Big picture after an overnight fast, or as dietary carbohydrate is reduced. Lower insulin, higher glucagon, dis-inhibition of hormone-sensitive lipase, Glycogen phosphorylase (breakdown) is activated and synthase is turned off. Gluconeogenesis is enhanced, and will replenish glycogen.
"The main idea is that in the complicated network of biochemical reactions, insulin stands out as a major point of regulation. Figure I‑2 shows how we describe it to medical students and this is how we will describe it here. The ups and downs of insulin are what we try to control in the use of dietary carbohydrate restriction as a therapeutic method. So, low‑carbohydrate diets provided some unifying theme in teaching."
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.... People on the very low‑carbohydrate ketogenic diet (VLCKD) lost twice as much weight...as the low‑fat controls despite the similar caloric intake...., 9 of 20 subjects in the VLCKD group lost 10% of their starting body weight, more weight than that lost by any of the subjects in the LFD group. In fact, nobody following the LFD lost as much weight as the average for the low‑carbohydrate group.
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From Summary of Fuel Sources in Chapter 7: .... 8. Whereas glucose can be converted to fat, with a few exceptions, fat cannot be converted to glucose. This will be a key idea behind the therapeutic use of dietary carbohydrate restriction. 9. Glucose can also be stored as the polymer glycogen. 10. Bottom line is the limitation of “you are what you eat.” Metabolism means the interconversion of foods.
Whenever a scientific paper presents data ...showing that one (usually low‑carb) diet, is more effective than another, somebody always jumps in to say that it is impossible, that it would violate the laws of thermodynamics. Like the cartoon characters who run out over the cliff and fall only when they realize that they are not on solid ground, somehow the data are expected to go away once thermodynamics is invoked.
Sugar is an easy target. These days, if you say “sugar,” people think of Pop‑Tarts. or Twinkies, rather than pears in red wine (Ingredients: 3 cups red wine, 1 cup sugar…) or tamagoyaki, the sweet omelet that is a staple in Bento Boxes ...Here’s a question, though: If you look on the ingredients list for Twinkies., what is the first ingredient, the one in largest amount? Answer at the end of this Chapter.
Figure 2-2. Consumption of macronutrients during the epidemic of obesity and diabetes. Inset: number of people with diabetes. The horizontal axis represents the period in which NHANES ( National Health and Nutrition Examination Survey) collected data. The left vertical axis is the absolute energy input in kcal. The right axis is the % change in calories. The ratios of macronutrient is shown along the top.