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Dr. Paul Mason – ‘Low Carb from a Doctor’s perspective’

So, my name is Dr. Paul Mason, I am a PhD in sports and sports medicine Today I want to take you on a trip Explore the science supporting low-carb diets and the process I hope you take something with you. first of all We want to debunk the "low-calorie" and low-fat hypothesis for weight loss. I want to tell you that a low-carb diet is actually good for longevity People live longer when they eat low carbohydrates The sugar cause fructose has some unique and toxic effects on the body.

Therefore, in order to start our journey, I would like to introduce you to one of my patients Now this is the kind of patient as a doctor. I like that she is very compliant So she came to my clinic for the first time with joint pain She is overweight and knows very well For both of us, if she can lose some weight that can help her regain her strength So we had a conversation And started talking about her existing weight loss attempts It seems she has a very traditional way Most doctors recommend: eat less and low fat Let's listen to her in her own words I'm making all the low-fat, you see my refrigerator is full of low-fat cheese No oil touches any frying pan in my kitchen All the meat is as thin as you eat, I ate it Salad and I have been starving You exercise madly six days a week I am doing these courses.

I am doing back-to-back courses. So behind our popular course is a pump class and Six days a week. So, then I felt very guilty on the seventh day Because i don't exercise and so She follows traditional advice She blindly followed this advice. She is exercising She is eating low fat, but the problem is that it does not work properly. At the time she saw that I was 30 kilograms overweight and was increasing.

And so When I faced this situation as a doctor, I had to ask myself Who is in charge? ¿ Who should be blamed? Therefore, patients follow the medical advice they have given So the patient or the doctor or medical professional gave advice? So I think doctors or medical professionals should be blamed Because the meaning of the suggestion is like this If you didn't lose weight You are lazy, you are greedy You just didn't work hard enough But this premise ignores the key elements of understanding weight loss and hormones The traditional "calorie consumption" hypothesis Ignoring the role of hormones is very powerful science So we have a lady here.

She is 35 years old and she has a problem called hormones Cortisol, she just gained weight This is when her hormonal problems were treated, she did not get more exercise advice She was not told to eat less. We solved the hormone problem and the weight problem disappeared The boy is three years old here. He weighs 42 kg, and his leptin hormone has problems At the age of 7, he lost 10 kilograms and his weight is very healthy See what happens when you solve the hormone problem The most common now Hormones in people who cause obesity It’s not one of them, it’s called insulin, this lady has insulin problems, but she has a unique problem Her pancreatic tumor secretes insulin And pump it into her circulation in this picture.

She is 107 kg tall and only 152 cm tall So she had surgery to remove the tumor and lowered her insulin level Now these photos are taken 50 days apart Her weight dropped to 89 kg. She lost 18 kilograms. If we look at her weight loss chart You can see that she lost 14 kg in 10 days Obviously there is an insulin problem here. It makes you fat Now this patient also has insulin problems. This is one of the patients I met her here 46 years old, 20 years old This is what happened when we solved the insulin problem, she lost 40 kg Here, she is about 8 years old The biggest difference is that she did not have surgery to solve her insulin problem. We changed her diet So you might ask, on God’s green earth, how does diet lead to such drama Changes in insulin levels can cause you to lose so much weight. Let's take a look. This is a picture The height of the line there represents how much insulin your body releases And every line is like this Represents one of the three main sources of energy in our diet: carbohydrates Protein or fat So let's look at carbohydrates.

Let's see what happens when you eat carbohydrates to your insulin level This is called the area under the curve and you get a huge sum Extended insulin release for more than two hours Let's take a look at the same amount of energy contained in protein This is surprising to many people Less fat. So, consider that high levels of insulin are associated with obesity Carbohydrates are the most effective stimulus for the release of insulin in our body Therefore, in order to lose weight, we need to control insulin levels We need to control carbohydrate intake Now we can do a wide range of classification Eat here on the left side into one of two groups We have a so-called low-carb diet, on the right We have a low-fat diet and carbohydrates tend to be higher Because the energy must come from somewhere So let’s look at a fair view of the evidence Compare these two types of diets in terms of weight loss Between 2003 and 2018 There are 62 published randomized controlled trials Compare low-carb diets below 130 grams per day Low-fat diet for weight loss 31 studies are statistically significant what does this mean The result is unlikely to be accidental You might believe them So what I am doing here is that I have mapped these 31 studies that are statistically significant No cherries are picked here.

I compared the average weight loss of the two diets Low-carbohydrate diets are shown in blue, low-fat diets are shown in red And you will notice that in each of these studies, we have a low-carb diet Causes more weight loss than a low-fat diet So the question is which horse will you go back to? right now let us Change it a little bit, look at fat and see how insulin makes adipose tissue grow Because if we understand this, then when you are 2 years old, we can understand the causes of obesity Every fat cell you might have So if you gain weight after two years of age This is because your fat cells have grown larger, not because they have doubled So if we can find out what makes individual fat cells bigger Then we can determine what makes you fat So what I want to show here is what you can see How to circulate, these blood vessels are closely related to each blood vessel Now every fat cell can understand this hormone Released by circulation and because of this relationship with blood vessels It can be transported to every fat cell in our body These blood vessels also contain fats called triglycerides You can see here These wiggly lines are depicted there.

So the weight gain is these triglycerides Into the fat cells, the fat cells become larger. The problem is that this triglyceride molecule is very large It consists of four different parts You have this glycerin skeleton, and then you have three The separated fatty acid and the whole molecule cannot enter the fat cell It must be cut first, and this is where the insulin enters So you can see on the left We see the triglyceride molecule Then it is converted into glycerol and fatty acids It is cut off And LPL transfer lipoprotein lipase This is an enzyme stimulated by insulin Then, once the fatty acids are released, they can cross and store fat without the need for insulin to activate You cannot store fat with lipoprotein lipase.

If we look at the top there You can see that glucose can also enter fat cells It does this through a small doorway or a transport vehicle Gluteal muscle 4 transporter Again, insulin is the cause of activation of this transporter Once the glucose enters the fat cells It will be converted to glycerin Then glycerol will combine with fatty acids Then you will have a complete triglyceride molecule. This is the storage form of fat Now, if you want to really burn that kind of fat, you have to increase the damage As you know, it must be cut again to leave fat cells It cannot pass through the fat cell membrane and is clipped. It must be activated by or Enzymatic cleavage called hormone-sensitive lipase Insulin makes this enzyme shed So you finally got a triple blow Lipoprotein lipase and gluten four transporter are activated, filling fat into cells and cells Then you have hormone-sensitive lipase that is deactivated This way you can’t burn fat, so biochemical insulin is the cause of weight gain.

Therefore, it turns out that insulin can cause weight gain Let's take a look at what happens to people who habitually inject insulin On the same website for a long time It causes what we call fat hypertrophy The meaning of hypertrophy is now greater These two On the left and upper right corner These two gentlemen habitually inject insulin Enter these parts of the lower abdomen for a long time The person in the lower right corner Their preferred injection site is at the front of the thigh Approximately 20% to 30% of patients with type 1 diabetes Actually will eventually encounter this situation Because they inject insulin Long enough dose long enough No matter what happens For your perfect patient, you know Before seeing me, the person who followed low-fat exercise advice in a low-key manner 30 kg overweight Ok we had a discussion She reduced her carbohydrate diet She gained fat By doing this, she solved the insulin problem Then this happened Three years after the final calculation She maintained a loss of 36 kg Her waist shrunk 28 cm, this is her actual photo.

And so Let’s take a look at what carbohydrates are, which can lead to an increase in insulin obesity. So it started to understand that we have to look at what carbohydrates are Here we have a glucose molecule Go through the middle there. We describe what we call complex carbohydrates You know you are eating the carbohydrates of brown rice Whole wheat bread what you have been told is good for you It is made of glucose Is sugar Carbohydrates are made of sugar When you eat them and digest them They ended up in the blood Increase your blood sugar levels When you see Rod, he decides to eat some rice Let the glucose rise from the rice enter his veins And in response to this increase in blood sugar The pancreas is stuffed into ours The abdomen released something called insulin here And then the work of this insulin Yes delete The sugar we circulate It prioritizes our muscle tissue and liver tissue Then, if any leftover stuff gets stuffed into fat The problem is if your insulin levels are high Long enough This creates a disease called insulin resistance We know that when you eat carbohydrates The peak period when you get this insulin If you habitually do it six times a day Many people may have been recommended Your body becomes numb Reach high levels of insulin.

It's like you walk into a room with an unpleasant smell At first it was overwhelming, after a few minutes you won’t notice it anymore Same with insulin Except it mainly happens In muscle and liver tissue, so they stop taking sugar Your body compensates by releasing more insulin Then the body can fill the excess sugar into your fat tissue So this actually explains Why do many people come in and they say do you know When i was 20 years old I sit on the sofa and eat potato chips I am very thin without exercise As I grow older, I just gradually accumulate on the kilogram Nevertheless, this is still Health awareness I now go to the gym three days a week.

I eat salad now So the reason they gradually gain weight is because Over the years, this happened in 10 years or more They become insulin resistant We can actually test with my patients in my clinic We do a test, the patient will drink 75 grams of glucose Then we measure their glucose level and insulin level In the course of 2 hours with We can actually According to the results, assess their insulin resistance level.

Let's take a look So here red means insulin level The blue line represents the blood sugar level So this is a metabolically healthy person. We load them with glucose, two hours later Let's take a look They say that blood sugar has not exceeded the level it should be And the blood insulin is not above the level it should be very healthy Then in the first stage Insulin resistance or metabolism my health You will notice that inlsuline levels start to rise But it still does a good job of expelling sugar from the blood So blood sugar has not risen If you have a blood test, a standard oral glucose tolerance test is performed at this stage Your doctor will tell you that you are perfectly healthy. Don't worry about going home, you're all right However, you already have the first signs of insulin resistance. You may have gained weight at this stage As it progresses It started to wriggle a little bit. Insulin is even higher And this stage What your doctor would say: Oh, you are pre-diabetic Do you know, have you ever thought of doing a little exercise? Still not too worried about the whole process Then over time, this blood sugar starts to destroy the cells in the pancreas Release insulin So even if you are becoming insulin resistant, you need more insulin and your body produces less Then when your insulin level starts to drop, you will drop sharply Your blood sugar level will increase, that's when diabetes is diagnosed So let's take a look at a few examples So this patient is here Hypoglycemia Low insulin levels Completely healthy.

I like this comparison This patient may be a little bit here You can see that blood sugar is very low at 5.6 in two hours But you can see that insulin has now risen to 83 Okay, we are starting to see insulin resistance here. We are starting to run into problems Here you can see that the blood sugar has now surfaced Insulin is higher again Blood sugar rose to 8.3. Then what happens at a more advanced stage? Blood sugar 11.4 By the way, this was when diabetes was diagnosed under standard blood tests. Insulin levels have dropped Pancreas begins to fail Now that all this is fine, okay, you are a doctor You can test insulin resistance in the laboratory But many people want to know if they have insulin resistance Can they check by themselves And you will be interested to know that you can see a lot By observing the skin for signs of insulin resistance with I have a few patients here today, you know I will Check your skin These are the so-called skin tags The most common cause of skin tags is insulin resistance If you have a skin tag You can almost certainly have insulin resistance Many patients told me Well, I went to see my GP and asked them the reason in one sentence I don't know, but do you want me to burn them? They are a warning sign They are usually located in the armpits of the neck in the groin area This sign is called pay can ptosis nigricans Skin pigmentation We often see it in the armpit neck of the groin Or more interestingly on the back of the finger Wrinkled skin here And there is good research showing Even before you start to gain overweight you can see Changes on the back of the fingers Before anything else.

I can see some people look at their fingers now I see many patients are involved Their skin complexion problem, we found that when we improve insulin resistance Significantly improve the ketogenic diet lowers your insulin levels and your skin becomes better. This is very good. This is one of the reasons Acne is common in the state Puberty is because the state of puberty is related to insulin resistance Now is good news Must come We can actually change this If you continue a low-carbohydrate diet, reduce your chronic elevated insulin levels Your insulin sensitivity will increase Look at the insulin level of this patient here Three months later Big drop This is another example We can see that one hour insulin is 114 Again to 71 In just a few months There is also a good asocieted weight loss guide So I think it’s very clear Low-carb diet is the best diet for weight loss But some of you may still worry that you might think hard, it’s good to be thinner But what happens if it kills all my saturated fat, right? So let's take a look The latest research on this topic so far.

It was published last year It has more than 135,000 participants They have been followed for more than 7 years in 18 countries. This is a major study So we can see It is the death rate per 1,000 people in the population with the lowest fat content Less than 7 years old Let's see what happens to the group That is to get more energy from fat 3 times more fat Their death rate dropped to 4 More fat and longer life If we look at the graph from the same study to prove this Your risk of death Is the higher the axis rise, the worse, the effect you have is the right hand On the side, as you can see, it doesn’t make sense to actually have more fat as a problem It seems that the more fat you have, the overall mortality rate will continue to decline So now let’s turn it over and look at the carbohydrate intake, if you have 46.4 Your energy percentage From carbohydrates The risk of death per 1,000 person-years is approximately 4 By the way, this is not a particularly low-carb diet, but it is very low Carbohydrates compared with ordinary diet.

Let's take a look at those crowds with increasing population 72.2% of its carbohydrate energy Their risk of death rises from about 4 to over 7 years old Contain more carbohydrates. Let's take a look at this picture again The more carbohydrates you have, the higher your mortality rate With such a low-carb and high-fat diet, you will live longer Now this is not a diet for everyone Some people may have 80 grams of carbohydrates per day Rod says his limit is 50 Some other people may only consume 20 grams of carbohydrates per day to achieve optimal health. We use something called a ketone meter Determine the optimal level of your carbohydrate restriction The only difference between a low-carb diet and a person now The ketogenic diet is the degree of carbohydrate restriction If you reduce carbohydrates enough to lower your insulin levels and allow fat burning Some fat during metabolism is converted into a chemical substance called ketone What needs to be realized now is in the human body. The only source of ketones is fat metabolism no others So if you have ketones in your blood, it means your body is burning fat Therefore, we can put a drop of blood on a meter in 10 seconds We have now got the answer.

This is the ratio we usually use, it is also very useful And indicate your fat metabolism To suppress your appetite, what we found in the clinic is over In recent years, those who entered ketones hovered at 4 o'clock or higher. They often say what you know I only eat twice a day now, I'm just not hungry This is confirmed in research We know when your ketone content is higher Has a continuous rising effect So not only that Do you burn more fat? But the whole "calorie calories disappear" is the first law of the thermodynamic equation You put less energy into the system So this is actually in full agreement with the traditional wisdom of "calorie consumption" But it adds another layer.

It starts to explain how you can reduce your calorie intake This is an example of a food diary Record the ketone on the right, the number on the side The reason we do this is because By recording your ketones and comparing them to your food. You can actually start to understand which foods can stop your fat burning let's zoom in a bit So we can see the right side here. We have some ketone numbers 1.1, which is good 0.7 is okay. 0.4 is still okay, and then we drop to 0.2 why? A small piece of sponge cake, ok May not be the best But it’s okay, because the next day they went back to 0.7 A slice of toast Reduce it to 0.2. This person is very sensitive to carbohydrates And didn't do it They will never know, so now I want to get closer.

Look at sugar with Has a unique toxic effect So we have seen that the glucose molecule on the left is yellow But the one on the right Called fructose When you add one of these molecules together It forms table sugar, sucrose You can see it Sucrose is exactly 50% fructose It's important Because many people say that we have no problem in Australia because we don’t have high fructose corn syrup High fructose corn syrup Only 42% to 55% fructose So they are very comparable Our table sugar here in Australia is as bad as high fructose corn syrup right now When we look at the sweetness of different sugars Fructose is the cause of the problem Its content is more than twice that of glucose and glucose this is a problem Because like humas We like self-satisfaction We already have this way in our brain Limbic pathway This is the way to strengthen Strengthens our behavior When we stimulate our brains with sweet things We got a chemical called dopamine It says yes do it again And fructose Since it is more than twice the sweetness of glucose, it activates this pathway It activates this path more strongly When we sacrifice for the brains of obese individuals And look at the dopamine receptors We can see that the number has decreased Dopamine receptors are in the brains of obese people.

So it means getting the same satisfaction from meals Obese people need to eat more This is where sweetness fits it. Over time, this change will decrease But the problem is Until they decrease over time, you have to limit the sweets in your diet Now fructose has another particularly toxic effect then Cause insulin resistance Fructose is much stronger than glucose, causing fatty liver So when you eat fructose Usually, about 80% of the muscle is absorbed by the muscle and absorbed by the liver then It enters the liver and has storage capacity in the liver because there is a kind of glucose called Sugar cause this set a little bit So the energy that eventually enters the liver Then go to the mitochondria in the liver Just a small part of what you take But with fructose It won't go to other organizations It doesn't have this reservoir Where it can be occupied or stored Every gram of fructose you eat is sent to the mitochondria of the liver. When those mitochondria are overloaded They can produce fatty liver The process is called DNA vapor generation.

This is a slide with those white balls Have fat globules In fatty liver Extra fractals can do this This is closely related to insulin resistance Another problem is Sugar can be attached to protein You have sugar Bathe your body and sugar cells over time Not only can be attached to it can form these Advanced glycation end product They can affect almost all types of cells and molecules in the body The issue is This kind of fructose is seven times more than glucose Another problem with fructose When we look at the consequences of these advanced glycosylation end products They affect many organizations that we see diabetic patients Nerve problems We have already discussed how the pancreas begins to fail Reduce its ability to secrete insulin Kidney problems, blood vessel problems You can be blind Arthritis is really real Now just to illustrate this point These advanced glycosylation end products are related to aging This is some molar rib cartilage in the upper left corner This is from 2 weeks old, 88 from the bottom right corner This is what usually happens throughout the life cycle This is very similar to the behavior of Maori reacting to Browning Caramelization, if you won’t be exactly the same, but along the same route over time The sugar in our circulation will change Our organization has a problem with me.

Why speed up the aging process by increasing the sugar content? right now We know that the most common source of added sugar in our diet is sweets Maybe some people will be surprised to find that cereals are one of the main ways to add sugars to our diet But sugar is also hidden in many foods Not many people will realize that it might squirt ketchup Far lower than the sugar in healthy teaspoons they actually habitually add But the real surprise is in the lower right corner here. This is a medium mango juice 12 teaspoons half sugar with There are other ways to hide sugar. I have an organic almond milk here. perfect You can see lactose-free soybeans. Gluten-free and sucrose-free. Ok you feel pretty good now Let's take a look at this ingredient Does it look okay? Show people who we think don’t look so bad Organic Agave Syrup You know agave syrup 75% fructose is even worse than table sugar.

It's worse than sucrose This is here Is a list first name This sugar is camouflaged in Australia's nutrition label Euphemisms that allow food manufacturers to use these sugars on their labels Make it very difficult Some people say now, but fructose is natural, right? Maybe it’s natural, but we don’t consume it in a natural way You won't know it, but this is the fruit tree on the left.

It has no fruit. This is because the fruit is seasonal We can't get fruit all year round If you will, dear Okay, you didn't go to Cole traditionaly If you have his honey, you have to ask if the bees line up So we consume fruit in a very different way. right now we There are 500 mils of orange juice, containing 6 oranges And it has taken out all the fibers So, other than that, don't drink your fruit. Just don't drink your fruit Now i want to talk a little bit before finishing That is artificial sweetener So we have discussed them as a pathway to the Olympics Strengthen behavior and The artificial sweeteners are exactly the same When we look at the evidence All cohort studies They show that the consumption of artificial sweetness is related to weight gain Weight gain perimeter metabolic syndrome Type 2 diabetes and heart attack Artificial sweeteners will not get a pass So I want to keep everyone here There are three key points the first: You shouldn't be blamed for being overweight If you keep receiving bad advice critical second: Low-carb diet is the best diet for weight loss Because they lower insulin At last People live longer on a low-carb diet Thank you

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