Six common beliefs addressed, Part 202

1. All weight loss and gain is mitigated through calories but yet they can never get you to overweight or slim.

When we speak about “weight”, we are referring to muscle, water and fat. Your entire body's make up. Calories affect muscle, water and fat because they have a short term effect on insulin. Insulin is an anti diuretic so when it lowers, you lose weight from the loss of water. Caloric deficits also induce stress in the body which causes some muscle break down. These effects usually do not go beyond 5 - 20 pounds.

This is why all weight loss and gain is mitigated through calories because calories always cause this effect on insulin. So you could use calories if you want to fit into your pants before the next high school reunion or you need to make weight requirements for the next wrestling match. You could also use calories to see some gains at the gym. Calories are fantastic when some “weight” is all you need to lose or gain.

You need a much more profound effect on insulin in order to go beyond this "body weight" loss and get to body fat loss. The reason that calories never get to the fat of things is because calories do not effect insulin long term or profoundly enough for this to occur. So what does? Blood glucose regulation. After all, it is abnormal blood glucose regulation that causes insulin's proper function to deteriorate.

When you restrict over all calories, you are not addressing blood glucose regulation to the extent you have to. This is because, half a doughnut still effects blood glucose. Not eating also effects blood glucose as it breaks down muscle into sugar and further reinforces the sparing of fat. Therefore, the elimination of the doughnut all together and eating enough to reduce the break down of muscle would effect blood glucose regulation more severely, impacting insulin more profoundly.

This is why macronutrients are king for addressing obesity, rather than just calories. After all obesity is high body fat, not high body weight. You don't want to burn "calories", you want to burn fat. Obesity can only be addressed through a long term, sustained effect on blood glucose regulation so that insulin can be profoundly affected. Until insulin is profoundly affected, other metabolic hormones will not follow suit. The premise is that this profound effect on insulin function will cause leptin expression to improve and body fat loss to occur. There is no body fat loss without proper functioning leptin.

2. Calories can be used to help regulate blood glucose.

Not in any meaningful way.

Like I wrote above, calories have a short term effect on insulin, more than they do on blood glucose. For instance, if you eat an entire doughnut your postprandial blood glucose may reach 200 mg/dL and then your fasting blood glucose may drop to 75 mg/dL. If you were to eat a doughnut hole instead, in order to keep with your caloric goals, your postprandial blood glucose may reach 130 mg/dL and then your fasting blood glucose may drop to 70 mg/dL.

Just because blood glucose did not reach as high as 200 mg/dL does not mean it's well regulated so you will begin to see weight slowly creeping up again, after an initial loss, even while diligently following your diet for some time. This is why calorie restricted diets are now recommending you stay away from doughnuts all together, well just because. They will never explain to you why because they themselves don’t know and they certainly don’t want your attention to go away from calories.

This weight stall or regain will automatically cause you to restrict calories even further in order to achieve the initial results. Unfortunately, this tactic will fail even more now because leptin will under express further in response to the chronic caloric restriction and your blood glucose regulation will continue to have large disparities as you swap the doughnut hole for "heart healthy" oatmeal instead. You are systematically reducing calories but not addressing the blood glucose dysregulation which is causing the weight gain to persist. You're merely rearranging chairs in the Titanic.

This is why we do not recommend the use of calories to manage blood glucose regulation because they do a very poor job at it. It is best to have a macronutrient composition that prevents/minimizes blood glucose dysregulation instead. The best diet for that is low carb, moderate fat and adequate protein.

People who already have metabolic syndrome have problems with their insulin to glucagon ratio, making them very sensitive to postprandial blood glucose highs. This occurs even when they don't "overeat" but it can be worse when they do. Overeating is defined as eating beyond satiation which differs between individuals. In order to prevent this, calories can come in handy and can be used alongside your individualized macros. Calories can be used effectively to prevent overeating, rather than sustaining a deficit, which means that caloric goals would be different for everyone. This is especially useful for individuals with disordered eating habits which also includes under eating, another problem the obese have.

Calories should always be used alongside your macros. Do not attempt to use calories on their own or you will return to the doughnut hole problem I described above. Remember calories allow any macronutrient as long as your daily caloric allotment is followed. Carbs are a macronutrient that will not allow you to properly regulate your blood glucose, irrespective of calories. You would have to go to starvation levels for carbs to not disrupt your blood glucose too much but then starvation itself, will disrupt your blood glucose as the disparities between fasting and postprandial numbers continue to increase.

3. The program 'Optivia' (Medifast) is not a "healthy" program to follow because it is very low in calories, comes with prepackaged soy-based "fuelings" and exercise is discouraged. The necessity for prepackaged "fuelings" is explained “to keep your metabolism going”. The only positives is that each participant has a coach and there's a support page. They claim to be "science based" and some have had success but I think it's nonsense. 

First, let me address the concern over whether this program is "healthy" or not. There is nothing "unhealthy" about any "diet plan", unless you go into the fringes of weight loss circles. Of course, those techniques are not monetized and sold to anyone as a "diet plan".

So, it really all boils down to results and as I've stated before, all diets work and all diets fail. There is no diet that doesn't work because all weight loss is mitigated through calories due to their short term effect on insulin. This is why all diet plans have some sort of caloric restriction in place. For some, this effect on insulin goes beyond it and actually effects leptin, which is what the premise of caloric restriction, and any diet, is really all about. But, when this occurs it's because these people were already leptin sensitive to begin with and they only needed to normalize their blood glucose enough to effect their insulin and magically their leptin followed suit. But again, like I've stated before, this is not the norm. These are exceptions.

This is why I describe all diets as shams because whether they work or not is completely dependent on your leptin sensitivity but that's not how they are marketed. They are marketed to appear as if they will work for everyone, across the board, as long as you follow them correctly. If they don't work, it is assumed you "cheated" or "gave up" due to lack of "self control". Though there are people who simply cannot commit to anything, that is not the case for 90%. Most people are just simply not leptin sensitive enough to get any real benefits from these type of diets. That is why we don't recommend them as you will likely be more successful staying away from calorically based diets, particularly if you are obese and have already tried caloric restriction before to no avail. So it's not about whether something works or not, it's about what is most likely to work.

Now about the things you found to be questionable in this diet plan:

• Most diet plans are about caloric restriction because they have an immediate effect on insulin which will make you think they are working. This is precisely why so many people continue trying new caloric restriction plans because they always have initial success. This is why they all promise, at least a five pound loss in one week.
• The packaged garbage is just another way to restrict calories further while making you think you're eating. The soy is irrelevant. Your metabolism will never "keep going" unless you are intaking suffice calories and protein. So again, the packaged garbage is just a way to make you think you're not starving and of course it's a way for them to make you have to buy something else other than just a "program".
• They discourage exercise because they know the caloric restriction is putting the body through stress and they do not want you to break down your muscle mass into more glucose than it already is by following the program itself. The more lean muscle mass you lose, the more you're up %^& creek.

As far as the "positives" are concerned. I don't see any. The coaches are a rip off and so is the support page. Unless the coach and support page can increase leptin sensitivity, they are basically just another way to make you think you are getting a lot for your money. Unfortunately, these tactics sell as most people, who jump from diet to diet, like the hand holding and these are the people making up the bulk of their clientele. The "science" they are talking about is most likely calories in/calories out (CICO), which is outdated but standard flim-flam.

Finally, as I have said before, the successes are not surprising. If you are leptin sensitive, you will succeed with just about any caloric restriction diet plan simply because they all effect insulin. So, the leptin sensitive can pretty much lose weight on the Twinkie Diet. In fact, the Twinkie Diet has been pretty successful. Depending on the amount of weight loss, which is truly just a measure of how deeply your metabolism has been affected, metabolic syndrome conditions can be reversed in just about anyone.

As you can see, the argument is not over success, it's over unsuccess. That's what we deal with here - people who simply cannot lose weight or keep it off. We help them know what's going on and what will help them address it. For those that have never dieted before, they can try whatever diet they want because they have no clue if they can lose body fat or not. Obesity does not automatically make you leptin resistant, it just makes you more likely to be leptin resistant. Whether you are or not is dependent on multiple factors. So we don't discourage any method that might cause you to lose body fat. We only discourage these failed methods for the people who it has failed for before since they no longer need to continue trying them. The more they do, the more their metabolisms will suffer.

4. I read a post by the American Diabetes Association (ADA) that stated: "Are Grapes Good for People with Diabetes? Yes; the ADA recommends that people with diabetes eat fruit, including green and purple grapes. Despite the fact that carbohydrates can raise blood sugar, the body still needs this important macronutrient." How does this make sense?

It doesn't make sense because it was horribly written. The main problem with associations like the ADA is that they try to over simplify their information, to the point where it becomes bad information. They are horrified of having to write essays on their posts, like I do, because they know no one will read them. I get it. It's difficult to be thorough in written explanations but if you aren't, then this horrible statement gets released and all the low carb bozos will run miles with it. The miles they refuse to actually walk with their feet, they will run on the internet, while sitting on their behinds and leaving comments with even more bad information. Let me fill in the blanks on the point the ADA was trying to make but failed miserably at.

The ADA deals with both Type I and Type II diabetes. They assume that people who are diagnosed with either condition are on blood glucose lowering medications which may or may not include insulin. For this reason, the general consensus stands that these medications make carbohydrates a requirement, hence the statement - "the body still needs this important macronutrient".

Actually, the body doesn't "need" it but those on medications usually do. When it comes to diabetes medications, carbohydrates become necessary in order to prevent blood glucose drops which can cause dangerous hypoglycemia. This is a huge problem in the treatment of diabetes because these drops in blood glucose are not always caused by over-medication but rather by the body's inability to regulate its own blood glucose properly alongside medication.

Type II diabetics are more at risk because Type I diabetics can avoid this complication with stringent insulin doses. Remember a Type I diabetic can regulate their blood glucose, without an issue, as long as they are dosing insulin correctly. Type II diabetics cannot, regardless of the medications used, so it is not uncommon for their blood glucose to be on a roller coaster even while medicated. This is why the ADA does not want to discourage grapes. Grapes are sort of like sugar cubes which prevent hypoglycemia.

The ADA also deems it a win if a diabetic eats a calorically restricted serving of grapes rather than a bucket of French fries. That is a very important missing piece of information here. Grapes, or any recommended food, are suppose to be part of a calorically restricted diet plan. People always seem to conveniently miss that fact for some odd reason. Recommending you eat something, does not mean recommending you eat it ad libitum.

Having said that, let's get to the nitty-gritty. Grapes, or any fruit for that matter, will not allow you to regulate your blood glucose properly. Remember, the disease is not high blood glucose and this is most likely why the ADA is dismissing the rise in blood glucose caused by grapes because they are also aware that's not the problem. The problem is blood glucose regulation. This means that any food, which contains glucose, whether in the form of sugar or starch, will cause the body to struggle further with its glucose regulation. You are putting in more of what it cannot efficiently handle.

So all diabetics should stay away from not only grapes, but all fruits and also not replace them with some other carb junk (French fries). The ADA will never say this though because they know that is impossible to adhere to and the only thing that will occur is that the diabetic will start ignoring all recommendations. But I am not the ADA so I said it and I will say it again. Stay away from grapes and all fruit as it will interfere with proper blood glucose regulation especially when they are being eaten just because. Eat proper meals instead and leave the fruit as a garnish.

If your medications are causing hypoglycemia, tell your doctor so the doses can be tweaked or the medication can be changed because disrupting blood glucose further, through the dosing of dietary sugar, is not the answer. That's akin to self medicating. If you stay away from things that disrupt blood glucose regulation, your medications will work much better and you will minimize the blood glucose roller coaster. This is why you need to check your blood glucose often, throughout the day, in order to have a clearer picture of what your blood glucose is doing and what affects it.

So no, the ADA did not put out this statement because they have stock in prosthetic limbs and they want everyone on insulin. Instead, they just have dumb, and most likely unpaid, writers posting on Facebook for them.

5. I read studies that say high triglycerides (trigs) cause leptin resistance. Everyday something changes...

Yes, everyday something changes when you nitpick everything that is found in research. This causes you to miss the forest for the trees. This is why I keep the information, on this blog, focused on what's actually important instead of on minutia.

Research has indicated that an increase in triglyceride level is partially responsible for "leptin resistance". These studies have concluded that trigs are implicated in leptin resistance as they impair leptin transport across the blood brain barrier.

But when you read research studies on "one thing", you have to be careful to not have a knee jerk reaction into thinking that "one thing" is the cause for a condition already in progress since these complicated metabolic processes rely heavily on reverse feedback loops. This means that once one process malfunctions, so do all the others.

This is the conundrum of - What came first, the chicken or the egg? For example, let's take diabetes and high body fat. Because most diabetics display high body fat, it is automatically assumed that high body fat directly causes diabetes. In reality, the pathological metabolic profile that causes an increase in body fat occurs decades before diabetes is diagnosed. Afterwards, this high body fat perpetuates diabetes and further advances the condition. Therefore, you can say that an increase in body fat is the “canary in the coalmine”, signaling that impending future diabetes is most likely but the fat increase is not the root cause. The root cause is the blood glucose dysregulation that caused a metabolic profile which begins to spare and accumulate body fat. Diabetes is the end stage of this process, blood glucose dysregulation is the beginning and everything else happens in between.

Therefore, body fat is a symptom, not the disease itself. This is why diabetics who lose body fat, even by a little, see improvement in their condition, since they moved the goal post back some. Unfortunately, this improvement reverses after a short time. This is because the metabolic profile persists and the fact that they stop losing weight, and can never get to lean, is the symptom of this. But body fat loss is still pushed as the "cure" for diabetes, even when it's not. The ability to lose body fat is the "cure" for diabetes because that means the metabolic profile that got you to fat, to begin with, is being reversed.

So, are high trigs causing the leptin resistance or is the leptin resistance causing the high trigs? Leptin is a starvation hormone. It burns body fat. If it does not burn body fat, then you would assume trigs would rise. After all, trigs are a measure of unused fat energy in the blood. Fat that is not burned, remains floating around in the serum, just like unburned glucose does.

Do these high trigs perpetuate the disease further and interfere in leptin signaling? Most likely yes. If there is plenty of fat energy in the blood, then leptin would naturally be under expressed. After all, why burn more of what already appears to be abundant? As you can see, we arrive again to a viscous circle as most metabolic processes do. This is why metabolic conditions are so difficult to reverse regardless of a quack telling you otherwise.

The most important thing you need to know, in order to nip this in the bud, is to preserve your leptin signaling. This is done through controlling your blood glucose and by control I don't mean keeping it low. I mean actually controlling its highs and lows by following a lifestyle that reduces large blood glucose disparities.

6. I am diabetic. I have to get better before I can eat bread again.

You can never eat bread again. I want people to be clear that when they start a protocol for metabolic health, it is never stopped. It's life long. You can never eat bread again, not because you are a diabetic, but because bread interferes with proper blood glucose regulation, diabetic or not.

I don't know why people continue with the fallacy that they have to follow a no sugar and grain free diet "because they are sick". It's not because of "sickness", it’s because a diet of no sugar or grains is the correct diet for a human being. Your dog has a diet it has to follow. So does your cat. Your reptile and bird do too. You don't feed bird seeds to a cat or a live rat to a bird, unless you're into falconry. Well, sugar and grains cannot be in a human diet as humans aren't designed to eat them.