Six common beliefs addressed, Part 45

1. I am a very hard case that can't follow the diet consistently. I also can't fast and can't exercise.

I do not offer any miracles here. This blog is only for people who can still help themselves. Readers of this blog must be able to:

• Adhere to a proper carbohydrate restricted diet, consistently.
• Fast for an appropriate and beneficial period of time daily, minimally 12 hours.
• Exercise up to their limitations.

None of the above recommendations are easy or comfortable. The only thing that is easy and comfortable is going out to dinner and shopping.

• Adhering to a proper, low carbohydrate, whole foods diet removes from the table many of the familiar foods that you are use to. This means you have to retrain your palate. This can be grueling.
• Fasting does not allow you to partake in habitual fun behaviors, which you enjoyed in the past, like eating while watching TV or grabbing something from the fridge, just because you walked by it.
• Exercise is painful, tiring and exposes you to "icky" things like heat, sweat and sun. It takes time out of the day, which could have been otherwise spent reading, on the computer, sleeping and eating.

But, those are the only three things, which help with weight loss and metabolic health, aside from bariatric surgery. We cannot offer any other help besides these, because there is nothing else to offer. Anything that goes beyond these recommendations requires pharmaceuticals, which we do not provide nor can advise on. If you cannot do any of these three things, then you must talk to your healthcare provider and follow his instructions.

2. I tried a low carbohydrate approach and felt terrible, so I had to stop.

Many people who begin following a low carb diet, experience uncomfortable symptoms. They can have no energy, feel fatigued, have heart palpitations, hair loss, anxiety, feelings of being cold, etc. The list of symptoms is endless. For others, it worsens thyroid function and/or causes increased hunger, rather than a decrease.

99% of the time, these symptoms are being caused by electrolyte imbalances, so they can be corrected with the right supplementation. Make sure that when you begin any low carb diet, you treat electrolytes as a fourth macronutrient. You do not want to put all of your focus on carbohydrates at the expense of everything else.

An electrolyte guide can be found here.

Electrolyte imbalances can cause much more than just uncomfortable side effects. They can cause permanent adverse health effects if they are ignored. Electrolytes are required for proper thyroid and digestive function.

3. I am losing too much weight on a ketogenic diet. I should eat carbohydrates again.

Yes. If you wish to be fat, you must eat a fattening diet and carbohydrates are part of a very fattening diet. But, if you want to be lean and healthy, or remain that way, then you have to sustain a carbohydrate restricted diet.

The first thing you need to do is make sure that you are truly losing an abnormal amount of weight. Being thin, and staying that way, is not indicative of abnormal weight loss or that you are becoming unhealthy. Being fat is not a sign of good health. "Normal weight" has been clouded in an atmosphere of mostly obese people, so now anyone who is not coated in a layer of fat is deemed to be anorexic. So, make sure you are interpreting your weight loss correctly by making the proper measurements, not just eyeballing the mirror. Then you should discuss any weight loss concerns with your doctor.

While you wait for an appointment, you can take into consideration the following - The only time that a ketogenic diet would cause abnormal weight loss is when it is protein restricted and/or very low in calories. Other than that, abnormal weight loss is not a common occurrence and usually only happens to people who are obesity resistant. These people did not have a significant amount of body fat to lose, when they started the diet, and may have gone ketogenic for other reasons that were not weight related. Because they are not obese, they immediately lose weight quickly and can go below their usual, already lean, baseline body weight. This is why it's so important to have a well formulated ketogenic diet and not follow clowns online. It is very easy for ketogenic diets to become protein and calorie deficient, causing adverse health effects, or even become fattening.

To counteract this effect, up your protein and calories. Calories can be made higher by increasing dietary fat. Remember, the less body fat you have, the more dietary fat you can consume. You also need to make sure that you are doing the proper exercises to build muscle.

If you continue to lose a lot of weight, then you have to discuss it with your doctor, as this most likely has nothing to do with the diet and something else could be going on. This is especially the case if you have been a long term Type II diabetic. Any diabetic who experiences abnormal, persistent weight loss, needs to see their doctor immediately.

4. Can I ignore my high blood glucose because I am already on low carb?

There are people out there that will tell you to ignore your blood glucose, if it starts rising, while following a low carb/"keto" diet. They make excuses and caveats about how the diet is still working, even with high blood glucose because, to them, high blood glucose can be "normal" on low carbohydrate. They minimize effects like Dawn Phenomenon (DP) and physiological insulin resistance.

I have written extensively about DP, and though it’s a normal event that occurs to everyone, the DP diabetics experience is not normal, even if they are following low carbohydrate. If the DP is persistent, and does not improve with time, it must be addressed.

Physiological insulin resistance, also known as 'adaptive glucose sparing', is another occurrence that everyone on low carb experiences, to some degree, but if it persists, especially when consuming low carbohydrate items like above ground vegetables, then it is absolutely not normal.

The same goes for weight. Weight gain is not "health gains", it’s obesity. So, if weight is creeping up on you, it's indicative of a problem. Don’t listen to the excuses given by fanatics, who are so twisted by their absurd blind belief in their diet, that it causes you to harm your health.

If your blood glucose is still high on low carb/"keto" then you’re still sick. If high blood glucose did not indicate sickness you could have accepted high blood glucose on the Standard American Diet as well. The goal of the diet is to stabilize blood glucose within a normal range in order to improve its regulation, improve insulin and start losing body fat. 

5. Is there a macronutrient, which is best for people with metabolic syndrome?

There is. Protein.

Protein is the only macronutrient that will not contribute further to your fat mass. 

6. All symptoms of metabolic syndrome/diabetes will disappear once insulin levels lower.

Each organ in your body has a specific, independent and unique metabolic profile. The body is not a monolith, though everything must work in sync.

Lower insulin without improving its function only starves glucose dependent tissues more. Certain glucose dependent cells in the nervous system, retinas, kidneys and red blood cells cannot use fat. Lower insulin levels mean that these cells will struggle more to acquire the glucose they need. This can exacerbate certain conditions like retinopathy, neuropathy, anemia, etc. This is most likely the mechanism behind worsening of certain diabetic conditions, when following “keto” and extended fasting protocols.