning that most people seem to be following these diets so so what's different in this study well it's not randomized meaning people sign up for it because we want to do this diet instead of signing up for a weight-loss trial and then someone throws to diet some Tyson and say you know you should eat low-fat diet or you should is a vegan diet or usually the look of like maybe don't wanna do that maybe you don't like that and why should you keep doing it for two years just because someone rolled the dice you know you wouldn't right so the compliance is much lower I think this is actually a much truer representation of what what happens if you if you start a diet that you believe in that you think you can do and that you want to do and that means that effect in all these or CTE trials is an underestimation most likely of the true effect of someone who's motivated and want to do it which is quite interesting moving on is a long term cure possible I mean there are no studies right the longest study that I know of is is it not even for years but you can ask doctors who do this for a living all the time so I asked this is dr. Ted Nieman he works in Seattle he has worked in the same clinic for more than 15 years treating patients with low carb and he says he has numerous patients that have reversed or even cured the diabetes long term and and the way he uses the word cured is normal blood glucose levels without medication for at least a year and he says this happens with some regularity interesting he says that the people who only do low-carb they have to stay very low carb forever to keep the effect going but if they start doing quite a lot of exercise he believes that they can often increase the carb intake by weight and still keep the diabetes reversed which is interesting here is to the right is dr. Jay Wortman he reversed his type-2 diabetes 16 years ago on low-carb and he says he has a normal that Lucas still with no medication judging from this image maybe there is some exercise in the package as well speaking of whether a diet is sustainable it may be worth to just briefly I don't have that much time for it but briefly go through possible side-effects so you know at least especially in the beginning there are some common side effects but they can often be handled quite well if you know how to do it so for example the famous keto flu will get headache etc the first week it's usually manageable if you get enough fluid and salt leg cramps can happen also the fluid and salt can be helpful possibly magnesium constipation can happen also often probably due to dehydration so drink enough get enough salt again some other things you might may want to consider fiber supplements or milk of magnesia if it turns into an issue bad breath you if you have very very high ketone levels you can tend to smell acetone in the breath this is often temporary but not always breath fresheners may be used of course but if this is an issue for you you may want to eat a little bit more carbs to reduce the ketosis and and get rid of this smell but that will also reduce the effect so then you would have to balance it a little bit what preparations can happen in the beginning can also be due to dehydration reduce physical performance of course in the beginning muscles need to adapt and again it's very important to get enough water and salt perhaps some targeted carbs before competitions if you need it so these are relatively minor and mostly in the beginning and worst case you can always easily with more carbs and get rid of them the one that scares people perhaps a little bit more is this issue with possibly elevated cholesterol usually not an issue there's been other talks on on the topic here typically you improve your HDL triglyceride strugglers rights but a few percent may be hype respondents get very high LDL and it's unknown if it's dangerous but you may wanna just to be safe stop drinking bulletproof coffee maybe have more olive oil maybe do some intermittent fasting and if necessary list with more carbs and less fat this side effect is scary this I don't think it's reversible even so probably not a good thing can a low carb diet shorten your life reading the news you may think that it might at least this is from last year low carb diets could shorten life studies suggests now it seems a little bit uncertain in the language there this is the study titled carb intake the mortality prospective cohort study meta-analysis I would say when it says prospective court study you can just keep reading something else instead this is probably garbage and this is not an exception unfortunately observational studies are very very weak and this one is bad for second reason low-carb is under 40% what does 40% of carbs look like under 40 it looks like this this is a low-carb diet with 39 percent carbs if you do a diet coke right so are you really looking at people doing low-carb or are you just looking at people eating fast food can't really say plus to know to get a good evidence you really need a very good a very big effect like quit it like smoking in lung cancer you get like 10 times and 10 times increase in risk and in this case is it's 1.2 so no that is is almost certainly random or healthy user bias or something in fact like professor John I honored itself this kind of science is a scandal it should just go to the waste bin and this guy is smart he is professor of medicine and health research at Stanford and also a professor of statistics at Stanford so he knows what he's saying and other people say similar things just ignore this kind of science so I think the the death thing we can just probably just ignore but the thing that that is real is that there are some possible side effects and you may have to weigh those against the possible benefits so benefits like weight loss without hunger like type 2 diabetes reversal like lower blood pressure etc etc anybody can can weigh the pros on the con and decide whether is something for you about to wrap this up do you need a lot of supplements to do the low carb diets because that for me would make it less sustainable if you need this all the time but the fact is these ketone supplements and whatever it's called there is no good science saying that it's you know of any benefit to normal people that I know of so I would suggest just save your money probably you don't need it you can use your money to buy some high-quality real food instead this I think is Kancha Lee a sustainable lifestyle that can be maintained maybe even for life and what could happen if people everywhere got the knowledge the tools and the inspiration they needed to do this if they are in a group that could benefit let's have a quick look my energy increase I was able to sleep I got off the medications that I'd been on for 20 plus years for high blood pressure 2014 beginning of 2015 I was off all my medications that hunger that I had for my entire life was it there her energy level and much like mine our mental well-being has improved as as much as our physical health I went from 374 pounds to 139 pounds of 200 pounds in roughly 18 months the real freedom was the emotional freedom you know not having to crave and not having these blood sugar dips and spikes I now take zero medication and I was on four different types of tablets maybe six tablets a day I feel like work wise I can be more focused on projects and get through projects better I feel absolutely free of IBS now it's good my life was transformed by it I would have never believed that within my lifespan I would have my life back like this [Music] pick up anything right [Applause] around the world a billion people could benefit from low-carb those are people with obesity type 2 diabetes metabolic syndrome high blood pressure that's a billion people with a B and together we can help empower people everywhere to reverse disease to improve health in a way that is maintainable and sustainable thank you [Applause]

Channel: Low Carb Down Under

Views: 27,084

Rating: 4.8917837 out of 5

Keywords: Low Carb Down Under, LCDU, www.lowcarbdownunder.com.au, Diet Doctor, Low Carb Denver 2019, #LowCarbDenver, Andreas Eenfeldt, ketogenic Diet, LCHF, Low Carb High Fat, weight loss, diabetes reversal, obesity, saturated fat, food revolution

Id: rsxG11p3XWw

Length: 32min 11sec (1931 seconds)

Published: Sat Aug 24 2019