Six common beliefs addressed, Part 37

1. Is carbohydrate restriction easy to follow?

Low carb diets are hard to adhere to. I know that the new and popular, watered down, online version of low carb, with the jugs of cream, mountains of artificial sweeteners, ridiculous egg fasts, pounds of bacon and "mock" cakes and cookies seems doable, but that's not low carb. Seeing the train wrecks online and at low carb conferences, helps me completely sympathize with conventional medicine's reluctance for accepting low carb diets. Low carb is meat and above ground vegetables only. It is not an "eat all the fat you can" diet.

For this reason, a true low carb diet is described as a lifestyle intervention, because it's not a set of rules you follow on the days you feel like doing N=1 experiments or after you become scared when a family member keels over from a heart attack. True low carb is a way of life and it incorporates much more than food, because the dysfunction is not cured by diet alone.

2. My damaged metabolism is causing my "disease".

Metabolism is an adaptive system, so your metabolism is not "diseased", per say, it has simply adapted. If metabolism was not adaptive, we would not be able to survive environmental food changes, which we were exposed to constantly during our evolution. Metabolism adapts to seasons, nutrient availability, energy availability and energy requirements. Metabolism can sense differences between being asleep or awake, between sitting and running, between summer and winter, between being 50 years old (not growing) and 12 years old (growing), between pregnancy and menopause and between eating and fasting. Metabolism responds accordingly to all of these conditions. It is pliable and never static, nor does it respond to any one single condition. Anyone who says it does, knows nothing about obesity, because to know anything about obesity, you first have to know how human metabolism behaves.

There are certain metabolic adaptations, which we did not evolve to sustain for the long term. These adaptations, with time, can result in diseases like cardiovascular, liver or kidney disease. But, metabolic syndrome/diabetes, in of itself, is not a true disease, though it can lead to the above conditions. These metabolic conditions are abnormalities in function. This is why metabolic "disease" does not kill you directly, but instead kills you through a series of complications.

Your metabolism is reacting normally, even though it's functioning abnormally. The metabolism of people with metabolic syndrome/diabetes is reacting perfectly normal to the conditions it's being placed under. It has adapted to starvation. Your liver is dumping out glucose and storing fat, within itself, because hormones are telling it to. Your blood pressure is high, because hormones are making it that way. You're losing your muscle mass, because your body wants to continue breaking you down into glucose, so it can make more fat. All of these things are normal and expected, when you don't give the body any other choice. It's no more abnormal than breaking a leg, if you jump off a 4 story building, or having an immune response after being infected with the flu virus.

3. Fasting is the best way to lower insulin levels. Insulin is always the primary hormone to target to improve obesity and metabolic disease.

Yes, insulin plays a major role in obesity/diabetes, but it is not the be all/end all of metabolic problems. There are many other hormones that are at play and their regulation worsens with fasting.

Just because fasting has a temporary beneficial effect on insulin levels, does not mean it's providing any benefits for insulin function and the regulation of other hormones like leptin. Many other hormones become more dysregulated with fasting and normalizing them is much more complicated than it is to just lower insulin. This is why we see so many who are still obese, even after years of continuous fasting.

4. People with metabolic problems should just live off fat. It's a "free food".

Giving the impression that dietary fat is a "free food" is wrong, dumb and ignorant. Dietary fat does not raise bolus (postprandial) insulin, but it does raise basal (fasting) insulin, which is the insulin you should be trying to lower. Its this rising basal insulin that interferes with fasting blood glucose. 

If a protocol claims that "It's the insulin, stupid.", then all functions of insulin should be addressed. You cannot myopically focus on short term insulin response, from diet, and never mention the body's over all long term insulin demand, which is heavily influenced by the amount of energy the body is trying to keep in storage, while it uses the energy from diet.

That’s why obese people don’t need prolonged insulin stimulation from carbohydrates and/or fat, which only contributes to the storage and withholding of excess energy. They instead need insulin stimulation from protein, which builds lean body mass, not more fat mass. Eating excess fat only contributes to more storage and more withholding of energy, especially when there already is excess body fat. Obese people always have a higher insulin demand, because of their excess body fat. Piling excess dietary fat, on top of that, only makes things worse. Not better.

5. There is no one way to fast.

Um, yes there is. There is only one way to fast and its when you don't consume anything, but water.

The low carb world sure loves to change the definitions of words. They should make their own dictionary. They have already changed the definition of reversal, ketosis, obesity, gluconeogenesis, insulin, obesity, etc. They just make stuff up as they go along and fasting is no different. Now they have made up their own definition for what fasting is.

Fasting protocols that include the drinking of tea, coffee and bone broth are completely ludicrous. That is not fasting and you can't just redefine 'fasting' to fit your narrative. Eating while fasting is called snacking and that equates to caloric restriction. Call it whatever you want, but drinking while fasting is not fasting. It is a very low calorie liquid diet.

6. You must become fat adapted to reap the benefits of low carb. 

The body does not require adaptation. It knows how to burn fat and glucose, because it has always done this, interchangeably, as needed. The body only requires access.

Access occurs when insulin levels drop low enough to stop storing fat and allow its release for energy by leptin. You will not go into starvation mode, as long as your body senses sufficient calories and nutrients coming in. You will go into starvation mode if the body stays in a prolonged state of only having access to its body fat. The body doesn't like to use body fat exclusively. It needs to sense enough nutrients coming in from diet.