Putting things into your digestive system, that you cannot digest, is unnecessary. When you eat a carbohydrate restricted diet, you might see that you no longer need to use the bathroom as often as you used to. This whole concept of "regularity" is man made. The body regulates its own regularity. The body knows when it has to eat, when it needs water, when it is hot, when it is cold and when it has to eliminate waste. It doesn't care about a man made schedule. It does what it has to do, when it needs to.
Fiber bulks up your stool, giving you the impression that you are eliminating a lot of waste, but you are only eliminating the fiber, you just consumed, that your body cannot digest. When you stop consuming so much indigestible roughage, you have less bowel movements. It's important to give your body food that it can use, has bioavailable micronutrients and your digestive system was designed to handle, not a bunch of stuff that it has to spend time trying to break down through fermentation and eliminate through bowel movements.
The benefits of fiber come from the bacteria that feed from it through fermentation and convert it into butyrate, a short chain fatty acid. Butyrate (butyric acid) has many health benefits, including the reduction of neuroinflammation and of fatty liver disease. I know they try to hide the fact that butyrate is a type of fat, by giving it a fancy, "sciency" name. This makes you think that only through the magical powers of plants, can it be delivered into the body, but that's not true.
You don't have to wait for the body to try and convert what it needs by consuming things it doesn't need. You can deliver butyrate to it directly by consuming foods that abundantly contain it. When you eat animal foods, which contain animal fats, particularly dairy, you receive a heavy dose of butyrate with no dietary fiber needed.
2.Will I have a nutrient deficiency if I exclude vegetables from my diet?
Vegetables do not supply any nutrients that cannot be found in meat. Meat has all of the bioavailable nutrients that the body needs, and the fat, to help deliver them appropriately. Let me debunk three common excuses made to keep plants in a diet:
- Need for fiber - Read above for information on the "more fiber" mantra.
- Need for Vitamin C - Vitamin C is not needed in large quantities unless it's competing with glucose. The people who developed scurvy did not develop it because of "Citrus Deficiency Syndrome", they developed it from eating large amounts of rice. In order to metabolize rice, you deplete your Vitamin C, causing disease. That's why high grain diets have to be supplemented with Vitamin C. Get rid of the grains, you get rid of the problem.
- Need for antioxidants - The antioxidants in plants are for the plant and cannot be used by humans. We make our own antioxidants and the best way to not deplete them, is to be in a state of low oxidative stress. A sure way to keep oxidative stress down is to not consume foods that contain high glucose and excessive polyunsaturated omega 6 fatty acids, both which are found in plants, especially grains.
- Need for phytonutrients - All of those great phytonutrients are for the plant. They are mostly not bioavailable to us.
Plants have everything needed to make a healthy plant, not a healthy human. You can certainly omit all vegetables, if you don't enjoy them or they produce health problems for you. If you eat vegetables, do so because you enjoy them, not because of any health requirement.
3. Is fasting more important than carbohydrate restriction?
Carbohydrate restriction has a more profound effect on metabolic hormones, because you can't fast forever, but you can restrict carbohydrates forever. Fasting is temporary, carbohydrate restriction is permanent. Therefore, dietary intervention is primary and a fasting regimen is secondary.
The most important thing you have to learn to do is eat correctly. Avoidance of food through fasting is not a long term solution to the problem, because you cannot avoid food forever. You will, eventually, have to learn how to eat.
4. Is it fine to have alcohol, as long as it's "low carb"?
Alcohol is metabolized in the liver, in the same way that sugar is. Fatty liver was always a disease that lifetime alcohol drinkers would face. When it was also found in non-drinkers it was renamed as 'Non Alcoholic Fatty Liver Disease' in order to differentiate it from the former.
Alcohol is metabolized first in the energy hierarchy, so for people who are already having issues metabolizing energy, you do not want to have glucose pushed back further down the line. You want your body to be as efficient as possible in clearing it from the bloodstream.
For this reason, I do not advise alcohol consumption for anyone that has metabolic disease, regardless of the amount of "carbs" that it may contain. Your liver is already struggling enough.
5. Do you need to become "fat adapted" for carbohydrate restricted diets to work?
The confusing term “fat adapted” basically means nothing. The body does not have to “adapt” to anything. It just needs to have access.
Fat adaptation simply implies a state of low fasting insulin levels. Until insulin is kept at low levels during fasting, consistently, the body's fat stores will continue to be kept locked and inaccessible. Once insulin is sustained at normal levels, the body can access it’s fat stores for energy and leptin can do its job. You know when this occurs when two things happen:
- You can fast for extended times, more than 12 hours without hunger, lethargy or discomfort caused by hypoglycemia.
- You are losing body fat. This is measured through inches lost, not weight lost.
Another very important test that can be done is a fasting insulin test. If the results are below 3, the body will have maximum fat loss. If it's between 3 - 6 the body will continue to have access to body fat and maintain weight loss. This is the gold standard test for "fat adaptation". Everything else is just rearranging the chairs in the Titanic.
Even though achieving a very low fasting insulin state is the purpose of the diet, some people have a very hard time reaching it. Insulin resistance is a time dependent disease. The longer and higher your insulin levels have been, the longer it will take for them to come down. For some people this process takes a very long time and requires diligent consistency of dietary adherence in order to achieve these results. Eating a lot of fat, testing ketone levels and taking exogenous ketones, will not get you there any quicker, but can hinder the process all together.
6. Can the grams of allowed carbohydrate a day, on low carb diets, come from anywhere? Is the only thing that matters is the gram amounts?
This all depends on your goals and your reasons for restricting carbohydrates. Not everyone is restricting carbohydrates for the same reasons, so not everyone, on this type of diet, can be lumped into the same category and required to follow it the same way. A bodybuilder or athlete may be restricting carbohydrates for an entirely different reason than an obese, diabetic. To the body builder it doesn't matter if they meet their carbohydrate allowance, for the day, from a Snickers bar or broccoli, but for the diabetic, this makes all the difference in the world. Just like calories are not all created equal, nor have the same effect on metabolism, not all carbohydrates are created equal nor have the same effect on metabolism.
The purpose of restricting carbohydrates for better metabolic health is to normalize blood glucose homeostasis. This would mean that the quality of carbohydrates you consume are just as important as the quality of your fats because not all carbohydrates impact blood glucose in the same way. The carbohydrate of concern for the obese is glucose. Glucose can come as sugar or starch. Fiber is irrelevant.
Your carbohydrates should be coming from non-starchy, whole vegetables, not grains or sugar. Grains and sugar products are man made, highly processed, concentrated forms of carbohydrate, which the body does not metabolize in a natural way. There is a different blood glucose response to 20 grams of carbohydrates in donuts and 20 grams of carbohydrates in cauliflower, just like there's a difference between 200 calories of apple pie and 200 calories of salmon. The food you eat is giving your body information, through blood glucose, which signals it to balance metabolic hormones in a specific way, and that way can either be obesogenic or not.
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