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  #16   ^
Old Tue, Sep-27-16, 13:06
MickiSue MickiSue is offline
Senior Member
Posts: 8,006
 
Plan: Atkins
Stats: 189/148.6/145 Female 5' 5"
BF:36%/28%/25%
Progress: 92%
Location: Twin Cities, MN
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LOL, bintang. If I were you, and I'm not, I would kindly send the physiologist ALL the research results you've found, with a suggestion that she read it, as her guidelines appear to be based on erroneous information.

While it would be satisfying, emotionally, to do so, it would, assuming that she actually reads it, demonstrate to her that her guidelines are simply bad. Could one hope that she'd actually work to have them modified?
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  #17   ^
Old Tue, Sep-27-16, 14:55
M Levac M Levac is offline
Senior Member
Posts: 6,429
 
Plan: VLC, mostly meat
Stats: 202/200/165 Male 5' 7"
BF:
Progress: 5%
Location: Montreal, Quebec, Canada
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For a thing to grow, it must exist in the first place. Visceral fat exists before it grows, and it exists naturally, it serves a purpose a priori, therefore any risk associated with it is merely incidental, not causal.

Fat tissue growth is not a cause, it's an effect. That this effect is associated with disease does not suddenly turn this effect into a cause. Disease itself is an effect as well. Therefore there is an association between two effects.

So what's the cause? Some pathogen, some dietary factor, some injury, or a combination. For our purpose, the primary cause of fat tissue growth is dietary carbohydrates through their action on insulin. With fat tissue, it's a special case. Once it grows, it can remain larger permanently through a process called insulin-induced lipohypertrophy, just like any other tissue that grows through similar processes, i.e. bones, muscles, eyes, skin, etc. So fat tissue isn't really a special case after all.

You went low-carb, you fixed the primary cause. But low-carb can't fix this permanent growth, it's there to stay, there is no mechanism where fat tissue can be shrunk permanently by diet or by exercise. Unless we look at removing fat tissue physically like with liposuction or with a drug called Adipotide (prohibitin-targeting peptide 1, or PTP-1) which causes the blood vessels lining fat tissue to suicide, fat cells die off as a result, fat tissue shrinks permanently.

If carbs were the only cause, then you're good to go. If there was other causes, find them, fix them. The sequence is:

carbs -> insulin -> fat tissue accumulation. So the sequence is:

carbs -> fat tissue accumulation. But the sequence can also be:

drugs (or some pathogen, or injury, or inflammation from these) -> insulin -> fat tissue accumulation. Therefore the sequence is also:

drugs (or the other things) -> fat tissue accumulation. The sequence is always:

something -> insulin -> fat tissue accumulation.

Now that fat tissue has grown, has it become dangerous on its own? It's possible, but unlikely. Fat tissue on its own does not cause disease, unless we're talking about lots of fat, then the disease would be called something like "can't move cuz I got this huge weight pinning be down", which is actually possible, but that's not what we're talking about here. We're talking 1kg of fat tissue mass inside the abdomen cavity. There's probably 20kg of stuff in there, 1kg isn't gonna make much difference. But it's not 1kg, it's half that, cuz fat tissue grew, remember? It grew from whatever it was, to 1kg, so it probably was already 0.5kg, and it didn't make a difference then. So, in order for 1kg of visceral fat to become the culprit, we have to believe that only 0.5kg of it is the culprit, while the other 0.5kg just keeps doing its thing which has always been there for a genuine purpose.

The experts don't do this super simplified logic, they're not trained to look at things like that. For them, it's all about statistics. Well, There Ain't No Such Thing As A Free Statistics. It's all gotta be based on genuine facts, otherwise it's just an idea, belief, not real.

Let's look at facts. How do you feel since you went low-carb, since you lost all that weight? Make a list of things that changed. I did, my list is impressively long. The fact that we don't quantify these things with exact numbers is irrelevant, we can feel things and it's real, it's facts. I doubt we can feel the difference between 1kg of visceral fat and 0.5kg of visceral fat, so why all the fuss? Even if we could feel that difference, it wouldn't be that obvious, so why all the fuss? Granted, that fat was obviously much larger before, but we shrank it with low-carb, right down to the minimum possible it can be, after it had grown permanently a bit of course. Think about it, we don't visit the doc when nothing's wrong, unless we believe the doc can somehow divine the future, he can't, let's not fool ourselves. We are the ones who know when something's wrong, we can feel it, it's real, it's facts. Somehow, at some point in time, somebody convinced us that what we feel is an illusion, and the only thing that's real is lab numbers. Really?

Making a list is awesome. Somehow it makes these feelings more real, as if the feelings themselves weren't real enough. They are, there's just something magical about reading it on paper.

Am I an expert? Not in the least. I'm just some guy on the internet, and everything I say is BS.
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  #18   ^
Old Tue, Sep-27-16, 21:23
Bintang's Avatar
Bintang Bintang is offline
Senior Member
Posts: 258
 
Plan: MyOwn:CHO<90g/d
Stats: 207/149/150 Male 169 cm
BF:40%/17%/18%
Progress: 102%
Location: Jakarta, Indonesia
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Quote:
Originally Posted by MickiSue
LOL, bintang. If I were you, and I'm not, I would kindly send the physiologist ALL the research results you've found, with a suggestion that she read it, as her guidelines appear to be based on erroneous information.

The thought did cross my mind but I doubt the physiologist is interested. I think her business model requires that she scare the bejeezus out of everyone who has a scan done.
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  #19   ^
Old Tue, Sep-27-16, 22:40
Bintang's Avatar
Bintang Bintang is offline
Senior Member
Posts: 258
 
Plan: MyOwn:CHO<90g/d
Stats: 207/149/150 Male 169 cm
BF:40%/17%/18%
Progress: 102%
Location: Jakarta, Indonesia
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Quote:
Originally Posted by M Levac
The experts don't do this super simplified logic, they're not trained to look at things like that. For them, it's all about statistics. Well, There Ain't No Such Thing As A Free Statistics. It's all gotta be based on genuine facts, otherwise it's just an idea, belief, not real.

Am I an expert? Not in the least. I'm just some guy on the internet, and everything I say is BS.
There are two kinds of experts:

Real experts are those who whilst being extremely knowledgeable and clever in their field of expertise nonetheless retain enough humility to admit that they do not know everything and sometimes they can be wrong.

Pseudo experts are those who can never be wrong about anything in their field of expertise because they know it all and have superior opinions to the rest of us, e.g. flat-earth registered dietician nutritionists
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  #20   ^
Old Wed, Sep-28-16, 00:22
M Levac M Levac is offline
Senior Member
Posts: 6,429
 
Plan: VLC, mostly meat
Stats: 202/200/165 Male 5' 7"
BF:
Progress: 5%
Location: Montreal, Quebec, Canada
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Quote:
Originally Posted by Bintang
There are two kinds of experts:

Real experts are those who whilst being extremely knowledgeable and clever in their field of expertise nonetheless retain enough humility to admit that they do not know everything and sometimes they can be wrong.

Pseudo experts are those who can never be wrong about anything in their field of expertise because they know it all and have superior opinions to the rest of us, e.g. flat-earth registered dietician nutritionists

That's how I see it too. I was saying it differently, i.e. knowledge vs belief, facts vs ideas.

By the way, I would rely on more reliable indicators like BP/BG/HR, rather than on VAT. Those are very reliable and are much better indicators of overall health. However, the average values for "normal" isn't actually reliable. Best to go with your personal numbers and go on from there. For example, when I was at my best, numbers were 90/60, 67mg/dl, 60. Then they jumped to 120/80, 100mg/dl, 80. This was accompanied with a slew of bad stuff which I won't list here. A doc won't see it that way, he goes with the "normal" range and sees nothing wrong with those numbers, even when I point out the previous numbers and how these new numbers jumped in just a few days/weeks. Well, let's say your numbers jump suddenly yet remain within "normal", would that actually be normal for you especially if there's no apparent reason for it? Reverse logic. If there was anything wrong with 1kg of VAT, it would show up in those numbers (higher than what you recorded), but it doesn't, therefore there is nothing wrong with 1kg of VAT. If something goes wrong with VAT suddenly, it will show up in those numbers just as suddenly. Those numbers literally don't change on their own, there's always something else that changes at the same time, i.e. injury, infection, exertion, sleep, pleasure, etc. I guess this used to be widely known by docs, but somehow they forgot about that. I mean, it's the basis for risk factors, but they forgot how to apply this to the individual.
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  #21   ^
Old Wed, Sep-28-16, 04:53
Bintang's Avatar
Bintang Bintang is offline
Senior Member
Posts: 258
 
Plan: MyOwn:CHO<90g/d
Stats: 207/149/150 Male 169 cm
BF:40%/17%/18%
Progress: 102%
Location: Jakarta, Indonesia
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Quote:
Originally Posted by MickiSue
While it would be satisfying, emotionally, to do so, it would, assuming that she actually reads it, demonstrate to her that her guidelines are simply bad. Could one hope that she'd actually work to have them modified?
It's possible I've been a bit harsh on my local DEXA scan physiologist. Her suggested target of zero for visceral fat is not her's exclusively. It is being advocated more widely as shown by this example from a Los Angeles based DEXA scanning service.



I bet this advice has a common origin. Could it perhaps be coming from the marketing departments of DEXA device manufacturers? After all when you want to sell more of something it helps if you can find a way of artificially creating a demand.
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  #22   ^
Old Wed, Sep-28-16, 05:10
cotonpal's Avatar
cotonpal cotonpal is offline
Senior Member
Posts: 4,135
 
Plan: very low carb real food
Stats: 245/128/135 Female 62
BF:
Progress: 106%
Location: Vermont
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Quote:
Originally Posted by M Levac
Let's look at facts. How do you feel since you went low-carb, since you lost all that weight? Make a list of things that changed. I did, my list is impressively long. The fact that we don't quantify these things with exact numbers is irrelevant, we can feel things and it's real, it's facts. I doubt we can feel the difference between 1kg of visceral fat and 0.5kg of visceral fat, so why all the fuss? Even if we could feel that difference, it wouldn't be that obvious, so why all the fuss? Granted, that fat was obviously much larger before, but we shrank it with low-carb, right down to the minimum possible it can be, after it had grown permanently a bit of course. Think about it, we don't visit the doc when nothing's wrong, unless we believe the doc can somehow divine the future, he can't, let's not fool ourselves. We are the ones who know when something's wrong, we can feel it, it's real, it's facts. Somehow, at some point in time, somebody convinced us that what we feel is an illusion, and the only thing that's real is lab numbers. Really?


Well said. This is something I have been interested in for a long time, how did we get to this place in medicine where doctors pay such close attention to lab values and so little attention to symptoms? It leads to the absurdity of doctors dismissing patients with symptoms that have no corresponding "abnormal" lab values and treating patients who feel just fine because their lab values are not "normal", often making them sick in the process. Low carb works because I feel better. That's my starting point.

Jean

Last edited by cotonpal : Wed, Sep-28-16 at 07:34.
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  #23   ^
Old Wed, Sep-28-16, 07:10
khrussva's Avatar
khrussva khrussva is offline
Posts: 6,845
 
Plan: My own - < 30 net carbs
Stats: 440/205/210 Male 5' 11"
BF:Energy Unleashed
Progress: 102%
Location: Central Virginia - USA
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Quote:
Originally Posted by Bintang
It's possible I've been a bit harsh on my local DEXA scan physiologist. Her suggested target of zero for visceral fat is not her's exclusively. It is being advocated more widely as shown by this example from a Los Angeles based DEXA scanning service.



Every time I see the phrase "is associated with" the first thing that comes to my mind is "does this association prove or even support the conclusion that is being made?" The association may very well be true. The conclusion drawn from it may or may not be.

Is the assumption being put forth here is that visceral fat is bad for you? The presence of visceral fat itself causes the metabolic problems? Does it? How did it get there? To have visceral fat then you must have had a diet & lifestyle that resulted in the accumulation of visceral fat. So in most people with visceral fat, that diet/lifestyle thing is also present. Perhaps this is what is bad for your metabolic health -- not the visceral fat itself. If you change your diet and lifestyle to one that does not accumulate visceral fat - but actually reduces it - does the association still hold water?

Without an actual study that looks into the "diet/lifestyle" association, I can only speculate and draw conclusions from my own experience. I changed my diet and lifestyle to one that reduces visceral fat. At my last annual checkup (2 years into changing my diet) my doctor marveled at how little visceral fat I had. I didn't have a DEXA scan, but I'm sure that I still have some visceral fat present. Still, it took 2 years to get to that point. My metabolic "risk factors" were improving from day 1 of this WOE and most were fully resolved when I still obese and still had a boatload of visceral fat. So if I were to cast a vote, I'd say the poor diet/lifestyle association is more of a risk factor than the visceral fat itself. So their conclusion that we need to shoot for zero visceral fat to be healthy may very well be based on a false assumption.
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  #24   ^
Old Wed, Sep-28-16, 08:06
MickiSue MickiSue is offline
Senior Member
Posts: 8,006
 
Plan: Atkins
Stats: 189/148.6/145 Female 5' 5"
BF:36%/28%/25%
Progress: 92%
Location: Twin Cities, MN
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Finding a medical professional who DOES pay attention to symptoms is like finding a jewel in mud.

When my TSH was smack in the middle of the "normal" range, my endo went ahead and raised my Armour thyroid dose, because I was symptomatic. And when, having lost weight in the 6 months since I started that higher dose, I was symptomatic of hyperthyroid, he went back to the baseline, not dropped it dramatically, as many do.

Having seen an endo who was much more the other way, I know what a treasure this man is. Luckily, he's young, so I have a good chance that he'll be around for a while!
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  #25   ^
Old Wed, Sep-28-16, 13:58
deirdra's Avatar
deirdra deirdra is offline
Senior Member
Posts: 3,857
 
Plan: HF/vLC/GF,CF,SF
Stats: 197/136/150 Female 66 inches
BF:
Progress: 130%
Location: Alberta
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Quote:
Originally Posted by Bintang
There are two kinds of experts:
Real experts are those who whilst being extremely knowledgeable and clever in their field of expertise nonetheless retain enough humility to admit that they do not know everything and sometimes they can be wrong.
Pseudo experts are those who can never be wrong about anything in their field of expertise because they know it all and have superior opinions to the rest of us, e.g. flat-earth registered dietician nutritionists

Another way to tell a real expert from a pseudo expert is that Real scientists like me have never felt the need to use the words "evidence-based" in any publication, because true science is implicitly based on evidence, we don't just pull it out of our a$$es like pseudo experts do.
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  #26   ^
Old Wed, Jun-20-18, 23:01
mikejakart mikejakart is offline
New Member
Posts: 2
 
Plan: none
Stats: 220/210/200 Male 6'3"
BF:
Progress:
Default Dexa in Jakarta

Hi Bintang,

Did you find a Dexa scan in Jakarta?

It appears that maybe Rumah Seti Setiabudi has one, but I just tried to call and couldn't find out.

Thanks
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  #27   ^
Old Thu, Jun-21-18, 03:43
Bintang's Avatar
Bintang Bintang is offline
Senior Member
Posts: 258
 
Plan: MyOwn:CHO<90g/d
Stats: 207/149/150 Male 169 cm
BF:40%/17%/18%
Progress: 102%
Location: Jakarta, Indonesia
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Quote:
Originally Posted by mikejakart
Hi Bintang,

Did you find a Dexa scan in Jakarta?

It appears that maybe Rumah Seti Setiabudi has one, but I just tried to call and couldn't find out.

Thanks


No I haven't bothered. I've satisfied my curiosity enough and don't want to waste any more money. Besides my weight has been so incredibly stable now (69.0 kg +/- 2%) for the last 2 years.
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  #28   ^
Old Fri, Jun-22-18, 02:46
mikejakart mikejakart is offline
New Member
Posts: 2
 
Plan: none
Stats: 220/210/200 Male 6'3"
BF:
Progress:
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Thanks Bintang.

I tried calling the hospitals but no luck in finding anyone who could answer my question so far...

I'm only in Jakarta for a few months... so Indonesian is not so good.

For me, I just realized that over the last 15 years, my weight is going up and down by 8 kg in busy times over months and then losing that extra weight fairly quickly over a few weeks in less busy times...

but now I've just come to the conclusion that this just basically water weight going up and down... and i've never made a true dent on any of the fat % ever...as it appears to make any true dent in that -- for 8 kgs, there is no other way to do it than over the course of 4 months+ as now I realize that it's just impossible to burn fat in such a quick time... so it was just my water weight going down and up.

it's just my weight either going up or down but never stable...between 90 and 98... so want to at least get a proper baseline measurement to start....now that i'm at 94...

if you happen to notice any Dexa scanning in Jakarta, please let me know - thanks.
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