1. I recently had the flu, so I followed the advice in a fasting group to "fast it away". I ended up in the hospital with dehydration. The moment I ate again, my symptoms subsided, and I recovered quickly. My doctor told me I had done a dangerous thing. How do these people get away with giving this type of advice?
I hate to say it but if you play stupid games, you win stupid prizes.
Illnesses like the flu can cause serious dehydration and this in turn can result in electrolyte imbalances. You have to be well hydrated, but you also need proper nutrition because electrolytes are mostly controlled in the colon by what you eat. This is why you can get very sick when you fast, even if you drink suffice water. It's simply not enough.
Your immune system also needs protein to make antibodies and since stress causes for there to be a lot of lean muscle mass breakdown into sugar, you have to make sure you eat adequately to help your body fight off infection. In fact, access to nutrients has been a major factor in humans surviving infectious diseases like the flu. Malnutrition/not enough food is the main contributor of death in third world countries. The best and only support available for viral infections is proper electrolyte administration.
The reason these people get away with this type of advice is because others are foolish enough to follow. Don't blame the leaders, blame the followers. Anyone who goes online to seek medical advice, is basically a fool. I prefer for people to become educated and not follow idiots rather than censoring them. Let them give all of the advice they want but if no one follows, they will simply have to find another gimmick.
2. I have obesity and metabolic syndrome, so I have to be on a low carb diet in order to control these conditions. Unfortunately, I also have a genetic condition where I cannot metabolize fats very well, so I tend to get sick on a "high fat diet". The protocol for my particular condition recommends that I restrict fat to only 20 grams a day. When I remain low fat, I feel great. Is there a practical way of going low carb and low fat at the same time for the long term?
Yes. Low fat and low carb is basically a protein sparing modified fast protocol. You are restricting (fasting) the energy macros from your diet (fat and carbs) and keeping (sparing) the protein. There are multiple ways of applying this protocol because the macros can be modified depending on your goals. Hence the name of the diet.
But before I take a deep dive into your question, I want to address the "high fat diet" part. We do not recommend "high fat" protocols on this blog. Those are not legitimate protocols. This blog is all about low carbohydrate, not high of anything. I know there are some legitimate protocols out there that have unfortunately been described as "high fat" but those are false labels. The only "high fat diets" that exist are being followed by very obese, low carb advocates online that went rogue. No legitimate protocol endorses that way of eating.
When a protein sparing modified fast is being used for body fat loss, it is quite restrictive, making it very difficult to adhere to. It also cannot be used for the long term as it should no longer be followed once body fat goes below a healthy percentage.
- For a man, 2–5% fat is essential, 2–24% fat is considered healthy, and more than 25% classifies as obesity.
- For a woman, 10–13% fat is essential, 10–31% fat is healthy, and more than 32% classifies as obesity.
Of course, the obese will have a very difficult time getting to "essential" or "healthy" fat percentages, so they are pretty safe following protein sparing modified fasts for as long as they are still obese.
But of course, this diet can be modified. That's the operative word. It doesn't have to be so restrictive especially if you have to follow it for life. You can simply keep dietary fat up to 50 grams a day in order to give you some leeway. In your case, you can keep it at 20 grams a day so you feel your best. Keep your protein consumption adequate so that your body does not reinforce its starvation response. The carbs can go anywhere from 0 to 100 grams a day. Remember, the priority of this protocol is protein, not fat or carbs so they are irrelevant as long as they are kept low.
Practical ways of achieving this is avoiding dairy products, as they are very high in fat. If you wish to still consume them, you will have to get the 'low fat' or 'fat free' versions but watch your carbs if you do so. Buy 'lean' to 'extra lean' meats and add your own fat at home, if needed. Remember farm animals still contain a high amount of fat even when labeled lean. But adding your own fat to lean meats (preferably wild game) can help you control how much fat is in them without sacrificing protein which is your priority. Avoid unnecessary novelties like nut products and other "low carb" favorites which usually are more fat than anything else. Your priority is protein not fat.
Stay away from junk. Go for the naturally 'low fat', 'fat free' foods which are still whole and not processed or packaged. In other words, choose part-skim mozzarella and not fat free Oreo's. The premise of consuming whole foods still applies to low fat diets.
3. I was sitting at the grocery store and saw that nearly every obese person who passed by me, had a cart that was either empty or had very little food items in it. Yet, every single one of them went directly to the bakery to pick up a pie, cookies or a cake. The stereotype is always that a fat person would basically inhale the entire market, but their carts say otherwise. Strangely enough, every person who was slim bypassed the sweets and went to the bread aisle of the bakery instead. It was an eye-opening experience and I was wondering if you can opine on it.
You pretty much experienced the reality of the obese and why the calories in/calories out (CICO) approach as a treatment has failed so miserably. The obese are the least hungry people on earth. At least, for food. I will relay to you my own experience with this, and I have two examples.
Example 1: My husband's mother was morbidly obese and diabetic. When we would go out to eat, she would take two bites of her food and then stop. Then she would either bag it for the dogs or tell me I can have it. You would imagine, from simply looking at her, that she would wolf down the entire table of food but it never happened. She would blame her hiatal hernia for being unable to eat as it caused her to feel full prematurely but she would then order the dessert and eat it in its entirety by herself.
She would wake up in the morning with no hunger whatsoever and wouldn't eat a thing until almost evening. Of course her meal would consist of mango juice or a milk shake at the ice cream shop. I never saw her sit down to a real meal. Ever. Every time food was available, she was never hungry. She never even cooked. She lived off novelties.
This woman was well at or below her daily calories chronically but yet she was still obese. As you can see it wasn't the quantity of food she was eating that was causing her obesity but her disordered eating habits instead. She was on a high fat/high carb novelty diet and calories be damned.
Example 2: I had a friend who was overweight and diabetic. She did the exact same thing. Every time we would go out to eat, she would take two bites of the meal and then tell me to eat the rest. She blamed her missing gallbladder, but she always had room for dessert, the bread and the fries. She just could never stomach the meat and vegetables. She was never hungry but always had room for high carb "junk". Again, disordered eating habits.
This doesn't end at these Standard American Diet (SAD) followers. We also see this in the obese who follow "keto" or the fad low carb diets you find online. None of them ever sit down to a real meal. Their food always consists of fat. Cream cheese, butter, ice cream, fat bombs, bulletproof coffees, high fat sauces and novelties are considered "meals" for these people. They simply went from disordered eating habits which featured high carb foods to disordered eating habits which feature high fat foods, but the disordered eating habits remain. They were never changed and not even acknowledged.
So yes, I have also seen the very obese walking around the market with a skinless chicken breast, fat free milk and salt free broth in their cart, plus a package of brownies. I have also seen the obese live off salads and veggies because they refuse to eat a real meal. The obese have very strange eating patterns that go well beyond "overeating". Most of the time "overeating" isn't even on the docket. It's really overeating of sugar and under eating of real food or eating air. Real food is meat and vegetables. You know the type of stuff they consider boring and not fun. It's a chore to cook but a joy to open an Entenmann's Bakery box or drink of gallon of diet soda.
Of course, this is also a huge contentious topic with the obese as they do not like to be criticized for their eating habits. They rather blame someone else for their problems, like their doctors, fat free diet products or the Dietary Guidelines. Obesity is already very difficult to treat biologically, and this "victim" mentality and "don't fat shame me" attitude makes it all the more difficult. Behavior must be addressed when treating obesity or the condition will always return, no matter what amount of weight is lost. This is why "weight loss surgery" has been a failure as well.
Thin people heading to the bread aisle of the bakery is a much more complicated topic as bread is eaten around the world and obesity does not track with it. Obesity tracks with sugar intake, not bread. All cultures have their own bread recipes, and they are quite old, yet obesity is a modern condition.
Regardless, bread is a food item that is not recommended on this blog because it is very difficult for an overweight/obese/diabetic to control their blood glucose regulation while keeping bread in the diet. In fact, grains in general are to be avoided at all times. But we all know that bread is very different from doughnuts.
For a person who is still metabolically healthy, what will ward off disease is the overall macronutrient composition of their diet, eating habits and other lifestyle factors. A lot of these thin people, who are headed to the bread aisle of the bakery, are mostly using calorie restriction to maintain their metabolic health even though we know this will ultimately fail if they aren't watching their blood glucose as well. But they will be able to sustain their blood glucose regulation for longer if they continue to bypass the cupcakes and get a loaf of rye instead.
4. Are eggs and cream cheese a good meal to have? A lot of low carbers have told me it's really good.
Eggs and cream cheese are not a "meal". It's a novelty. This type of disordered eating will only make you fatter, especially if you have had a hard time losing weight since that is indicative of leptin resistance. Low carbers shouldn't be telling you that eggs and cream cheese are "really good". The only thing that's good is regaining and sustaining proper blood glucose regulation. That is the only lens you should be using to formulate your dietary choices because that is all that matters.
When you are leptin resistant, any fat you eat is stored and never burned. This causes for dietary fat to be extremely obesogenic as it only adds to your fat mass.
There is no reason to live off cream cheese. Low carb is not cream cheese. It's meat and vegetables. Eat a real meal.
5. Is it true that the purpose of "keto" is not weight loss?
The purpose of "keto" depends on your goals.
There are many iterations of a ketogenic diet. Each is designed for different goals. The classic ketogenic diet is for the treatment of cancer, seizures and other neurodegenerative conditions. There are ketogenic protocols for muscle gain, for weight gain, for the treatment of metabolic syndrome/diabetes and also for weight loss.
The fad "keto" protocol promoted online was marketed as a weight loss diet. This is what caused hordes of people to flock to it and give it a try. When it didn't work, suddenly the purpose was redefined.
Don't let these people gaslight you. This diet gained popularity as a weight loss tool, period. That is probably why you decided to follow it too. If it didn't work, dump it. No weight loss = no long term metabolic change. So who cares what it improves in the short term. Obesity can only be treated with long term changes.
6. Is it "healing" for the body to shift from burning glucose to fat and does this "cure" you of obesity?
As of this post, there is no known cure for overweight/obesity. There is nothing to "heal". Overweight/obesity is not a "disease" that requires "curing" or "healing". It is a metabolic state that requires changing.
Your obesity was not caused from "burning glucose". Your obesity was caused from not burning fat. Glucose burning can displace fat burning but that's meaningless in obesity. That happens to everyone. Our bodies are constantly burning both glucose and fat. It never does one or the other. It does them both at different rates.
For instance, athletes burn massive amounts of glucose all day and do not become obese from it even if it temporarily displaces fat burning. At the end of the day, when they reduce their glucose burning, they burn fat just fine and continue to do so while resting. The obese do not. They just simply don't burn enough fat to not be obese.
The obese also burn very little glucose. The glucose they have is turned into more fat instead. So, the obese are not burning much of anything. This is why they are constantly tired and growing fatter. In fact, most of the energy that the obese "burn", is from converting glucose into more fat. This is why some obese people have high metabolic rates but are still obese. It takes a lot of energy burning to be fat. Not only to they have to lug around gym weights in the form of body fat, but they have to keep converting glucose into more fat.
When the obese are starved of dietary glucose, they simply convert more lean muscle mass into glucose and continue expanding their fat mass from it. They do not magically start burning fat because there is no glucose in sight. There is always glucose. It never disappears just because it's not on your plate. The only thing that causes the obese to burn fat is an increase in leptin expression. This can occur through the normalization of other metabolic hormones but it's not guaranteed.
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