I’ve been wanting to do some of these for a while now, and just decided that today is the day for them. So buckle up, it’s bout to get flowy.
Okay, first off, here’s an awesome flow chart drawn up by Robb Wolf.
Also, here’s another couple of flow charts that are more about asking questions than answering them. I don’t think there’s any 100% consensus on this stuff yet, just some different hypotheses with varying levels of support. Hopefully we will do some science to this issue and get it figured out.
This is sort of the “accepted causation” flow of how people get the metabolic syndrome. You eat too much, don’t move enough, you put on weight because your calories in are greater than your calories out. The increased adipose tissue causes insulin resistance, which eventually blossoms into full-on diabetes, and then you are on the fast track to heart disease, cancer and strokes. Also, amputations. Sometimes people skip a step, but they’re outliers and they don’t matter. These are the skinny folks with type 2 diabetes. If excess body fat causes diabetes, why do you have skinny people with diabetes? Anyway, that’s neither here nor there.
Okay, here’s another flow:
Under this model, overconsumption of carbohydrates is what’s screwing you over in the first place. Specifically fructose, and specifically refined fructose in the form of sucrose and high-fructose corn syrup. That junk is processed in your liver and forms lipid droplets which gives you non-alcoholic fatty liver disease and bunches of other problems. If you want to know how this works, here are some great sources: Sugar: The Bitter Truth, Is Sugar Toxic?, Sugar 101 Essentially, sugar is bad, mostly because of fructose. A lot of cultures eat significant amounts of starch (which breaks down only into glucose) but not much sugar, and they don’t have obesity and diabetes problems. They also don’t have the rates of heart disease that Americans do. A healthy person, relatively lean, with good insulin sensitivity, can eat a fair amount of starch without much negative effect. In fact, if you’re a very active person, eating some starch is probably very good for you, as it repletes your glycogen stores. For the average, overweight American looking to slim down, starch needs to be reduced, which is why you see so much success with low-carb diets and overweight people. It gives their pancreas a rest and they get to rebuild some insulin sensitivity.
So there you go. Two competing models of what causes insulin resistance, both of which with some scientific backing. The biggest confusion comes when you throw epigenetics into the mix. Epigenetics is what happens when your environment interacts with your genes. Some people are just wired up to be leaner than others, and they can stay lean even if they’re insulin resistant. So maybe the real word we’re looking for here is “contribute” rather than “cause.” Because there are people who can eat cakes and pies and candies all day and not gain weight or develop diabetes or anything else. They’re just genetically lucky. There are some people who seem destined to be thick, no matter what they do. Some people are genetically inclined to be addicted to alcohol. Does that mean that their genes will make them alcoholics even if they never drink? Obviously not. It’s all about predisposition and how your choices interact with your genes. You do have some measure of control, you just have to determine what you can get away with before you start flipping unfortunate switches in your body.
There’s also another possibility and that is that it’s a combination of all of these things. Maybe you start eating too much sugar which starts a little bit of insulin resistance, which then starts fat to piling up on your booty. The fat then sends some hormonal signals telling your body to keep it up with the insulin resistance. Maybe? I don’t know. It seems plausible, right? Hormones are really the big culprit here. To steal an analogy from Taubes (again) your hormones are what make you grow taller, and they inspire hunger so you’ll eat enough to fuel that growth. Why should we assume that our hormones govern that growth but have nothing to do with our girth growth? It’s not like eating too much makes some people taller, right? Kids aren’t growing because they’re eating so much, they’re eating so much because they’re growing. So I think it’s silly to discount the role of hormones in weight gain. It seems like they have to have something to do with it. Since hormones control feelings of hunger and satiety, that’s as good a mechanism as any to get you to stuff your gob.
Okay, so hopefully that made sense or clarified something or made you think or all of the above.
That’s probably enough for now. I had some other ideas, but they’re best saved for another post. So there you go. Some flow charts. Fun, right? Don’t act like you don’t love it.