• 4 Votes - 4 Average
  • 1
  • 2
  • 3
  • 4
  • 5
Dr Jack Kruse blog - fix for Leptin Resistance vs IF

Expert Low-Carber



I noticed something very interesting in the "Why is Oprah still obese? Leptin part 3…" article, quoted and linked below.

I'm wondering if this could help us settle the IF debate a little bit. I have been critical of IF proponents because I think they think it's the perfect fix for everyone, and none of them (pretty much) ever heard of rT3, which to me is a warning sign that they are a bunch of amateurs. Plus the ones that are the most passionate about it always seem to be running photos of their chests and not their faces, you know "look at my muscles" types.

Quote:...Oprah can become equal to them if she has somebody explain this to her. Dr Oz certainly has not for over decade! Her goal is to focus on becoming leptin sensitive by being required by eating 50 grams of protein at breakfast everyday within 30 minutes of rising, eliminating all snacking especially past 730 PM, eating three meals a day, and limiting her carb intake below fifty grams per day for about 6-8 weeks. In my practice, over the last 5 years that is about the bell curve I have seen for most patients to require their regain their signaling back. I check leptin sensitivity by asking a few questions or by ordering a reverse T3 level...

http://jackkruse.com/jacks-blog/

Above is Dr Kruse's recommendation to Oprah to get past leptin resistance. Note that it has protein first thing in the morning, and 3 meals a day.

This is not IF obviously. IF proponents seem to think that IF fixes everything, all the time, for everyone, and if you disagree, something is wrong with you.

If I am reading Dr Kruse's blog right, what I see is steps to overcome leptin resistance that one should do before one begins to IF.

Despite what a lot of people think, I'm really not an anti-IF campaigner. I'm just not happy with how sloppy the proponents are and would like to pinpoint WHEN it is advisable, as well as what interval and frequency.

Makes sense to me. Is this right Dr?

Thanks in advance.

DFH's blog for diet and health: http://dietforhumans.com/

Advanced Low-Carber



In other words, the overwhelming majority of people who visit low carb boards are overweight/obese and one would assume mostly Leptin resistant.

So therefore it was a dangerous and destructive and abusive FAD to push this IF idea onto the community at large.

Apologies need to be made.

Expert Low-Carber



It's not just that, but yeah.

There is a discussion on Mark's forum that was started by a Primal newbie and he was asking about his weight loss stalling, and how important is exercise? Most of us told him "diet first, exercise second," and of course someone had to pipe in with the IF stuff, as they always do.

Someone also suggested that people that start to exercise reward themselves with more food, and they don't realize how few calories they actually burned by exercising so they over compensate.. There goes that calorie theory crap again!

There is also a good discussion (a separate thread) on carb cycling to get leaner, and the person who started it was wise enough to note that he was talking about people who are already fit, not everyone.

See the pattern? We need an explanation that can help us distinguish when the advice the gym rats are giving everyone (assuming everyone is like them) is applicable. This applies to IF, carb cycling, and ramping up the exercise.

Sometimes the discussion deteriorates to "calorie theory" and sometimes it becomes, "Well only a few people are a hormone wreck, I'm talking about most people, etc.."

Maybe this "Leptin Theory" is a more specific hormone theory that can help us understand what works for who and when.

Makes sense to me, maybe the gym rats are right when they are talking to other gym rats, and the rest, if we could lump it together as leptin resistant, then that's a separate approach. I don't care what we call it, we just need some clear way to sort out all this conflicting advice that makes some sense.

DFH's blog for diet and health: http://dietforhumans.com/

Advanced Low-Carber



Apologies need to be made


He he

Senior Low-Carber



Why the 50g of protein with 30 minutes of rising? I never feel hungry till I've been up a couple hours.




Expert Low-Carber



A few observations:


I've read Dr. Kruse's posts on leptin, although I confess I have not read everything else on his site. I don't see the reasoning behind his recommendations for restoring leptin sensitivity. I agree with you, marilynb, I'm not hungry first thing in the morning, either, usually, and eating when I'm not hungry seems to be one of the reasons I got fat to begin with (my mother was constantly making me eat now so I wouldn't be hungry later--not that I'm blaming her, she was doing the best she could).

I also do not see anything about how leptin sensitivity is lost, and it seems to me that would be crucial to knowing how to restore it. However, I have read a theory about it here:

http://wholehealthsource.blogspot.com/20...ctins.html

Quote:Something about our modern lifestyle tricks the body into deregulating this system. It could be damage to the small intestine, direct interference with leptin signaling, vitamin deficiency or something neurological like sugar messing up appetite control. Or something else.

Any way you slice it, the treatment is the same: grain (esp. wheat) avoidance; carbohydrate restriction; intense, intermittent exercise and/or strength training; intermittent fasting. I think the first two are the most important.

and here:

http://wholehealthsource.blogspot.com/20...rt-ii.html

and here:

http://wholehealthsource.blogspot.com/20...t-iii.html

Stephan Guyenet believes wheat lectins, and possibly other lectins, binding to leptin receptors, create leptin resistance.

Dr. Kruse posts:

Quote:Here are my questions for assessing a patients leptin status…….. Do you notice you sweat more and have less muscle fatigue when you do exercise now? Have your carb cravings gone away? Is your hunger under control now? And are you waking up more refreshed?

Even doing Atkins induction, I could not answer "yes" to those questions until I stopped eating wheat and sugar/sweeteners and began intermittent fasting.

Senior Low-Carber



But what I think Dr Kruse is saying is that IF is not good for people who are still leptin resistant; it's only for those who have regained their leptin sensitivity or who never lost it.


However, I'm skeptical about this whole emphasis on leptin, as though it were proven beyond doubt.

If there was so much widespread evidence for the importance of leptin, and leptin resistance or leptin sensitivity, why didn't Gary Taubes give it more emphasis in GC, BC (one mention in the prologue), or in WWGF (no mention in the index)?

And why hasn't (as far as I can see) Dr Kruse cited some published primary sources?


His own clinical experience may well validate his hypotheses to himself, but patient confidentiality means they can never be open to public scrutiny

Junior Low-Carber




Someone also suggested that people that start to exercise reward themselves with more food, and they don't realize how few calories they actually burned by exercising so they over compensate.. There goes that calorie theory crap again!

[...]
Sounds like a loose regurgitation of something they *heard* was in Taubes' book regarding exercise for weight loss

Liz Wolfe
Steve's Original
Cave Girl Eats

Advanced Low-Carber





However, I'm skeptical about this whole emphasis on leptin, as though it were proven beyond doubt.

If there was so much widespread evidence for the importance of leptin, and leptin resistance or leptin sensitivity, why didn't Gary Taubes give it more emphasis in GC, BC (one mention in the prologue), or in WWGF (no mention in the index)?

And why hasn't (as far as I can see) Dr Kruse cited some published primary sources?

My Answer........IF is a terrible idea if youre leptin resistant. When youre sensitive it is perfectly fine. If you IF too early you can increase cell death via autophagy. Not good. I answered the Gary Taubes issue in the comments. Solving leptin resistance is easy and does not violate HIPPA.


His own clinical experience may well validate his hypotheses to himself, but patient confidentiality means they can never be open to public scrutiny

Come visit me at http://www.jackkruse.com to Optimize your Life.

Advanced Low-Carber



There are over 30,000 article on pub med.....on leptin. The answers are there. Gary focus was on why no one was reading the literature on carbs. His point was taken. Leptin is tied to carbohydrate metabolism in higher centers. (brain) not insulin. Insulin only is a transporter protein to adiposity and muscle entry for oxidation.

Come visit me at http://www.jackkruse.com to Optimize your Life.

Expert Low-Carber



My Answer........IF is a terrible idea if youre leptin resistant. When youre sensitive it is perfectly fine. If you IF too early you can increase cell death via autophagy. Not good... .
Thanks for answering. This is what I suspected, kind of.

I hadn't thought of cell death via autophagy. I had been thinking that if someone starts out with no issues, extended IF will HAVE to kick in the famine response at some point, detected by higher rT3. I wasn't thinking that many people will already have this response start to surface due to leptin resistance and not calorie restriction (the brain doesn't know the difference). After reading your blog and Mastering Leptin, I can see the issue is more this:

People who already are leptin resistant need to get their resistance solved before IF. The people who recommend IF for weight lose troubleshooting need to back off and understand this better.

Also-

Insulin resistance (high fasting insulin, high triglycerides) and leptin resistance are closely related. If you are insulin resistant find it difficult to lose weight, you are likely leptin resistant too and the same cautions on IF apply.

IF is for people who don't have these resistance issues and just want to make a fit body more fit.

BTW-I discussed this with my doc from Holtorf Med yesterday also. He said there was a leptin number to test for? When I started going there, they tested for signs of insulin resistance. Since then, they added leptin as well. I didn't get the leptin test because the other numbers normalized. I think we added leptin to my next lab anyway just to see.

DFH's blog for diet and health: http://dietforhumans.com/

Advanced Low-Carber




In other words it is not good for 95% of the people who are on low carb forums, which is where it is being pushed over and over and over. Almost fanatically.

I suspect Dr Kruse is about to be attacked big time.

Just by mentioning this science, he will have disturbed a very large hornets nest

Expert Low-Carber




In other words it is not good for 95% of the people who are on low carb forums, which is where it is being pushed over and over and over. Almost fanatically.

I suspect Dr Kruse is about to be attacked big time.

Just by mentioning this science, he will have disturbed a very large hornets nest
Get out the torches and pitchforks!

I think it depends on the forum. The 95% may be a bit high. Mark's Primal forum seems to have a pretty even mix of people wanting to lose that have issues, and people that want to tune up. The IF crowd is truly fanatical and single minded for sure. You question IF, it's like stirring up the faithful in church.

It is very much true that pro-IF folks are telling nearly everyone to IF, and many people believe it. That is what worries me a bit. The "It works for ME" argument is weak, considering the science behind it.

I have looked around leangains a bit and have not seen a single "don't do this yet until...." statement anywhere. The site is just a one-sided fanatical rant to do IF from beginning to end.

DFH's blog for diet and health: http://dietforhumans.com/

Advanced Low-Carber




In other words it is not good for 95% of the people who are on low carb forums, which is where it is being pushed over and over and over. Almost fanatically.

I suspect Dr Kruse is about to be attacked big time.

Just by mentioning this science, he will have disturbed a very large hornets nest

Dave who cares if the attack me.......why? The best part about science is that whether you believe it or not it is still truth. There is a reason a fat person does not loose weight with exercise initially. In fact it makes them feel worse. The reason is the biochemistry of UCP3. Once you get a new thought it could change your life and DNA forever.

Read my blog today about Chasing Change. I think this clearly explains how I think and how I practice and what you need to do as patients to effect the change you seek.

Come visit me at http://www.jackkruse.com to Optimize your Life.

Expert Low-Carber




In other words it is not good for 95% of the people who are on low carb forums, which is where it is being pushed over and over and over. Almost fanatically.

I suspect Dr Kruse is about to be attacked big time.

Just by mentioning this science, he will have disturbed a very large hornets nest

Dave who cares if the attack me.......why? The best part about science is that whether you believe it or not it is still truth. There is a reason a fat person does not loose weight with exercise initially. In fact it makes them feel worse. The reason is the biochemistry of UCP3. Once you get a new thought it could change your life and DNA forever.

Read my blog today about Chasing Change. I think this clearly explains how I think and how I practice and what you need to do as patients to effect the change you seek.
This is all great stuff Dr Kruse. I think we all owe you a big thanks for helping us sort out these topics.

I already have a Part 2 on IF thought up for my blog, and I'll be writing it today. I hope it's OK if I grab a few of your quotes on here and I'll link to The Quilt and to here.

The IF fussing is a lot more intense on Mark Sisson's forum, and I wasn't sure if I should use your quotes because maybe you wouldn't want to get in the middle of it. I'll do my best to be fair and if I screw anything up, I hope you will set me straight.

I talked to my doc at Holtorf Med about this yesterday, and I'll use some info from Mastering Leptin too, even though I don't agree with their negative comments about Atkins.

I think understanding leptin is a complement to Atkins, or any low carb approach.

BTW-My own doc does IF too! He said a good source is Burke. I looked on Amazon and the only Burke was a woman that does some expensive sports nutrition textbooks. Same person?

DFH's blog for diet and health: http://dietforhumans.com/

Advanced Low-Carber




In other words it is not good for 95% of the people who are on low carb forums, which is where it is being pushed over and over and over. Almost fanatically.

I suspect Dr Kruse is about to be attacked big time.

Just by mentioning this science, he will have disturbed a very large hornets nest

Dave who cares if the attack me.......why? The best part about science is that whether you believe it or not it is still truth. There is a reason a fat person does not loose weight with exercise initially. In fact it makes them feel worse. The reason is the biochemistry of UCP3. Once you get a new thought it could change your life and DNA forever.

Read my blog today about Chasing Change. I think this clearly explains how I think and how I practice and what you need to do as patients to effect the change you seek.
This is all great stuff Dr Kruse. I think we all owe you a big thanks for helping us sort out these topics.

I already have a Part 2 on IF thought up for my blog, and I'll be writing it today. I hope it's OK if I grab a few of your quotes on here and I'll link to The Quilt and to here.

The IF fussing is a lot more intense on Mark Sisson's forum, and I wasn't sure if I should use your quotes because maybe you wouldn't want to get in the middle of it. I'll do my best to be fair and if I screw anything up, I hope you will set me straight.

I talked to my doc at Holtorf Med about this yesterday, and I'll use some info from Mastering Leptin too, even though I don't agree with their negative comments about Atkins.

I think understanding leptin is a complement to Atkins, or any low carb approach.

BTW-My own doc does IF too! He said a good source is Burke. I looked on Amazon and the only Burke was a woman that does some expensive sports nutrition textbooks. Same person?
Yes I think so. The real issue for me is that on all these forums we dont have a lot of understanding of both research, basic sciences and clinical medicine. This is where I think I have a big advantage. I live in all three realms. So does Dr Deans. Researchers like Taubes, Masterjohn, and Guyenet all have a very good command of their fields but their view is "myopic" about what is going on because they have focused in on one area of the research in a very intense fashion. As a clinician I have to have a 30,000 foot view of it all. Many o fmy collegues have that view but dont command the research or the latest known in biochemistry and physiology. The system is not set up to do that. You have to be self motivated to do so. And they way medicine is these days docs are getting crushed so I dont see them being the change force yall need. That is why I want you patients to realize this and help them change.

And I have read enough to have a myopic view of what they know and what occurs within a cell at a biochemical and physiological level. They factor for clinical medicine is that hormones are what control th eentire process. The problem for obesity and diabetes is that we focus on insulin which is not the major issue. It is distal to the real problem. Leptin. This story is very similar to what has been happening in heart disease research for 50 yrs. We believe it caused by cholesterol and fats in medicine when the real target is carbohydrates and omega 6 FFA. The low carb community needs to realize if it were all about insulin only we should have slayed the dragon with treating insulin resitance. Well medicine does that now. How is that working out for Diabetics? They are dying at record numbers and the recent ACCORD data says they die on avg 6 yrs earlier with IDEAL treatment. That tells you something is amiss. We are aiming at the wrong target. My blog is about optimizing all life and disease by tying it all together. As I lay it out you will begin to see how it is all tied together.

Come visit me at http://www.jackkruse.com to Optimize your Life.

Advanced Low-Carber



Dr. Kruse, your enthusiasm is contagious! You have a lot to offer with your knowledge and motivation. Many thanks to you and to Jimmy for all you do!

Senior Low-Carber




And I have read enough to have a myopic view of what they know and what occurs within a cell at a biochemical and physiological level. They factor for clinical medicine is that hormones are what control th eentire process. The problem for obesity and diabetes is that we focus on insulin which is not the major issue. It is distal to the real problem. Leptin. This story is very similar to what has been happening in heart disease research for 50 yrs. We believe it caused by cholesterol and fats in medicine when the real target is carbohydrates and omega 6 FFA. The low carb community needs to realize if it were all about insulin only we should have slayed the dragon with treating insulin resitance. Well medicine does that now. How is that working out for Diabetics? They are dying at record numbers and the recent ACCORD data says they die on avg 6 yrs earlier with IDEAL treatment. That tells you something is amiss. We are aiming at the wrong target. My blog is about optimizing all life and disease by tying it all together. As I lay it out you will begin to see how it is all tied together.

Dr Kruse, I have already replied to your blog, and I don't mean to go on at you, but I will add a couple of comments here.

I question some of the things you write, but I do admire what you are trying to do, so if I come over as critical, please try not to take it too badly. I am trying (as a non-scientist, although worked in a scientific background all my working life) to be scientifically honest, and not just accepting propositions at face value, but testing and challenging them. This is part of the scientific method, as I'm sure you would accept.


Slain the dragon of insulin resistance? Of course medicine hasn't done that, and Gary Taubes already told us why, and what we need to do about it. That doesn't mean that insulin is not the problem.

"We are aiming at the wrong target" - And you are now certain that leptin resistance is the right target. So how's that going? Did injecting obese people with leptin make them normal? No, not as far as I know. Now that doesn't necessarily prove it's not leptin that's the issue, but it does make one stop to think about it.

If you care to go over to Stephan Guyenet's blog, you will find a (rather vociferous) commenter there who says that leptin didn't make her lose excessive weight - she did that by low-carbing. But then she found problems in keeping the weight off, and found that leptin injections then seemed to help her keep the weight off and not be hungry, cold and tired all the time.

She has a hypothesis as to why: An ex-obese person slimmed down to BMI=22 is not the same as a never-obese person BMI=22: She has a lot more fat cells, only they are now shrunken, and not producing enough leptin for her body mass. The only way she could produce enough leptin to be in balance and not be hungry would be for the fat cells to grow again, i.e. to get fat again. (Curiously, Gary says something similar in GC, BC without mentioning leptin). It's an interesting story and theory. Her "handle" is (IIRC) "It's the woo2". She doesn't believe leptin resistance was her problem. If that was the case, her leptin injections wouldn't be working (and they are very low dose)· Leptin is playing a part, but it may not be the key part, as you believe. Admittedly, by her own admission, she has had a difficult hormonal history, and may not be representative of the average obese person. On the other hand, she probably has more practical experience of leptin than most of us here.



Regards,
Mike Ellwood

Expert Low-Carber



I don't think that injecting people with leptin is known to fix anything we are talking about.

I'm trying to think of a simple way to explain insulin and leptin resistance.

If I have this right, insulin resistance is about cells mis-communicating with each other. Leptin resistance is about your fat tissue mis-communicating with your brain, and your brain communicates with your endocrine system-its complicated.

You can go low carb and do things to address insulin resistance, and possibly improve leptin sensitivity at the same time without even knowing what leptin is.

In fact, this is what I did myself. My doc was working on my high triglycerides and insulin (insulin resistance) and went after the high rT3 by changing thyroid meds. Now that the numbers are in line, you could say this was addressing leptin too, and we just didn't talk about it! Who cares really, as along as you get where you want to be?

I talked to my doc about this last week and he agreed with the above. He started adding a check for what he called a "leptin number," for his patients and he added it to my next lab just to see-but he said we pretty much covered it already.

DFH's blog for diet and health: http://dietforhumans.com/

Expert Low-Carber



Quote:The Ob mouse is a strain of mouse that has a genetic mutation that makes it obese and unhealthy. It has been used for many years as a model of obesity to do research on, though the reason that it was obese had eluded scientists. This changed when, in 1994, Jeffrey Friedman discovered that this mouse lacked a previously unknown hormone called leptin, and when it was injected with leptin it became thin, vibrant, and very healthy within weeks. This made headlines around the world, "the cure for obesity found" and pharmaceutical companies started tripping over themselves with trillion dollar signs in their eyes to be the first to genetically manufacture leptin on a large-scale. This did not last long. When people were tested for leptin, it was found that, unlike the Ob mouse, they did not lack leptin; on the contrary almost all overweight and obese people have excess leptin. These people were "leptin resistant" and giving extra leptin did little good. The financial disappointment was extreme and scientists working for pharmaceutical companies said that leptin wasn't important anymore since they could not find a drug to control it, and therefore the industry couldn't make money on it. To make big money in medicine one needs a patent and this generally means remedies which are not commonly or easily available -- that are not natural. This illustrates two extremely unfortunate principles in modern medicine; only those therapies that will make lots of money (generally for the pharmaceutical industry or hospitals), ever get pursued and then taught to physicians (since most of medical education after medical school takes place by drug reps), and these therapies, almost by definition, will be unnatural. This inhibition of extremely important knowledge is not only unfortunate, it is deadly, and is exemplified by how few people, including doctors, know anything about leptin, though I would consider it to be the most important chemical in your body that will determine your health and lifespan.

http://drrosedale.com/resources/pdf/Lept...0aging.pdf

DFH's blog for diet and health: http://dietforhumans.com/