1. Sugar and carbs are only not good in "excess".
Sugar (fructose/glucose) is not "good" in any amount. Why? because it had been shown to be problematic and disruptive to liver and metabolic function irrespective of calories (amount). It does this through a disruption in blood glucose homeostasis. This means that there is no anti obesogenic amount of sugar that you can have. It is all obesogenic, in any amount.
Other carbs like starch, which is basically glucose, are not good in excess. Excess is difficult to determine but if they make up a good percentage of your overall diet, you will have a problem. If they replace protein, you will have a problem. If they are consumed alongside refined fats, you will have a problem. If they are consumed as processed foods, you will have a problem. If they taste sweet, you will have the biggest problem and soon you will be as big as all your problems. You must follow your macros and keep carbs low.
So, overall, carbs must be restricted. Carb restriction will help you maintain better control over your weight than if they were unrestricted.
2. Protein will not raise blood glucose if it's balanced with fats.
That is pseudo science. Avoidance of symptoms is not the proper way of treating metabolic problems.
If you have metabolic syndrome/diabetes, protein will most likely raise your blood glucose but this is not a pathological rise and will correct itself with time. The proper way to address this is by dividing your daily protein into several meals, not adding more fat to the mix. You already have plenty of fat on your behind. Use it.
3. Diabetics should take a lot of supplements.
We do not recommend specific supplements but we do generally advise on magnesium 400 IU a day and a good quality multi vitamin. If you have been tested and are deficient in anything else, then follow your doctor's advice. Diabetics usually are low in B vitamins so if you want to add a coenzymated B complex supplement, then you can do so. If you are protein averse or simply cannot meet your daily protein goals, then a good quality whey protein supplement would be advised.
4. If you are prediabetic it means you are basically a full diabetic who has it under control enough to stay below the radar.
Technically, this is correct. If you are watching your diet and incorporating other lifestyle habits, you can control the symptoms of your metabolic syndrome and even prevent it from progressing. But avoiding the metabolic states that contribute to the adaptation, like erratic blood glucose fluctuations, does help reverse the syndrome.
Unfortunately, this is not the case for everyone and that's why there is no cure for metabolic syndrome. I was able to reverse my prediabetes but many others have not, even when doing the same thing I did. Reversal is completely dependent on how much blood glucose control you can obtain and sustain, which will ultimately (hopefully) determine how much body fat you can lose and insulin sensitivity you can regain. Not everyone is capable of obtaining or sustaining their blood glucose regulation to a degree that will cause reversal or remission. The reasons for this are complex and have to do with how your metabolic hormones, fat cells and hypothalamus reacts to treatment.
5. Some people are able to put their diabetes into remission effortlessly, and remain thin, while the vast majority cannot, no matter what they do.
That is the most complicated issue with metabolic conditions, and why most will shy away from giving an answer for it since they have no answers, but it basically has to do with an individual's neuroendocrine response to treatment.
Just like with any other condition, some people respond to treatment and others do not. I have spoken before about the known culprits that can effect outcomes like age, length of disease, co morbid conditions, gender, sex hormone status, etc. Behavior is also a big one which effects the consistency and adherence to treatment. But at the end of this laundry list it all boils down to leptin. How much leptin sensitivity can you acquire and, most importantly, how much can you retain?
Some people can acquire leptin sensitivity very easily and retain it for a long time. Those are the ones that can reverse their condition rather "effortlessly". After all, leptin is the "starvation hormone" and since metabolic syndrome/diabetes/overweight/obesity are starvation adaptations, leptin is the target hormone that can reverse them. Unfortunately, most people cannot become leptin sensitive enough or retain this sensitivity for the long run. This is not good as obesity is a condition that requires a long term treatment.
Leptin function appears to be driven by genetics/epigenetics as leptin is produced by adipocytes (fat cells). Fat cells are unique to every individual and have some heritability. Fat cells also change with time depending on the "metabolic environment" they are exposed to. Add to that the hypothalamic damage, which many obese people end up with, and you are left with a recipe for failure. The hypothalamus is the area of the brain that communicates with leptin. This is why leptin resistance is so complicated since it's not fully understood where it develops (brain or fat cells or both?) or from what exact trigger (obesity alone or insulin resistance or both?). So far, it does not appear to be reversible in the long term for most individuals.
This is why a good sign that your treatment for metabolic syndrome is working is when there is body fat loss. Body fat loss is an indicator that leptin is responding to treatment and if leptin is responding then we can safely assume other hormones are reaching homeostasis as leptin is a slave to insulin, glucagon, etc. This is also why conventional diabetes treatments have such a dismal outcome because none of them induce body fat loss. This means metabolism is still damaged, regardless of how low your blood glucose goes. As long as you're obese, you're sick and have not obtained proper blood glucose regulation.
So when a former diabetic or obese person tells you that they "did all the right things" in order to "cure" themselves, don't buy it. The only right thing that happened to them was a proper leptin response, which they had no control over. This means that whatever they did, does not apply to you unless your leptin can do what theirs did.
6. If blood glucose is kept low, you should not be overweight.
Well, you're still overweight because low blood glucose is not indicative of proper blood glucose regulation. Until you are able to obtain and sustain proper blood glucose regulation, you will not normalize insulin release/expression and so you will never become leptin sensitive enough to be slim. I explained that in the above question, but let's tackle how this relates to blood glucose as that's a bit more interesting.
The body doesn't see blood glucose "numbers", it only sees disparities. You see numbers because you have a blood glucose meter but the body only goes by homeostasis. Disparities disrupt homeostasis. A drop from a 220 mg/dL blood glucose, postprandial, to 90 mg/dL fasting is the same as if the blood glucose was 85 mg/dL and then dropped to 40 mg/dL. Blood glucose dropping in this manner signals starvation. The body will now actively try to prevent this by keeping blood glucose higher than it should. In fact, it will strive to keep blood glucose high all of the time in order to prevent any drops.
When you stop eating pizza and your postprandial blood glucose no longer goes to 220 mg/dL, your body will still react to your blood glucose lowering from a normal 90 mg/dL to a normal 80 mg/dL. Your metabolism has become adapted to react adversely to any lowering of blood glucose, regardless of its range.
This is why it's so difficult to reverse this metabolic adaptation because it tends to continue even at seemingly normal blood glucose levels. In other words, it doesn't matter how low someone can keep their blood glucose, they seem to never acquire proper blood glucose regulation. The body will continue actively trying to be in a state of hyperglycemia. It takes a very long time to normalize this depending on a multitude of factors, most importantly insulin expression which tends to remain abnormal in certain tissues, even after proper clearance, particularly in the fat mass. As long as insulin is abnormally expressed, blood glucose will continue to fluctuate erratically, even at supposedly normal levels. This is because insulin over expression always drops blood glucose too low during fasting and the body will continue to actively try to prevent this.
How does this relate to leptin and you still being overweight? Well, leptin is a slave to insulin. Obtaining leptin sensitivity so the body can lose body fat is extremely difficult and insulin/glucagon abnormalities do not make it any better. Metabolic dysfunction ultimately deteriorates leptin expression and it is not known if it can be regained. So far the data is dismal and this is why overweight/obesity are still considered conditions with no known cure. This is why the only thing you can do is be one step under obesity. Control works just as well as remission. Keep your blood glucose under control so things do not become worse and with time, everything might follow suit.
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