Six common beliefs addressed, Part 204

1. I've started to notice that a lot of "low carb doctors", who push carnivore or "keto", are obsessed with eggs. They are now pushing eggs over meat. 

You have to understand that for most of these "doctors", “keto” and low carb are not their first rodeo. These people have been peddling one failed diet or another, for many years, before they got here. Most of the ones pushing eggs and greens, as a “keto” protocol, were once pushers of plant based protocols so they continue pushing a "less meat" agenda, even when they have been forced to include meat.

Stay away from “keto/low carb doctors" and stay focused on what's really going on with you. You cannot treat what you don't understand. Obesity is not caused by following the wrong food lists or buying the wrong diet book. Obesity is the chronic under expression of leptin due to metabolic abnormalities caused by blood glucose dysregulation. Blood glucose dysregulation ends in metabolic syndrome/diabetes which are starvation adaptations that further perpetuate obesity. In fact, the only commonality found in obesity research, between patients, is blood glucose dysregulation. Obese people vary in gender, age, health, pathologies, diets, lifestyles, appetites, etc. but they don't vary in blood glucose dysregulation. 

So in essence, all you have to worry about is obtaining/maintaining proper blood glucose regulation. Everything else is flim-flam. It doesn't matter if you can achieve proper blood glucose regulation through eggs or filet mignon. No one individual food item is going to achieve proper blood glucose regulation anyway. Only the right macronutrient composition of low carb, moderate fat and adequate protein can.

2. A family member was recently hospitalized for severe dehydration and has not been released from the hospital because they developed rhabdomyolysis. Doctors told them they would need dialysis if it continues. This reminded me of diabetes, for some reason. 

Rhabdomyolysis (rhabdo) is a potentially life-threatening syndrome resulting from the rapid breakdown of skeletal muscle which leaks muscle contents into the blood. The most common causes are crush injury, overexertion, alcohol abuse and certain medicines and toxic substances. Rhabdo can cause damage to the kidneys because they become overworked trying to eliminate this muscle waste. Rhabdo is not directly associated with diabetes but any chronic disease, like diabetes, can put you at more risk for developing this condition after any injury or illness. When the body loses resilience through one chronic condition, it affects how it handles all other conditions.

I think that the reason you thought of diabetes when you heard about rhabdo is because diabetics also break down their lean muscle mass, at an exaggerated rate, and eventually develop kidney disease. This is because their kidneys are also overworked as they try to eliminate this excess waste. The excess waste from a diabetic's muscle break down is mostly sugar. So rhabdo can damage kidneys in a few days and diabetes can take a decade, but their end result is the same - dialysis.

There are also other factors in diabetes that cause kidney damage as well, which include the chronic inflammation and excess water retention caused by hyperinsulinemia itself. This water retention causes high blood pressure and high blood pressure, especially in the small vessels, damages the kidneys over time. So even though these conditions are not connected, they both overwork the kidneys, eventually damaging them.

3. Low carb advocates always talk about insulin resistance or insulin sensitivity, but they never fully explain either. 

I have used the term insulin resistance and insulin sensitivity before but I refrain from doing so as much as possible. This is because low carb advocates blame insulin resistance for a slew of ailments that have nothing to do with insulin. It is such a misused and overused term that it has lost most of its meaning. Insulin sensitivity is also too general a term to use since diabetics are very insulin sensitive, at the fat mass only, so without nuance the term is mostly meaningless.

So since there is no such thing as being completely insulin resistant or completely insulin sensitive, I like to use insulin function instead because ultimately that's what’s deteriorated in metabolic problems. Insulin serum levels are chronically high, insulin is over expressed at the fat mass and it’s under expressed in other tissues and organs, at varying rates. That's poor overall insulin function.

4. My friend is on a traditional diet that's calorically restricted and I am following a "keto" protocol. Once a week, we both allow ourselves to have a dessert. I make myself a "keto" dessert, which complies with my macros, and she has a "cheat day" where she eats something she usually can’t, like a brownie. I think my "keto" dessert is a better option than hers but she thinks it equates to the same thing for us both.

Your "keto" dessert is definitely better because you are not going off protocol just to have a dessert. More importantly, a day of higher fat does not disrupt blood glucose regulation but a day of higher glucose does.

Of course, your friend is seeing this through the lens of calories so she assumes, both desserts are a wash at the end of the day but if you have been reading my posts, you know better. Just one episode of "dietary induced hypoglycemia", meaning that your postprandial blood glucose was disrupted enough to cause a prolonged insulin release/expression which then drops blood glucose while fasting, is enough to get the ball rolling towards metabolic disaster. You have to understand that our blood only has about one gram of glucose, at any given time. This means anything over that is technically overload.

Now this doesn't mean that your friend will drop dead instantly from a piece of pie. After all, there are hunger/gatherers who are forced to eat honey, for weeks on end, just to survive. Our metabolism is pretty resilient, particularly when there is nothing wrong with it at the moment. It just means that your friend is setting the stage for future problems.

On average, we live longer than hunter/gatherers so we have a future to worry about it. Most hunter/gatherers do not have to worry about losing a leg at 60 years old. Because we can live such long lives, we have more time for things to go wrong and things will go wrong. If your friend is already overweight/obese and/or suffering from other metabolic dysfunction, then things will go wrong much more quickly for her.

5. There is no way to reduce systemic stress.

The best ways to reduce systemic adrenal stress are the following:

• Take control of any chronic underlying conditions - Chronic conditions like metabolic syndrome, auto immune or any other inflammatory disease will cause your body to be in a persistent state of stress. It is very difficult to regulate blood glucose under stress. You need to discuss with your doctor effective ways of gaining control of any chronic condition you may have. A lot of people just go to routine doctor visits and find no real improvement in symptoms. They are either misdiagnosed or given ineffective treatments. You have to take control of your healthcare. Make sure you aren't just going through the motions when you visit your physician. If they can’t help you, find one who can.
• Take control of medications - You have to make sure you aren't being over medicated with drugs that effect blood glucose regulation. A lot of people don't realize that lower doses of medications are still effective in treating their condition. Others don't realize that the medication they are on is actually useless and not helping them at all. So make sure you discuss with your doctor your medications, particularly if you have been on them for a very long time and the dose has not been changed nor has your condition been recently re-tested. Some people are still taking medications for conditions they no longer even have. Others are taking over the counter medications, at their own discretion, when a better prescription medication may be available which can be better monitored.
• Exercise daily in a predictable routine - Exercise helps regulate inflammation by directly affecting inflammatory hormones like cortisol. You should have a predictable and consistent exercise routine you follow daily so the body becomes primed on when to burn energy and when to store it.
• Eat two to three meals a day in a predictable routine - Eat real meals, not novelties or "snacks". Meals should be protein prioritized, low in carbs and moderate in fat. Make sure your meal timings are consistent every day. Do not go long stretches without eating. Make sure you eat enough at each meal.
• Fast in a predictable routine - If your meal timings are consistent, then this would automatically make your fasting times consistent as well. 12 -18 hours is the only daily fasting schedule that we recommend on this blog. Choose the schedule within that time frame that prevents hunger and/or any other symptoms.
• Sleep in a predictable routine - Go to sleep at the same time nightly. Not only will this allow you to sleep better and wake up naturally, without the alarm clock, but it will help you get enough sleep. Sleep induces the lowest insulin state you will have in a 24 hour period.
• Get rid of any caffeine - You will never be able to control your blood glucose until caffeine, in every form, is removed from your diet. Blood glucose dysregulation is the main cause of adrenal stress. 
  

As you can see most of the above recommendations are focused on normalizing circadian rhythms. Your circadian clock is the way your body communicates with its environment. It's not enough to just be conscious. To help keep your circadian rhythms healthy, keep a schedule and do things according to it. Do not be willy-nilly with your time because that will throw off your eating, fasting and sleeping schedules. Take your time more seriously. Remember, we only have a finite amount of time. Make the most of it. 

Following circadian rhythms reduce systemic stress through their affect on cortisol and other stress hormones. All animals follow circadian rhythms. Dopamine plays a crucial role in regulating circadian rhythms. Dopamine affects metabolism profoundly as it regulates metabolic hormones seasonally for fat storage and burning. So living erratically and unpredictably is not good for metabolism. This is particularly true for people with current metabolic syndrome.

6. They will never tell us the truth about obesity. 

This is because they don't have effective ways of treating obesity since it has no cure. For this reason, they want to place responsibility on you to keep it "under control". The advice that is currently given to the obese, only works for the lean as it can reduce their risk of future obesity. For the already obese, it is mostly useless.

It is reprehensible the way obesity is discussed in medical circles. It is akin to malpractice in my opinion. To tell an obese person to "aim for a healthy body mass index (BMI)" and "increase their exercise" in order to "cure" a condition without any known cure is abusive.

Obesity is a leptin condition, not a diet condition. You can not achieve a healthy BMI without leptin. I find it impossible to believe that a medical doctor would not know this as this information is not hidden in a mysterious vault that only warlocks can view. This is actually consistent in obesity medical literature.

So I am with you on your outrage. I just don't have any answers for you. The only thing I can think of is that they want people to continue “being mindful of their weight” and they don't want to give them any excuse to not be.