Six common beliefs addressed, Part 87

1. Is there is a persistent stress response with low carb and/or fasting?

There are some people who cannot get over an exaggerated stress response, which interferes with their ability to follow low carb or adopt a fasting regimen. This is simply a problem of the central nervous system, which was affected by years of metabolic stress and it causes over expression of the adrenal stress hormones.

Metabolic stress is caused by erratic highs and lows in blood glucose, with large disparities between the two. This in turn stimulates chronically high insulin, which loses its pulsatile function. Chronically high insulin exacerbates this glucose roller coaster further, doubling down the counter regulation response, which then further effects insulin. As you can see, it's a vicious circle. A "death spiral", as each effect contributes to the other.

This spiral chronically stimulates the body's "flight or fight" response (stress hormones) in a pathological way. This abnormality in the body's stress response can persist, even after insulin levels have lowered. Insulin is a hormone that has persistent action on certain tissues of the body, long after it's cleared or is at lower levels

Normalizing stress hormones is particularly difficult, depending on the time length of metabolic dysfunction and other hormone status, such as sex hormone and thyroid. All of these are impaired in people with metabolic dysfunction and further exacerbate the problem. Metabolic dysfunction is a "disease" of the neuroendocrine system. Notice the word neuro in there. In other words, it's not just hormones, but it also includes the brain and the nervous system and how they interact and respond to endocrine signals.

Unfortunately, for some people, they cannot take control of their stress response, no matter what their diet looks like. This means they continue having Dawn Phenomenon and/or hyperglucagonemia. This is why these people are recommended a low to moderate carb diet, that eliminates all sugar and grains, but does not go so low in whole carbs that it induces long periods of ketosis. The person must consume adequate protein, track their electrolytes, keep their fasts short (no longer than 16 -18 hours), avoid OMAD (one meal a day protocols) and not over exercise. One of the greatest regulators of the stress response is exercise if it's steady state and not strenuous. All of these, combined, eliminate and/or help reduce the stress response for people who have persistent stress issues.

2. Is allulose sweetener "keto" friendly?

All artificial sweeteners are "keto" friendly because they usually do not affect blood glucose enough to kick you out of ketosis. But all artificial sweeteners are "obesity unfriendly" because they cause adverse long term effects to the hypothalamic-pituitary-adrenal axis (HPA). They do this through taste. The taste of sweet is detrimental to metabolism and the ability to lose body fat.

So, if you are on a ketogenic diet for the treatment of epilepsy, you can use any artificial sweetener you want. After all, you are under a doctor's care, who will monitor your weight, while on this protocol. But if you are ketogenic for the treatment of obesity and/or metabolic disorders, you should be having 0 artificial sweeteners.

3. You can get enough protein from a one meal a day (OMAD) protocol.

Extremely unlikely. I can't even imagine it, unless you are downing some serious protein shakes, which should not be your primary method of obtaining protein anyway. "Shakes" are not real food. You must eat real food first and then if you have to supplement protein, that's fine, but you shouldn't be using shakes just to eat an OMAD.

Eat two to three meals a day.

4. Not all nuts are "keto". 

Ketosis is a metabolic state where you primarily burn fat for fuel through the breakdown of fatty acids. This breakdown causes a byproduct called ketone bodies, which are primarily used by the brain. Some will say this occurs in the "absence of glucose", but there is never an "absence of glucose" because if there was, you would be dead. The body still makes its own glucose.

What do nuts have to do with this? Nothing. All nuts are "keto", if you are able to sustain the burning of fat for fuel, while eating them. All nuts are not "keto", if you are unable to sustain the burning of fat for fuel, while eating them.

5. Foods that "spike insulin" cause a plateau.

That is complete nonsense from people that are either truly ignorant of how obesity works or they just pretend to be, in order to dupe you. Plateaus are solely caused by leptin. I explain this mechanism in this article.

Insulin is not an obesity hormone. It’s a growth hormone and what it grows is at the discretion of your neuroendocrine system, which is influenced primarily by the macronutrient composition of your plate and secondarily by other lifestyle factors.

People who are pre- or full diabetic do not have sufficient "insulin spikes" to cause anything, except the inability to halt glucagon expression, thereby releasing enormous amounts of glucose postprandial. So, "spiking insulin" is the least of their worries and their main concern should be eating to properly regulate their metabolism, not "control insulin spikes".

6. Does "keto" causes preventricular contractions (PVCs)?

PVCs are quite common and can be triggered by all kinds of things, from exercise to emotional stress to hormones to gastroesophageal reflux disease (GERD). PVCs are tightly correlated to an over excited/stimulated autonomic nervous system. Some people have issues regulating their autonomic nervous system and can suffer for months from non-stop PVC attacks.

Always get checked out by a doctor, but if the PVCs are correlated to "keto" then one of three things can be going on - inadequate electrolytes or a heightened stress response or both. I suggest you follow this electrolyte recommendation.

You also may want to ditch "keto", if this is stress related, and follow a low carb diet instead, as the benefits are the same.