Six common beliefs addressed, Part 61

1. You must eat lots of fat to not be hungry on low carb.

"Hunger for fat" is a sign of metabolic disease. I want that to be completely understood and clear. Having to eat enormous quantities of fat, in order to reach satiety, is a sign that you are very metabolically sick and not better or getting better by any stretch of the imagination. People with healthy metabolisms do not ever experience this. They reach satiation with protein, not the energy macronutrients.

Metabolically dysfunctional people experience this same issue with carbohydrates. They have to eat an enormous amount of carbs in order to reach satiety, significantly disrupting their blood glucose and making them uber fat. When they switch to fat, the same thing occurs. This is a sign that leptin is not communicating fat stores, to the brain, and the body is constantly in starvation mode, since it doesn't see its own exceeded fat reserves.

This is active obesity. The body is demanding large amounts of energy, through hunger, which it obviously doesn't need, in order to continue building fat mass. Hunger for fat or hunger for carbs, means you are getting fatter. If the diet was truly reversing your obesity and healing your metabolism, this wouldn't be occurring. Stop feeding your fat mass with fat. You already did that before with carbs.  

2. "Keto" will prevent cardiovascular disease (CVD).

CVD is mostly determined by genetics. Having said that, certain genetic lipid abnormalities can be exacerbated by diet, regardless of what the charlatans say. If diet can have a positive effect on some, it certainly can have a negative effect on others.

There is a segment of the population that reacts adversely to saturated fat intake, especially when the consumption is ridiculously high, as is the case for the fake "keto", practiced online. These people develop an increase of small dense LDL and abnormally functioning apolipoproteins.

This is why you should have an advanced lipid panel ordered, yearly, instead of relying on a basic one. You won’t know how your diet is affecting your lipids, until you analyze them, in depth, since total amounts are not enough to tell you anything about their health.

3. Eating lots of salt is healthy.

It should ring alarm bells when someone who is selling salt, recommends you eat plenty of it. (Reeeeally, now....)

Like fat, there is no need to avoid salt, but also no need to over consume it. Salt your food to taste. Do not chew or suck on salt or salt your water. That’s stupid. Eat salt to tolerance. People on low carbohydrate diets, need to keep their focus on their electrolytes, not just salt. An electrolyte guide can be found here.

Some people are salt sensitive and once they go over a certain amount, they begin having adverse reactions. People with certain kidney or cardiovascular diseases may have issues with salt, as well as people on certain medications. Listen to your body and don’t ignore bad reactions. If you are experiencing edema or high blood pressure, put down the salt shaker.

4. You must be overweight/obese to have metabolic syndrome.

No. There are many thin people who have metabolic syndrome. Metabolic syndrome is a cluster of 5 abnormalities that appear to track together:

• Waist circumference over 40 inches for males or 35 inches for females
• Blood pressure over 130/85 mmHg
• Fasting blood glucose over 100 mg/dl
• Fasting triglyceride levels over 150 mg/dl
• Fasting high-density lipoprotein (HDL) lower than 40 mg/dl for males and 50 mg/dl for females

But, you do not have to experience them all to have metabolic syndrome. Each person manifests the condition differently. In the absence of any other disease and/or medication, which might be contributing to these abnormalities, you are considered to have the syndrome if you manifest 3 or more of these conditions.

5. Can "keto" cure mixed hyperlipidemia (MN)?

MH is considered a genetic condition where the person has high blood fats, including high cholesterol and high triglycerides. But, there are lifestyle factors that can cause and/or aggravate this condition, as well, including ones that promote metabolic syndrome. So, before a condition can be deemed completely “genetic”, make sure that the appropriate genetic testing has been done to determine that is the case.

“Genetic” is a lazy term that is often thrown around the doctor's office to make it seem as though there’s nothing you can do to change certain conditions, except through pharmaceutical intervention, when that’s simply not the case. Many people with high triglycerides and/or cholesterol, have been able to normalize their markers through lifestyle interventions. If no lifestyle intervention causes changes, then you can begin suspecting other causes. Genetic testing would be a great place to start identifying them.

6. If you add potatoes, to your diet, you will become obese again.

No. Never, in the history of humanity, have potatoes made anyone obese. Potatoes are not the cause of obesity, they have only contributed to obesity. 

Potatoes, like all carbs, profoundly affect blood glucose. Usually, potatoes are eaten alongside other carbs that affect blood glucose even more. For this reason, potatoes need to be restricted, particularly if you already have metabolic syndrome and your body is using any source to drive blood glucose upwards.