Six common beliefs addressed, Part 142

1. Diet advice is very confusing and doesn't seem to provide any one single answer to the problem of obesity. 

Obesity is very complex and once you are obese, many systems in the body are affected. Obesity is still a "disease without a known cure" as of this post. This means that whatever shenanigans they want you to follow, in order to "treat" or "cure" obesity, is a lie by default. 

The only thing you can do to better manage obesity and have a chance at reversing is to follow the actual data that is known about it. Abnormalities in blood glucose regulation has been the only metric that has tracked linearly with obesity in research. Nothing else. For this reason, blood glucose is what you should be addressing.

2. On "keto", my menstrual period stopped for several months and I felt better than I ever have in my entire life. With time, my menstruation returned back to normal and I started to feel run down again.

Hormonal imbalances, fluctuations and chronic release cause havoc in the body. I know that in modernity amenorrhea (lack of menstruation) is seen as something sinister and it can be, if it's being caused by an actual pathological condition or deficiency. Therefore, the 28 day cycle is considered "normal". But, hunter/gatherer women, who are completely healthy, do not menstruate every month because of their low body fat so in essence, this tells us that we never evolved to menstruate on a 28 day cycle chronically. 

When you start "keto" and your body fat takes a significant plunge, you feel the beneficial effects of not menstruating on a monthly basis, but as body fat goes back up, you once again fall into a 28 day cycle, which is the maximum ovulation cycle that a human female has. This constant marination in sex hormones, without a break, can cause side effects such as bloating, premenstrual syndrome, headaches and low energy. If you are going through peri/pre-menopause, you might experience even nastier side effects, such as migraines, allergies and auto immune activity. It is no wonder that women experience so many health conditions related to their sex hormone status and these conditions only become worse as their hormones become increasingly imbalanced. 

Menstruation is mainly driven by body fat and "stress". Even at a normal fat percentage, the body will have a 28 day cycle. It is only when body fat dips below a certain percentage or is actively being lost in large amounts that menstruation will halt. This is because a challenge to body fat is a stressor on the body. Stress is hormetic when it's controlled and occurs in low doses. When low body fat or the loss of body fat is the only stressor that the body is sensing, it becomes beneficial. 

The body will not sustain a body fat deficit in a modern environment so menstruation will eventually return to a 28 day cycle. You would literally have to go live with the hunter/gatherers if you want to avoid this hormonal chaos. The only thing you can do is mitigate these symptoms by actively trying to keep body fat within a normal range, continue a healthy diet and have an exercise regimen in place. The healthier you are metabolically, the better your body can handle this hormonal onslaught and keep sex hormones balanced. 

3. Will "keto" help resolve uncontrollable overeating?

Stabilization of blood glucose can have a direct effect on hunger because metabolic hormones follow suit. This addresses the biological causes for hunger and that can be enough to resolve overeating issues if there aren't any behavioral drivers. But unfortunately, most uncontrollable overeating is not driven by biology but by mental health issues. For this reason, a mental health professional would be most helpful, rather than diet.

4. On "keto" you usually "forget to eat", so it's okay to follow a 'one meal a day' (OMAD) protocol. 

If you are healthy and slim, this is not a problem. It simply means that your metabolism is working as it should and acquiring energy from fat storage. There is enough fat storage to do this without any unpleasant side effects like low energy. The body is in perfect balance between what it eats and what it stores and the energy it derives from each. A healthy metabolism balances energy all by itself without your interference. 

But if you are overweight or obese, and not actively losing weight, you shouldn't be "forgetting to eat". I know it's trendy to "forget to eat" in low carb circles but this practice only sabotages weight loss and blood glucose control over time. If forgetting to eat truly treated obesity then the caloric model would be fool proof as a treatment but we know that's not the case. You need to have set times for your meals and you should never do frequent OMADs. 

5. Do carnivore and "keto" use the same macros for protein?

Macros are highly individualized. As far as protein is concerned, if the diet is being used for the treatment of obesity and metabolic conditions, protein should be prioritized. The main difference between carnivore and "keto", when used for the treatment of obesity and metabolic conditions, is simply the carbohydrate amount and its source. 

Carnivore is a "0 plant" diet while "keto" still has a carb allotment of no more than 30 grams a day. The carbs in carnivore are coming from diary and the carbs on "keto" come from vegetables, primarily leafy greens. 

6. I cannot follow low carb dieting because "stress" makes me eat. 

"Stress" cannot "make you eat" because it doesn't have hands that bring food into your mouth. 

People often confuse their bad eating habits with "stress" since we tend to be stressed often. When people refer to "stress" they usually mean some kind of "emotional stress". But nothing stresses the body more than inappropriate eating, especially when that's coupled with inappropriate food. This only perpetuates metabolic stress, a real and dangerous stress, that eventually leads to disease if it hasn't already. 

You need to find a way of addressing your bad eating habits, without giving them an ambiguous cause such as "stress". The type of stress you are referring to cannot ever be resolved, so you are trapping yourself into a corner and basically blocking all of your own exits. When people do this, it usually means they simply aren't ready to make the lifestyle change necessary to tackle such a complex and long term issue as obesity and/or metabolic health. You need to revisit the diet again when you become truly ready.

Six common beliefs addressed, Part 120

1. Is Crystal Light okay to consume because it has 0 sugar?

Just like with last week's post about diet sodas and sugar free Jell-O, Crystal Light is not okay to consume just because it has 0 sugar. 0 sugar does not give things a pass for consumption. The battle is not against sugar, per say. It is against blood glucose dysregulation. There are many things besides dietary sugar that affect proper blood glucose regulation. For example, endogenously produced "sugar" also affects proper blood glucose regulation.

Negative effects to hypothalamic function, caused by sweet taste, is obesogenic because it causes a dysregulation of blood glucose homeostasis. Just drink water. 

2. Should you drink bullion cubes or bone broth?

Bullion cubes are usually consumed when you need sodium. Some people use bullion to up their electrolytes, but you should really track and supplement electrolytes in a more precise way than this. 

You can't make a meal out of bone broth, so that means you would be consuming it between meals and that's snacking. Snacking is not recommended on this blog. Bone broth can be used in recipes, etc. Other than that, you shouldn't be drinking your calories, in any way shape or form. That means that you shouldn't drink Pepsi, but you should also not drink olive oil or bone broth. 

 

Teeth are anti obesogenic. Use them. 

3. Will artificial sweeteners help you transition away from sugar?

No. The only thing that artificial sweeteners do is replace sugar. You don't want to replace sugar. You want to eliminate it. 

The only thing that helps you transition from sugar is stopping the taste of sweet, in all of its forms. Replacing sugar with artificial sweeteners is what the calories in/calories out (CICO) advocates believe in. After all, if the artificial sweetener has no calories, then it becomes benign. Well, we know that's not true because obesity is a metabolic adaptation, not a calories condition. The taste of sweet drives obesity, irrespective of caloric content. It does this through dopamine expression.

 

Metabolism is not fooled. It can't store the artificial sweetener, so it just waits for the calories to come in from elsewhere and stores those instead. You cannot out run, out fast or out smart obesity. You can only treat it effectively or not. 

4. You can "control" high morning blood glucose by eating breakfast later. 

You can control not seeing your high morning blood glucose by eating breakfast later. The high morning blood glucose is still there, whether you choose to see it or not. 

High morning blood glucose is indicative of metabolic syndrome and/or diabetes, depending on how high it actually gets. Metabolic syndrome is the first sign of impending diabetes. You probably are already aware of that and I am sure your doctor is too, as they use fasting blood glucose to determine a diabetes diagnosis. 

 

High morning blood glucose is referred to as Dawn Phenomenon (DP), which I have covered extensively in my past blog posts. It's basically an adverse response to dropping blood glucose during the overnight fast. When blood glucose begins to drop when fasting, in the presence of higher than normal insulin levels, the body overreacts and adrenal counter regulation kicks in to release blood glucose and prevent hypoglycemia. Cortisol is the hormone that is responsible for DP as this is the hormone that naturally wakes you from sleep.

This problem will persist, as long as you have metabolic problems. You can try things to manipulate this effect, but none of them will correct the problem. They will only "mask" it. For instance, you can exercise, the moment you wake up, and that might drop your blood glucose. For others, it actually rises it further. You can eat breakfast, as soon as you wake up, and it might drop your blood glucose, as the stress response lowers but again, for others it makes their blood glucose even worse. 

The reason there are so many variables between individuals and there are no remedies is because chasing symptoms like DP is not correcting the root problem. You can spend years on this roller coaster of ups and downs every morning, as diabetes keeps progressing right under your nose. 

 

The only solution to this problem is proper blood glucose regulation. Keeping blood glucose as steady as possible, through the proper and consistent implementation of a diet, fasting and exercise routine is the first step in combating this problem. Consistency in your protocol is what will lower this stress response over time. 

 

Don’t flip flop between diets. Don’t fast for three days straight and then binge for a week, to then fast again for another week. Don’t take a month off from your exercise routine. All that BS will only make DP worse. 

5. Exercise can have an adverse effect on blood pressure, so it must be avoided. 

This is caused by an exaggerated stress response. Just like above, the stress response is kicked on due to any effect that is deemed stressful for the body, like lowering blood glucose during the overnight fast and/or exercise. Exercise lowers blood glucose, just like fasting does. Well, metabolic syndrome/diabetes are conditions that prevent the lowering of blood glucose as it wants to be kept at a high set point. People with metabolic problems have a dysregulation of their catecholamines, which are also released by the adrenals just like cortisol is. 

When you exercise blood glucose lowers and since metabolic syndrome is a condition that tries to keep blood glucose high, your stress hormones respond by releasing more blood glucose and also raising your blood pressure and/or not allowing it to lower. I don’t know what type of exercise you may be doing, but I recommend that you downgrade it. Steady state exercises like walking are what’s recommended on this blog. Stay away from anything strenuous, until your body can take control of this response. 

6. You cannot "overeat" real food. 

I try to stay away from the term "overeating" on this blog, unless absolutely necessary. This is because it is very difficult to quantify what "overeating" is. Nutrient recommendations are very individualized and must be determined on an individual basis. This is why we like to use macros instead of any other metric. Remember, the target here is obtaining proper blood glucose regulation and macros are a more precise metric to affect blood glucose than calorie counting or special "small" plates. So when the term "overeating" is used, I usually think of disordered eating habits which usually do not manifest in the quantity or quality of food. 

 

For example, I could be eating salads for breakfast, lunch and dinner. That would be overeating salads and their calorie totals or quantity wouldn't much matter as I am not getting adequate protein or fat due to this disordered eating habit. Eating salads is basically starvation reinforcing blood glucose dysregulation. 

 

I could be drinking "keto" coffees for dinner, instead of a real meal, again affecting adequate protein intake and making me go over moderate fat intake. Once fat goes over 150 grams a day, it becomes much easier to store, particularly if I am leptin resistant.

 

I could be eating rib eyes, fried in butter, for dinner, going over the recommended moderate intake for fat, once again. 

 

Salads, "keto" coffee and rib eyes with butter are all real food but yet, my eating habits have made them all obesogenic. So in essence, I would be overeating them and affecting my blood glucose regulation, regardless of the calories consumed. 

For others, disordered eating habits do fall into quantity. For example, if I am able to eat a pound of burgers with a block of cheese and a jar of mayo, poured over them, plus a bucket of "keto" ice cream for dessert, I have a problem. I am disrupting my insulin/glucagon ratio just by the massive workload I am putting on my digestion. How long will it take me to digest all of that? How much insulin will I release in response to it? How much glucagon will follow? All of this disrupts blood glucose regulation, irrespective of calories. 

So, we have to be very precise when we speak of overeating. Overeating what and how? None of the information needed can be obtained through the calorie or quality metrics of the overeating.

Six common beliefs addressed, Part 19

1. I don't get enough greens, but I don't like eating them.

If you don't like them, don't eat them. No where has it ever been proven that greens are needed. I understand that many hundreds of years ago people wanted to sell their crops and came up with the whole "you need your greens" mantra, but don't let agricultural marketing ploys control what's on your plate today. The only thing you need is to breathe. If you prefer a diet without greens, then eat only animal products.

2. Stable blood glucose is not important, because diabetes is a disease of insulin.

Diabetes is a disease of poor blood glucose regulation which eventually affects insulin release, function and expression (insulin resistance). Therefore, stabilizing blood glucose is extremely important to correct diabetes, because these erratic blood glucose fluctuations continue driving the insulin resistance. Everything else that occurs is always downstream from poor blood glucose regulation. 

Stabilizing blood glucose, in the context of pharmaceutical medications, is a fool's errand. Diabetes is a chronic and progressive disease, because the medications that "treat" it, only work to lower blood glucose, not to properly regulate it. This is why these medications do not "cure" diabetes, since they never reverse insulin resistance. 

3. Is taking magnesium and potassium enough to correct an electrolyte imbalance?

There are seven important electrolytes, which the body requires, and all of them work in unison - sodium, potassium, calcium, magnesium, chloride, phosphorus and sulfur.

If only one of them is too low or too high, it can affect how all of the others work. For this reason, concentrating on only sodium, magnesium or potassium is not enough to correct electrolyte imbalances. Consuming salt in isolation can also cause more dehydration,  furthering electrolyte imbalances. Salt needs to accompany the correct amount of fluid.

You need to replenish and balance electrolytes with a good quality electrolyte supplementation. These supplements can be found in health food stores or vitamin shops. Make sure the product you choose does not contain sugar. Also avoid products that are labeled electrolytes but contain other vitamins, minerals and "antioxidants" as fillers. You want electrolytes, not anything else. 

Discuss electrolyte concerns with your healthcare provider, so you can get the appropriate testing required to have a better understanding of what might be going on. This is especially true if you are symptomatic.

4. Since low carb diets will always work, I can just go back to them after binging and cheating.

No. 

Yo-yo dieting has extremely negative effects on metabolism and can eventually dysregulate leptin function, thyroid function, stress hormones, etc. This is because with yo-yo dieting you end up disrupting blood glucose even more, over time. 

Poor leptin expression can cause the inability to lose weight, unless extreme measures are taken. The more extreme, the less sustainable and the higher the failure rate. This is why a diet that worked once, might not work a second time.

This is why practicing a consistent dietary, fasting and exercise protocol is so important. You have to stick with it, so you can develop a healthy circadian rhythm, that your body will respond to. You do not want to stress your metabolism into no longer responding to anything.

5. I was told sugar is bad, but fructose is fine, since it does not raise my blood glucose.

Fructose does not raise blood glucose, because it is metabolized in the liver like alcohol, and becomes liver fat. Liver fat only perpetuates metabolic dysfunction further. 

The sweet taste of fructose interferes with incretin hormones, insulin and hypothalamic function. 

For this reason, you have to stay way from fructose as it is particularly obesogenic. 

6. Is coconut water good for electrolyte imbalances?

Coconut water contains all of the electrolytes needed, but if you are symptomatic, this is not enough. The more fluids you intake, the more you urinate and this causes more electrolyte loss. Electrolyte supplementation will be your best course of action, not drinking more.

Six common beliefs addressed, Part 18

1. People who have metabolic syndrome or diabetes can never eat whole food carbohydrates.

As long as the individual is able to obtain and sustain proper blood glucose regulation, then there is no reason for them to not be able to eat whole food carbohydrates. 

Metabolic syndrome is not a "carb disease". It is a disease of poor blood glucose regulation. Once the person has metabolic syndrome, their poor blood glucose control, becomes very sensitive to carbohydrates so it is best for them to restrict all carbohydrates, regardless of being whole or not. But this is very individualized.

2. Can you have rice as your carbohydrate allowance? 

You can have anything if it doesn't interfere with your blood glucose. 

The reason that rice is not recommended is because it is known to interfere with proper blood glucose regulation. This is particularly true for people who already have poor blood glucose control. 

People with metabolic syndrome should restrict carbohydrates, particularly sugar, grains and starch. Rice is a grain. 

3. Why does fasting cause me to binge once I start eating again?

Binging or hyperphagia is usually a sign of metabolism adapting to extreme energy conservation. This is why extended fasting is not recommended on this blog.

Carbohydrate restriction should always be primary and in most instances, it is enough to achieve metabolic goals, but if you are still having issues, then intermittent fasting can be a good secondary, additional intervention.

In most instances fasting is the easiest and most convenient way to control your intake of carbohydrates and keep a healthy hormonal balance by allowing the body sufficient catabolic times. Unfortunately, for a few, these benefits are not achieved because of binging, inability to be consistent with fasting/eating schedules or extreme discomfort. Though implementing and keeping a fasting regimen is a beneficial intervention, if you have tried it and it doesn't seem to work for you, stop it. There is no purpose of continuing something that's obviously not working.

Instead of fasting you might want to implement a time restricted feeding regimen instead, where you do not have to fast for 18 hours, but can eat a maximum of 3 meals a day, at specific times only. Breakfast in the morning, lunch at mid day and dinner in the evening, with no snacking in between. In this way, you are not constantly eating throughout the day, but you are still eating at short enough intervals to give the illusion that you are not fasting for any specific length of time. You would basically be fasting only overnight, which is about 12 hours. For some, it is much easier to refrain from snacking and/or binging when they know that their next meal is coming up soon, rather than having to wait 16-18 hours.

Paired with a carbohydrate restricted diet, time restricted eating can be a viable option for achieving goals. This method of eating still allows for insulin levels to go up and down, in a pulsatile way, which is how hormones are suppose to work.

4. Can "high protein" cause kidney damage?

Protein does not damage kidneys. That is a myth. The other myth is that there is even such a thing as "high protein". Protein is managed naturally through satiation and the wallet, so it is impossible to eat high protein from food in its whole form. No one is "addicted" to pork chops and they didn't cause the obesity epidemic, nor the kidney disease scourge, we are all facing now.

Kidney damage is caused by chronically high insulin levels. These insulin levels are caused by erratic blood glucose fluctuations putting stress, not only on the kidneys, but the entire body. The water retention caused by insulin and the need to excrete excess glucose puts the kidneys in an abnormal state that eventually causes disease. The high insulin directly affects the kidney tubules causing inflammation, scarring and irreparable damage. The high blood pressure caused by the water retention from chronically high insulin also damages the small blood vessels in the kidneys.

Once the kidneys are damaged they can no longer handle anything, including normal protein metabolism, since they are not functioning properly. Kidneys are responsible for a lot of things and once they are compromised, they become overworked easily. The person with kidney disease is now left having to restrict protein, amongst other things, and that's a recipe for getting fatter and more diabetic. Insulin causes insulin resistance. Metabolic disease causes more metabolic disease.

5. My fingernails are weak and brittle. Can this be the cause of carbohydrate restriction?  

Brittle nails, ridges and other nail problems are usually related to thyroid function. Just because you’re not having a clinically diagnosed thyroid issue does not mean your thyroid is working optimally.

When fasting and following a carbohydrate restricted diet, the most common thing that affects thyroid function is electrolyte imbalances. Make sure you are getting enough electrolytes.

Aside from that you can try rubbing fresh garlic on your finger nails, once a week. Olive oil is also very good for finger nails. You can also try a collagen and/or biotin supplement or cream. You can get more information on supplementation at a vitamin or health food store.

Digestive enzymes can help with nutrient extraction and having your doctor check you for a vitamin deficiency can also be helpful.

6. My toenails are falling off and I blame carbohydrate restriction. 

People always blame any new diet for everything they suffer from. But diet is only a palliative treatment for what ails you, so it is highly unlikely to cause new ailments. 

If you recently started exercising, along with your new diet, and find that you're having toenail problems, this is most likely due to the moisture and heat created by activity and walking shoes.

• Make sure you are wearing the appropriate cotton socks, that wick moisture.
• Take your shoes and socks off immediately after exercising and allow your feet to breath by wearing open toed sandals at home or whenever possible.
• Spray your toes with vinegar once you are done exercising. Vinegar helps prevent nail fungus and can cure any nail fungus you already have. Fill a small cosmetic spray bottle with white vinegar and keep it handy after your workouts.
• Sprinkle cornstarch based baby powder on your toes to keep them dry. Do not use talc.
• Use nail polish on your toenails. It helps create a moisture barrier. You can use clear polish if you don't want it to be visible.
• Always dry your feet well after showering and do not put on shoes or socks until you do. 

Toenail fungus is very difficult to get rid of and there has been no proven, effective, long term treatments. High doses of antibiotics and other chemicals are not recommended, as they usually take many dose cycles and often do not work. Some at home remedies that people have found useful have ranged from Vicks Vapor Rub, to lemon juice, to pure oregano oil, to bleach. I personally have had success with plain vinegar and baby powder, so that's what I recommend.

Fungus likes dark, moist places. Take their environment from them and they die naturally. It's something you will have to work on, for a while, but at least it's a real cure and prevention from it happening again.