Six common beliefs addressed, Part 73

1. "Keto" diets are complicated.

They sure can be. There are many diets, which fall under the umbrella of "ketogenic". The ketogenic diet is not just one diet. There are many. The one you choose to follow will depend on what your goals are and what you’re trying to treat. I’m not talking about nonsense like “dirty keto” or "keto carnivore". There are no such things. I’m talking about true ketogenic diets. They differ in their ability to sustain ketosis, the types of fats used and what they are restricting. All low carbohydrate diets are ketogenic, because they all mobilize fatty acid metabolism.

You can achieve ketosis many different ways: fasting, exercise, calorie restriction, protein sparing and carbohydrate restriction. These all induce ketotic states, to varying degrees, but their long term effects are different.

To keep it simple and in the scope of metabolic treatments only, a ketogenic diet is completely determined by carbohydrate restriction. You must maintain a low carbohydrate intake to obtain ketosis, but just how low you need to go, is very individualized. This sounds pretty simple, but it can get very complicated depending on the person's current metabolic state, habits, preferences, adherence and side effects.

Badly formulated ketogenic diets can cause weight gain, new health problems and/or make current metabolic problems worse. For this reason, I only recommend the Virta ketogenic protocol on this blog. Their protocol can be found here.

2. Will fasting always result in lower insulin levels?

Not in the long term. To properly address metabolic dysfunction, all treatments must be implemented for the long term, since metabolism only responds to long term treatments. How far along you are in the disease, determines the effect treatments will have on insulin. Fasting will not accomplish this, in the long term, because insulin levels aren't affected solely by food intake. Therefore, fasting needs to be combined with other strategies.

People who have the wrong information about low carb assume that because nothing is coming in, through the mouth, then it's completely logical for blood glucose and insulin levels to lower in response. You are, after all, technically "starving" them into submission. This is complete stupidity. This comes from the false belief that diabetes and metabolic syndrome are completely and solely controlled by diet alone. That is false. These conditions may have started with the diet, 30 years ago, but it is now driven by an adapted metabolic state.

This means that you don't have to consume glucose anymore, to continue producing it at an exaggerated rate, driving insulin levels high and keeping them that way, furthering blood glucose abnormalies. Triggers that raise the body's compensatory stress response, like long fasts and chronic caloric deficits, only make this worse. The further along you are in your condition, the harder it will be for you to lower insulin levels through any one treatment alone. Insulin levels are strongly determined by body fat. The more body fat you have, the higher you will drive your insulin, as it is the "dam" keeping all that fat in storage. Body fat puts a high insulin demand on the body, regardless of diet.

For these reasons, in order to truly lower insulin levels you have to consume the right diet, mitigate the body's stress response and lower body fat. Fasting is nowhere in that equation.

3. Metabolic "disease" is a nightmare. I am now more scared than ever.

Metabolic syndrome is only a nightmare when it's not treated properly, as it's progressive. It won't go away on its own. It only gets worse with time.

The information I provide is so people are aware that treatment requires a lifestyle intervention with personalized tweaks, depending on how the condition is manifesting in them, as an individual. There are no one size fits all treatments and there are no magic pills. I stay away from presenting treatments based on fads, gimmicks and pseudoscience, which is what the low carb community seems to be very adept at doing. They have a simplistic, short term, "symptom chasing" protocol for the "treatment" of metabolic dysfunction, which is absolutely wrong, regardless of how much money it might be making them. That is why I debunk myths, inconsistencies and just plain nonsense on this blog. If you don't understand what's happening to you, you won't be able to treat it effectively. You might end up treating it incorrectly, causing other serious issues to replace it or not treating it enough and end up right back where you started, in a few years.

Unfortunately, the rates of remission for obesity/diabetes are dismal, because of the inconsistencies, inaccuracies and confusion that the current information is providing. I like being straightforward and truthful in what metabolic syndrome is, the challenges it creates and what it takes to achieve true remission. I don't paint feel good, easy peasy BS about it, because that won't help you. It might help you feel relieved, but it won't treat your condition. Relief based on lies is just future panic in hiding.

4. Can artificial sweeteners raise insulin levels?

It depends. Some artificial sweeteners, like certain sugar alcohols, are converted back to sugar in the body. But, that’s not the primary reason you shouldn’t have artificial sweeteners. You shouldn’t have them because of their effects on dopamine and other hypothalamic functions. The taste of sweet affects the brain and obesity is not just a disorder of the body, but of the body's communication with the brain. That's why it's a condition of the neuroendocrine system. Neuro pertains to the brain and endocrine are hormones.

5. Is the P:E diet a good diet to follow for metabolic health?

Yes. Dr. Ted Naiman's P:E Diet is highly recommended on this blog. It's a whole foods based, low carb, ancestral diet that is great for reducing body fat, so it's targeted for the obese and those with metabolic disease. The best thing about this diet is that there is no "dogma" associated with it, nor pseudo science. It is based exactly on how our metabolisms actually works.

Dr. Naiman's "protein to energy diet" is specifically designed to burn body fat, through the normalization of blood glucose regulation, with none to minimal loss of lean muscle mass and no metabolic slowdown, as the diet prioritizes protein and uses fat as a lever. In other words, the more fat on your body to lose, the less fat on your plate. The thinner you become, the more leeway you have for dietary fat intake. This prevents prolonged weight stalls or too much weight loss. You can sort of think of it as a protein sparing modified fast, but designed to be followed for the long term, as you individualize it for your particular goals.

6. Low carb groups and pages always give out the same useless advice that does not cause a single pound to be lost.

This is because low carbers usually use a magical low carb eight ball that only has three outcomes, when they shake it: “Eat more fat”, “Fast longer”, “Stay away from nuts and dairy”. That’s it. That’s there reply for everything and if they are challenged further, then they pull out their three useless talking points: “Lower your insulin”, “Increase autophagy” and “Vegans suck”. That pretty much sums up low carb advice, as it stands on the internet today. When the going gets tough, they will have zero answers for you. Zero. I personally guarantee it, because I saw it happen, with my own eyes, for years. They can answer simple, silly questions like "How should I eat my eggs?" But, they have zero answers for the real questions, like "Why can't I lose weight on 'keto'?" That one is never answered, because they simply have no answers. The answer doesn't fit what they are trying to sell, so the person is simply ignored or they go back to the magic eight ball.

The sad reality is that the vast majority of the low carb community, as it is today, has zero clue of what obesity is or what truly causes metabolic syndrome and no, it's not potatoes. Low carb has become a fad that will never be taken seriously, by anyone in the medical field, and that has been solely caused by its advocates. You can't present information, at a real science convention, using junk science. That's why they create their own "low carb" conventions, where they aren't challenge or harassed by pesky and annoying facts.

For those that can't lose a pound on low carb, I suggest you go back, way back, to Atkins and start all over again, because following the low carb dogma of today will only make you uber obese.