This is true and it's primarily because most people follow the fad "keto" diet, found online, which contains an astronomical amount of fat, sabotaging their results over time. The Mediterranean Diet lowers the fat load and causes some weight loss.
But, let's pretend that this isn't the case at all. Let's say the person was following a proper ketogenic protocol. Then a more complex situation occurred.
Ketogenic diets fool the body into "starvation" through the presence of ketones. People with metabolic syndrome/diabetes produce ketones rather easily because of their poor insulin function. This causes for the body to assume it is starving for a long period of time, as you aren't truly starving and can follow the diet indefinitely. A metabolism that is already adapted for starvation, is now being convinced that is exactly what's occurring because of ketone presence. This dysregulates blood glucose further through the stress response.
When you switch to a Mediterranean diet, which drops ketone levels and allows the body to go in and out of ketosis naturally, it simply up regulates leptin expression and causes the burning of body fat as the brain becomes aware that it had body fat to burn.
This is the classic example of how leptin can be manipulated through nutrient availability and why there are such fad diets as "Eat more and lose weight!" or "Eat more frequently and lose weight!". This is also why fasting advocate's favorite saying is "Switch it up!" if you are stalled.
All of these gimmicks are just temporarily effecting leptin, causing temporary weight loss.
The problem is that leptin, once again, down regulates its expression once body fat is challenged, significantly enough, and you remain obese. I know that people don't like to hear this because they want to hold onto hope, but this is the reality that the diet industry will not tell you or come up with some snake oil to try and combat it. Leptin always under expresses when body fat is lost and it stalls weight loss, causing weight regain over time. This means that diet alone is not enough for you to lose enough body fat and keep it off. You need to have an overall lifestyle that is anti obesogenic which includes predictable meal timings and most importantly of all, exercise. Anti obesogenic lifestyles are ones that reduce and/or eliminate all interference with blood glucose regulation.
2. Even though calorie restriction feels like starving, "keto" is too difficult to follow because it does not allow grains.
"Starving" on caloric restriction is basically the reality of this protocol. Caloric restriction is starvation. The body then responds as it should. It's trying to prevent starving by ramping up hunger. The body is starvation resistant and though many metabolic functions will fail, with time, its anti starving mechanism will remain in tact until the very end. Literally. That's why all diets fail.
As far as everything else goes, there's not much that can be done. If you can't follow "keto", leaving you to resort to caloric restriction, then there isn't really much left for you to do, except basic low carb. Of course, basic low carb will not work in the long term because it still includes sugar and grains, just in smaller amounts, which continue to dysregulate blood glucose. But maybe that's as far as you can go.
If there is no commitment, there are no results. If you can't do any diet, then maybe you shouldn't be dieting. You might not be ready to commit to what you have to do in order to get to where you want to be.
3. I don't know why they assume that the grains used to fatten livestock would make humans thin.
This is ridiculous. They feed livestock grains ad libitum. They don't assume that humans would "feed" that same way. So, basically they are basing grain consumption on caloric restriction through calorie tracking, portion control and the reduction of fat intake, so it doesn't compete with carb intake. The most fattening diet in the world is one that is both high in fat and carbs, just ask the Pima Tribe. The Standard American Diet (SAD) is both high in fat and carbs and this is why it's so very fattening.
The solution then is to eliminate one of the energy macronutrients in order to make the overall diet reduced in calories.
So, the logic works as follows - Reduce the fat in the diet and that only leaves the carb. Now the diet is restricted in calories by default because one energy macronutrient has been significantly reduced, giving the other one more leeway. The premise is correct. Whether you reduce fat or carbs, the overall diet is now less in energy. Unfortunately, that's not where the story ends. If only it did, obesity would have been resolved decades ago.
The problem with this premise is it surmises that overweight/obesity is solely the result of overall calorie intake, especially fat calories. That is incorrect. Weight gain or loss is the sole result of overall calories. Overweight/obesity is much more complex and it is driven by blood glucose abnormalities caused primarily by carbohydrate calories. So, they have kept the wrong macronutrient in the diet.
Carbs cause pathological abnormalities in gluconeogenesis, blood glucose regulation and the stress response. This easily turns carbs into body fat and you in turn acquire a hormonal profile that spares this body fat and builds more of it, irrespective of overall caloric intake. In other words, you can restrict carb calories alone to begin reversing these pathologies, but this same reversal is not seen in the restriction of all calories.
For this reason, you get much better results increasing protein calories, dropping the carb calories, all together, and moderating fat calories.
4. Cereal should not be labeled "heart healthy".
But they are because they do not raise cholesterol. Cholesterol and smoking are the most commonly used metrics, that conventional medicine relies on, to ascertain heart disease risk. Cereals do not effect cholesterol and when they do, it's to lower it. This is mainly achieved through the lowering of HDL, making your total cholesterol appear lower.
For this reason, cereals are labeled "heart healthy".
Of course, they aren't. They usually contribute to heart disease because people who buy these type of "foods", generally follow a bad diet over all. In other words, what makes cereals so unhealthy, is not the cereal itself, but the fact that its a staple of the Standard American Diet (SAD). People who eat cereal, eat SAD.
5. If your HbA1C has not lowered, it's because you're using artificial sweeteners.
Nope. At least, not directly. There are some artificial sweeteners that turn back into sugar in the body, but a high HbA1C is caused by one of three things:
- Dawn phenomenon - High blood glucose in the morning
- Hyperglucagonemia - High blood glucose after eating
- Both - High blood glucose all the time, basically diabetes
What I do know is that artificial sweeteners have nothing to do with this directly. The taste of sweet contributes to obesity, indirectly, through the disruption of the hypothalamic axis. This will contribute to your body fat. Body fat heavily contributes to further blood glucose abnormalities because body fat puts a high insulin demand on the body.
6. Your arteries should be healthy if you have low to normal cholesterol.
Total cholesterol is not the culprit of heart disease. It's more complex than that. Remnant cholesterol and LDL function are better metrics when it comes to heart disease. If serum LDL is high, it can be an indicator that LDL is not functioning and/or clearing properly, but that's not always the case. LDL clearance and function is mostly determined by apolipoproteins and this is mostly genetic with some epigenetics thrown in for good measure. In other words, lipids are very complicated and are effected by many things.
Your arteries can be damaged by other things that are not lipid related. High blood pressure and hyperinsulinemia are known to cause endothelial damage to the arteries. In other words, cholesterol can be perfectly normal and you can still acquire heart disease.