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“The central concept…is that improving the quality of what we eat will reprogram fat cells to store fewer calories…” David Ludwig, MD, PhD, Always Hungry? (Grand Central Life Style, 2016) 

Unlock Your Fat Cells

Forget Calories, Think Quality and Satisfaction

Harvard professor David Ludwig, MD, PhD, is rewriting the rules of diet and weight control.

To lose weight, eat less and move more. That’s what we’ve been told. Calories in, calories out; they’re all the same. Cut carbs, fat, portion size, or anything else that cuts calories. If you’re really serious, cut fat, because that’s where the calories are; fat has twice as many calories as carbohydrate or protein.

The problem is that it doesn’t work. Those who do manage to lose weight usually gain it all back—and more. Only a small percentage of people—perhaps ten percent—lose weight and keep it off.

I’ve long said that diets don’t work because they leave you feeling hungry and dissatisfied. That the secret lies not in how much you eat, but what you eat. If you eat the right foods you can eat as much as you want and still lose fat; it's actually hard to overeat. What happens is you become full and satisfied before you take in more calories than you burn. My eating philosophy is summarized here: http://www.cbass.com/PHILOSOP.HTM

 This photo was taken by my father in August of 1964.
 I was 26 and weighed almost 200 pounds.

It has worked wonderfully well for me. While I’ve never considered myself fat, I was pretty chucky in my Olympic lifting days, topping out at 200 pounds. (My first wife was not pleased.) I took the excess weight off preparing for physique competition in my 40s, and never looked back. My lifetime training pictorial shows that I’ve kept the weight off; over 35 years later and I’m still lean and muscular: http://www.cbass.com/PICTORAL.HTM

I’ve had it right for a very long time. I understood that we are programmed by nature to eat when we’re hungry. It’s in our genes. Our ancient ancestors ate all they could hold when food was available, so they could survive when food was scarce. Those that didn’t eat didn’t survive to pass on their genes. We must adjust to modern times of plenty or continue to grow fat.

What I didn’t fully understand is how weight control works at the metabolic and cellular level. David Ludwig, MD, PhD, a practicing endocrinologist who specializes in obesity prevention and treatment, addresses those issues brilliantly in his book Always Hungry? (Grand Central Life & Style, January 2016).

I’m excited and I believe you will be as well.

Calorie Type Affects Burn

Let’s start with a study by Dr. Ludwig and colleagues which tests the belief that calories are all the same. (JAMA, June 27, 2012)

“Are we really to believe that, for someone on a diet, a cup of cola with 100 calories would make a better snack than a one ounce serving of nuts containing almost 200 calories?” Ludwig asks in introducing the study in his book. He calls that flawed thinking. “Recent studies show that highly processed carbohydrates adversely affect metabolism and body weight in ways that can’t be explained by their calories content alone,” he explained.

The researchers examined 21 overweight and obese young adults after they had lost 10 to 15 percent of their weight on diets ranging from high carb and low fat (60% carbs, 20% fat, and 20% protein) to high fat and low carb (60% fat, 30% protein, and 10% carbs). Despite consuming the same number of calories on each diet, the participants burned about 325 calories a day more on the high fat/low carb diet than on the high carb/low fat diet. Simply put, digesting the high fat-low carb diet (think the nuts) speeded up their metabolism.

“The results of our study challenge the notion that a calorie is a calorie from a metabolic perspective,” the researchers wrote. “Total energy expenditure differed by…an effect corresponding with the amount of energy typically expended in one hour of moderate-intensity physical activity.”

“So the type of calories we eat can affect the number of calories we burn,” Ludwig writes in Always Hungry? All calories are not the same. The type of food we eat can help—or hinder—weight control by speeding or slowing our metabolism.

That’s only the beginning of what Dr. Ludwig has to tell us.

Here’s his breakthrough theory—not fully proven—in a nutshell. We’ll look at the underpinnings next and then the implementation.

Hungry Fat Cells

Ludwig says that fat cells play a key role in determining how much weight we gain or lose. Fat cells often feast while the rest of the body starves. They suck up calories, triggering shortages elsewhere. The brain responds by sending out hunger signals and slowing metabolism. This sets off a vicious cycle that makes us eat more and grow fatter. Low-fat and low-calorie diets work against us by triggering fat cells to hoard more calories, and the obesity epidemic continues.

The solution is to eat high quality foods that keep us satisfied without setting off alarm bells. Energy in and energy out comes into balance. Our fat cells relax and slowly burn off their excess, putting us on the path to leanness.

It rings true. Logical. Let’s look at the supporting science.

Body Fat Critical to Survival

While we tend to think of it as an ugly nuisance, the truth is that body fat is a highly specialized organ crucially important to our wellbeing. Among other things, it protects us against starvation and death.

Dr. Ludwig explains that the calorie requirements of our brain are enormous—and absolute. “Any interruption would cause immediate loss of consciousness, rapidly followed by seizure, coma, and death.”

Our ancient ancestors often went for long periods without food. The key to their survival was body fat.

If we go more than a few hours without eating, our body must look to stored fuels for energy. The carbohydrate in the liver and protein in muscle are in dilute forms, while stored fat is highly concentrated. Pure carbohydrate and protein have less than half the calories of pure fat, making them relatively weak sources of energy.

“In the absence of body fat, even a muscular man would waste away in days without eating,” Ludwig explains, “whereas all but the leanest adults have enough body fat to survive many weeks.”

Moreover, fat cells are far from inert. They actively take up excess calories soon after meals and release them in a controlled fashion at other times, according to the body’s needs. “When fat cells malfunction, big problems ensue,” Ludwig writes.

So it’s no surprise that fat cells can become hungry hoarders—and make us overeat. When fat cells feel threatened, nothing else matters. Certainly not how you look at the beach.

Dr. Ludwig says it’s Endocrinology 101. What’s new is the application. He suggests that the usual way of thinking about obesity is backwards. “Overeating hasn’t made our fat cells grow, our fat cells have been programmed to grow, and that has made us overeat.”

You’ll find the results of his team’s 16-week pilot study and hundreds of other supporting studies spread throughout Always Hungry? Beyond that, he invites readers to try his program and judge for themselves.

With that background, let’s examine how low-quality diets make and keeps us fat—and how high-quality eating puts us on the road to leanness and health.

Low-Quality or High-Quality Effects

Ludwig cites numerous studies showing that food quality has profound effects on both body weight and body fat, starting with a study published in The Lancet.

Ludwig and colleagues examined two groups of rats fed diets differing only in carbohydrate type. One group ate the kind of starch found in beans, which digests slowly. The other group ate the kind of starch found in white potatoes, which digests quickly. They altered the total amount of food given to each group to keep their average weight the same throughout the 18 week study (about 15 rat years).

The results were two fold. First the animals eating the fast-acting food required less food compared to those eating the slow-acting food to prevent excessive weight gain—“evidence that their metabolism was slowing down.” Secondly, they analyzed body fat distribution. Even though both groups weighed exactly the same, the rats on the fast-acting carbohydrate diet had 70 percent more body fat, and a commensurate reduction of muscle tissue. (Amazing)

“These findings completely defy the calorie-balance theory of obesity,” Ludwig observes. “Despite having consumed less food, [the group eating the fast-acting carbs] had more fat."

It works the same way with humans. Researchers from Israel and Harvard assigned adults with large waistlines to either low fat or Mediterranean type diets (good fat), and measured changes in body fat over 18 months. “Preliminary analyses suggest that the diets had profound differences on fat content in the abdomen, heart, liver, pancreas, and other organs, above and beyond weight loss,” Ludwig tells us. (Study results unpublished)

Penn State researchers had similar results feeding 48 adults high-fat almond or high-carb muffins for six weeks each. “Belly fat decreased significantly while the participants consumed the almond-containing diet,” Ludwig writes.

Finally, several other large studies provided consistent messages about highly processed carbohydrate. “Topping the list for weight gain were potato products and sugary beverages, with refined grains not far behind,” Ludwig writes. “In contrast, nuts, whole milk, and cheese either had no relationship with weight gain or were associated with weight loss. So it seems that those high-fat foods we’ve been avoiding for decades may be key to losing weigh after all!”

Yes, how about that.

How does Dr. Ludwig suggest putting these enlightening revelations to work? It’s weight management with a smile, the only kind that really works.

Reprogram Your Fat Cells

Forget Calories. Focus on Quality. Let your body do the rest. So simple and so powerful.

“As the body begins to enjoy better access to fuel, metabolism runs better, hunger and craving subside, and weight loss occurs naturally” he explains. “It’s diet without deprivation.”

Ludwig says that man has “enormous flexibility” in the ratio of macronutrients; humans have for the most part been able to subsist on whatever the environment offers. Inuits in the Artic could survive almost exclusively on sea and land animals. At the other end of the spectrum, many hunter-gathers eat plant-based diets, with meat as a supplement.

He proposes a three-phase plan which settles into roughly 20 percent protein, 40 percent fat, and 40 percent carbohydrate.

He explains that protein in the right amount counter-balances blood sugar/insulin spikes and other negatives of carbohydrate. Too much can challenge the liver’s ability to process amino acids resulting in buildup of ammonia to toxic levels. Eggs are fine and “the scientific evidence provides no reason to banish animal products.”

Fat is important because it slows digestion and helps you feel full for hours after eating.

Ludwig says we can survive without carbohydrate, but he doesn’t recommend it; “very-low-carbohydrate diets can be quite challenging…and the possibility of adverse effects has not been ruled out.”

His program calls for whole, natural, slow-digesting foods. That’s important, because that kind of food is satisfying and stays with you longer. It fills you up without overshooting your energy needs. It calms your brain—and allows your body to give up excess fat.

Ludwig stresses that the type of carbohydrate “matters critically.”

“All carbohydrate breaks down into sugar, but the rate at which this occurs in the digestive tract varies tremendously from food to food,” he explains. “Highly processed grain products—like white bread, white rice, and prepared breakfast cereal—and the modern white potato digest so quickly that their Glycemic Index ratings are even greater than sugar (sucrose),” he continues. In contrast, minimally processed grains, non-starchy vegetables, whole fruits, beans, nuts, and unsweetened dairy products digest more slowly—and “have far more gentle effects on blood glucose.”

The type of fat is also important.

Fat for Fat Loss 

As noted above, thinking on dietary fat and weight gain is changing. Dr. Ludwig relates two recent studies showing that, as in the case of carbohydrate, all fat calories are not the same.

In one trial, normal weight adults were overfed 750 calories a day with muffins containing either saturated fat (from palm oil) or polyunsaturated fat (sunflower oil). After seven weeks, both groups gained about 3 pounds, as expected, but total body fat and liver fat were significantly greater in the saturated fat group, whereas lean body tissue was greater in the polyunsaturated fat group.

In the second study, young adults received diets that were high in either saturated (palmitic) or monounsaturated (oleic) fat during two separate periods. Otherwise, the diets were the same. “Remarkably, participants consuming the saturated fat diet had slower metabolic rate at rest, were spontaneously less physically active, and reported higher levels of anger and hostility.”

Complicating matters still further, not all saturated fats are alike. What you eat the fat with also makes a difference.

Saturated fat and processed carbohydrate is an especially dangerous combination. “So without bread, butter may be relatively benign,” Ludwig observes.

On the positive side, Ludwig says that the saturated fats in dairy appear to be healthier than the saturated fat in red meat.

Ludwig recommends eating unsaturated vegetable fat, along with some dairy and fish.

There’s no reason to avoid plain whole milk and cultured full-fat yogurt, says Dr. Ludwig. “A dash of heavy cream with fresh berries makes a much healthier dessert than the usual sugar-laden options,” he delights in telling us.

His program also includes several servings of fish each week to provide omega-3 fats. “Vegetarians can satisfy this nutritional requirement with flax oil and some types of nuts, but the omega-3 fat in plants is short chain and somewhat less efficient in the body,” he adds. (Emphasis mine)

*  *  *

I have merely given you an overview of Dr. Ludwig’s breakthrough book. I hope it’s enough to make you want to dig into the details. I’ve focused on weight control, bypassing the health aspects, which are a major upside of the Always Hungry? program. Part Two of the book—the How To section—is twice the size of the science section I’ve keyed on. The meal and physical activity plans alone are worth the price of you book. Ludwig tells you everything you need to know to put his exciting weight loss and health plan to work in your life. If anything, he makes it too easy.

Read Always Hungry? Do it now!

My Take

I love Dr. Ludwig’s “hungry fat” theory of weight control. Why shouldn’t I? I was describing—and using—my own version of quality eating more than a decade before he completed medical training in the 1990s. Admittedly, I didn’t fully understand the underlying physiology; I doubt if anyone did. I give Dr. Ludwig full credit for that. Thank you, Dr. Ludwig!

I didn’t discover the importance of good fat until some years later, or know that all calories are not the same. But I understood and practiced dieting without deprivation—and never counted calories or macronutrients. That (along regular exercise) has made and kept me lean and muscular for over 35 year.

Dr. Ludwig invites readers to report the results of high quality eating. I began doing that in 1980.

I wrote this in my first book, RIPPED: The Sensible Way to Achieve Ultimate Muscularity (1980):

Self-discipline is the problem: It’s hard to discipline yourself to eat fewer calories than you burn. I found the solution to this problem. I discovered by eating only natural, unprocessed foods, you avoid almost all concentrated calorie foods, and you won’t overeat. You’ll become lean.

People marveled at my results but questioned my diet. Many said (or thought) it was too good to be true. That I was oversimplifying or just didn’t understand how weight control works for most people.

Now I have a plethora of new support for my approach. Thank you again, Dr. Ludwig.

March 1, 2016

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