1. Is "nutrient availability" related to micronutrients? Is this what leptin is looking for?
No. I know that a lot of different people are on the bandwagon of obesity, from athletes to diet mongers to holistic nutritionists but none of them will help you. All they do is muddy up the waters and cause more confusion.
When I speak about leptin, I talk about long term nutrient availability. This is exclusively related to MACROnutrient availability, not MICROnutrient availability. Macronutrients are the energy handling (metabolic) nutrients - carbohydrates, fat and protein. Micronutrients are vitamins and minerals.
Macronutrients are what tell your body how to allocate energy and this affects body composition and metabolic homeostasis. Leptin doesn't care about your micronutrients. This is why you can lose weight on the micronutrient void Twinkie Diet. All leptin cares about is how many calories are coming in. All insulin cares about is where these calories are coming from. Leptin is a slave to insulin so at the end of the day where these calories are coming from reigns supreme for obesity treatment.
So your nutritionist can save you from beriberi but not from obesity.
2. If I gain weight, does it mean I am headed towards obesity?
Weight gain is no more obesity than cell growth is cancer. Unregulated, exponential growth of cells that refuse to die is cancer. Unregulated, exponential growth of body fat that refuses to be burned is obesity. The operative word here is body fat. Obesity is excess body fat, not excess body weight. Weight gain and obesity may appear similar because they both affect the scale and how tight your pants fit, but they are very different and that’s why what affects one does not affect the other (i.e.: calorie input).
So no, gaining weight is not obesity and losing weight is not slimness. The body naturally goes up and down in weight. These are normal changes in water, muscle and fat composition. A fluctuation in weight, up or down, of about 20 pounds is normal.
3. I have a friend who is having digestive issues and swears up and down that it's being caused by so many years of low carb dieting. They insist that others who follow low carb are always having issues as well. Is there something in low carb that causes health problems after a while?
No. Low carb diets are not anything special or new. They consist of real food - meat and vegetables. If real food is causing disease, then I don't know what to tell you. I do know that there is nothing in pizza and bagels that preserves digestive health. If meat and vegetables cause you digestive issues, then you have major problems as pizza and bagels will cause you even worse issues.
I don't take any of these claims seriously because most of the people who follow low carb are very sick and very old. Like I have said before, most people resort to an elimination diet when they have reached the end of their rope and by then, it is usually too late. Sick and old people suffer from many ailments and instead of blaming the obvious complexities of their age, health status and long term medication use, they seek to blame some simple external source. A lot of times this is just an excuse to go back to their previous diet.
When someone does have an issue with low carb it is because they are not following the protocol correctly. They are either:
- Not eating enough - living by salad
- Eating processed "low carb" junk - living by "keto" snacks
- Ignoring their electrolytes - what are those?
The first two can occur with any diet and people who have issues with low carb, have also had these same issues in the past with other diets. Electrolytes are different. Remember that low carb lowers insulin rapidly and this releases large amounts of water. This causes electrolyte imbalances so you have to keep your electrolytes in mind when following low carb to avoid the symptoms that this can cause. This is why some people have such a hard time specifically with low carb diets. Dehydration affects blood glucose regulation.
Other than that, there are some exceptions which can be considered:
- Vegetables - Some people have a very difficult time with vegetables. Low carb diets automatically increase the amount of above ground vegetables consumed as they are now replacing grains and starchy vegetables. This can be problematic for many. Vegetables can cause serious digestive issues for some. Gas, heartburn, bloating and diarrhea are not uncommon ailments when vegetables are increased. The simple solutions are to decrease vegetable servings, find the problematic ones and avoid them or eliminate all vegetables all together.
- Meat - There are some digestive issues that can be exacerbated through the breakdown of protein. This means that eating meat can cause severe digestive issues for these folks but this usually occurs when enzymes are taken along with food or when too much meat is consumed at once. Some meat is harder to digest than others so simply avoid the problematic ones.
- Dairy - Some individuals have an adverse reaction to dairy and since many low carb protocols introduce dairy into the diet, these individuals may develop digestive issues. This can be resolved by opting for lactose-free dairy and/or grass fed dairy which has a different protein composition. Lastly, they can simply eliminate the dairy all together. Dairy is not required. It is complimentary, not necessary.
4. I am diabetic and my doctor told me that grass fed meat is healthier than grain fed meat because it has "less saturated fat". They said that if I can't afford grass fed meat to simply eat less meat overall and eat more vegetables like avocados instead. Is this a good idea?
I received several questions this week pertaining to medical foolery. Let's start with this one.
If your doctor is telling you to eat avocados instead of meat then he doesn't care about saturated fat as avocados are very high in saturated fat. Saturated fat is saturated fat so why are they only concerned with the saturated fat in meat? Don't let them gaslight you.
What's different in grass versus grain fed meat is the composition of the fatty acids not the amount of saturated fat. Grass fed meat simply has a healthier fatty acid profile than grain fed meat and this makes a difference in how the liver processes this fat. Research has shown that there is more liver fat accumulation with grain fed meat consumption than grass fed but there are a lot of other factors involved in this rather than just a linear cause and effect. But let's stick to the fact that the fat composition is absolutely different between these meats and that does have a metabolic effect.
I would never recommend you swap protein (meat) for carbs (vegetables). Vegetables do not have enough calories or protein to keep you from starvation. This only reinforces the metabolic profile you already have. Remember, diabetes is a starvation adaptation. More starvation only makes it worse.
What your doctor should have told you instead is that if you can't afford grass fed meat, to diversify your meats between red meat, poultry and fish. You can also buy leaner grain fed meat and add your own fat at home during cooking. The most important thing is to remain low carb.
Little by little you will have more grass fed meat options at cheaper prices if the demand continues to increase and the United States Department of Agriculture (USDA) continues to cooperate in helping to increase the grass fed industry. Right now, it's in its infantile stages but you can already see how grass fed options are slowly becoming more mainstream and you can even find them at Walmart.
5. My endocrinologist told me that honey, agave syrup, coconut sugar and maple syrup are all sugar and they shouldn't be eaten because they all raise blood glucose just like regular table sugar would.
This one is only half foolery.
Yes, all of those sugars are sugar. Sugar by any other name..... They all need to be eliminated, not because they "raise blood glucose", but because they interfere with proper blood glucose regulation. I want people to get out of viewing diabetes through the lens of high blood glucose. That is not going to help you in the long run. What will help you is to look at it through the lens of what it truly is - poor blood glucose regulation. These means BOTH the highs and lows in blood glucose are abnormal.
Many things can lower your blood glucose and not resolve your diabetes one iota. In fact, the low carb world is plagued with obese people who now have lower blood glucose while still on Metformin. As time passes, their blood glucose again begins to rise. This is because lower blood glucose does not mean your diabetes is in remission, proper blood glucose regulation does.
Many other things raise blood glucose like exercise, the overnight fast and protein consumption but all three are necessary for obtaining proper blood glucose regulation in the long term so you don't stop them because they raise blood glucose in the short term.
Still, there are some people who have "diabetes in situ". Dr. Joseph Kraft coined the phrases "diabetes in-situ" and "occult diabetes", occult meaning “hidden” . The diabetes is hidden or "masked" because the blood glucose is being driven down by high insulin. This causes for blood glucose to actually drop after meals due to the massive insulin released in response to abnormal blood glucose. This is also diabetes even though it's marked by very low blood glucose rather than high. In fact, these drops in postprandial blood glucose reinforce the condition more than if glucose went high. These people are at a greater risk of becoming Type I diabetics in the future as their beta cells stop functioning.
You can't miss the forest for the trees. Focusing on individual blood glucose readings is doing just that. You need to look at the long term effect on blood glucose regulation.
6. My endocrinologist told me that my blood glucose rises during fasting because my liver is "blind" to insulin and "dumps out too much glucose". He also said that once my liver glycogen is depleted (9 - 12 hours of fasting) I will begin to burn body fat as the body has to continue "burning something". Is this true?
That is a lie. A cruel lie at that because it makes people think they have just been given the weight loss secret they had been waiting for their entire life since it sounds so "sciency" and was said by a doctor. I swear these doctors either act dumb or they are dumb for real. If they are dumb for real, we are in serious trouble.
First, if that were true, then the cure for diabetes would have already been found. All people with diabetes would simply have to fast long enough to deplete liver glycogen. This would cause them to loose their body fat and their diabetes would go into remission as if by magic. Unfortunately, we are aware that's not what happens and that's why there is no cure for diabetes. Ask your endocrinologist how many of his patients have gone into remission from fasting overnight for 9 hours? Not a one.
Instead, when liver glycogen is depleted, the diabetic simply breaks down their lean muscle mass to create more glucose and their fat stores remain safely in place. Remember diabetes is the end stage of a metabolic adaptation towards starvation. This means fat reserves are never accessed because they protect from starvation. Fat would be the last thing a starving body tries to burn. Fasting reinforces that there is true starvation and this fat is necessary. This is why you should never fast for too long since the depletion of liver glycogen will do nothing for you and the drop in blood glucose only reinforces the adaptation.
Your liver is also not "blind" to anything. It's just doing what it should under starvation - keeping blood glucose high. Insulin resistance is a natural process in order for the body to not only make as much glucose as it can but also spare it for creating more fat. So the diabetic is not "burning glucose". They are using glucose to make more body fat. Many metabolic systems in the body become insulin resistant in order to keep this glucose production efficient and its conversion to fat uninterrupted.
It's not just the liver implicated in this either. This glucose is being produced through the hypothalamic/pituitary/adrenal axis (HPA) as well. It is not solely the result of liver glycogen release.
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