All macronutrients matter for fat loss and metabolic health. They just effect overweight/obesity in different ways, so they shouldn't be targeted in the same way.
- Carbohydrate - Carbohydrate is the main macro that you want to keep low as it significantly and negatively affects blood glucose regulation. It takes very little carbohydrate calories to contribute significantly to weight problems through its affect on blood glucose. Because the modern food supply is mostly carbohydrate based, this is the macro that you have to be most diligent to stay away from.
- Fat - This macro has to be tracked as well because too much of it contributes to body fat through its affects on fasting insulin. Insulin over expression contributes to the dysregulation of fasting blood glucose. Fat calories have more leeway than carbohydrate's because it is the body's primary fuel and is constantly in demand, whether you are at rest or not. But since the overweight/obese are usually also leptin resistant, dietary fat can become a problem quickly.
- Protein - This is the macro of least concern except to ensure it's adequate and prioritized because it does not chronically interfere with blood glucose regulation, it stimulates the most satiety, it is not stored as body fat and it contributes to the building of lean muscle mass. Muscle is the kryptonite of fat. Protien also stimulates insulin in a healthy way, not a chronic way.
As you can see each macronutrient contributes to obesity, or not, in its own unique way and so they all have to be tracked in order to combat "diabesity". Obesity/diabetes is not the fault of any one macronutrient, but of an overall obesogenic macronutrient composition that interferes in proper blood glucose regulation.
2. Inflammation should be a concern for people who eat "high levels" of saturated fat.
Staying fat or getting fatter should be the main concern for these people. Generally, saturated fat does not cause any inflammation, but this is dependent on your genetics. Some people who have a genetic problem metabolizing fats, specifically saturated fat, can see their inflammatory markers go up while eating "keto". These people usually also have a heart disease risk, regardless of diet.
For this issue, I recommend two things you can do.
- The first is reduction of saturated fat intake. Since this statement mentions "high levels of saturated fats" it makes me wonder just what type of BS protocol it's referring to. If the goal is ketosis then you have to achieve that by burning your own body fat. That is determined, solely by the carbohydrate content of the diet, not its fat content. Lower fat intake to no more than 150 grams a day. See if that lowers inflammation. You can continue lowering your daily fat intake, in increments until you see results. Once you reach 50 grams a day, go no further. See at what level you begin seeing a reduction of inflammation.
- Second, if that doesn’t work and there's still inflammation, scrap the saturated fat in the diet, all together, and replace it with monounsaturated fats like olive oil. If you still see no improvement go to a low fat diet of no more than 35 grams of fat per day. Continue to eliminate all sugar and grains. If that still doesn’t improve anything, you need to check what other items are in your diet, besides fat, that could be the culprit.
If none are found, you have to discuss with your healthcare provider more in depth testing, until you can figure out where this inflammatory response is coming from. It might not be from diet at all, but from some other underlying condition that hasn’t been discovered yet. Doctors are notorious for detecting certain inflammatory conditions like autoimmune disease, at their final stages. Don’t let that be you. Fight for testing and the proper diagnosis. Don’t let them sweep this under the rug because it is ultimately you that will suffer, not them.
3. If blood glucose is low and ketones are high, you should be losing weight.
Obesity is not a "disease" of blood glucose or ketones. It's a condition of poor blood glucose regulation. Losing body fat is determined by how much you can obtain and sustain proper blood glucose regulation.
You can't lose body fat if you are only burning dietary fat. That would only cause high ketones while your still obese. Lower dietary fat to lose body fat. Lowering dietary fat will help lower fasting insulin levels and halt its over expression on your fat mass. This will help you regulate your blood glucose better, further improving insulin expression/release.
4. Carbohydrates is the only way to gain weight. If you have been lean your whole life, nothing else will make the weight go up.
That is actually true. The obesity resistant are super leptin sensitive. They have proper insulin expression/release and their blood glucose regulation works properly. For this reason, it is very difficult for them to gain body fat. Calories will not do it, fat will not do it, protein will not do it. None of those things affect blood glucose regulation enough to cause body fat gain. They must consume carbohydrates. Carbohydrates have a profound effect on blood glucose homeostasis and will eventually break proper blood glucose regulation, causing an increase and sparing of body fat over time.
Of course, all of this is dependent on how easily you can affect an obesity resistant person's blood glucose regulation. Just because carbohydrate consumption would be the most common way of doing it, doesn't mean it would automatically work. After all, we have all seen college kids eat endless pizzas and drink liters of soda and not gain a pound.
Obesity resistance, though seen in the young, is extremely uncommon at older ages but it does exist. These people have blood glucose control that is very resilient to changes. It refuses to adapt. This of course, would cause these people to not fare well during a famine but in modernity, these people will live just fine, lean and slim, well into old age, while everyone else stares in envy.
So, if you are obesity resistant and what to gain weight, gain muscle mass. That will increase your weight and you won't have to put your blood glucose regulation at risk. You have been blessed with great blood glucose control. Do not potentially sabotage it yourself through carb consumption.
6. Carbohydrates have to be 20 grams or less, a day, to lose weight.
Negative. As long as you can obtain and sustain proper blood glucose regulation, you will lose body fat. That could be done with 0 grams a day, 20 grams a day or 100 grams of carbs a day.