1. Is it true that the American Heart Association (AHA) now recommends "keto" diets?
Don't let people gaslight you. A lot of low carb people will usually make the claim like the American Diabetes Association (ADA) or the AHA are now "recommending keto or low carb", but none of that is true.
The American Heart Association, just like the ADA, does not endorse any particular diet. It simply recommends for healthcare providers to develop individualized plans for their patients based on three concepts:
- A moderately reduced calorie diet.
- A program of increased physical activity.
- The use of behavioral strategies to help patients achieve and maintain a "healthy body weight".
That's it. This is precisely why you can never get clear answers from your doctor about what diet you should follow. They always fall back to these same vague recommendations and then refer you to a dietitian or nutritionist to help sort out the details. In a way, this is good because there is no one diet that is best for everyone.
On their websites, these associations always use generic recommendations for dieting such as "to eat a variety of fruits, vegetables, and grain products, particularly whole grains; choose fat-free and low-fat dairy products, legumes, poultry, and lean meats; and eat fish, preferably oily fish, at least twice a week".
These associations have leaned heavily on the Mediterranean style of eating for a long while now. That type of diet is not low fat. It is low in saturated fat which is the stance that these associations still hold. Even when they recommend a moderate fat diet, they emphasize that the focus be on "healthy fats" which for them simply means primarily monounsaturated plant fats, not animals fats, as monounsaturated plant fats are extremely low in saturated fat. So their stance on fat has not changed. They still want you to follow a low saturated fat diet.
The reason that the AHA is still holding on to a low saturated fat diet is because some people who have lipid abnormalities do not do well on diets which contain saturated fats. Study after study has shown this to be true. Should these studies have been used for recommending low saturated fat to everyone? No, but the recommendation does not hurt anyone either unless the saturated fat is replaced with sugar, which is what ended up happening. The AHA is aware of that now and has retracted their stamp of approval on high sugar foods.
"Keto" isn't mentioned anywhere here. It's a non factor. Can some people benefit from "keto"? Yes. If the "keto" can keep their diabetes and metabolic syndrome at bay, which contributes to certain cardiovascular conditions. Can some people have worsening cardiovascular outcomes on "keto"? Yes. If "keto" worsens lipid function and composition, it will certainly contribute to certain cardiovascular conditions.
By the way, if you want to get technical, a Mediterranean style diet can absolutely put you in ketosis so I suppose that in that respect, we can say these associations recommend "keto".
2. For some reason protein hates me. It makes my blood sugar and weight go up. I had to cut down on protein lately and increase my fat. Now my weight is stable and my blood glucose is better.
But your metabolic syndrome is getting worse. "Stable weight" while being obese is not a good thing and "better blood glucose", whatever that means, is meaningless. I need hard numbers.
Protein doesn't hate you. What hates you is your insulin function. You need proper insulin function to regulate glucagon and metabolize protein. When you can't do either properly, you have issues which aren't solved by decreasing protein and increasing fat, unless you want to get fatter and worsen this condition over time.
What you need to do is drop all that fat eating, then calculate your protein macros and divide them between three meals. Use common sense not reactionary dieting. Remember, you aren't simply "losing weight", you are trying to reverse a detrimental metabolic adaptation.
3. I can't fast and I’m slim.
That's a good thing. If you are slim and you can't fast, it means your leptin is working as it should and demanding nutrients so it can burn fat. If you are slim and can fast, that's also a good thing. It means your leptin is working as it should and burning body fat as long as it can until nutrients are available again.
Being slim or obese tells you what your metabolism is doing because it sets the context. In the context of slimness, we can assume everything is working well to keep you healthy. In the context of obesity, we can assume everything is working well to keep you obese.
4. Why do all "keto" doctors teach people how to cook replacement sweets?
Unfortunately most people desire that type of food and it's very hard to run a paid diet program without offering them.
5. I was told that statins are "toxic". Is this true?
I am not a chemist/pharmacist and this is not a blog about pharmaceuticals but this is a blog about common sense and fact based information. For this reason I only share what the data actually shows. The data on statins has been pretty clear. What we know for sure is this:
- Statins effectively lower total cholesterol but do not prevent heart disease. This means statins have not prevented a single heart attack through the lowering of total cholesterol. That makes sense since heart disease is multifactorial and it appears that "high cholesterol" is the least of those factors. Treating a number is not treating the problem. This is precisely why we don't consider preventing high blood glucose a proper treatment for diabetes.
- Statins have been beneficial in people with current heart disease. The exact mechanism as to how or why this is the case remains unclear but we can safely say that it is not related to the lowering of total cholesterol. This doesn't mean lowering total cholesterol is useless for everyone. In theory, there would be a beneficial effect in individuals with certain genetic lipid related problems which put them at risk for heart disease. This is because if total cholesterol lowers, so does their malfunctioning LDL. LDL is absolutely implicated in the atherosclerotic process but it appears that its number does not always correlate with its malfunction. Number tracks more closely with malfunction when LDL is significantly high, like over 300 mg/dL. Either way, these individuals are basically slowing down the inevitable by having less LDL through less total cholesterol.
That's all. Those are the facts.
All medications come with risks and benefits. There isn't a single one that doesn't cause some kind of side effect or even long term permanent damage. You can use blood pressure medications as a prime example of that. Blood pressure medications have long been implicated in the development of kidney disease. This could be the result of the medication itself or that blood pressure medication simply does not lower blood pressure enough to prevent future kidney disease. Even borderline high blood pressure damages the kidneys.
Regardless of the reason, what this means is that eventually you will develop kidney problems on these medications but this won't occur until 15 - 20 years later. Untreated high blood pressure, on the other hand, could have killed you in 6 months - 1 year and also damages kidneys more rapidly than the medication does. So, the question is, do you want to die now or later? The risks of treating your blood pressure vastly outweigh the risks of not treating it.
Now what quacks are trying to sell is that you can easily treat your blood pressure, all by yourself, and have 0 risks and nothing but benefits. Would you invest money with an investment firm that makes you this promise? Does it sound like a scam to you? It should, because it is. There are things you can proactively do which can better your treatment outcomes for any condition but most conditions are very complex. No matter how well you try to treat them on your own, you can never treat them enough to reduce your risks of dying from them. That's why there is medical intervention. Does medical intervention end up killing some? Of course. Any intervention can cause death or new problems to arise but medical intervention ends up helping most.
One of the best ways of helping yourself is staying away from quackery as that will prevent you from choosing a proper and effective treatment.
6. There are people who eat one brownie and are thin, but fasting "keto" people follow that "weird diet" and are still obese and sick. Why?
Once you develop metabolic syndrome all bets are off. That's when you begin to pile on body fat, exponentially, and this trajectory will not reverse unless something affects metabolism profoundly enough to halt this adaptation towards starvation. Adaptation towards starvation simply means a metabolism that keeps a high blood glucose, insulin and body fat set point. The body adapts to keeping its blood glucose and body fat high, by any means necessary. This is exactly what occurs during "classic starvation". Of course with classic starvation the body simply can not achieve the body fat and so the person eventually dies. But the mechanism itself, regardless of its success, is exactly the same. In a way, obesity can be described as what occurs when there is long term starvation with sufficient nutrients to prevent death.
The person who has not developed metabolic syndrome yet, can handle this brownie for as long as their body continues to retain its blood glucose regulation. How long the body can retain this is dependent on multiple factors of which the amount of brownie is the least of them. So trying to eat only a little bit of brownie is not going to cut it in the long run. The brownie will eventually break metabolic homeostasis 99% of the time. There are a rare few who can handle this brownie well into age 100 and beyond but don't bank on that being you. Especially if you are already overweight/obese and reading this.
These fasting obese "keto" people all have metabolic syndrome to some degree. That's why they resorted to this diet to begin with. They didn't willingly give up their doughnuts. It took disease and impending death to make them do so. Metabolic syndrome is anything from overweight/obesity to diabetes and everything in between. Their "weird diet" has simply not affected their metabolism profoundly enough to reverse this adaptation. There are multiple reasons for this, one of them being the "weird diet" itself.
This is why the goal is the reversal of this adaptation, not to follow a "weird diet". You have to be sure that the protocol you are following is actually addressing the issue at hand and the best way to know that is to see if it's lowering your body fat.
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