Six common beliefs addressed, Part 31

1. "Keto" is only practiced correctly, if you eat foods that are "keto".

This blog does not follow "fad keto", which is being promoted by obese "keto" proponents and low carb zealots. This blog only supports true ketogenic diets and they can range anywhere from moderate carbohydrate restriction to 0 carbohydrate.

Ketosis simply means you are burning fatty acids and that can be done through varying degrees of carbohydrate restriction. There is no one size fits all to ketosis. The carbohydrate amount, which a person can still sustain ketosis in, is very individualized and based on their own personal degree of carbohydrate tolerance. Many foods can still keep you in ketosis, even with a higher carbohydrate amount, if the overall diet is ketogenic.

I have written an article detailing ketogenic diets, which can be found here.

2. I can lower my blood glucose while fasting, so this means fasting is "curing" me.

"Artificial" blood glucose control simply means that blood glucose lowers and becomes normal, only during the period these protocols are actively being practiced. One popular artificial intervention is extended fasting, but other ones include medications, exogenous insulin and caloric restriction.

None of these common artificial control methods will result in long term, proper blood glucose regulation or "cure". They are all just means to achieve a temporary end result. If you stop your artificial control protocol, your blood glucose will begin to creep upwards. Inability to have normal blood glucose, without taking a pill or injecting insulin, is not normal, as diabetes is not caused by medication deficiency. Inability to eat 2 - 3 meals a day, everyday, without hyperglycemia is not normal. Blood glucose regulation that is dependent on any of these interventions is not indicative of "cure".

Because there are so many artificial ways of lowering blood glucose, there are many people who are, once again, losing their blood glucose control over time. Medications and exogenous insulin will eventually need to be increased, as the body's resistance continues to rise. The body develops resistance to fasting, as metabolism adapts to starvation, and the person has to continue fasting, longer and longer, until they can no longer fast long enough. Caloric restriction cannot be sustained forever and the person eventually has to eat normally again. Once these protocols have to be increased, beyond sustainability, and they eventually all have to be, they stop working and blood glucose begins to rise again, as the disease is unmasked. This is because all of these protocols are only meant to lower serum blood glucose (palliative).

For this reason, you have to implement a lifestyle intervention to tackle metabolic dysfunction, at its root, instead of chasing symptoms. Lowering of serum blood glucose, alone, does not mean you are cured, because low blood glucose in the context of active metabolic disease, is useless and actually worsening the problem. So, any program or protocol that claims they have "cured" you, simply because your blood glucose is lower, while following it, is a liar. At least your conventional medicine doctor is upfront and honest when he makes you aware that the medications he is prescribing only mitigates symptoms and are not "curing" diabetes, since diabetes is a chronic and progressive disease of which they do not have a cure for, but the quacks online are hoodwinking you.

Metabolic syndrome/diabetes is only in remission when you can naturally sustain proper blood glucose regulation, without the need of any extreme protocol. Not only do you have to lower serum blood glucose, but you also have to stop the body from making blood glucose when it doesn't need it, make its own glucose when it does and obtain insulin's normal pulsatile function.

3. My "fasting muscle" is getting stronger, the longer I fast.

Yes, and it's helping you get fatter.

Every time you do long fasts, it becomes easier and easier to do them, because your "fasting muscle", also known as your fat cells, are getting better and better at withholding energy and telling your brain to stop burning it. They are also demanding more storage, when you eat again, so they can become bigger and stronger, preparing them for the next long fast.

In fact, your entire hormonal profile switches to "starvation mode", so that your body becomes primed to hold onto and store fat more efficiently. So, when your "fasting muscle" gets stronger, you are actually getting fatter. Extended fasting is like a gym membership for your fat cells. Remember, the fatter you are, the more you can fast. It's nature's way of adapting our metabolisms to help keep us alive during famine.

4. I am so insulin resistant than I can't even eat leafy greens.

The carbohydrates in leafy greens is mostly cellulose (fiber). Cellulose is not sweet (fructose) and it functions differently from starch (glucose), though it also contains glucose. Though we have enzymes to break down starch into glucose, the glucose in cellulose cannot be broken down and so it is not accessible to the body.

There are a lot of obese people, out there, that claim they cannot even consume cellulose, because "they are so insulin resistant". But, what's really triggering their out of control blood glucose, after eating, is the presence of food itself. Any food consumption is causing a glucose dump from their own liver, due to insulin resistance. It is insulin resistance that's driving up their blood glucose, not cellulose, as the body cannot break it down.

5. I only have high blood glucose after meals, so I am "cured" of diabetes, since my blood glucose is normal afterwards.

This type of high blood glucose is the direct result of hyperglucagonemia. It simply means the body is producing glucose, when it shouldn't be.

Glucagon is a counter regulatory hormone to insulin. Both of these hormones mitigate each other, through a complex feedback loop system of which leptin is also involved. But, when there is insulin resistance of the glucagon producing alpha cells, of the pancreas, glucagon is not well regulated and is overexpressed, leading to the liver dumping out glucose, even when it's not needed.

While a large percentage of all high postprandial blood glucose is coming directly from the liver, it can be more noticeable when following a carbohydrate restricted diet. This may be a surprise to many, as most have been misinformed and led to believe that if they aren't consuming carbohydrate, in any form, their blood glucose should automatically remain low. That is not true. High postprandial blood glucose is caused by insulin resistance, not carbohydrates, though carbohydrate restriction can help to not further exacerbate this effect and avoid prolonged insulin release.

Though hyperglucagonemia occurs with carbohydrate intake, it tends to be more controlled, since the glucose in the carbohydrate, stimulates a greater and longer release of insulin. This helps mitigate the body's out of control catabolism, because it takes a much higher insulin level to stop catabolism than to facilitate glucose entry into cells, as that is mostly done by various glucose transporters, not insulin. When you are carbohydrate restricted, you do not produce a greater and longer release of insulin. Rather, your insulin levels begin to normalize. Fat does not stimulate postprandial insulin levels by much. Protein, on the other hand, does stimulate insulin, but not enough to stop exaggerated catabolism. It is this out of control catabolism that is the culprit for high postprandial blood glucose, even in the absence of all glucose in the diet.

Like I have stated before, insulin is anabolic, but it can be more accurately described as anti-catabolic. It prevents the body from breaking itself down, and everything you eat, into glucose and ketones. But, this is dependent on sufficient insulin spikes, which people with metabolic syndrome/diabetes do not have. Their insulin is chronically high and they lack its normal pulsatile function. This chronically high insulin causes poor insulin sensitivity of the glucagon producing alpha cells. These cells are usually the first to succumb, to the resistance, as they work specifically with insulin spikes and are in very close proximity to insulin producing beta cells.

This is why insulin spikes are normal and necessary. It's asinine to avoid foods that spike insulin using an "insulinogenic foods" chart. If you have metabolic syndrome/diabetes, trust me, your insulin is not spiking, so don't waste your time. All healthy people have insulin spikes, after eating, and low insulin levels while fasting. Unfortunately, people with metabolic syndrome/diabetes do not have either.

If you are still experiencing high blood glucose, after eating, your protocol is not addressing your blood glucose regulation properly.

6. Carbohydrate restriction only hides metabolic dysfunction, but does not "cure" it.

Carbohydrate restriction, when used alone, is only a palliative therapy for metabolic dysfunction, but not a cure. There is no known cure for obesity, diabetes or metabolic syndrome. 

Metabolic dysfunction is very complex, as it's a condition affecting multiple systems of the body including fat mass, leptin, adiponectin, glucagon, adrenal counter regulation, ceramide flux, energy flux, triglyceride synthesis, mitochondria, etc. It also affects the anabolic and catabolic processes of the body. You can't just make it disappear with the "magic pill" of going low carb.

Having said that, carbohydrate restriction is one of the most profound treatments that a person with metabolic dysfunction can implement, as it allows them to take initial control of their metabolism and begin lifestyle strategies to obtain remission. Carbohydrates interfere with proper blood glucose regulation, which in turn affects insulin in a pathological way, irrespective of gram amounts and calories. No other macronutrient behaves this way. Not fat. Not protein. Only carbohydrate. Even low to moderate consumption of carbohydrate can produce metabolic abnormalities.

That is why the removal of carbohydrate has such an immediate effect on metabolism, of which is unmatched by the removal of fat or protein, restriction of calories or any other dietary intervention that has been tried. Carbohydrates cause the initial metabolic abnormality, which is the erratic ups and downs in blood glucose, so it's the first thing that has to be eliminated.

Carbohydrate restriction is also a great way to prevent metabolic dysfunction from ever occurring in the first place, especially in an environment of consistent and predictable food availability. First World environments of abundant food access are the best fit for carbohydrate restriction. It allows you to eliminate excess energy by restricting the macronutrient of least importance, while still being able to eat everyday. This automatically rids the diet of nutrient/protein poor, convenient, processed junk food, which only exacerbates obesity.