Six common beliefs addressed, Part 226

1. My coach said that she used to use macros but had to switch to calories because people never followed it. She finds that "women" seem to follow food lists and calories better than macros, but she said that you can't just count calories, you have to count them within certain groups of food. I thought a calorie was a calorie.

This coach is basically making women appear like idiots. The reality is that most diets are followed by women. Men get fat and either stay that way, without complaining, or just do what they have to in order to fix it. They don't need any guidance or hand holding to get it done. They just guide themselves by results. They aren't in denial as to what is making them fat and they don't make excuses. I suppose I am now making women appear like idiots.... Well, it is what it is.

There is no denying that some gender differences can be advantageous and others not so much. Men definitely are at an advantage when it comes to dealing with their weight issues simply because of behavior and approach. Because of this, I can imagine most of the people in your coach's program are women. After all, women are the ones who seem to require more "help" to deal with their weight issues.

Aside from the gender wars, calorie centered protocols have always been much easier to follow. They are also user friendly because there is no elimination of any particular food. This is why people are more likely to follow them. This is not new. This is why they are highly recommended by everyone, from your doctor to your neighbor, and they make up 99% of the diet industry. If your coach wanted to keep clients and make new ones, it is not surprising that she had to change her protocol to a calorie centered one.

Tsk, tsk though. She is sending out the message that calories are king, when it comes to weight loss, but still telling you that you have to count the calories within certain macronutrients. That's not a true calorie centered protocol. It's a hybrid and those whining women will be none the happier when they see they can't count out the calories in cookies but will be forced to eliminate them. "I have to eliminate foods and count calories too? I don't think so. Either or."

Oh well, to each his own, but this goes to show you the type of shenanigans that go on in the diet industry. This coach knows that calories are not enough but yet she hides the reality behind the excuse that "people will not follow my program on macros". Basically, her profit margin is more important than addressing the problem. This is why you have to be leery of diet programs because they will never advise on legitimate protocols. It's just not profitable.

Of course, a calorie is a calorie when it comes to weight loss, but a calorie is not a calorie when tackling overweight/obesity.

2. Men stay leaner longer and can lose weight quicker.

Testosterone is the hormone of leanness. Testosterone helps keep fat away from the subcutaneous and builds muscle instead. This process remains in equilibrium as long as there is sufficient testosterone, no disruption in blood glucose regulation and none of these:

• An imbalance of sex hormones because of childhood onset of obesity. Males that become obese before sexual development tend to become estrogen dominant and will have an obesity pattern similar to females with the development of "man boobs", hips, butt and large subcutaneous fat reserves.
• Getting older causes a decline in testosterone and this slowly tilts the axis towards estrogen dominance. Older males will now develop the "man boobs", hips, butt and large subcutaneous fat reserves typical of women.
• Obesity alongside testosterone is very dangerous. Testosterone forces fat to go into the visceral causing a large, hard, extended stomach, known as a "beer belly" but in actuality it's a "fat liver". The extremities will continue to be thin and there won't be much subcutaneous soft fat. This usually occurs in middle age men when there is still enough testosterone for the effect to take place.

If a man is still producing enough testosterone, they will quickly achieve results from diet and exercise. This will occur much more quickly than it would for a woman. Estrogen prevents women from losing fat easily. Men that are estrogen dominant, either from early onset obesity or from just being older, will have a much more difficult time losing weight.

Aside from that, men tend to stick to their diet due to the gender differences in behavior that I mentioned in my previous reply. Men who want to lose weight tend to be more committed and use less excuses. They do not require "support" or "hand holding", so they are less susceptible to falling for quackery and fad diets. They are also willing to do more exercise and sacrifice more foods. Their competitive nature and respect for self-accountability works to their advantage when it comes to dieting. This is why you see less men in "diet programs" and more men at the gym, while still achieving the most results. Again, this shows the behavioral aspect of obesity.

3. Body mass index (BMI) is "old school" and not reliable.

BMI is a pretty solid guide. Yes, it's old school and that's a good thing because it has stood the test of time. Of course, it is not one hundred percent accurate but that's only the case for body builders or other athletes that have crazy muscle mass. For the average person, BMI works pretty well.

But I have said it before and I will say it again - standing naked in front of a mirror tells you everything you need to know about your body, without the fancy calculations.

4. My coach calls vegetables "carbs".

Because they technically are but this is also a misnomer, since the "carb" in vegetables is fiber, not glucose. Fiber is not usable by the body, so the only carb of concern is glucose.

Coaches just want to sound cute calling vegetables "carbs" because they want to push back on the idea that "carbs" are "bad". If "carbs" are "bad" then where does that leave wholesome "veggies"? But this is all just a gimmick. It's no different than when "keto" people push back on the Dietary Guidelines by eating sticks of butter. It's not funny or "smart". It's asinine and it doesn't help you understand how to eat better.

The carb that is detrimental is glucose. Glucose is found in fruits and starchy vegetables. Starch turns into glucose in the body. Fibrous vegetables, which are basically all, above ground, non-starchy vegetables are carbs in the form of unusable fiber. This is why potatoes can raise your blood glucose but not cauliflower, even though they are both carbs. Not all carbs are created equal.

So, why would you have to watch out for these fibrous vegetables if they aren't a detrimental carb and are also low in calories? For several reasons.

• They can replace protein. Any food that displaces protein is detrimental in the diet. Protein is always the priority, but some people rather have a bowl of mashed cauliflower than a steak.
• They can become conduits for excess fat. Bacon fried green beans and mayonnaise drenched coleslaw have to be monitored. A lot of people like their vegetables because they can add a stick of butter to them or a tub of sour cream. Be careful with the preparation of your vegetables.
• They can become a conduit for sugar. Sweet and sour broccoli and honey coated asparagus are not proper ways to eat your vegetables.
• They are air, which is basically starvation. Be careful you aren't eating too much of them.

There is no such thing as a "good carb". The only "good carb" is the one your body makes itself through glycogenolysis and gluconeogenesis.

5. How does a person develop large disparities in blood glucose? Does it happen from getting fat? I know you have said that is the root of metabolic syndrome/diabetes, but I don't understand how this occurs.

This is a good question. These large disparities in blood glucose regulation are most commonly triggered by diet. This is the timeline of how this occurs:

• At 10 years old eating pizza. Blood glucose goes to 120 mg/dL post postprandial and 84 mg/dL fasting. Everything still appears normal even though the higher postprandial number makes 84 mg/dL fasting appear to be an abnormal drop in blood glucose to metabolism. Since a child is still growing, insulin expression is harder to adapt to these blood glucose abnormalities so everything continues to appear normal.
  
• At 20 years old eating pizza. Blood glucose goes to 140 mg/dL postprandial and 70 mg/dL fasting – Large disparities between postprandial and fasting blood glucose are much more apparent. This will only widen over time. Overweight begins to creep in, usually for a female.
• At 30 years old eating pizza. Blood glucose goes to 170 mg/dL postprandial and 60 mg/dL fasting – Postprandial hyperglycemia and fasting hypoglycemia. Obesity rears its ugly head, and it also becomes noticeable on males. That testosterone won't save you forever.
• At 40 years old eating pizza. Blood glucose goes to 200 mg/dL postprandial and 120 mg/dL fasting – Active hyperglycemia all of the time while the body believes the fasting number is still hypoglycemia. It will only double down in trying to keep fasting blood glucose as high as the highest postprandial number.
• At 50 years old eating pizza. Diagnosed as diabetic.
• At 60 years old eating pizza. On dialysis and missing a leg.

Keep in mind, the above timeline can differ depending on how the syndrome manifests in the individual. You can be on dialysis and missing a leg at a much younger age than 60 and you can absolutely become obese at age 10.

Notice how the pizza got the ball rolling by significantly raising postprandial blood glucose. This causes a large drop in fasting blood glucose, even when the body is just going back to baseline normal. The body doesn't like this and will actively fight these large drops in blood glucose as this is a signal to it that it is starving. Because it thinks it's starving, it starts sparing fat. This is the beginning of overweight/obesity.

As time goes on and insulin function deteriorates, you can see how the postprandial blood glucose keeps going higher and higher, while eating the same pizza. Fasting blood glucose never goes back to normal but remains high, even though a significant drop continues to occur, in comparison to the postprandial number.

What is occurring is that fasting blood glucose is trying desperately to catch up and match postprandial blood glucose, so that blood glucose is basically always high, and the large drop never occurs. The body is adapting to high blood glucose because it likes to keep blood glucose within a very controlled range. That is what diabetes is - an adaptation towards high blood glucose.

By 50 years old, fasting blood glucose is the same as postprandial blood glucose. The fasting blood glucose finally caught up and now blood glucose is always high, whether fasting or not, in other words diabetes. This adaptation causes for the body to do anything to keep blood glucose high and it does this through an over expression of gluconeogenesis and adrenal output, irrespective of diet. The 60-year-old that is now on dialysis and missing a leg had been showing signs of illness, since their 20's when they started becoming overweight/obese.

Like I said above, the onset of disease can be much earlier depending on how frequently these highs and lows in blood glucose occur. If this pizza eating person also eats ice cream, cookies and cakes, then this roller coaster in blood glucose occurs at every mealtime and the adaptation happens quicker, making them a diabetic at 30 years old, blind at 40 and on dialysis at 50.

You can see why overweight/obesity and diabetes are considered time dependent conditions. They don't occur over night. There is a decade span between each progression of the disease. So, this doesn't occur from "getting fat". Getting fat is the canary in the coalmine. It is telling you that something is wrong. Your metabolism is under stress.

Most people do not see this disease process occur because it happens so slowly and blood glucose is only checked while fasting, during your yearly physical. So, you never see these large disparities occurring. Some of those drops in fasting blood glucose can go well into the 50 mg/dL and 60 mg/dL during the overnight fast because of prolonged insulin release due to high postprandial blood glucose. It takes time to clear that glucose and insulin will remain in circulation during it. It then takes time to clear that insulin but by then, your blood glucose just keeps dropping.

Most prediabetics and diabetics develop a resistance to these drops in blood glucose and manifest no symptoms of hypoglycemia, even when their blood glucose becomes dangerously low. This is why many diabetics die in their sleep. This is also why many individuals with metabolic syndrome experience pseudo hypoglycemic symptoms even when their blood glucose is completely normal or even higher than normal.

These disparities will make you uber fat as the body continues to think it is starving because blood glucose is so erratic. You see, the body doesn't just use calories for nutrient availability information. It uses blood glucose as well. Nothing tells the body it is starving, more than a sudden drop in blood glucose. It's not the calories in the pizza. It's not the fat in it. It's not that it's junk food. It's the carbs that disrupt blood glucose regulation.

This is precisely why some people are at a loss as to why they are so fat. They don't seem to eat much and many times they don't even eat often enough. This is because what they are eating is reinforcing this adaptation, irrespective of portion sizes and calories. This is also why overweight/obesity cannot be treated using calories as that is not what caused the "disease". Yes, pizza has a lot of calories and that will cause you to gain weight, but you will only become obese because of the blood glucose disparities. This is why the younger you are, the better you can "handle" this pizza load even though the calories in that pizza are the same for a 20-year-old as for a 50-year-old, but the hormonal state of a 20-year-old is very different than a 50-year-old. The 50-year-old is more susceptible to blood glucose abnormalities.

How can all of this be avoided? Eat foods that do not disrupt your postprandial blood glucose. Disruptions in postprandial blood glucose will set the stage for this process to occur and once it begins, diet is only a palliative treatment.

6. A friend told me that she eats baked potato with plenty of butter in order to prevent blood glucose from rising too much.

You are either low carb or you're not. If you're not, then I recommend calorie restriction as this will at least ward off the "disease" for some time.

Mixing carbs with fat creates a high carb/high fat diet. Basically, that's the Standard American Diet (SAD), the most fattening diet on the planet. Just because the fat displaces glucose temporarily, and you don't see it rising on your blood glucose meter, it's not doing a thing to treat your condition. You're still getting fatter and sicker over time.

Six common beliefs addressed, Part 205

1. The diet industry seems to be unaware of leptin. 

Like all other metabolic hormones, leptin has had its “Fifteen Minutes of Fame”, in the diet sphere, for all the wrong reasons. This is a shame because leptin is central to obesity. These diet mongers are constantly focusing on targeting one metabolic system or the other in the exact same useless way – by eating less. So here are some basic things that are known about leptin, as of this post, without the BS:

• Leptin sends a signal to your brain that helps you feel full and less interested in food. Because of this you may hear leptin described as a "satiety hormone", in weight loss circles, though this is not a correct description. Inducing satiety is still believed to be the Holy Grail for combating obesity, since the consensus is that the obese are fat due to being "hungry all the time". But when you get away from the shenanigans, the reality is that leptin is better described as a “starvation hormone” because it determines how and when your body turns fat into energy. When leptin is working properly, it signals satiety through the burning of fat. It doesn't signal it just because it's present.
• Leptin is mostly made by your fat cells but your stomach also releases some when you eat. Leptin circulates in your bloodstream and travels to your brain where it delivers the message that you have enough fuel so you don't need more (satiation). But the real magic is that leptin now signals to the brain that it can burn the fat you have stored.
• Leptin suppresses appetite, in a healthy manner, when it burns fat for fuel. Again, the suppression of appetite is overly emphasized as it is believed the obese eat uncontrollably. The reality is that when you have proper leptin expression, it helps you maintain a healthy weight by balancing the amount of food you eat with how much fat you burn. The amount of food eaten is inconsequential to this process. The important process is in how much fat you burn. We know this from starvation studies where people were chronically over or under fed. The overfed simply burned more fat and refused to eat. They put on a capped amount of temporary weight and never became obese. We see this effect in healthy people who are struggling to put on weight and simply cannot, no matter how much they eat. The underfed simply burned less fat and their appetites tapered down with time. They lost a capped amount of temporary weight and then refused to lose more. We also see this effect in the overweight/obese who are struggling to lose weight and simply cannot, no matter how little they eat. So the real problem with obesity is not in how much you eat but in how little you burn.
• Fasting for several hours can cause your leptin levels to lower. The more you fast, the less hungry you become. This is the unhealthy way that leptin suppresses appetite. As you can see less hunger is not always a good sign so it shouldn't be a primary goal in weight loss. You could be hungry or not hungry and still not burn fat. Again, the problem is in how little you burn.
• Chronic inflammation and high levels of triglycerides can make it more difficult for leptin to cross the blood-brain barrier.
• People with leptin deficiency are prone to early onset obesity. They need daily doses of a leptin-like protein to control their weight. This same treatment cannot be given to people with "leptin resistance" as their problem is not insufficient leptin but poor leptin expression. It is still being researched whether this poor leptin expression occurs at the fat cell, the brain or both. Until this is known, leptin cannot be targeted with medications for the treatment of obesity.
• Leptin also works with other systems in the body, including immune cells. A strong immune response is a good thing when you’re sick, but chronic inflammation from an overactive immune system causes health problems. People who have obesity and high leptin serum levels often have chronic inflammation. This is linked to cardiovascular diseases, insulin resistance and cancer.
• There are no obesity treatments which use leptin at the current moment for the issues discussed above, but it has been used in obesity research. Over the counter "leptin" supplements are just caffeine riddled junk food. Remember, the problem is not leptin serum levels but its expression on fat cells and the brain. Supplements do not resolve this. If they did, the pharmaceutical companies would already have a leptin medication for the treatment of obesity but they do not. Obesity is still a condition with no known cure.

As you can see, leptin is quite complicated as are all systems in our bodies. Maybe in the future some breakthrough will be found where this hormone can be targeted for obesity treatments but as of today, there just isn't enough information on how or why it malfunctions to cause obesity. The research appears to be pointing towards the most likely explanation that leptin is not malfunctioning at all but acting in accordance to a metabolic profile of starvation which is set in motion by other factors, like blood glucose dysregulation.

2. Overeating eventually leads to obesity.

In a healthy person, "overeating", in of itself, cannot lead to obesity as their metabolism truly regulates the balance between what’s coming in and what’s going out. We do know that "overeating" does have an effect on the glucagon/insulin ratio of people who already have metabolic syndrome. This effects blood glucose homeostasis, progressing the condition further. So there is a clear and distinct difference when it comes to "overeating" between the healthy and the metabolically impaired.

We have evolved with mechanisms that prevent "overeating" so the conversation shouldn't be about "overeating" but about what you're burning. The path to obesity is set in motion through blood glucose dysregulation, not total calories (overeating). We have fail-safes to prevent "overeating" but there are no fail-safes to prevent blood glucose dysregulation. Blood glucose dysregulation stops the "burning" of fat.

This blood glucose dysregulation occurs from consuming a completely normal plate of pasta with no "overeating" required. The blood glucose dysregulation from the pasta will cause you to become overweight over time. In response, you will reduce the pasta in order to try to "control your weight". You think its calories but in reality, the less pasta you eat, the less blood glucose dysregulation you experience. This makes you not gain more weight and so you falsely believe that eating less, across the board, is helping you but in reality you're only reinforcing the starvation response that you already induced with the blood glucose dysregulation caused by the pasta. You haven't gained more weight but you also haven't lost a pound and you will gain more in time. This will cause you to double down on eating even less and your metabolism will double down on keeping you fat. You are on the road to diabetes, all while preventing "overeating" but ignoring your blood glucose dysregulation. You will go from overweight to obese rather rapidly.

This is why we refrain from throwing around ambiguous terms like "overeating". You have to be able to define what you mean by "overeating". What are you "overeating" and according to what criteria? The only criteria should be your macros, calculated by your body fat percentage and goals because the only thing you should be concerned with is "under burning" fat, instead of "overeating" calories.

3. I cannot lose weight. I have tried everything. I have been at this for decades with no headway. I am now a senior citizen and tired of struggling with my weight. I don’t want to spend the rest of my years like this anymore. I don’t want to be lied to anymore. I am at a time in my life where I can take the truth. Will I ever be able to lose weight?

I cannot make predictions of this sort with finality but I can say that you can safely assume you will never lose weight. At least, not body fat. For some, proper leptin expression will simply never occur. This is most likely the result of hypothalamic damage, which is still being researched in obesity.

At this point, you would have to take draconian actions in order to lose body fat. After all, everyone can lose weight. These actions would be unhealthy and not recommended on this blog. For instance, if you starved and physically worked yourself at concentration camp levels, you might lose weight, if you don't die of malnutrition/stress first, but you would be putting your health at risk. It’s simply not worth it, as the weight loss would not cure your obesity. It would only reinforce it.

You could also go through bariatric surgery, which is simply a way of making your stomach believe it’s in a concentration camp. I personally, wouldn't ever recommend this type of mutilation, especially for a senior. Remember, even bariatric surgery is temporary so you will eventually get out of the "concentration camp" and the only way you can lose weight and keep it off is by staying in there permanently.

The only thing you can do now is continue a healthy diet and lifestyle that is antiobesogenic so that you can minimize blood glucose disparities and ward off pathology for as long as you can. Obesity, in of itself, is not directly pathological. It is only a symptom of a metabolic abnormality that puts you at risk for pathology. But if you can control the abnormalities, eliminating them all, even if you have to remain overweight, is still success.

4. Losing inches means your losing body fat. 

No. The inches lost have to actually be body fat in order for them to count. Usually you can tell this is the case if you are losing inches consistently and not gaining them back. The inches that matter most are the ones around your middle. This loss occurs over time and in the long term. Fat is never lost in the short term.

If you lost inches rapidly, because you reduced your weight by four or five pounds, then those lost inches were only water weight bloat. When you reduce water weight bloating, you reduce inches but those don’t matter.

5. "Keto" ice cream has too much fat.

When it comes to novelties, you have to shift your focus from calories, carbs or fat to the taste of sweet itself. The taste of sweet is what’s harmful. That's why every diet on the planet allows desserts, in accordance to their macronutrient and/or caloric goals, and this has done nothing for the diet to succeed. In fact, a good predictor of whether a diet has the potential of being successful or not is in the amount of allowed desserts.

The amount of cream found in "keto” ice cream, or any ice cream for that matter, is not very significant. Ice cream is sort of like whipped cream, but the ice takes the place of air. If you actually melt a serving of ice cream, you will see it doesn't consist of much cream, so the fat content is not the problem. The problem with traditional ice cream is the sugar content. "Keto" ice cream contains no sugar. So why would it still be considered obesogenic? Where is the obesity coming from if not from its macronutrients? The obesity is in the sweet taste itself.

Overweight and obese people are particularly sensitive to gaining more body fat from any fat storing trigger that their body receives. Sweet taste is one of those triggers which works through dopamine. Dopamine is a very powerful metabolic regulator. So you have to be very careful when consuming these types of items as their sweet taste will cause you to store all of the fat in them and in everything else you eat that day.

Taste carries metabolic information. This evolved through the availability of certain foods at different times of the year. Sweet taste is information to store for winter. The winter that will never come. The sweet taste found in these novelties is also much stronger than any sweet taste we would have found as hunter/gatherers, aside from honey, so its effect on your dopamine is even greater than any natural food source would have. Also a sweet natural food source would not be accompanied by fat. The combination of sweet and fat, further disrupts dopamine and enhances fat storage.

So, be cautious when incorporating these desserts in your diet. You should really be limiting your exposure to sweet taste if you are serious about tackling your obesity. This is especially true if you also have disordered eating behaviors and cannot keep the consumption of these novelties under control.

6. I am never hungry. Because of this, I can fast for long stretches but I was told this was not a good practice. But I like to use my hunger as a signal to eat or not. 

Hunger is not the right way to gauge food intake for the overweight/obese. Overweight/obese people are either chronically hungry or chronically never hungry. Healthy people aren't chronically anything. Their hunger fluctuates normally, up and down, as their body maintains its weight homeostasis. The overweight/obese have a satiety signaling that is completely dysfunctional and shouldn't be taken seriously. Interestingly, the overweight/obese people who are never hungry, tend to have the most stubborn body fat and often have intractable obesity. This is not surprising if we again remember how obesity works.

Obesity is simply a starvation adaptation that perpetuates through chronic blood glucose dysregulation, which abnormalizes insulin and chronically under expresses leptin. The less hungry you are, the less frequently you eat and so the more you starve. The more you starve the more you "teach" your fat cells to store and hoard. You are adapting them towards obesity.

Unfortunately, because of the calories model of obesity, the overweight/obese person thinks that their ability to starve themselves, without hunger, is a great thing. They will deem themselves much luckier than the unfortunate obese person who's always hungry. Of course, they will constantly wonder how in the world can they still be so fat when they hardly ever eat. Well, chronic "hardly ever eating" makes the overweight/obese fatter over time. Everything they do eat, will be stored much more efficiently and at a greater rate than the always hungry fat person or the healthy person. I have said it before, the only starvation that works for the obese, is the starvation that ends in death. As long as something is coming in, they will remain fat.

This is why it's so very important to take control of this and eat at set meal times only. This practice is a very good control mechanism against the erroneous information you are receiving from your faulty "hunger" signals. Having consistent and predictable meal times will also help normalize your satiety hormones as you better control your glucose/insulin homeostasis through the reduction of the stress response. Taking control of your diet is not just choosing what to eat but also when to eat.

Six common beliefs addressed, Part 180

1. I am 110 lbs. at 5'4 and still considered overweight according to "waist measurements and ratios".

Body mass index (BMI) is a measurement of relative body weight, not body composition. Because lean mass weighs far more than fat some people are incorrectly classified as obese based on BMI. This is particularly true for athletes and body builders. Skin fold testing provides a more accurate body fat assessment than BMI for those individuals.

Since it is not specified how you are determining your "waist measurements and ratios" I can only guess why you are being classified as obese. It can be because you have an oddly shaped body or maybe your 110 lbs. is all fat around your middle, which is not good. 

This is why there is no one marker to determine if your metabolic health is at risk. You need to know multiple markers, taken in the context of what your current issues are, including how fat is distributed on your body.

2. If sugar is truly "addictive", then why weren't people "addicted" to it 500 years ago?

Precisely! Sugar has been around for a very long time and though it does create changes in the balance between catecholamines and hypothalamic function, it is not considered a truly addictive substance. For this reason, we do not describe sugar as "addictive" on this blog.

Instead, we recommend anti obesogenic approaches in lifestyle in order to combat overweight/obesity. Considering yourself a victim of "addictive sugar" is a very pro obesogenic stance to have. After all, if sugar is addictive, and food companies put it everywhere, then you aren't to blame for your predicament. If you aren't to blame, then you can't do a thing about it. This will only keep you obese.

We not only tackle diet and exercise, but we also challenge the beliefs and behaviors that perpetuate overweight/obesity.

3. Many people, who have been successful on their new way of eating, still end up with gastrointestinal issues.

Aside from diet changes, which are the main cause for gastrointestinal issues, there are also other culprits. One of them is lower insulin levels. Low insulin levels usually cause gastroparesis.

4. You wrote before, in one of your posts, that: "If you are not losing weight or are gaining instead, then the body is in active obesity mode and the reduction of appetite is coming from a thrifty metabolism that is not burning any fuel and so does not require any more of it." So tell me again why I need to not fast longer?

Because fasting, short or long, does not address a thrifty metabolism, which is the operative word in my post. Just because the body does not require more fuel, does not mean that it will respond positively if you don't give it any.

What you need to address instead is its fuel management so it burns what it has. That is caused by improving leptin expression which is not done through fasting but through normalizing blood glucose control in order to improve insulin sensitivity. That cannot be done through fasting, as fasting disrupts blood glucose homeostasis.

5. All diets should include "carb cycling".

"Carb cycling", sometimes also referred to as "carb loading", involves going back and forth between high carb days and low carb days. You would usually have a high carb day when you plan on doing intense exercise. Supposedly, on those days, your body would require more fuel so you would need more carbs. No one who is treating their metabolic dysfunction, should be doing any exercise that would require primarily carbs for fuel as that would exacerbate their condition. So intense exercise should go out the door.

Aside from that, carb cycling is a topic that should never be under discussion when it comes to overweight/obesity and or metabolic health since it does not pertain to either. Carb cycling is a topic that belongs in athletic forums. This is not an athletic forum.

6. Nothing proves that "keto" would be better than a "clean vegan" diet.

Trying to "prove" anything of this sort is above my pay grade and a waste of time since people are usually not motivated by "what’s better for them" but by what they want to do instead. I recently wrote a post explaining what the issues are with vegan/vegetarian diets. You can read it here.

You would have to do your own research and try both diets to see which one is actually better for you, depending on the goals you have for your own health. You have to do the work. I'm not a salesperson so I don’t try to sell anyone anything.

Six common beliefs addressed, Part 75

1. I was told that body mass index (BMI) charts are not reliable.

I am sure that many obese people want you to believe that, but belief doesn't make things true. I have spoken about the BMI chart before and it's potential issues. This chart should not be used alone and requires context. 

The BMI chart is generally correct and the results only begin to skew for bodybuilders and/or athletes that have a significant amount of muscle mass. But, that's not the people we target on this blog. If you are reading this, then chances are you are just the average overweight/obese person. Common sense will take you a long way when interpreting your BMI chart results.

For example, if you are a healthy athlete and your BMI chart results indicate you are obese, you can pretty much guess that something is off. If you are a diabetic that looks like the Kool Aid Man and your BMI chart results indicate that you are obese, you can pretty much take it to the bank that it's correct. The mirror tells you everything you need to know.

So, using common sense is vital when dealing with a not so perfect measurement, such as the BMI chart. For this reason, I have a post that explains the proper way of measuring body fat here.

2. Protein negatively affects a diabetics gluconeogenesis.

People with metabolic syndrome/diabetes have over expressed gluconeogenesis, which is one of the main drivers of the disease, and is referred to as hyperglucagonemia. Unhealthy gluconeogenesis does not allow the body to regulate its blood glucose properly, so repairing not suppressing this important metabolic function, is vital for obtaining remission. Because of this inability of gluconeogenesis to function properly, diabetics are very efficient at breaking down their bodies, and everything they eat, into glucose. This means further loss of lean muscle mass and a continuous high insulin demand, which further deteriorates blood glucose homeostasis. For this reason, people with metabolic syndrome/diabetes require more protein, as they lose significant amounts from this heightened stress response. Protein also helps regulate gluconeogenesis, so it can begin functioning normally.

The protein itself does not cause hyperglucagonemia, nor does it make it worse. It simply unmasks it, exacerbating symptoms, which were always present to begin with. But this is transient and as the condition goes into remission, the symptoms disappear. People who "chase symptoms" immediately have the knee jerk reaction of restricting protein, because their blood glucose goes higher than it should, postprandial. Unfortunately, this will not solve anything, as eventually even breathing will cause high blood glucose if it is not properly treated.  

Protein restriction is not a proper treatment for metabolic abnormalities. Divide your daily protein requirement, into several small meals, instead of restricting it.

3. Should low carb diets be primarily plant based?

This is extremely common in diet advice. You would be surprised how many low carb proponents are ex vegans/vegetarians, that almost killed themselves on their plant based diets, and now want to "save the world" with low carb diets, which include meat. Actually they want to fill their wallets much more than they want to save the world, but let's give them the benefit of the doubt, for the sake of this reply.

Most of these ex vegans/vegetarians feel guilt for having left their "pure diet" and succumbing to eating animal products, so they insist that you must follow the diet with mostly plant foods. You don't have to do that. That's BS. Don't let someone else's guilt trip affect your health.

There was a time when the only "salad" that a human being would have, was found in the stomachs of ruminants, already partially digested, so the bounty of man-made, hybridized "plant foods", found at the farmer's market, is not going to save you. When trying to choose what to eat, keep in mind that:

• Meat = whole food
• Eggs = whole food
• Dairy = whole, fermented food
• Fruits = man-made, hybridization
• Vegetables = man-made, hybridization
• Grains = processed, man-made, hybridization

Which foods seem more natural to you?

4. The body's stress response has nothing to do with metabolic abnormalities. Blood glucose control is completely determined by diet alone.

The body's stress response is something that is often ignored and/or misunderstood, but is at the center of metabolic abnormalities. It irks me that no one explains this to people who have metabolic syndrome/diabetes. Low carb advocates ignore it completely and keep their focus, exclusively, on what's on your plate. The American Diabetes Association (ADA) makes no mention of it, even though that's why they ignore, exclusively, what's on your plate. This does not help the person who is trying to reverse their pathological metabolic adaptation.

Even though I sometimes refer to metabolic problems as "diseases", for simplicity's sake, I want everyone to get use to the idea of thinking about their condition as an adaptation, not a true disease. Metabolism has adapted to the hypo/hyperglycemic events, caused by an improper diet. This adaptation is pathological, meaning that it causes disease and eventually morbidity.

One of the main hallmarks of this pathological adaptation is an unregulated and exaggerated stress response by the body. This is caused by many decades of erratic blood glucose regulation of which hyperinsulinemia is at the forefront. When your blood glucose is unnaturally and chronically high, along with high insulin, any dip in it, even if by a little, causes the body to overreact with exaggerated adrenal (fight or flight/stress hormones) and pancreatic (glucagon) counter regulation. The gut also has a stake in this, as glucagon producing cells exist in the stomach, as well. Basically, the body has now "adapted" to high blood glucose and even dropping glucose levels to normal is seen as "hypoglycemia". This stress response is more complicated, as it doesn't just cause exaggerated glucose production, but it also down regulates insulin's effect, requiring even more insulin.

Chronic hyperglycemia adapts metabolism to live off its stress response. This is why I like describing it as a "metabolic adaptation to starvation" response. The body's metabolism is now set for increasing body fat, not losing it, as this starvation response goes hand in hand with the stress response, preserving and sparing fat mass at the expense of muscle.

This is why I always say that metabolic syndrome/diabetes is much more complicated than what some low carb person describes it as. Just because your diet is on point, does not mean you have taken control of this adaptation and its symptoms. This is what the ADA knows and why they don't put too much credence on dietary interventions. Too bad they don't explain this to anyone, so that the person with metabolic syndrome/diabetes understands what they are truly dealing with. This is also why low carb has been seen as "quackery", since it does not address this stress response at all. Low carb only addresses one part of the problem, the easy part (symptoms), which respond to what's on your plate, for the most part. But the problem has many parts. If it was so simple, it would have been cured back when it was discovered.

5. You will not gain weight eating "keto" ice cream. It's only 65 grams of fat, for the whole pint, and hardly has any carbs.

You will soon realize this is false if you do the math correctly, using the obesity algorithm, not what an obese "keto" person told you:

• 65 grams of fat + plus the taste of sweet = 6500 grams of stored fat.

That type of math is not present by simply turning over the carton and "glancing" at the fat and carb grams per serving. Glancing doesn't cure diabetes.

Remember to keep your dietary fat intake between 50 - 150 grams a day. The more fat you have to lose, the closer to 50 grams a day you should stay. Stop allowing for obese low carbers online, to advise you on what to eat. If their advice hasn't worked for them, it won't work for you.

The fat you consume should be from whole foods, that are not sweet and are nutrient dense. You are wasting your fat allotment by eating a pint of high energy junk, that will basically take up 70% of your daily fat intake and cause hypothalamic malfunction.

6. It is easier to lose fat gained from eating fat than from fructose. 

Fat is fat. I was obese once and I know people try to negotiate with their fat mass, all the time, but it doesn't work that way. Though the chronic taste of sweet causes permanent damage to hypothalamic function, making fat loss nearly impossible, the actual fat mass on your body is the same regardless of where it came from.

The fat that accumulates in the liver, due to fructose consumption, is extremely easy to get rid of. This is why fatty liver disease can be reversed by abstaining from fructose intake for about 7 days. The body is quick to get rid of this fat, because it doesn’t want it and will get rid of it any chance it gets.

The fat that is stored directly into fat tissue, from excess fat and/or carbohydrate consumption, is extremely hard to get rid of because you need intact and proper leptin expression to do so. If you are accumulating a lot of this fat, then you can pretty much guess leptin is not doing its job anymore. This means that fat stores in adipose tissue is extremely difficult to get rid of.

The body doesn't want to let this fat go, because it has adapted to withhold it for protection. Remember, the body is experiencing an exaggerated stress and starvation response, so it always finds a way to spare fat mass, not get rid of it. You can see this clearly in many people who have lost weight, but continue having excess "flab" fat (not skin). They have lost their visceral fat, but are left with a large "soft" fat mass, which they find impossible to lose. This is a sign that their metabolism continues to be abnormally adapted for obesity, not leanness. These people can gain weight at a drop of a dime, because their fat mass is just sitting there, waiting for any chance to expand and/or grow further.

This is a problem, because it will only take a very small push for them to start accumulating fat in the visceral, once again, since they are exceeded subcutaneously. For this reason, you don't want any excess body fat, regardless of what made you fat to begin with, because exceeding your fat stores is a sign of metabolic abnormality.