Six common beliefs addressed, Part 17

1. The sick are the only ones who should eat healthy.

Everyone needs to eat healthy, because you never want to get sick and then try to fix the problem. Prevention is worth a pound of cure. If you want to keep your good health, then you have to begin implementing the lifestyle that will help you acquire it now. We were all healthy once.

2. Can fat turn into glucose? 

If needed, the body can turn fat into glucose through gluconeogenesis. It does not just use protein to do this. Excess fat is stored and is only converted to glucose in a tightly regulated way. This is demand driven, not supply driven. That is always the case for gluconeogenesis.

Triglycerides are derived from the foods we eat and the glycerol in triglycerides can be converted back to glucose. So, even though fat cannot be directly converted into glycogen, it is possible for stored fats to be broken down into glucose, which can then be converted into glycogen.

3. Can weight loss, by fasting, reduce loose skin?

Natural weight loss is what reduces the risk of loose skin. When weight loss occurs very rapidly and unnaturally, it tends to develop large amounts of loose skin. I never had loose skin during my weight loss, because I did it naturally and at the pace that my body wanted it. Little by little, my body "ate" all of it.

There has not been any proof that fasting will prevent the development of loose skin, but there has been studies that have proven fasting has no affect on it. Though there is protein catabolism, from fasting, most of these proteins are broken down from the musculoskeletal system, not the skin. Skin proteins appear to be preserved during fasting, so it doesn't reduce.

We can see this, in real time, with the results of bariatric surgery patients. All of them have been basically put through a forced fast, from their surgery, but they have all had issues with excessive loose skin. This extreme weight loss from rapid metabolic change is the most likely culprit. The body just cannot catch up with this unnatural rate of change.

The amount of loose skin you can have, after weight loss, is also dependent on age, fat cell health and genetics. Some of us just have looser skin than others and there are differences in the amount of subcutaneous fat that we all store. If you want tighter skin, exercise will be your best bet to get it. There are also several supplements available that can help with loose skin.

4. I automatically refuse any medication my doctor prescribes.

You have the right to refuse any treatment, including medication, that a doctor recommends, but it's vital to make an informed decision and not one based on something you read or saw on the internet. Medication should only be rejected after you do your research and have the appropriate discussion with your doctor.

Good topics to discuss are:

• Why is this medication being prescribed?
• How does the medication work?
• What are its side effects and long term effects?
• How long will you be expected to take it?
• What real benefits will you derive from it?
• What real risks will you have from not taking it?

Getting answers to these important questions will help you make a better decision, rather than just automatically rejecting treatments that can be beneficial for you.

5. Do I need to add resistant starch and fat to improve my diabetes?

Metabolic syndrome and diabetes are not caused by resistant starch or dietary fat deficiencies. It is caused by poor blood glucose regulation.

There is no magic pill, out there, that cures diabetes. The only thing that reverses it is obtaining and sustaining proper blood glucose regulation. 

6. Is leptin only responsible for raising metabolic rate?

When you have too much body fat, you make too much leptin and develop leptin resistance. This is the most common form of leptin dysregulation for people who are obese, but you can also have poor leptin signaling at the level of the fat cell itself or the brain, irrespective of leptin levels.

Leptin is not only responsible for satiety and the ability to increase basal metabolism, but it is also a very important regulator of glucagon.

If you are leptin resistant, then glucagon will automatically be over expressed and continuously release too much glucose from the liver, which in turn can raise insulin levels. High insulin levels will dysregulate blood glucose even further and the whole cycle begin again. This can be exacerbated further after eating, as glucagon rises to mitigate postprandial insulin levels. If glucagon did not do this, rising insulin would clear too much blood glucose and cause hypoglycemia. 

The problem is that now, glucagon is "running wild", with no control from leptin or insulin, because the metabolic dysfunction has left the person resistant and with inadequate expression of both hormones. When glucagon is left to do its bidding, with no control, blood glucose rises to very high levels as glucose is being dumped from the liver, in an exaggerated rate, and other substrates (proteins, lactate, glycerol) are also being converted to glucose, in response to the presence of insulin. That's why postprandial blood glucose is always the highest.

You must improve both insulin and leptin sensitivity to improve metabolism. Insulin sensitivity is improved with a carbohydrate restricted diet and an intermittent fasting regimen. This will help control blood glucose better and lower insulin levels to normal.

Leptin sensitivity is improved with the correction of body composition, which is done through exercise, avoidance of "starvation" and the right macronutrient profile of adequate protein, moderate fat and low carbohydrate. This will help leptin expression and the loss of body fat. If you have high body fat, you are particularly sensitive to excess dietary fat, as your leptin will not respond to it by increasing metabolic rate and you will end up storing it. Unlike insulin, leptin responds to food intake over the long term, so it takes time to correct its dysregulation. 

So, be careful how you address your insulin resistance. You do not want to swap one resistance for another. Leptin takes a very long time to regulate, is much more complicated to address and it's dysregulation can become permanent as it can lead to hypothalamic damage.