Six common beliefs addressed, Part 217

1. There is no difference between a macronutrient centered protocol and a calorie centered protocol.

On this blog, we only recommend macronutrient centered protocols. These protocols restrict the calories of individual macronutrient (macros), to varying degrees, in order to create a specific macronutrient composition, irrespective of total calories. There is no total calorie deficit goal because these protocols usually do not restrict total calories. Don't get me wrong, some do, but not any that are recommended here.

With our recommended protocols you track your macros instead of total calories. This is completely individualized depending on the protocol chosen, current metabolic state, activity level, goals and body fat percentage.

Calorie centered protocols restrict total calories from all sources. These protocols are not proper treatments for overweight/obesity, and this is why they aren't recommended here. These protocols require calorie tracking, mostly through the weighing of food, as that's a more precise way of calculating calories. These programs do not focus on what macronutrient composition is used, as long as the "calorie budget" for the day is met. Calories and only calories are the metric used for weight loss. The metric that the overweight/obese need to use though, is blood glucose homeostasis and that's best achieved through macros.

Keep in mind, that some of these calorie centered protocols will sneak in macronutrient tracking as well. They mostly do this by recommending that you acquire your "calorie budget" from specific macronutrients, making them a pseudo version of a macronutrient protocol. This is because calorie centered protocols have had such a dismal success rate that they have tried to merge macronutrient tracking, along with calorie tracking, for better outcomes or they would go out of business. It's a way of admitting their protocol is a fail, while still saving face. After all, they can always chalk up their macronutrient recommendation to the fact that "you should be eating healthier anyway". It's smoke and mirrors though. If the protocol has added macronutrient recommendations, then that's what's causing any benefits obtained, not the total calories, unless the person has an eating disorder.

For this reason, do not pay an arm and a leg for calorie centered protocols because regardless of how fancy they are packaged, they are all basically the same thing. You shouldn't pay an arm and leg for any protocol but especially calorie based ones because they can be given to you free, by your dietitian or doctor. You can also find them everywhere online. Instead of that trainer or coach, get on Weight Watchers and Silver Sneakers. The result is the same and it's cheaper. The American Diabetes Association will even give you a program and menu to follow for free as well.

When choosing a protocol, you should first identify and determine what your goals are. Are you overweight/obese or do you just want to lose some weight to fit your bikini after a pregnancy? Do you have metabolic syndrome/diabetes, or do you just want to get in shape with muscle tone? Your goals and what your current issues are will determine what protocol would be best to follow.

Simple weight loss, muscle toning and/or muscle gain can be easily achieved through a calorie centered protocol, along with weight training. These protocols are easy, non-restrictive, only for the short term and can achieve your goals quickly when you are otherwise healthy. This is why they really don't require any true commitment unless you want to body build professionally.

But if you are tackling serious overweight/obesity/diabetes issues then you need a much more restrictive, long-term protocol, that will profoundly affect how your metabolism works. You need to give your metabolism way more information, in order to make this change, than just calorie input. This is because calories won't even scratch the surface of your problems. I think everyone reading this can attest to that from experience.

2. I don't understand what's going on. I was losing weight, and everything was going great until I started eating low calorie pre-prepared foods. I am staying under my recommended calories for the day but yet I am gaining weight. 

This is the reason we recommend macronutrient centered protocols rather than calorie ones. An overweight/obese person can have the same calorie meals as their thin counterpart and remain overweight/obese or even gain weight. They have to be in a perpetual state of starvation just to not tip the scales further, but this starvation never gets them to lean. In fact, it causes them to be more susceptible to further weight gain over time. This is because the overweight/obese are particularly sensitive to macronutrient composition, irrespective of calories because certain macronutrients interfere with their already failing blood glucose regulation. Calories do not affect blood glucose the same way.

Items marked low calorie like bars, chips, frozen foods, desserts, etc. all have the same macronutrient composition regardless of their calorie content. This composition usually goes like this – high in carbs, high in fats and low in protein. When they do contain protein, it is inferior plant-based protein. Technically more carbs. This equates to disruptions in blood glucose homeostasis, irrespective of total calories.

This macronutrient composition is the most obesogenic of all because it has prolonged effects on blood glucose and insulin expression. In fact, if you were to take the moniker - "you are what you eat" literally, then you can see you are actually becoming what you are eating. You are becoming mostly glucose (high carbs), body fat (high fat) and no muscle (low protein). You are also mimicking your favorite snack's calorie content as well. It has low calories, and you use no calories. You are becoming the living embodiment of your favorite low calorie snack.

Stay away from "low calorie" foods. Meeting your calorie goals for the day will not get you to slim. Millions have already tried that. You need to make sure you truly become what you eat by eating the macronutrient composition, you would like your body composition to mimic – mostly muscle (adequate protein), low body fat (moderate fat) and no glucose (low carb). Then your body will actually use its calories for you. So, when you sit down to a meal, make sure your plate looks like how you want to look.

3. What can I do to minimize the chance of getting Alzheimer's/dementia? It runs in my family.

Alzheimer's/dementia are beyond the scope of this blog but maintaining metabolic health will help you with all other conditions.

Some people have genotypes that cause them to have a predisposition for dementia. The best thing you can do help reduce your susceptibility is to keep your metabolic health on point. Metabolic syndrome, even in its infancy stage, begins to deteriorate how the brain uses its energy and increases oxidative stress which profoundly effects the brain. This is why glutathione, the most powerful antioxidant the body produces, has been shown to decrease the symptoms of neurodegenerative conditions when given in high doses.

Do not deplete your glutathione through the oxidative stress of metabolic syndrome because the more of it you deplete, the less your brain will have for its everyday requirements. Keep your metabolism functioning correctly.

4. My C-Peptide has been slowly dropping with time while on low carb. In fact, it is now being flagged red. My blood glucose is perfect and so is my HbA1C. I feel great. 

I cannot interpret lab results for you. Only your healthcare professional can diagnose you and offer a treatment plan. On this blog, we can only give general information on metabolic panels. For this reason, I am going to reply to this question with general information for you to discuss with your doctor.

C-Peptide is a gauge of how much insulin is being produced in the body and so it can help you determine how your body is handling its blood glucose. C-Peptide is usually ordered by an endocrinologist, either because they suspect an issue, or you have been already diagnosed with Type I or Type II diabetes or are at risk for either one.

A low C-Peptide can mean that your body is not making enough insulin either because of Type 1 diabetes, Addison's disease or a disorder of the adrenal glands. But it can also mean that your body does not have much need for insulin because your blood glucose is always normal. This is why, you have to discuss your results with your doctor because they can be either negative or positive, depending on other factors. Numbers are meaningless without context and nuance.

I can only give you general information on Type I diabetes. If you have been having regular medical screenings, you would have already been diagnosed with Type I diabetes. Especially if your C-Peptide has been lowering over time. You would have very high blood glucose, a very high HbA1C and high ketones. All of these would have been easily seen during routine blood work. You would also have other nasty symptoms, including significant and unexplained weight loss.

Type I diabetes is the result of an autoimmune condition, but it can also occur after long term Type II diabetes. If you have none of the blood markers or symptoms of Type I diabetes, then this low C-Peptide is the result of something else and I am sure your healthcare provider will explain this further to you or screen you for different conditions if he suspects it's warranted.

In the absence of any preexisting condition, a low C-Peptide can simply be the result of a low carb diet. Low carb diets help keep your blood glucose low, so you do not require much insulin. This means that a low C Peptide would mean your body is doing exactly what it is supposed to do. It is not producing much insulin so that your blood glucose does not drop too low.

5. I keep thinking that I’m losing weight, then it feels like I gained weight. All of this because of my clothes. Sometimes they are tight, sometimes they are loose. I’m going crazy.

This has to do with water retention causing bloat. It can be caused by multiple things from digestion, hydration, hormonal fluctuations, being sedentary, etc. This water retention can be very significant and can affect the way your clothes fit.

6. "Keto" is right for lipedema.

It can be if it’s done correctly, but "keto" is not a protocol specifically for this condition. It is primarily a metabolic intervention. Because of its benefits to metabolic health, you may see secondary benefits in other conditions.

Six common beliefs addressed, Part 149

1. "Stress" causes migraines because of the "glucose dump". 

Migraines are a neurological condition of which the causes are not well understood. There seems to be a correlation between migraines and micro vascular changes of which stress can be a culprit among many other things. 

Having a dump of massive glucose into the body from cortisol will effect metabolic processes over time but it's not linearly responsible for migraines themselves. 

2. Alzheimer’s is caused by eating sugar. That's why its called Type III diabetes.

First, let me be clear - No cure has yet been found for Alzheimer’s disease as of this post. Believe me, when one is found, Nobel Prizes will be handed out and you will be the first to know as it will be earth shattering. The breaking news you will receive of this will not come from some obscure quack, selling books or supplements, online. 

People who are obese and/or have diabetes are at an increased risk for dementia, of all kinds, but it is unclear why. If you have dementia running in your family, it is a good idea to make lifestyle changes early on that can help reduce your risk. Low carb diets are one way you can begin doing this. They are effective in preventing diabetes, when followed correctly, as part of an overall healthy lifestyle that includes exercise. The healthier you remain overall, the less vulnerable you will be to developing Alzheimer's. If you reach 60 years old and already have obesity, diabetes, fatty liver disease, cardio vascular disease and a slew of other conditions, you will automatically be at more risk for Alzheimer’s and just about everything else on the menu. You are only as strong as your weakest link. This is why metabolic health is so important because metabolic pathologies come in clusters and each one makes you less resilient overall. 

Alzheimer's has been loosely described as "Type III diabetes" but let's focus on exactly why it was called that, instead of taking this label and running with it. We have seen over reach with diabetes diagnoses from Alzheimer’s to cancer. I myself, have stopped calling Alzheimer’s Type III diabetes because of how that label misrepresents it. So let's go through the basics. 

Alzheimer's is a very complex disease. It is comprised of many different pathologies, each of which contributes to its onset and progression. The exact cause of Alzheimer's is not known, though it seems to have some heritability. Because of this, Alzheimer's falls under the umbrella diagnosis of "dementia". Dementia is a syndrome, not a disease. There are many abnormalities in Alzheimer's and it is very difficult to discern which one came first. For the sake of simplicity, let's describe Alzheimer's as a progressive disorder that causes brain cells to degenerate and eventually die. 

One of the things that degenerating and dying cells do not do is use energy effectively. After all, they are dying. Healthy cells do not have this problem. This does not mean that this reduced ability to metabolize glucose for energy is the root cause of their death, it's simply a correlation. Causality has not been established so far. If this hasn't been established by the researchers, who have devoted every waking moment to studying Alzheimer’s, then a low carb fool online certainly can't establish it themselves. 

Insulin nasal sprays have been shown to improve Alzheimer's/dementia symptoms but not stop the progression of the disease. Insulin facilitates glucose entry into cells so it improves the cells ability to metabolize glucose temporarily. This of course, can improve cell function, but the cell is still dying. Regardless, this is what led to the whole "Type III diabetes" thing to take hold. When the "keto" fad took over, everyone pointed out how Alzheimer’s cells can use ketones more effectively than they could glucose. This is not surprising as glucose metabolism is a bit more complex than ketones and dying cells will go with the simplest alternative given. Just like when you're dying you will also try to make your remaining life as simple as possible. But, ketones did not prevent the cells ultimate death or the progression of the disease. This in itself, tells us that something else is going on with these cells other than just an "energy crisis" as ketones supply the cells with all the energy they need but yet they still eventually die. 

Of course the layman reading all of these clickbait headlines immediately assumes that if too much sugar causes diabetes, then too much sugar causes Alzheimer's and if ketones can be used by those cells, then eating a block of butter will cure Alzheimer's to boot.....um...no. Too much sugar causes the metabolic abnormalities and oxidative stress that put you at risk for many different pathologies, including Alzheimer’s, but it does not directly cause Alzheimer’s, so its absence doesn't cure it. Generally unhealthy lifestyles put you at risk for a variety of conditions. Sugar intake is one part of a generally unhealthy lifestyle. Obesity is also the result of an unhealthy lifestyle so eating a block of butter, which will go directly into your already expanded fat mass, will not cure Alzheimer’s. It will only put you at more risk for it. 

The "energy crises" that the brain is experiencing in Alzheimer's has to do with the Alzheimer’s. Of course this "energy crisis" can be exacerbated if the Alzheimer's patient lives an unhealthy lifestyle, but living a healthy one will not cure Alzheimer’s or halt its progression. For those currently without Alzheimer’s, living healthy reduces your risk of this disease, but does not prevent it. 

So to make things much simpler, adopt my same strategy and just call Alzheimer’s what it is - Alzheimer’s. Leave the diabetes description for actual diabetes. It will prevent a lot of confusion and false assumptions. 

3. You should never eat pork rinds because they are too high in protein. In the absence of sugar, protein is recognized as a carb. 

I receive many messages with a list of dumb things that people have heard around the internet but this one takes the cake. Now the stupid has reached critical levels. 

Protein is never "recognized" as a carb, whether in the absence of sugar or not. If your body is recognizing protein as a carb, you would have died as a fetus. In fact, you wouldn't have even reached fetus status. You wouldn't have been able to even develop as life, since protein is needed to grow cells and if your body is recognizing it as a carb, well then...how the ^&%! are you growing? 

Protein is converted to sugar through gluconeogenesis when the body demands it. This is because the body requires a certain amount of glucose circulating in the bloodstream at all times. There are certain cells in the body that are completely dependent on glucose. This is also the way our metabolisms were made to function. The body does not just use protein to do this. It also uses the glycerol in fat to do the exact same thing. The body does this to its own lean muscle mass, even when no protein or fat is consumed. In other words, the body never stops gluconeogenesis from occurring when it needs it. Never. It uses it to keep cells healthy, to regulate the effects of insulin and to retrieve additional energy during times of stress. 

People with metabolic syndrome/diabetes have uncontrolled gluconeogenesis because of poorly functioning insulin, over expression of cortisol and dysfunction of glucagon among, other abnormalities, which constantly break down their lean muscle mass into glucose. This has nothing to do with the amount of protein you eat. This has to do with the breakdown of protein already in your body. 

Pork rinds are just fine to eat. Their protein content is irrelevant, but you have to watch their fat content. Don't eat them as snacks or as your main protein because snacking is a very obesogenic habit to have and pork rinds are not as nutritious as meat. Pork rinds are fine to have with your meals, as a garnish or side item only. 

4. You should walk 10K steps a day, not 8K. You should also hit your target heart rate while exercising. 

There is a significant decrease in health for people who walk less than 5K steps a day but there isn't a significant increase in health for people who walk 10K, rather than 8K steps a day. Now this is not the case once you go well beyond 10K steps. There is a difference between 10K and 20K. Hunter/gatherers average about 16K a day so if you want to get more bang for your buck, don't focus so much between 8K and 10K but try to do an average of 16K instead. You can certainly do your 8K and then remain active the rest of the day, doing other things besides walking, like gardening, cleaning, anything that's not sitting. 

As far as a target heart rate goes, you can follow that if you like, for your own personal enjoyment, but it is not required. Some people like tracking that kind of stuff and hitting certain goals. It keeps them motivated. We never discourage any physical activity on this blog. Follow the activity level you enjoy and track whatever you wish to. If you want to hit a specific target heart rate and walking isn't cutting it, then jog, run or jump. You obviously have to do something more strenuous to achieve this goal if that's what you want. 

On this blog, our recommendation is to be active daily and for as long as you can be. We don't have any caveat other than that. You want to be more active than you are sedentary. Don't lounge around for long periods of time. Lounging is obesogenic and as bad for metabolic health as a can of Pepsi. The chair is the same as junk food. People are always quick to point to all the bad food but they forget to point to the bad chair. Sitting is the disease. 

5. You should mix whole milk with half n half in order to reduce the carbohydrate in it. 

This practice is worse than dumb. It's useless. Dumb can sometimes get your results because even a broken clock is right twice a day but useless is just plain useless. 

The carbs in whole milk are irrelevant in the context of an overall low carb diet. The fat in the milk is relevant. This is because low carb diets are always higher in dietary fat so adding even more fat to the mix will only cause problems. 

You don't have to mix whole milk with anything. Drink your milk, normally and naturally, as it comes. It is already whole and contains fat. You don't have to add more fat to it or you will start expanding again. Addition is the main problem you will encounter in any diet. In fact, the Standard American Diet (SAD) is the king of all diets that have additions. SAD adds sugar and fat to everything. You don't want to keep adding energy to your food. It already has the energy required. 

6. You should only eat a "Proper Human Diet". 

That's a marketing slogan. 

Hunter/gatherers of the past and present have already made it clear that there is no such thing as a "proper human diet" because there is no one diet that humans have followed which has been shown to be better than any other. Humans can survive and thrive in a vast variety of dietary conditions. It is this adaptation to different diets that has allowed for humans to live in many different environments and climates. It allowed us to be mobile and leave our homes to seek new and better ones. There are only two diets that no hunter/gatherer has ever followed and they are: 

• Vegan Diet - A diet containing no animal products.
• Standard American Diet (SAD) - A diet mostly consisting of processed and refined added carbohydrates and fat with a primarily sweet taste. 

Let me make a little commentary on the SAD diet. Though it is named the "Standard American Diet", it should be renamed to the "Standard Western Diet". Europe and Canada eat just as much garbage as Americans. In fact, you can find this junk filled diet in every corner of the world now but it derived in Western society, not exclusively from America alone. 

So since here is no "proper human diet" that we know of, there are two improper human diets that we do know of. Don't follow either of the improper ones and you will be good to go.

Six common beliefs addressed, Part 24

1. Is Alzheimer's really caused by insulin resistance?

Alzheimer's is a very complex disease. It is comprised of many different pathologies, each of which contributes to its onset and progression. The exact cause of Alzheimer's is not known, though it seems to have some heritability. Because of this, Alzheimer's falls under the umbrella diagnosis of "dementia". Dementia is a syndrome, not a disease. There are many abnormalities in Alzheimer's and it is very difficult to discern which one came first. For the sake of simplicity, let's describe Alzheimer's as a progressive disorder that causes brain cells to degenerate and eventually die. 

One of the things that degenerating and dying cells do not do is use energy effectively. After all, they are dying. Healthy cells do not have this problem. Insulin nasal sprays have been shown to improve Alzheimer's/dementia symptoms but not stop the progression of the disease. Insulin facilitates glucose entry into cells so it improves the cells ability to metabolize glucose temporarily. This of course, can improve cell function, but the cell is still dying. This is what led for some people in the low carb community to make the claim that Alzheimer's is "insulin resistance of the brain". This is not true. The dying cells are simply exploiting the extra insulin and improve temporarily.   

2. Does cancer really feed off sugar? 

Cancer cells use glucose and glutamine for fuel. Both are created by your own body. The body creates all the glucose it needs so it does not have to be dosed exogenously. 

Glutamine is the most abundant free amino acid in the body. The body produces all the glutamine it needs, in the muscles, so it's not dependent on diet. As long as cancer has glutamine, it can continue "living" just fine. Depending on the type of cancer and what stage it’s in, it can also use fat for fuel.

As you can see, cancer is very complex. For this reason, I always advise to receive your cancer treatment from a cancer specialist, not from someone online, especially if they are promoting diet as the sole cause and curator of cancer.

3. As long as I am insulin sensitive, I won't get fat.

The obese are insulin sensitive, at the fat mass. The way you do not get fat is by maintaining proper blood glucose regulation, so that you never develop insulin resistance. 

4. The body cannot go into "starvation mode". It's not real.

Chronic caloric restriction and chronic extended fasting cause metabolic adaptations, that are harmful in the long term, through the development of adaptive energy conservation (starvation mode). When the body is put through these conditions adiponectin, an adipokine released by your fat cells, induces an anti-inflammatory effect that causes for fat cells to become more insulin sensitive. This appears to be a great thing, but it is actually going to make you fatter once nutrient/energy conditions change.

Inflammation reduces insulin sensitivity, in the cell, so that it stops up taking energy. Healthy individuals, with no metabolic disease, maintain a healthy level of inflammation at the adipocytes. It's a form of localized insulin resistance, that is beneficial and regulates weight. Leptin uses inflammation in order to signal the cells to stop up taking energy, so this energy can be burned instead.

If this anti inflammatory effect persists, in the long term, through the chronic stimulation of adiponectin, you are priming and honing your fat cells to store even more fat, once you begin eating normally. This is because the body is adapting and preparing itself to face "starvation", once it occurs again. This is why people who yo-yo diet tend to put weight back on, and then some, once they go off their diet. The dieting has actually helped make them fatter.

Don't be fooled, everyone will go off their diet. This is because you can't calorically restrict forever and you can't fast forever. You will have to eat normally again and when you do, the body will store even more fat than before.

This is why I don't promote "dieting" on this blog, nor extended fasting. I only advise a proper carbohydrate restricted diet, that can be followed for life, and a fasting protocol that is sustainable. This prevents the yo-yo affect that has dire, long term consequences.

5. How can fat weigh less than muscle?

We often say this to make things simpler for the person who is concerned about their scale weight, but there is always someone, out there, that will nitpick and try to put you to task, for this statement. So, the more technical way to describe it, is as follows:

A pound of fat weighs the same as a pound of muscle, but because of their different densities, an inch of fat weighs less than an inch of muscle. This is why a fatter person might weight less than a leaner person. Even if two people have the same scale weight, one can still be fatter than the other. The one with more body fat, is unhealthier.

6. I use to eat fat ad libitum and never had to worry about it. Now I have stalled in weight loss.

When you improve blood glucose regulation, you will lose weight, even with a higher dietary fat intake, since you just eliminated carbohydrates from the diet, which no longer disrupts blood glucose or has to compete with fatty acid oxidation.

When glucose is present, fat burning slows down. Remove the glucose, fat burning ramps up and the body is able to burn both dietary and stored body fat. But, soon, as your weight decreases, you will stop burning body fat and the body burns dietary fat instead, causing a weight stall. If the dietary fat is excessive, you will not burn enough of it either and you will begin storing it. Now the weight stall becomes weight gain.

So, as weight begins to stabilize and insulin function continues improving, the macronutrient ratios you started with, must be changed, if you still have more weight to lose. You need to lower your fat intake and up your protein intake. This further lowers basal insulin and forces the body to acquire its fat fuel from your own body.

If you want to maintain your weight loss and stop losing, then and only then, can you up your dietary fat intake.