1. I am only able to control my weight when I control my calories.
This is because all weight loss and gain is mitigated through calories. All overweight/obesity is mitigated through blood glucose regulation (insulin/leptin).
If you are of normal weight and are trying to prevent an increase in some pounds, over time, then controlling calories should work well. People who control calories are usually referring to ups and downs in weight of 5, 10, 20 pounds. Once you go beyond that, calories won't cut it. So if you really want to prevent future obesity, you should start controlling your blood glucose.
2. I have diabetic and overweight/obese friends and the one thing that is common in them is their inability to eat real food. Even when they try to eat healthy, they still choose the "healthiest" junk. Why?
This is a complicated question because it is so individualized. In my experience, the main common denominator, I have seen in the overweight/obese, is their rejection of exercise. They seem to think they can control their condition through diet alone but diet is only a palliative treatment while exercise is an actual curative treatment. Yet, it is the thing they are least willing to do. This is because exercise is tiring and makes you sweat, while dieting is fun because you get to choose new junk to eat.
But I have also seen the eating of "junk" you are referring to. Your observation is not incorrect. Many overweight/obese people have a behavioral problem that perpetuates their condition further. They refuse to eat real meals, they live off novelties, they have an aversion to protein, they binge, they starve, etc. There are many different types of eating habits that contribute to obesity.
Many obese are in denial of this and refuse to address it. Instead, they just jump from diet to diet thinking that the next diet will be the solution but they only carry their bad behavior on to their new diet. It's not an easy fix because the solution is very individualized to what exactly that person is doing.
3. Why can some people fast and eat any way they want and never develop diabetes? If starvation can cause obesity/diabetes why can thin people fast with no issues?
The answer to this question is quite simple but 99% of people do not know it. Not even your doctor, coach, dietitian or so called "obesity expert" will answer this correctly. Certainly the low carb followers online can't either. This is why obesity/diabetes is so poorly treated because it's so poorly understood. People get caught up with the effects of calories on overall, temporary and minimal weight fluctuations and apply it to obesity/diabetes. This is why diet is still considered the main solution to these conditions and this is precisely why diet has not been able to solve neither of them. There are a lot of diets to choose from out there and they will all fail.
The path to obesity/diabetes is in blood glucose control. As long as your blood glucose is controlled, you can eat whatever you want and fast however you like with no problems. This is why healthy people can fast for days on end with no adverse health effects. This is why your healthy friend can eat a carton of Ben & Jerry's with no weight gain. Once blood glucose control deteriorates, then the stage is set for obesity.
So at the end of the day, it is blood glucose control that determines who gets sick and who doesn't. Of course there are lifestyles that help preserve blood glucose control and lifestyles that don't but in the end, it's how well your body can preserve its blood glucose control despite this. That is what's king.
No one knows why some people are more resilient in preserving their blood glucose regulation, even with less than healthy lifestyle habits, while others begin experiencing glucose dysregulation in childhood. It seems like some people are genetically wired to not experience an exaggerated adrenal stress response due to blood glucose disparities and they can preserve their insulin function despite blood glucose abnormalities, while others cannot. We see this in certain ethnicities which are more susceptible to developing obesity/diabetes at a lower body fat percentage. Other ethnicities experience massive body fat accumulation in response to blood glucose abnormalities but have a delay in becoming diabetic. So there is definitely a genetic/heritable factor in this issue.
No one yet has been able to pinpoint exactly what that is but certain studies have shown that it appears to be related to the intrinsic nature of certain individual's hypothalamic, pituitary, adrenal (HPA) axis. In other words, some people's stress response is very heightened, while others isn't. The ones with the heightened version, are more prone to developing diabetes over time, than the ones who aren't.
Another factor involved in this is insulin function (release/expression). Some people have hyperinsulinemia without much expression at their fat mass (skinny diabetics). Others have a high insulin expression on the fat mass without serum levels becoming very high ("healthy" obese). So there is a lot of genetic diversity when it comes to the behavior of and cross-talk between insulin, fat cells and the HPA axis among individuals and this is why some become obese, some do not and others can reverse and others cannot.
4. Can cortisol cause diabetes?
Yes, kind of.
Cortisol is just one of the many pathways that perpetuates diabetes and allows it to progress through blood glucose disruption. As far as it causing diabetes, all on its own, is up for debate. Some people are more susceptible to pathological rises in cortisol than others but there has to be a combination of other factors or some catalyst to really end in diabetes. For example, caffeine.
Many do not realize just how much caffeine has played a role in the scourge of diabetes. Caffeine is lethal for blood glucose control. I would argue that the caffeine in soda is just as responsible for diabetes as its sugar content. This is why we do not recommend drinking tea or any other caffeinated drink because you cannot control your blood glucose as long as you are intaking caffeine, in any amount. Caffeine profoundly affects cortisol and other stress hormones like adrenaline.
So when we describe cortisol as being implicated in diabetes, we mean pathological cortisol dysregulation caused by metabolic stress from poor blood glucose control, an auto immune condition, caffeine consumption and inactivity. We do not mean everyday emotional stressors.
5. Are protein bars a good choice?
Because of the satiety it induces, protein is a very difficult macronutrient to keep at the recommended daily target. This is why oftentimes you will have to supplement. The best supplementation is whey protein alongside exercise. After all, if you don't use protein to build anything, the body will simply eliminate it. You can supplement with a whey protein drink or bar. Just make sure the ingredients are clean and no sugar is added.
But unfortunately, most obese/diabetics buy protein bars for snacks or to replace a meal while they sit all day. They are not truly supplementing anything but adding yet something else to their meals which wasn't needed. Worse, they usually choose the worst bars because those are the cheapest since they use inferior plant protein which is useless. They are also the ones that taste the best as they are all sugar.
So my general recommendation, to the obese/diabetic, is that protein bars are not a good choice. Eat real meals.
6. Is it true that they keep lowering blood pressure goals because of "Big Pharma"?
This has nothing to do with overweight/obesity/diabetes, but the answer is no. It would make a good conspiracy book though and it does make sense when you don't have all of the nuance and context behind it.
You would be surprised how easily blood pressure can be lowered without medications. This is especially true when most high blood pressure is caused by metabolic abnormalities and caffeine intake, which when corrected will drop blood pressure to normal levels rather rapidly. I used to have blood pressure in the 200 mm Hg range. It is now in the low 100s and has been for years. So, blood pressure can be easily reduced if there is no other underlying condition causing it to be high.
The reason they are lowering the recommendation for what normal blood pressure should be is because they are targeting more diseases that result from abnormal blood pressure, than just strokes and heart attacks. They have found that the current recommendation has not reduced or prevented the incidences of certain common ailments which a lower reading effectively can. In fact, they have found that healthy people have a much lower blood pressure reading than the current recommended 120/80 mm Hg. Like I said, mine is in the low 100s and has even dropped into the 90s.
It's sort of like blood glucose, right? 100 mg/dL doesn't sound too bad until you realize that a healthy person's blood glucose is around 84 mg/dL. All these low carb people do not have an issue with them lowering the recommendation of what a normal blood glucose should be, so they shouldn't have an issue with the lowering of blood pressure either.
For example, an elevated blood pressure of 130/85 mm Hg is not considered an emergency. Many people have blood pressure around this range and they do not keel over from strokes and heart attacks. In fact, your doctor will probably not even mention it to you. But that doesn't mean that this blood pressure will not cause pathology. After all, you don't just want to treat strokes and heat attacks, as that's end stage cardiovascular disease. Instead, you also want to treat micro vascular damage which can end in a array of different pathologies.
Chronically elevated blood pressure, even of 130/85 mm Hg, will damage the very small blood vessels on the periphery of your organs, over time. This can cause kidney disease and poor circulation in the extremities which can lead to wounds that do not heal. It can also cause retinal damage, dementia and other common ailments that could have been prevented by keeping your blood pressure normal to prevent micro vascular damage.
But if what's considered normal blood pressure is not low enough, then you would have developed these conditions without your knowledge. Most people will not concern themselves or try to lower a blood pressure of 130/85 mm Hg. They do not consider it an issue but it will become an issue over time. It is best to make people aware of that.
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