Six common beliefs addressed, Part 165

1. I keep reading on low carb pages that this is the "best diet in the world", with the "best foods", but everyone keeps "falling off the wagon". 

Because people like junk food and other man-made creations. They are fun, economical, easy to obtain and highly palatable. Few people can make a commitment to eat as if this was the 1800's because it's a new millennium.

Low carbohydrate diets are simply the best protocols to follow if you have metabolic syndrome because they help blood glucose homeostasis. But they aren't the "best diets in the world", nor do they promise the "best foods". They are just a diet, like any other, that consists of real food.

The people who make claims about low carb being best, can't even follow the diet properly for more than three days at a time. Low carbohydrate diets are restrictive and highly boring, until you get the hang of them and become accustomed to your daily fare. Some are able to do this better than others. This is why low carb is not the first diet recommendation you will get from a nutritionist or dietitian. They always start with caloric restriction first, as most people can stick with those protocols better and for longer.

2. I am struggling to stay within my macros because I am still hungry. 

Use protein as a lever. When it comes to hunger, protein can be increased to achieve satiation. Protein is the hunger lever and fat is the weight lever.

3. Insulin levels are very variable and can go up and down erratically, depending on your food intake. Because of this, it's advised to not give this marker any importance. 

This is somewhat true. Insulin is very variable and that is why it's not the only marker we focus on. But when we discuss insulin on this blog, we are specifically referring to basal insulin levels and primarily to insulin function (release/expression). Basal insulin levels, your fasting insulin, should be low. It should not be high as there is no need for it to be high if you are fasted. High basal insulin levels will interfere with your fasting blood glucose, by dropping it too low. This will reinforce the metabolic adaptation known as metabolic syndrome. There is a percentage of obese people who do not display high insulin levels, even while fasted. It is believed that these people are simply no longer making enough insulin due to beta cell dysfunction.

More importantly, you need to focus on insulin function. People who are overweight/obese and/or have metabolic syndrome have poor insulin function, regardless of its level:

• There insulin does not spike high enough to stop catabolism postprandial.
• There insulin does not trigger a proper counter regulatory response while fasting.
• There insulin is over expressed at the fat mass, diverting all energy to it and not allowing any out.
• There insulin is under expressed in their muscles, organs and tissues, basically "starving" them and sparing more glucose for more fat conversion.
  

This is the result of poor insulin function and may not be reflected in insulin levels. For example, a very obese person may have an insulin of only 12 and you might have expected 45 or more. Well, 12 is still quite high for basal insulin but it's not as high as you would have expected. So why is the person so incredibly obese? Because of poor insulin function.

It's good to know your basal insulin level but it's also good to not ignore what your body is telling you. If you are overweight/obese, your body is letting you know it is having poor insulin function.

4. Since obese people have poor insulin function, they should restrict protein.

No. That's the reason they should increase it. Because protein does not go into the fat mass for storage, it helps build and maintain the lean muscle mass that the obese have left.

4. Body builders use insulin for energy.

No. Bodybuilders use insulin for muscle growth, not for energy.

5. All "low carb" doctors seem to have differing opinions about how insulin works.

Because a lot of doctors do not like to stay in their lane. What ends up happening is they have a little bit of knowledge about a variety of things but not enough to complete the picture. In other words - jack of all trades and master of none.

Nearly all doctors have no understanding of obesity. They have an understanding of weight gain and the things that contribute to it but they have no clear understanding of obesity itself as a pathology. This is also true for the diet and exercise industry.

For example, you may continue to hear the following common fallacies from many of these doctors such as:

• The obese are very insulin sensitive because they are able to get and remain fat, which requires insulin.
• Insulin is not implicated in obesity because there are obese people who do not have very high insulin levels.
• Insulin cannot make you fat. It is a very slimming hormone. Just look at bodybuilders.

The people making these statements give themselves away as not having a clue as to what they are talking about. They have a complete misconception of insulin and how it works in the body. So, let's correct these statements:

• The obese are very insulin sensitive, but only at the fat mass. There is no such thing as being completely insulin sensitive or completely "insulin resistance". The body exhibits both at the same time. Insulin resistance occurs at different rates and to varying degrees in each organ and tissue of the body. It is believed this occurs in order to spare glucose for further fat conversion.
  
• The abnormality in insulin when it comes to the obese, is in its function, more than its level. By function we are talking about insulin release and expression. You can get a hint of this dysfunction, through basal insulin levels but that's not always 100% linear. Excess body fat and/or the presence of metabolic pathologies are the main indicators that insulin is malfunctioning, rather than just insulin levels on their own.
• Insulin is a very slimming hormone but not in the context of obesity. It is slimming in the context of obesity resistance. Athletes and body builders know how slimming insulin is when it is building muscle rather than fat. Over weight/obese people know how fattening insulin is when it is building fat rather than muscle. Insulin builds your body as it is an anabolic hormone. Rather, it is best described as an anticatabolic hormone. If the body is prevented from breaking itself down, then it can be left to build itself up. The body is always building. You are either building fat or muscle. So insulin is not anymore a slimming hormone than it is an obesity hormone. It's not either. It only does what it is allowed to do in the neuroendocrine environment it's working in.

So when you follow any of these doctors, be very careful of their information. None of them have it 100% right. There is a lot of BS mixed in with their message. Do not leave your health in the hands of anyone. Do your own research.

6. Can cholesterol be too low?

Only if there is a genetic abnormality that is causing hypocholesterolemia. Cholesterol is made by every cell in the body, so it is not an "essential nutrient". If you have a genetic abnormality that causes very low cholesterol it would have been detected very early in life as the result of most hypocholesterolemia wouldn't just be low cholesterol numbers, but other symptoms that would have resulted in serious health issues.