Six common beliefs addressed, Part 164

1. Calorie restriction forces you to go lower and lower in calories to achieve the same results.

Yes. The body always compensates when its calories are reduced and its fat mass is challenged. It then adapts and continues gaining body fat with the new lower caloric set point. The body does this when its starved in any way, including by extended fasting, which is a form of caloric restriction.

The only way around this is to fool the body into thinking that it is under caloric restriction by giving it calories it will not store, like protein and eliminating/restricting calories it does store like carbs and fat. That way the body is not under caloric restriction but it is at the same time. Though you may be in a surplus of calories from protein, the body will not store them but use them for the building of lean muscle mass or simply expel them.

2. There is no way to know if you are insulin resistance.

We only use the classic five criteria to determine insulin resistance, which are present in metabolic syndrome:

• Waist circumference over 40 inches (men) or 35 inches (women)
• Blood pressure over 130/85 mmHg
• Fasting triglyceride (TG) level over 150 mg/dl
• Fasting high-density lipoprotein (HDL) cholesterol level less than 40 mg/dl (men) or 50 mg/dl (women)
• Fasting blood sugar over 100 mg/dl

You do not have to have all of them. If you experience three or more of the conditions listed above, you are considered to have metabolic syndrome, unless they are the result of some other condition or medication. Metabolic syndrome is always indicative of poorly functioning insulin (insulin resistance).

3. Is glaucoma early insulin resistance?

Glaucoma is caused by the death of the ganglion cells of the eye. Period. Until is is definitively known what causes the death of these cells, then the disease can never be cured. You can't cure what you don't understand.

We know that whatever kills any cell, will kill ganglion cells as well. This includes chemicals, injury, infections, toxins, radiation, etc. That tells us nothing as to why ganglion cells, specifically, die in certain people causing glaucoma. So no, glaucoma is not "early insulin resistance". Glaucoma is simply the death of ganglion cells and though there are interventions which will reduce your risk of going blind and significantly reduce its symptoms and progression, the disease itself remains as there is no known cure for glaucoma.

Like with all other diseases, staying as healthy as possible, for as long as possible, can reduce your risk of glaucoma.

4. People are getting gout for the first time after starting "keto".

People are getting gout for the first time after starting vegan, vegetarian, low fat, carnivore, Standard American Diet (SAD), fruitarian, Mediterranean and just about any other diet under the sun because people are getting gout, for the first time, on a daily basis.

The best way to avoid gout is to avoid metabolic syndrome as gout can be best described as early stage kidney disease. The vast majority of kidney disease, in the Western world, is caused by metabolic abnormalities. Carbohydrate restricted diets can reduce your risk of metabolic syndrome.

5. If you don't check ketones you won't know if you are in ketosis.

You don't, but you are. We all go into ketosis every single night during the overnight fast. Our body's metabolism is a hybrid which uses both glucose and fatty acids. The metabolizing of fatty acids, produces ketones. If you are on a low carb diet, you will go in and out of ketosis naturally. If you are diabetic, you will go into ketosis even easier. 

6. You should count total carbs not net carbs.

It depends on the protocol you are following but you shouldn't be counting any carbs. Counting carbs is not necessary on an appropriate low carb protocol as you would only be eating the carbs found in above ground vegetables.