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Comment by soulbadguy | Hacker News Reader

> but I feel like CICO is the default position and additional nuance requires proof

Is there really a need to default position ? CICO and the fact that distribution (both in time and macro) of the calorie in matter can both be true. The assumption i do not agree with in CICO is CI is an independent and infinitely controllable variable. Now it's possible that the causal link between a certain macro distribution (let say high carb diet) and weight gain is mediated by CI, but from there it doesnt follow that CI control is an effective way of weight control.

> but we have not translated this to epidemiological studies.

Depends on what you call epidemiological study, but using the diabetic population, the causal link between insulin and weigth gain is pretty strong. The book "obesity code" make of good case for that.

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> CICO and the fact that distribution (both in time and macro) of the calorie in matter can both be true.

Maybe they do matter somewhat, but here's the deal: if everyone who was obese in this country all of a sudden started eating a diet that was macronutriently ideal and consumed at the perfect times, but maintained the same number of calories, there would be no difference in the prevalence of obesity. I think the science really confidently supports that position, and I'd be happy to look at anything you think denies it.

> Depends on what you call epidemiological study, but using the diabetic population, the causal link between insulin and weigth gain is pretty strong. The book "obesity code" make of good case for that.

I am very familiar with Dr Fung's work and don't think that any of it makes the case you are trying to make. All of his work provides proof for what I've been saying over and over in this thread: IF and Keto can be great ways to create compliance to a diet, but there is no evidence, including the work of Dr Fung, that shows these diets behaving differently from simple calorie control outside of the compliance aspect.

> if everyone who was obese in this country all of a sudden started eating a diet that was macronutriently ideal and consumed at the perfect times, but maintained the same number of calories, there would be no difference in the prevalence of obesity. I think the science really confidently supports that position, and I'd be happy to look at anything you think denies it.

Again, no. You are tautologically restating CICO. We have no evidence of this being true. You are implicitly assuming that CO will be constant and would be independent of CI... We do not know that to be true.

> I am very familiar with Dr Fung's work and don't think that any of it makes the case you are trying to make. All of his work provides proof for what I've been saying over and over in this thread: IF and Keto can be great ways to create compliance to a diet, but there is no evidence, including the work of Dr Fung, that shows these diets behaving differently from simple calorie control outside of the compliance aspect.

I seem to recall a bunch of animal models where compliance was controlled for and still showed a strong correlation between insulin and set weight.

> You are implicitly assuming that CO will be constant and would be independent of CI... We do not know that to be true.

No, we can reason about this fairly easily knowing the extraction costs of calories from macronutrients. You're correct in that macronutrient content can affect CO, but you're vastly overstating the amount. There is no model of digestion we've come up with that accounts for much more than 10% of calories going to digestion, so even if you max that out, you still end up with pretty similar levels of obesity. We cannot fix this problem without radically reducing the amount we eat, regardless of the macronutrient content.

> I seem to recall a bunch of animal models where compliance was controlled for and still showed a strong correlation between insulin and set weight.

Please send links, all I can do is respond to the specifics of an actual study.

Or higher basal metabolism and higher activity levels ... Both of which would increase CO...

But we're getting out track , my point is simply that CICO expresses a relationship between calorie in , calorie out and the variation in people weigth . It's doesn't say that one can control people weigth using CI. The analogy that Judea pearl uses is that there is a relationship between the number displayed on a thermostat and the temperature outside , but that does not imply that one can control the temperature outside by changing the number displayed on the thermostat

> It's doesn't say that one can control people weigth using CI.

It absolutely says that. Absent other factors changing, a reduction in caloric intake will result in a weight loss. It does not disagree with there also being other inputs to CO.

Yeah I had the feeling that that's where we would disagree. Happy to agree to disagree on this one

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