Dr. Asif Khan
4 Comment(s)


The IIFYM and flexible eating bunch have been at this for a while.

Your body sees all carbs as just carbs."

"There's no difference in how your body uses carbs from pop-tarts to jasmine rice to sweet potatoes. So long as your macros are the same each day it's all the same."


Ok, let's just try to end this once and for all.

If a carb just a carb is just a carb, then that would mean a few things.

  • All carbs would elicit the same response from the body in regards to insulin.
  • All carbs would be stored exactly the same way in the body.
  • All carbs would have the same inflammatory response in the body.

So let's start with number one.

Carbs, insulin, and leptin –

Ok, if you don't know what the glycemic index is, it's a number scale based on the body's glycemic response. That means, how fast it converts said carbohydrates into glucose in the body.

The lower the number, the lower the rise in blood sugar in the body. This also means the lower the response for insulin.

The higher the number, the faster blood sugar and insulin rises in the body.

Generally carbs that have a number of 55 or below are considered carbs that have less impact on raising blood sugar and insulin. And as we know, part of getting leaner and building muscle is controlling and timing insulin release.

"But people often mix in proteins and carbs thus it changes the glycemic index of the food."

You're right. But we're talking about the difference in carbohydrates alone today. So give it a rest.

Based on the fact that the GI scale exists at all, tells us that all carbs are not treated the same way by the body in regards to insulin and blood sugar. In fact, fructose does not even stimulate insulin production nor does it have an effect on leptin levels.

In case you don't know what leptin is, it's the hormone that regulates your appetite. When your leptin levels rise, it signals to your body that you are full. When leptin levels are low, then it signals your body to eat.

Simple, right?

But what if the foods you ate, made you leptin resistant? So you would eat, but your leptin levels either didn't rise, or didn't rise enough to signal to your body that you are full. This is the other factor in obesity. It's not just that obese people become insulin resistant, i.e. their insulin levels don't respond the way they are supposed to in regards to carbohydrate intake, but they rarely get full, or it takes a LOT of food for them to stimulate leptin release.

But wait. Wait.

I am totally going to copy and paste this part, because well, I love it so much. I mean I really do.

Research also reveals that fructose has effects independent of this mechanism to induce this metabolic syndrome. Whereas fructose increases weight through the standard mechanism of stimulating more food intake and blocking the burning of fat, even when you control caloric intake, fructose can affect body composition.

This is because when you eat fructose, you actually generate more fat in your liver for the same amount of energy intake, compared to other types of sugar... For example, if you calorically restrict an animal but give it a high-fructose diet or a high-sugar diet, it will still produce fatty liver and will still become insulin resistant. According to Dr. Johnson, fructose has two effects:

  • It stimulates weight gain through its effects on your appetite and by blocking the burning of fat
  • It also changes your body composition to increase body fat even when you are on a caloric restriction.

So let's look at that last part again.

It also changes your body composition to increase body fat even when you are on a caloric restriction. more time.

It also changes your body composition to increase body fat even when you are on a caloric restriction.

Remember all those guys that told you, that it doesn't matter what you eat because so long as here's a calorie deficit, that you'd lose weight? And there is some truth to this. However, depending on your choice of carb intake, it may not be that simple.

If your diet is high in refined sugars, fructose, etc. then you could be in a calorie deficit....AND STILL GET FATTER.

Boy that fucking sucks doesn't it?

Fructose doesn't even cause a secretion in insulin. Which means if you eat fructose, and you aren't depleted if liver glycogen (more on that in a minute) then theoretically, that particular sugar can behave like fat intake. If insulin isn't transporting the nutrients into muscle cells, then where is it going?

It's making you fatter.

The guy that penned that piece? Dr. Richard Johnson. The head of nephrology at the University of Colorado. 25+ years of research in the field of nutrition with over 500 peer reviewed articles about said topic. So before you point me to Joe Bodybuilder who also has a PhD, he really can't carry this guyssammich.

The body does indeed respond differently in regards to blood sugar, insulin, and leptin for different types of carbohydrates.

So there's strike number one.

How different carbs are stored –

Are all carbs stored the same way in the body?


Carbs that come from most (not all, but most) fruits are high in fructose, for example.

Fructose gets stored primarily as liver glycogen. Now before you say "you're now saying fruit is bad?!?!"

No. Fruits also contain fiber and water, and it's gonna be pretty hard to eat enough fruit in one sitting to totally fuck yourself up in regards to fructose intake. But if we're talking about using fruit as say, a post workout choice, it's not a very good option because fructose doesn't go towards replenishing muscle glycogen. The sugar in fruit is also called "natural sugar". It is obviously not an added sugar.

Carbs that are higher in dextrose (aka glucose) get stored primarily as muscle glycogen.

The reason it's important to note the difference is because in order to stay as anabolic as possible, there needs to be enough muscle glycogen to fuel your workouts and keep cortisol low. Once you deplete muscle glycogen, then liver glycogen, cortisol levels rise in order to create glucose.

Cortisol eats through lean muscle tissue.

Does this sound like a good idea to someone who is trying to either hold on to lean muscle or to build it?

Yah, doesn't sound good to me either.

Now some will tell you that so long as you eat carbs later in the day, that replenishing glycogen will occur. However the research back and forth on that isn't clear. I've read and read and read. Some studies show a higher uptake of glucose in a short window post workout, and some show that it doesn't matter so long as you get your carbs in over the course of the day to replenish both muscle and liver glycogen.

So I'm going with empirical evidence and some "well this just seems right" in this instance.

If you just depleted a significant portion of your muscle and liver glycogen, then it stands to reason that post workout, the body would be more primed to uptake glucose into the muscle cells, so long as the proper type of carbohydrate was being ingested. In this context, post workout is 30-60 minutes after you're done training.

However let's get away from this for a second. It's actually more important to pay attention to the pre-workout meal in regards to this. Depending on how far out you eat from the workout is going to to play a part in choosing a viable carbohydrate. If you're 45 minutes out? You want to spike insulin in push glycogen into the cells quickly. If you're a few hours out? A lower glycemic carb will probably work best. Yes, I heard you. Adding in fats and proteins will lower the glycemic index however if you're eating pixi sticks two hours out from your training session instead of sweet potatoes then you're probably doing it wrong.

So to get on with this, not all carbs are stored the same way in the body. And if you're all about gaining muscle and losing fat, then choosing what kind of carb you are going to eat and when you're going to eat it, does in fact matter.

Strike two.

Inflammation - Now here's where we really get into why it's important to understand that a carb is not just a carb and where the IIFYM crew goes wrong.

Their mantra about this is "all carbohydrates get converted to sugar in the body".

Yes, we know that. However we've already covered two points that show what happens after that, depending on carb source, can be dramatically different.

The controlling of inflammation in the body is vitally important if you want to avoid shit like heart disease, the beetus, cancer, and pretty much all diseases including death.

Death seems serious. It's hard to come back from catching a bout of that.

So what the hell does carbs have to do with inflammation?

Well, there are certain carbs (and fats, like Omega-6 fatty acids) that can cause or trigger an increase in inflammation in the body. Remember that the body needs a normal amount of inflammation to operate in a healthy or productive state, i.e. brain function. But if inflammation levels rise above that, then you're looking at a myriad of health issues that come with it.

Arachidonic acid is a type of non-essential fatty acid that your body produces that while needed to function properly, if it becomes elevated in the body can cause elevated inflammation in the body.

Food wise, what can cause this?

I'll save you some time on this one…

In conclusion, whole grain consumption may be related to lower circulating plasma concentrations of PAI-1 and CRP, which in turn could lower the risk of type 2 diabetes and cardiovascular disease. These findings suggest that the protectiveness of whole grains in relation to type 2 diabetes and cardiovascular disease may be due to an effect on plasma inflammatory protein concentrations and reinforces the public health recommendations that whole grains be consumed daily as part of a healthy diet. Refined grain intakes were positively associated with PAI-1 concentrations, indicating that refined grain intake could have proinflammatory effects. The novelty of this finding warrants further investigation into the potential effects of refined grain consumption on metabolic and inflammatory measures.

This article is getting long, so I'm going to stop there. The point is, the type of carbohydrate you consume can either increase or decrease inflammation in the body as well. Now of course, the fatter you become, the more factors that come into play in regards to increasing inflammation but at the end of the day, you get fatter by making poor food choices.

Strike three.

Where the IIFYM and flexible dieting people miss the boat -

IIFYM is not a horrible diet. If you're a male, and 15-18% bodyfat, and you just want to get down into the 10-12% range, it will work.

For a few select outliers, they can use it to get into men's physique type stage shape. And I do say they are outliers because the fact is, 99% of the bodybuilders in the world cannot use it, and go win shows.

There isn't a single guy that will stand up on the Olympia stage this year and have a shot at winning using IIFYM. Not one. Zero.

Now let's examine that statement for a second....

If pro bodybuilders have all of these pharmaceutical advantages, and they are also genetic anomalies, then why can't they use IIFYM and get in championship bodybuilding winning shape?

Because the simple fact is, at that level, you have to account for more than "20 grams of carbs is 20 grams of carbs." The carb source, and how the body reacts to it can be the difference in winning and placing out of the top five. Let me put it to you like this; a few too many packs of splenda over a week might mean the difference in winning and placing third. True story.

So when you say "Matt Ogus uses flexible dieting and he has won shows." no one gives a fuck. You're not him. Not to mention that, a handful of men's bikini competitors that are naturally lean and don't need to get peeled to win at their shows aren't exactly the best examples of why IIFYM "works" when works means, in context, bodybuilding stage shape.

But since we're not talking extremes here, what about the male well over 20% body fat? You know, flat out obese people.

Well IIFYM typically fails there too, in my opinion.

With very obese people who are pushing up against the type 2 diabetes wall, they need to get their insulin levels and inflammation under control ASAP. Not only that, but it's been proven through research that people who consistently stuff their face with overly processed foods and added sugars, develop a dopamine based reward system for those kinds of foods.

In other words, they need to literally approach their diet like a 12-step program and abstain from those kinds of foods long enough to "go through detox" essentially. Obese people literally crave shit food like drug addicts crave their drug of choice.

So telling a really obese individual that they can still have their pizza and ice cream and doughnuts on this diet is like telling someone trying to get off crack that they can still hit the crack pipe "2 or 3 times a week, so long as you're clean the rest of the time, you'll eventually overcome addiction."

Now does that make any sense to you at all?

Yeah, me neither.

Lean people can generally get away with things like IIFYM and flexible dieting. However their body is probably in an optimal state of nutrient partitioning, i.e. it does a better job of moving glycogen in, and storing fat less. But obese people are poor at nutrient partitioning. And honestly, don't need things like "cheat meals". They need a very long period of eating very healthy foods to undo the damage they have done.

So with all of this said.......

Still think "a carb is just a carb?"

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