Six common beliefs addressed, Part 157

1. Metabolic syndrome/diabetes can be described as "diseases of high body fat". 

Metabolic syndrome/diabetes and other related metabolic dysfunctions can be described as "diseases of high body fat" and often are because the people who suffer from these conditions have high body fat. All of them. Whether the body fat is invisible on the inside or very obvious on the outside. Any way you put it, body fat accompanies these syndromes. So it is not incorrect to describe them as "diseases of high body fat" since the fat to muscle ratio, in all these people, indicate high body fat. You can also say that the loss of body fat "reverses" these conditions but this is where the whole story is not being told.

Excess body fat is the canary in the coalmine. When your body begins piling on body fat and sparing it, you know you are headed up %$& creek. Not because soon you will no longer fit in your pants but because soon you will need injectable insulin. Putting on excess body fat is a sign that some metabolic abnormality is at play and it will progress if not stopped. That metabolic abnormality is blood glucose dysregulation.

The body puts on excess body fat and spares it when it is under starvation. That is its defense mechanism. This is why conditions like metabolic syndrome/diabetes/overweight/obesity are all metabolic adaptations towards starvation. This means that something occurs, before the body fat is put on, to cause this adaptation to take hold. We know this because normal weight gain, does not cause this. Like I have said many times before, weight normally fluctuates up and down and its gain does not cause obesity nor does its loss cause cachexia. A healthy metabolism regulates its weight very well and within tight parameters. Obesity is when the body goes well beyond these parameters and raises its weight set point, particularly body fat at the expense of lean muscle mass, to an abnormal level.

The cause for this abnormal blood glucose regulation and that is multifactorial and complex but we certainly know that two things are involved:

• Diet - A diet that causes large disparities between highs and lows in blood glucose sets the ball rolling for adapting metabolism to a high blood glucose, insulin level and body fat set point. This deteriorates proper metabolic function. Large disparities in blood glucose are a signal to metabolism that it is "starving". The trigger for this adverse reaction is the drop in fasting blood glucose after a very high postprandial rise (e.g. pizza eating).
• Exercise - A lifestyle where you are mostly sedentary dysregulates blood glucose control further and adversely effects leptin expression.
• Fasting (Starving) - Time spent in hypoglycemia is detrimental for this process to take hold and progress. Not eating regular meals at predictable times, eating low protein, chronic caloric restriction and simply not being hungry enough for a meal but certainly for a novelty are the primary causes for this. 
  

All three of these things cause for metabolism to begin piling on and sparing fat. This excess body fat further contributes to the downhill progression of the condition. When you follow a lifestyle that addresses blood glucose regulation and leptin function, you halt the adaptation and you begin seeing fat loss as the body allows for this fat to be lost. This in turn improves your condition. So, yes, technically the loss of body fat helped but what helped you lose the body fat was addressing your blood glucose regulation.

The problem comes in when the person simply can't regain and/or sustain proper blood glucose regulation to make a difference. This means that they simply didn't effect their insulin expression profoundly enough to correct their blood glucose, even when it is corrected postprandial. Body fat is at the mercy of your neuroendocrine system and the state it is in. When fat loss doesn't happen, it's because you didn't change that system enough to make a significant, long lasting difference. It doesn't mean this was necessarily your fault. Blood glucose regulation and leptin expression can only be affected so much by your actions. But this is why being fat is never okay. As long as you're fat, you have metabolic problems.

2. Intermittent fasting and caloric restriction are the same thing, if they both equate to the same caloric deficit at the end of the day.

In order to understand how this works you have to abandon the premise that total calories are the only marker the body uses to determine its nutrient status. We have discussed in previous posts how total calories determine body weight loss and gain but not obesity. Obesity is not simple weight gain anymore than cachexia is simple weight loss, even if it appears that way to the onlooker.

The mechanism in obesity that is piling on and sparing weight, particularly body fat, is hormonal driven and doesn't respond to calories in any significant way as it's getting the bulk of its nutrient availability information from your neuroendocrine state. So it doesn't matter if at the end of the day you ate less calories by fasting or caloric restriction because you will still be obese. You can kind of think of obesity as "calorie blindness" because what's driving it is blood glucose dysregulation. You can disrupt your blood glucose with low calories. After all, macronutrients affect blood glucose more than calories but starvation does too. So caloric restriction is actually doubly bad for treating obesity as it uses two mechanisms to adversely affect your blood glucose regulation.

A healthy metabolism responds primarily to caloric input which causes periodic, insignificant, weight fluctuations as it balances itself at its weight set point. An unhealthy one bypasses all of that and can care less as its sole purpose is to continue putting on fat, beyond its threshold, and by any means necessary.

So what matters is what effect these practices (fasting/caloric restriction) have on the metabolic adaptation towards starvation which is what obesity/diabetes is. What exactly does blood glucose dysregulation affect, that would cause body fat to be stored and spared? Though this is very complicated, let's just focus on one hormone - leptin, as we want to get to the "fat" of the problem.

Leptin is usually referred to as the "obesity hormone" but it is best described as the "starvation hormone". Leptin is very sensitive to nutrient availability and it doesn't just measure this through calories. It measures this through meal frequency and activity levels. How does it know? Through insulin release/expression which of course is determined by blood glucose levels. If obesity is sort of a "calorie blindness" then calories are the least relevant information that leptin will go by. You can see this in real time as calorie restricted diet after diet fails miserably in addressing it. This is particularly true for leptin resistant obesity, which is the most common form of obesity. The obese that are still leptin sensitive lose all of their weight effortlessly, following a legitimate protocol, and do not complain about their weight ever again....well, at least for a very long time. This is quite rare but it does happen. If you are on this blog, that's probably not you.

• Intermittent fasting (steady blood glucose) tells the body that there is plenty of food available, it just has to wait for it. This allows leptin to burn body fat during a fast because it knows that plenty of food will still be coming in a short while. This raises metabolic rate.
• Chronic caloric restriction (too much time in hypoglycemia) tells the body that there isn't enough food available no matter how long the wait. Some kind of famine is occurring and leptin prepares the body to deal with that famine by sparing fat mass during fasting times in order to preserve it. After all, this fat mass will be very beneficial if food becomes even more scarce. This lowers metabolic rate to boot.

The way these practices (fasting/caloric restriction) relay to the body this information is through blood glucose homeostasis. Leptin has been around for as long as we have been around and it has evolved to listen carefully to these queues. It is much smarter than we are. It has been through many famines in the past. I know that our bodies seem new to us because our individual consciousness just got here but our bodies are actually "hand me downs" from past generations. Everything that was learned before, is in us and our consciousness can't do a thing to change it.

Our metabolism regulates itself. We weren't meant to interfere with it. When it's not working properly it's because it's being conditioned to do something it's not suppose to, due to the inputs its receiving.

3. If you are "addicted" to diet soda, you should cut it with sparkling water in order to reduce the negative effects.

If you approach your lifestyle change under the premise that you are "addicted" to something, then you should find some other treatment plan besides diet. You do not cure "addiction" by reducing the amount of addictive substances you use. So that right there is a recipe for failure. After all, if you are a "victim" of some "addiction" process then you have no control over what happens. You need to go to rehab. You should never try to tackle an addiction on your own as it requires professional help.

Secondly, if you begin your low carb diet by reducing the same foods you already eat, then you might as well try another diet. In fact, there is already a diet out there that does just that. It's called caloric restriction.

People come up with all kinds of tricks to try and comply with their diet. This is precisely why they came up with caloric restriction in the first place. Caloric restriction is just like cutting your soda with sparkling water. In fact, it's literally the same thing. Both practices make things "less bad". If you eat half the Hershey's Kisses you ate before, then they are only half as bad as they were. If you only have one bite of chocolate cake, then you now made it only one bite bad. We all know none of this works. 

• Half the Hershey's Kisses is still disrupting your blood glucose through the introduction of dietary glucose. 
• Half a glass of soda is still disrupting your blood glucose through its effects on the hypothalamus from the sweet taste and the introduction of caffeine.

When you don't understand obesity and how it works, it would seem that this reduction should produce results but it doesn't. This is because your metabolic issues are not reacting to the "amount of bad". It's reacting to the "bad". Period. As long as the bad remains, in any amount, the issues will also remain. This is why caloric restriction only gets you to calorically restricted obesity. Making your food half bad keeps you less obese but obese none the less. Now some people are just fine being less obese but their metabolic markers will continue to deteriorate over time. After all, you may be able to be half obese but you can't be half diabetic.

Elimination is the only thing that works. Not negotiation, reduction, replacement or manipulation. Now you can fool yourself playing around with your food like this but you can't fool your obesity. People who do things like this never get anywhere. I have seen this time and time again through all the years I've been dealing with these issues.

The best way to eliminate diet soda, is to eliminate diet soda.

4. My husband had a plate of rice and his fasting blood glucose of 84 mg/dL, jumped to 180 mg/dL an hour later. This morning, his blood glucose is still high but when he ate breakfast, eggs only, it dropped to 73 mg/dL. Is rice the culprit for these crazy highs and lows?

Yes, but no. This is actually a very good question and if you ask any low carb advocate they will immediately tell you that the rice is unequivocally the culprit of your husband's problems. They will get on a pulpit and preach that you must simply remove the rice, do nothing else, and your husband's problems will magically go away. Of course, they will conveniently ignore the drop in blood glucose from the eggs. Well, I'm not that kind of low carb advocate, as I don't sell hogwash.

Your husband is having metabolic abnormalities and though I haven't seen him, I'm pretty sure this is evident by the accumulation of excess body fat he has acquired through the years. These large disparities in blood glucose highs and lows, you are witnessing, have been occurring for a very long time and they didn't begin with just the rice. The rice is allowing for you to see this happening in real time because rice is one of the contributors to this blood glucose roller coaster. It makes this abnormality more obvious, particularly with postprandial highs.

The rice alone did not get your husband to this. It only contributed to the process. That is why the removal of rice alone will not solve this. We know this because Asians have eaten bowls of rice, for millennia, and they never developed any blood glucose regulation abnormalities. Of course, this was back in the day when Asians ate their carbohydrates in the context of starvation and had no sugar. No one willingly starves themselves, unless they have an eating disorder. We weren't meant to live under chronic starvation.

This means that two things must be done to stop your husband from becoming diabetic:

• Yes, he must get rid of the rice and never eat it again. Simple.
• But, he must also stop the erratic ups and downs in blood glucose. Not so simple and requires more than just getting rid of rice. It requires a lifestyle change.

He can't just do one of these. He must do both because their combination are what's causing the problem. There is no room for rice in a Western diet. It is very obesogenic in modernity. It is not needed and it is not proper nutrition.

5. Every time I join a low carbohydrate group or page, I am either bombarded with scientific jargon, that I don't understand, or I am bombarded with recipes that are completely useless.

This is why I run my blog differently. I only tell you what you have to know and in layman's language. No jargon or complicated studies required. After all, a great way to hide the truth and muddy the waters is through complicated jargon and "studies". I don't jump at every little new "discovery" made. It's not needed. I also give people meal ideas, rather than recipes and I even limit those.

Low carb is not difficult. It does not require recipes. It only requires meat and vegetables. Unfortunately though, that's what people like to browse as their brain turns to toothpaste on Facebook. They like recipe after recipe that they won't make anyway. Low carb advocates concede in order to continue getting the clicks.

6. If you follow a low carbohydrate diet, the only potatoes you can eat should be raw. 

I often receive questions about what types of fruit are allowed or what are the best tubers or is white rice better than brown rice. Let me be clear about something. Carbohydrate restricted diets do not focus on any of these items, since none of these items should be included on the menu. For this reason, there are no recommendations for them. It is irrelevant which are better or how you should eat them.

The focus of carb restricted diets is on meat and vegetables. That's why they are "carb restricted". As ridiculous as this might sound, "meat and vegetables" has to actually be defined for some, so here goes:

• Meat - Any item that comes from an animal, whether muscle or organs or milk. All animals are on the menu, from farm animals to wild animals. Humans are the only animals that others might have an issue with, so don't share your human meatball recipes in public.
• Vegetables - All non starchy, above ground, edible plants. This includes low sugar fruit like nightshades and fungi like mushrooms. All leafy greens are included and cruciferous flowers as well. Do not try to eat elm trees or saw grass. Edible plants only.

It's not rocket science. There are a multitude of combinations for meat and vegetables. In fact, you can have a different meal, every day, and not repeat any for a whole year and then some. I have a page devoted to just that. Here is a list of 365 meal ideas, comprised of meat and vegetables, including an extra one for leap year.

Notice that items like dairy, seeds, nuts and fruit are only used as garnishes. A very limited amount of meals also use tubers and even legumes as garnishes. The priority is not given to these items but to the meat and vegetables instead.

With this meals list, you will no longer need to eat raw potatoes like a badger. I don't even think they had raw potatoes in the gulag, so I am sorry you have had to live this way. Throw your raw potatoes away and eat real food.