Six common beliefs addressed, Part 268

1. What evolutionary advantage is there to blood glucose shifts to cause the body to go into a starvation response? I much rather be the person who can maintain their blood glucose regulation intact while eating doughnuts and pizza.

I know that when I speak of "proper blood glucose regulation" it seems as though you have to constantly walk a tight rope because your body is against you but it actually is not. It is doing exactly what it is suppose to do. Shifts in blood glucose homeostasis help the body determine what the food environment is like. It helps the body know how much and what type of nutrient availability there is. It uses this information to determine if it needs to get fat for survival or not.

Of course there is an evolutionary advantage for the body to kick into starvation mode the moment it senses a disruption in blood glucose. This is why most people get fat and very few are able to sustain staying lean well into old age. The person whose metabolism is resistant to respond to blood glucose shifts might be blessed in an industrial modern setting but they would be toast in a hunter/gatherer setting. How would they survive a famine or even times of general food scarcity? They wouldn't fare very well at all. It's the one who can get fat that survives and that's why there are so many of us left since we were the ones who didn't die off. Evolution has made the decision that anti starvation mechanisms like the propensity for overweight/obesity, is a good thing in general.

So when I speak about "proper blood glucose regulation", you can think of it more as avoiding its disruption as much as possible.

2. I watch a YouTube doctor, who has millions of subscribers, but the advice he gives is really generic, simplistic and kind of vanilla. It's like a public relations team writes his content for him. He tried to do a "keto" diet one time and complained about how much fat he had to eat and how boring and inconvenient it was. Then he said he had to drop the diet because his "cholesterol went up". I doubt that was even true. I think it was a gimmick to make people not want to try the diet out through fear mongering.

YouTube doctors are like daytime TV, full of sh%t. They are there to gate keep the status quo, push a narrative/agenda and virtue signal to their audience. I actually believe that you might be right and this doctor did make up that his cholesterol went up following this diet because he knows that is a common problem people face. He wanted to make sure you stick with the standard dietary advice without question, and if you attempt to veer off, well then bad things will happen to you.

Look, we know who the target audience for these young, scrub wearing, obesity resistant, athletic, feminized, male doctors are - middle aged, overweight women who are bored with their lives and their "health" has now become their only hobby. They are ready to follow any fool who makes the claim they can "save" them from whatever is ailing them. It also doesn't hurt that these doctors are easy on the eyes and relatable while doing so. Sorry for whoever I triggered.

Stay away from this type of nonsense. It will not help you lose one pound. Why this doctor decided to eat that much fat on "keto" is beyond my understanding because as a doctor, he should know that you can go naturally into ketosis through carbohydrate reduction exclusively, but who knows. He might not even be a real doctor. These people will do anything for views except state facts.  

3. I love pudding and I saw a "keto pudding" online which I ordered, thinking it was truly "keto". When I looked at the ingredients though, it is 100% starch. It doesn't say what type of starch. Isn't regular pudding made of corn starch? So what's the difference between this keto pudding and the real thing? Is starch even "keto"?

Anything that does not disrupt ketosis is "keto". I have said before that "keto" is not a set of ingredients, it is simply a metabolic state where you primarily burn fat for fuel and produce ketones. The more efficient you become at burning fat, the less ketones you will produce. This has zero to do with metabolic health. If you are here because you want to treat your overweight/obesity/diabetes, then your main concern should not be ketones but your blood glucose regulation. So I will reply to this question as if you are dealing with overweight/obesity/diabetes since you did not specify why you are on a "keto" diet.

Do not get duped by these "keto" and "low carb" labels. Manufacturers are using these labels in order to sell their junk to a new wave of customers who are following these fad diets. The reason that this pudding was most likely labeled as "keto" is because it does not contain granulated sugar but some sort of artificial sweetener instead. They know their customers are dumb enough (with all due respect) to not even know that starch is simply a chain of glucose molecules bound together. Basically, glucose. Glucose disrupts blood glucose homeostasis. So it doesn't matter if this product is "keto", it is obesogenic.

They most likely didn't use corn starch in order to not alarm any potential customers as many of these "keto" followers are leery of corn and avoid any product that has corn in their ingredients. Corn sounds too much like high fructose corn syrup. This means the starch used is most likely cheap tapioca instead, which is believed to be lower in carbs, though no specific number exists or even a comparison to corn starch. I can almost guarantee tapioca is either higher in carbs than corn or about the same. In fact, I actually prefer the corn. You can become 700 lbs on tapioca or any other type of starch. Remember starch is just a fancy term for glucose as described above.

Real "keto" pudding is not only sugar free but starch free. This means you have to go online and find a starch free pudding recipe. You will need to actually buy other ingredients, to replace the starch, and do some cooking and it will not be "instant pudding". In other words, it will be a pain in the a$$ to make and the results are not guaranteed to be the consistency or texture you are accustomed to. I have become convinced that a lot of these substitutions simply do not hold up to the real thing. You can't reinvent the wheel. The wheel is perfect as is and it can't be made any better.

For this reason, I do not recommend any of this "find a substitution" practice. You need to become accustomed to your new diet and this is best done by accepting it as it is instead of trying to make it something that it's not. You will have to live with the fact that some of your favorite foods will just have to remain in the past so you can move forward. Find some other "keto" dessert that is not a mock recreation of the usual high carb fare.

4. I know someone who had bariatric surgery and it was successful. They changed their lifestyle and kept the weight off. It has been three years since their surgery and their weight is still off but they are having serious health issues which have not been easy to diagnose. This isn’t the first time I’ve heard of this. I have read multiple stories online of people who have lost their weight, kept it off, only to be plagued by multiple, mysterious health issues that have ruined their quality of life. What is going on?

I don't know and I doubt anyone else does. Health issues are individualized and we simply don't know what is going on with this person, who had bariatric surgery. If their doctors haven't been able to figure it out, I doubt we will. It could be the result of such an invasive surgery. It could be the complications that occur afterwards. It could be something totally unrelated that just so happened to occur after the surgery. We can only speculate at this point.

What I can tell you is that obesity has long term health consequences even after it is resolved. Body fat is the largest endocrine organ in the body, aside from the thyroid, by sheer surface area and distribution. Challenges to this body fat can pose potential long lasting, metabolic effects. Bariatric surgery does not just cause body fat loss, but mostly muscle mass and water loss. Loss of muscle mass is implicated in shorter lifespans and disease. This is not even considering the effects of abnormal insulin expression on tissues and organs. Insulin is what gets all nutrients, energy and electrolytes into cells. Insulin resistance basically starves various tissues and organs, to varying degrees, of these nutrients and the long term effects of starvation are pretty dire. Because bariatric surgery can induce weight loss without the need of insulin normalization, for the most part, the metabolic problems continue which often lead to weight regain and inability to regain muscle mass. These insulin abnormalities will continue inducing pathology over time.

As you can see, the cure for obesity is not weight loss. The condition and the metabolic abnormalities that result in it, persist regardless of weight loss.

5. I was controlling my blood glucose with a low carb diet but I moved to a more rural area and am now having allergies that I never had before. This has disrupted my blood glucose control. I don't understand how allergies can affect blood glucose and cause me to start gaining weight again. I thought that as long as my diet remained low carb, I wouldn't have these issues any longer.

This is the fallacy of the low carb community. They keep promoting this myopic idea that carbs are the only influence on blood glucose but they are wrong. Many things can negatively affect blood glucose control and if this negative affect continues for a prolonged period of time, insulin will start to abnormalize and metabolic conditions will ensue. They say you can't get fat from air but in your case, that is exactly what's happening.

There is a bidirectional relationship between histamine and blood sugar, with each influencing the other's levels and contributing to metabolic dysregulation.

• Histamine can stimulate the release of insulin, which can lead to hypoglycemia.
• Histamine can increase glucose uptake in muscles and adipose tissue, further contributing to hypoglycemia. In the case of the already overweight/obese, who have super insulin sensitivity of their fat mass, most of that glucose is going into their fat mass rather than their insulin resistant muscle.
• Histamine can suppress the release of glucagon which can also contribute to hypoglycemia.
• For individuals with certain chronic conditions, like mastocytosis, histamine can lead to hyperglycemia.
  

Anyway you put it and through whatever mechanism, histamine affects blood glucose and metabolic conditions require for blood glucose to not be disrupted in order to regain its proper regulation. For this reason, it is not surprising that your new found allergies are affecting you in this way. You need to work with your doctor in order to ensure you can take control of this situation before it gets worse.

6. Can dehydration cause blood glucose issues? Low carb groups always say to consume salt in order to increase sodium intake.

Salt and sodium are not the same things. 1 tsp salt is made up of 5 grams of salt and 2.3 grams of sodium. The rest is chloride.

Sodium in an essential mineral. It is found in your blood serum and the extra cellular fluid that surrounds all of your cells. Your kidneys and adrenal glands help keep sodium balanced in your body. When you consume too much salt, your kidneys simply excrete more of it. If you eat too little, then your adrenals cause your kidneys to conserve it through the action of aldosterone. This causes the side effect of potassium waste, which you don't want. When sodium is reduced the adrenals release cortisol and adrenaline which interferes in blood glucose.

So yes, dehydration can cause blood glucose abnormalities through stress hormone release. The proper way of addressing this is by making sure you are intaking suffice electrolytes. It is not resolved through drinking more water or consuming more salt. Either one of these, can cause more dehydration.

Six common beliefs addressed, Part 247

1. I recently had the flu, so I followed the advice in a fasting group to "fast it away". I ended up in the hospital with dehydration. The moment I ate again, my symptoms subsided, and I recovered quickly. My doctor told me I had done a dangerous thing. How do these people get away with giving this type of advice?

I hate to say it but if you play stupid games, you win stupid prizes.

Illnesses like the flu can cause serious dehydration and this in turn can result in electrolyte imbalances. You have to be well hydrated, but you also need proper nutrition because electrolytes are mostly controlled in the colon by what you eat. This is why you can get very sick when you fast, even if you drink suffice water. It's simply not enough.

Your immune system also needs protein to make antibodies and since stress causes for there to be a lot of lean muscle mass breakdown into sugar, you have to make sure you eat adequately to help your body fight off infection. In fact, access to nutrients has been a major factor in humans surviving infectious diseases like the flu. Malnutrition/not enough food is the main contributor of death in third world countries. The best and only support available for viral infections is proper electrolyte administration.

The reason these people get away with this type of advice is because others are foolish enough to follow. Don't blame the leaders, blame the followers. Anyone who goes online to seek medical advice, is basically a fool. I prefer for people to become educated and not follow idiots rather than censoring them. Let them give all of the advice they want but if no one follows, they will simply have to find another gimmick.

2. I have obesity and metabolic syndrome, so I have to be on a low carb diet in order to control these conditions. Unfortunately, I also have a genetic condition where I cannot metabolize fats very well, so I tend to get sick on a "high fat diet". The protocol for my particular condition recommends that I restrict fat to only 20 grams a day. When I remain low fat, I feel great. Is there a practical way of going low carb and low fat at the same time for the long term?

Yes. Low fat and low carb is basically a protein sparing modified fast protocol. You are restricting (fasting) the energy macros from your diet (fat and carbs) and keeping (sparing) the protein. There are multiple ways of applying this protocol because the macros can be modified depending on your goals. Hence the name of the diet.

But before I take a deep dive into your question, I want to address the "high fat diet" part. We do not recommend "high fat" protocols on this blog. Those are not legitimate protocols. This blog is all about low carbohydrate, not high of anything. I know there are some legitimate protocols out there that have unfortunately been described as "high fat" but those are false labels. The only "high fat diets" that exist are being followed by very obese, low carb advocates online that went rogue. No legitimate protocol endorses that way of eating.

When a protein sparing modified fast is being used for body fat loss, it is quite restrictive, making it very difficult to adhere to. It also cannot be used for the long term as it should no longer be followed once body fat goes below a healthy percentage.

• For a man, 2–5% fat is essential, 2–24% fat is considered healthy, and more than 25% classifies as obesity.
• For a woman, 10–13% fat is essential, 10–31% fat is healthy, and more than 32% classifies as obesity.

Of course, the obese will have a very difficult time getting to "essential" or "healthy" fat percentages, so they are pretty safe following protein sparing modified fasts for as long as they are still obese.

But of course, this diet can be modified. That's the operative word. It doesn't have to be so restrictive especially if you have to follow it for life. You can simply keep dietary fat up to 50 grams a day in order to give you some leeway. In your case, you can keep it at 20 grams a day so you feel your best. Keep your protein consumption adequate so that your body does not reinforce its starvation response. The carbs can go anywhere from 0 to 100 grams a day. Remember, the priority of this protocol is protein, not fat or carbs so they are irrelevant as long as they are kept low.

Practical ways of achieving this is avoiding dairy products, as they are very high in fat. If you wish to still consume them, you will have to get the 'low fat' or 'fat free' versions but watch your carbs if you do so. Buy 'lean' to 'extra lean' meats and add your own fat at home, if needed. Remember farm animals still contain a high amount of fat even when labeled lean. But adding your own fat to lean meats (preferably wild game) can help you control how much fat is in them without sacrificing protein which is your priority. Avoid unnecessary novelties like nut products and other "low carb" favorites which usually are more fat than anything else. Your priority is protein not fat.

Stay away from junk. Go for the naturally 'low fat', 'fat free' foods which are still whole and not processed or packaged. In other words, choose part-skim mozzarella and not fat free Oreo's. The premise of consuming whole foods still applies to low fat diets.

3. I was sitting at the grocery store and saw that nearly every obese person who passed by me, had a cart that was either empty or had very little food items in it. Yet, every single one of them went directly to the bakery to pick up a pie, cookies or a cake. The stereotype is always that a fat person would basically inhale the entire market, but their carts say otherwise. Strangely enough, every person who was slim bypassed the sweets and went to the bread aisle of the bakery instead. It was an eye-opening experience and I was wondering if you can opine on it.

You pretty much experienced the reality of the obese and why the calories in/calories out (CICO) approach as a treatment has failed so miserably. The obese are the least hungry people on earth. At least, for food. I will relay to you my own experience with this, and I have two examples.

Example 1: My husband's mother was morbidly obese and diabetic. When we would go out to eat, she would take two bites of her food and then stop. Then she would either bag it for the dogs or tell me I can have it. You would imagine, from simply looking at her, that she would wolf down the entire table of food but it never happened. She would blame her hiatal hernia for being unable to eat as it caused her to feel full prematurely but she would then order the dessert and eat it in its entirety by herself.

She would wake up in the morning with no hunger whatsoever and wouldn't eat a thing until almost evening. Of course her meal would consist of mango juice or a milk shake at the ice cream shop. I never saw her sit down to a real meal. Ever. Every time food was available, she was never hungry. She never even cooked. She lived off novelties.

This woman was well at or below her daily calories chronically but yet she was still obese. As you can see it wasn't the quantity of food she was eating that was causing her obesity but her disordered eating habits instead. She was on a high fat/high carb novelty diet and calories be damned.

Example 2: I had a friend who was overweight and diabetic. She did the exact same thing. Every time we would go out to eat, she would take two bites of the meal and then tell me to eat the rest. She blamed her missing gallbladder, but she always had room for dessert, the bread and the fries. She just could never stomach the meat and vegetables. She was never hungry but always had room for high carb "junk". Again, disordered eating habits.

This doesn't end at these Standard American Diet (SAD) followers. We also see this in the obese who follow "keto" or the fad low carb diets you find online. None of them ever sit down to a real meal. Their food always consists of fat. Cream cheese, butter, ice cream, fat bombs, bulletproof coffees, high fat sauces and novelties are considered "meals" for these people. They simply went from disordered eating habits which featured high carb foods to disordered eating habits which feature high fat foods, but the disordered eating habits remain. They were never changed and not even acknowledged.

So yes, I have also seen the very obese walking around the market with a skinless chicken breast, fat free milk and salt free broth in their cart, plus a package of brownies. I have also seen the obese live off salads and veggies because they refuse to eat a real meal. The obese have very strange eating patterns that go well beyond "overeating". Most of the time "overeating" isn't even on the docket. It's really overeating of sugar and under eating of real food or eating air. Real food is meat and vegetables. You know the type of stuff they consider boring and not fun. It's a chore to cook but a joy to open an Entenmann's Bakery box or drink of gallon of diet soda.

Of course, this is also a huge contentious topic with the obese as they do not like to be criticized for their eating habits. They rather blame someone else for their problems, like their doctors, fat free diet products or the Dietary Guidelines. Obesity is already very difficult to treat biologically, and this "victim" mentality and "don't fat shame me" attitude makes it all the more difficult. Behavior must be addressed when treating obesity or the condition will always return, no matter what amount of weight is lost. This is why "weight loss surgery" has been a failure as well.

Thin people heading to the bread aisle of the bakery is a much more complicated topic as bread is eaten around the world and obesity does not track with it. Obesity tracks with sugar intake, not bread. All cultures have their own bread recipes, and they are quite old, yet obesity is a modern condition.

Regardless, bread is a food item that is not recommended on this blog because it is very difficult for an overweight/obese/diabetic to control their blood glucose regulation while keeping bread in the diet. In fact, grains in general are to be avoided at all times. But we all know that bread is very different from doughnuts.

For a person who is still metabolically healthy, what will ward off disease is the overall macronutrient composition of their diet, eating habits and other lifestyle factors. A lot of these thin people, who are headed to the bread aisle of the bakery, are mostly using calorie restriction to maintain their metabolic health even though we know this will ultimately fail if they aren't watching their blood glucose as well. But they will be able to sustain their blood glucose regulation for longer if they continue to bypass the cupcakes and get a loaf of rye instead.

4. Are eggs and cream cheese a good meal to have? A lot of low carbers have told me it's really good.

Eggs and cream cheese are not a "meal". It's a novelty. This type of disordered eating will only make you fatter, especially if you have had a hard time losing weight since that is indicative of leptin resistance. Low carbers shouldn't be telling you that eggs and cream cheese are "really good". The only thing that's good is regaining and sustaining proper blood glucose regulation. That is the only lens you should be using to formulate your dietary choices because that is all that matters.

When you are leptin resistant, any fat you eat is stored and never burned. This causes for dietary fat to be extremely obesogenic as it only adds to your fat mass.

There is no reason to live off cream cheese. Low carb is not cream cheese. It's meat and vegetables. Eat a real meal.

5. Is it true that the purpose of "keto" is not weight loss?

The purpose of "keto" depends on your goals.

There are many iterations of a ketogenic diet. Each is designed for different goals. The classic ketogenic diet is for the treatment of cancer, seizures and other neurodegenerative conditions. There are ketogenic protocols for muscle gain, for weight gain, for the treatment of metabolic syndrome/diabetes and also for weight loss.

The fad "keto" protocol promoted online was marketed as a weight loss diet. This is what caused hordes of people to flock to it and give it a try. When it didn't work, suddenly the purpose was redefined.

Don't let these people gaslight you. This diet gained popularity as a weight loss tool, period. That is probably why you decided to follow it too. If it didn't work, dump it. No weight loss = no long term metabolic change. So who cares what it improves in the short term. Obesity can only be treated with long term changes.

6. Is it "healing" for the body to shift from burning glucose to fat and does this "cure" you of obesity?

As of this post, there is no known cure for overweight/obesity. There is nothing to "heal". Overweight/obesity is not a "disease" that requires "curing" or "healing". It is a metabolic state that requires changing.

Your obesity was not caused from "burning glucose". Your obesity was caused from not burning fat. Glucose burning can displace fat burning but that's meaningless in obesity. That happens to everyone. Our bodies are constantly burning both glucose and fat. It never does one or the other. It does them both at different rates.

For instance, athletes burn massive amounts of glucose all day and do not become obese from it even if it temporarily displaces fat burning. At the end of the day, when they reduce their glucose burning, they burn fat just fine and continue to do so while resting. The obese do not. They just simply don't burn enough fat to not be obese.

The obese also burn very little glucose. The glucose they have is turned into more fat instead. So, the obese are not burning much of anything. This is why they are constantly tired and growing fatter. In fact, most of the energy that the obese "burn", is from converting glucose into more fat. This is why some obese people have high metabolic rates but are still obese. It takes a lot of energy burning to be fat. Not only to they have to lug around gym weights in the form of body fat, but they have to keep converting glucose into more fat.

When the obese are starved of dietary glucose, they simply convert more lean muscle mass into glucose and continue expanding their fat mass from it. They do not magically start burning fat because there is no glucose in sight. There is always glucose. It never disappears just because it's not on your plate. The only thing that causes the obese to burn fat is an increase in leptin expression. This can occur through the normalization of other metabolic hormones but it's not guaranteed.

Six common beliefs addressed, Part 201

1. Increasing muscle is the "cure for diabetes".

The healthy who have plenty of muscle mass, can ward off diabetes for a long time. The greater the muscle mass, the more time they allot themselves from succumbing to the condition. This is because muscle is very metabolically active and so it’s a buffer against blood glucose dysregulation. So muscle can be a great antidote for diabetes. It only has one caveat - it must be taken before the poison begins to take effect. In other words, it works like a vaccine, not a medicine.

Many people, who do not understand what diabetes is, usually resort to "the opposite must be good" solutions. For instance, diabetics always have low muscle mass, so they assume that high muscle mass would “cure diabetes”. Or, diabetics have high body fat, so they assume that low body fat would “cure diabetes”. Not so fast.

Diabetes was not directly caused by the low muscle mass or the high body fat. The pathological metabolic adaptation that caused the body to break down muscle and spare body fat is what eventually leads to diabetes. Once that ball is set in motion, both the low muscle mass and high body fat work in unison to progress the condition.

Diabetics will not magically increase their muscle mass. They do not have proper insulin function for glycogen and amino acid synthesis. All of their insulin is actively working on their fat mass instead and not anywhere else. In order to increase muscle mass, you need to be in a metabolic state that is cooperative for this effect to take place.

This is why I get a kick out of watching diabetics "lifting heavy" for absolutely no reason. All they do is get winded and give up in about a day. A healthy person can "lift heavy" and see gains rather quickly. A diabetic can "lift heavy" and see high blood glucose rather quickly. This is because the heavy lifting is stimulating their adrenal stress response more than activating their muscle building. Worse, whatever little muscle they do gain, is quickly broken down, by that very same stress response, for even more glucose creation. The diabetic is simply melting into a puddle of glucose except for their fat. That will always remain intact.

This is why the hormonal environment that is perpetuating the diabetes must be stopped first. Until it is, the diabetic will not gain muscle nor lose body fat as only healthy people build muscle and burn fat.

2. A lot of low carb advocates say that meal timings do not matter and you should just "listen to your body". They say to eat when you're hungry and don't eat when you're not.

When the body is delusional, it cannot be listened to because you would only be listening to the ramblings of madness. You only listen to your body if you are experiencing some sort of health problem. We all know when something "just isn't right" and that's when you have to seek the care of a healthcare professional. As far as hunger/no hunger is concerned, the obese should never listen to any of it. It's all a lie.

The reason low carb advocates are giving out this silly advice is because they are just like calories in/calories out (CICO) advocates. Their diets are only focused on one thing. For low carbers the only focus is carbs and for the CICOs, the only focus is calories. This is why neither one has been able to successfully tackle obesity because treatments fail when they are incomplete.

There was never a time in our history when we were allowed things out of sheer will or want. Food is one of those things. We didn't get to eat just because we were hungry. We ate when food was available to us and that was dependent on a lot of things. For this reason, you need to have specific meal timings because that's when food will be available to you. You cannot guide yourself by hunger because hunger is subjective. Take solace that in modernity, you can at least designate meal timings because hunter/gatherers usually can't even do that.

Hunger either means there is something wrong with your diet or your experiencing it when you shouldn't be. If there is something wrong with your diet, then you are either not eating enough during meal times or eating the wrong macronutrient composition. If you are experiencing hunger when you shouldn't be, then this is a psychological/behavioral issue that needs to be dealt with other than by eating. This is a "pseudo hunger" which is more akin to cravings than real hunger and usually has to do with dopamine dysregulation in the obese.

This is why meal timings are so important. They should be adhered to diligently. If it's up to the obese, they would either eat all of the time or none of the time. Both disrupt proper blood glucose regulation. Do you know what doesn't disrupt blood glucose regulation? Consistent, predictable meal times. This is one of the main recommendations given to diabetics and there is a reason for it. It is much easier to control blood glucose regulation when food availability is consistent and predictable. Of course, this should be done with proper meals, not snacks.

Adhering to meal timings helps:

• Ward off hunger. When you eat at specific meal times, the body's circadian rhythms follow suit and you will become hungry at those predictable times and not hungry when you're fasting. Hunger during fasting only ends up interrupting the fast.
• Avoid spontaneous food items. When you know what your meals will be and what times you will have them, it will prevent you from grabbing something "to go" or "along the way". You will be able to prepare meals ahead of time and schedule activities around those times so there are no interruptions.
• Better hormonal control. When you eat at predictable times, your hormones work as they should - in a pulsatile manner. This allows for better blood glucose control.

Always eat at your specific meal times, even if you aren't hungry because you will be hungry later. That's why back in grandma's time, kids had to eat dinner even if they wanted to play instead because no one was allowed to eat at midnight. Grandma knew that the kids will get hungry at some point and if they got hungry at midnight, then cookies would be the only option for them since no one is cooking a real meal at midnight. This is why the midnight sandwich, which is so bad for health, became so popular. So kids ate dinner at dinner time or not at all.

Skipping meals for the obese is not a good habit to have so the "not at all" option is off the table. There would be no reason to not be hungry at your meal times considering that you would be fasting for 16 -18 hours a day. But, if that is the case, it only reinforces that you have active obesity as many obese have such slow metabolisms, that they are never hungry.

If you have never had a consistent meal timing pattern, you will experience this non-hunger in the beginning but it will wane as the body becomes used to food availability at a specific time. Your meal time will eventually become the bell of Pavlov's dogs.

3. Since "eat less, move more" doesn't work, you can eat as much as you want as long as the foods are “healthy”.

The way to avoid metabolic syndrome/obesity/diabetes is to avoid what causes them - blood glucose dysregulation. Period. Eating less and moving more causes blood glucose dysregulation because if you aren't burning body fat, while exercising and starving, then your blood glucose will suffer from a stress response. Eating as much as you want of anything, healthy or not, causes blood glucose dysregulation as well because excess eating affects insulin to glucagon ratios.

When we say that "eating less and moving more" doesn't work, we are referring to calorie deficit diets. Counting total calories and keeping them at a deficit does not cause significant nor sustained weight loss because of its negative effects on leptin. Obesity is chronic leptin under expression. Starvation further reinforces this. This does not mean you can eat as much as you want as long as it's healthy. This just means that calorie deficits do not work for obesity.

You have to follow the right macronutrient composition alongside their right amounts. Remember, over eating of anything, interrupts insulin to glucagon ratios which affect blood glucose. This is much more prevalent in people who already have metabolic syndrome as they usually have hyperglucagonemia when they don’t require glucose (postprandial) and hypoglucagonemia when they do (fasting).

So you have to not starve but not over eat. Both starvation and overeating interfere with proper blood glucose regulation just like a high carbohydrate diet would. In order for you to live an antiobesogenic lifestyle you have to target all things that interfere with proper blood glucose regulation.

4. I consistently eat a clean, low carb diet but I am still having issues with feeling sleepy after meals. My doctor told me this was normal as the body is trying to conserve energy for digestion. Many people who follow low carb, claim they have been "cured" of their after meal sleepiness, but I haven't been. I don't think this is normal.

It is but it isn't. Feeling sleepy after meals is not uncommon and it's not necessarily abnormal but there is a general similarity in the people who experience this. They are usually elderly or obese/diabetic. This makes sense because people who are elderly or obese/diabetic are in an energy crisis. They simply cannot use energy properly or efficiently and so they become tired quickly. Digestion takes a lot of energy and so you might experience feeling more sleepy after meals if you have metabolic conditions than if you didn't.

5. Low carb people have resorted to eating insects. 

This is a gimmick.

Aside from that, insects are completely fine to eat if you like them and can sustain that type of diet. Insects are eaten liberally in many countries around the world. After all, they are the easiest prey you can ever hunt.

When it comes to metabolic syndrome/obesity/diabetes, no one food item or diet can prevent it. Only one thing matters - blood glucose regulation. As long as your chosen diet can sustain proper blood glucose regulation, you will not develop these metabolic abnormalities whether you eat dragon flies or buffalo.

So, all of these low carb people will tell you to eat this or eat that but, if you listen to them, the only thing you're eating is BS. Insects are fine but fecal matter is not.

6. Low carb advocates claim that "keto" is not a fad diet because it has been around for a long time.

First, let’s define what a fad is. According to the dictionary, a fad is "an intense and widely shared enthusiasm for something, especially one that is short lived and without basis in the object's qualities; a craze". That is pretty much what "keto" is. You can break it down for yourself. Is there an intense and widely shared enthusiasm for it? Yes. Is it short lived and without basis in quality? Yes. Is it a craze? Yes.

Classic ketogenic diets have been around for a very long time and they are used for the treatment of intractable epilepsy and other neurodegenerative conditions. These diets have been successful because of the way the brain utilizes energy. Ketogenic diets change the way the body uses its energy, including the brain.

They have never been fads. In fact, most people have never even heard of them. They have never been marketed as a "weight loss hack" because they are actually extremely difficult to follow. The only people who follow such extreme diets are the ones who have no choice. It’s either try to take control of epilepsy ketogenically or have brain surgery. These diets have also been much more successful in epileptic children than adults. This is probably due to adherence factors. Children do not have a choice on what diet to follow. Adults have the choice of whether they can sustain the diet or not.

Ketogenic diets for "weight loss" and metabolic health have also been around for a long time. They have just gone by a different name, other than "keto". They have simply always been known as low to moderate carb diets.

"Keto", on the other hand, is a bastardized version of a low carb diet. It is completely without basis because it is not addressing metabolism at all. It is just producing ketones from the burning of dietary fat. The diet is short lived because sooner or later the people who follow it realize they are still obese and whatever benefits they experienced initially begin to wane and reverse. Those people leave or alter the diet and new suckers are drawn in. This is why the diet is still around.

There is always a new sucker that can be enticed with empty promises. The advent of social media creates an endless crowd of suckers so unlike diets of the past, which have all come and gone, "keto" will be around until the end of time because it is not dependent on magazines, books or the news to stay alive. It can live happily, just sitting online, waiting for the right fool to come across it.

Six common beliefs addressed, Part 192

1. There are many lists of "keto" approved foods. 

The list should be very short:

• Meat - All meats, including organs.
• Vegetables - All above ground, non starchy vegetables.

That's it. It's not more complicated than that. All low carb diets, from "keto" to Atkins, are meat and vegetables if they are being followed correctly.

2. I have been "keto" for two years. My HbA1C is now elevating and my typical morning blood glucose has gone up to 100 mg/dL.

This is typical for people who already have an exaggerated adrenal stress response due to metabolic abnormalities. You shouldn't have been on "keto" for two years straight. You should have been on low carb forever. Going low carb causes fluctuating periods of ketosis. Our natural state is to be in and out of ketosis periodically.

A healthy person can sustain ketosis for long term, without an issue, if the diet is well formulated. People who already have metabolic stress from metabolic syndrome and/or diabetes might not fare well in sustained ketosis especially if it's being achieved through improper and unnatural ways such as is the case with "keto". Every time I hear the word "keto", I already know the person is not doing a ketogenic protocol correctly.

You have basically starved yourself for two years, increasing your stress response and adapting your metabolism even further for sparing fat mass and sustaining high blood glucose. That is why everything is going up. It will be extremely difficult now to reverse this without gaining even more body fat in the interim. Metabolic adaptations are extraordinarily difficult to reverse.

Stop the dumb "keto" and go on moderate low carb. If you can sustain that for long enough, you just might see a shift in your metabolism.

3. My husband thinks I am going to "die of cancer" due to the "red meat" in carnivore. 

Your husband should instead be worried that you are "going to die" of diabetes, heart disease, fatty liver or kidney failure instead. He should also be very concerned with having to be your care taker when you go blind and need amputations as that will rob him of a normal life, while you suffer waiting to die. These are all preventable outcomes.

4. My personal trainer told me to not do "keto" but do her diet instead. I don't know how to oppose her opinion.

The best way to oppose her opinion is to fire her. 

Other than that, you should have told her, from the start, that you only need her help with exercise, not diet, and you won't blame her if it doesn't work. She might have agreed to work with you regardless since she's getting paid either way.

5. Should I be worried if me blood glucose is consistently over 100 mg/dL every morning while on "keto"?

Ketogenic protocols are very low in carbohydrate which means you are running high morning blood glucose due to internal factors, not due to diet. This is serious, complicated and not easy to reverse. If it wasn't, diabetes would have already been cured.

I can say that "keto" is not helping you achieve proper blood glucose regulation because high morning blood glucose is Dawn Phenomenon. That's just a fancy way of describing an adverse reaction to the overnight fast. Your blood glucose was dropping too low in the night and you are having an adrenal over expression upon waking.

You shouldn't just ignore this stress response and hope it goes way. It won't. It will only get worse. Drop "keto" and go on moderate low carb. See if that improves your blood glucose.

6. I don't trust store bought "keto" breads. I much rather use "keto" bread recipes.

You are correct in not trusting them. "Keto" bread recipes shouldn't be trusted either. You shouldn't be eating high fat concoctions, of any kind, unless you want to remain uber fat. So if the goal is being fat and diabetic, then go ahead and eat all the "keto" bread you want. If the goal is metabolic health, then eat natural food.

Six common beliefs addressed, Part 181

1. On “keto” you have to stay under a certain amount of protein macros and you should do the same on carnivore. 

On a classic ketogenic protocol, for the treatment of intractable epilepsy or neurodegenerative conditions, protein macros are monitored and kept under a certain amount to minimize the body converting protein into glucose, a completely natural and normal process that is highly regulated. Since chronic ketone presence is a strong signal to the body that it is "starving", it tends to ramp up its stress response and convert itself and everything that's eaten into glucose at a higher rate than normal. This stress response will reduce ketone production.

The people on classic ketogenic diets need ketones because that's what they are forcing their brain to use for fuel in order to prevent symptoms. This is precisely why classic ketogenic protocols need to be monitored by a healthcare provider to ensure that the person does not lose lean body mass, develop a deficiency and/or gain weight. Classic ketogenic protocols are not only protein restricted but calorically restricted as well. They are very difficult diets to follow without professional guidance.

Ketogenic protocols for the treatment of overweight/obesity and/or metabolic dysfunction do not restrict protein. These diets induce ketosis through the severe restriction of carbohydrate. Protein macros are followed to ensure you are getting enough protein, since most people do not.

The reason protein does not have to be restricted is because protein is not a macronutrient of concern as it is not the cause of overweight/obesity and/or metabolic dysfunction. Having chronic ketone presence is also not the goal of these protocols because lack of ketones is not the cause of overweight/obesity and or metabolic dysfunction so their presence is not the cure.

Now a lot of people tend to take this information to mean they can eat all the meat they want, since it’s "protein" but meat is not just protein. It is also fat. For this reason, though protein on its own is not restricted, protein as meat is, since you can easily go over your fat macros depending on the type and cut of meat you are consuming. You have to calculate the protein to fat content in your chosen cut of meat when following carnivore, to ensure you are getting enough protein and not too much fat.

2. Too much protein will stall weight loss.

There is no such thing as "too much protein" but there is such a thing as too much fat, which usually comes with the protein. For this reason, you have to make sure you track your macros carefully and stick to your fat macro allotment.

People with metabolic syndrome who have hyperglucagonemia make a lot of sugar after eating anything, including protein, which could stall their weight loss for a period of time until this condition normalizes. This condition only normalizes once you can regain insulin/leptin sensitivity and function. Restricting protein achieves neither.

3. Red meat "stays in your system" for 2 weeks.

False. The body uses protein to build itself, so technically meat "stays in your system" until you are dead.

4. Some low carb doctors discuss cancer because some of their patients have gone into remission. 

No one knows exactly what causes cancer to go into remission or why remission occurs to some people and not others. So far, studies suggest that a person’s initial immune response, to the cancer, has a lot to do with their remission outcome.

Many conventional doctors have had their patients go into remission. In fact, the bulk of cancer patients in remission have done so using conventional treatments. Anyone can go into cancer remission and anyone can also die from cancer. Like I mentioned above, your immune response appears to be the main determiner of this and you have no control over it.

As of this post, no cure for cancer has been discovered. We know of some risk factors for certain cancers but, again, they have not been proven to be linearly causative. So a low carb doctor boasting that he has some cancer patients in remission is completely meaningless as any doctor can boast that.

5. "Certain bacteria” causes obesity.

No. What causes obesity is not a mystery. It is well known that obesity is caused by metabolic dysfunction through blood glucose dysregulation which ultimately deteriorates insulin function and leptin expression. This not only leads to overweight/obesity but eventually to diabetes. The accumulation of high body fat, caused by metabolic syndrome, is the result of a complex hormonal interplay exacerbated by certain lifestyle factors, of which there are many.

So, the debate as to what causes obesity has long been settled but for some odd reason, it appears to not have reached the masses. Very few people understand obesity, which is a shame considering that obesity is now at epidemic levels. You can not treat what you don’t understand. I believe it is this lack of understanding that has allowed obesity to spread, unabated, and made it easier for charlatans to sell you “magical cures”.

What hasn't been settled with obesity is its treatment. This is because of the complex hormonal interplay, which I mentioned above, which is extremely difficult to reverse. This is because obesity is a metabolic adaptation and not a real “disease” so there technically is nothing to "cure". Your body is doing exactly what it's suppose to do under the conditions it's been subjected to.

There are microbiome changes seen in the overweight/obese and this is mostly related to diet type and immune function. High body fat affects the immune system. But no, bacteria itself does not make you obese. To be obese you need poor functioning and abnormal insulin which affects leptin expression and in turn deteriorates proper metabolic function over time.

6. The American Diabetes Association (ADA) refuses to tell people that they can “reverse their diabetes”.

This is because, as of this writing, there is no “cure” for diabetes. The ADA has a lot of issues in its organization but quackery isn't one of them. The most the person with diabetes can hope for is remission but long term remission has still been difficult to acquire for most.

I am sure that you may have heard a low carb doctor say he can "reverse your diabetes" but he simply cannot. He can only lower your blood glucose but so can I. On this blog, low blood glucose is not reversal of diabetes. That is the mistake conventional medicine makes when they diagnose diabetes with simply high blood glucose. Their treatment, which is to lower your blood glucose, hasn't really made much of a difference has it? Of course not. That is because diabetes is not a disease of high blood glucose. This means diabetes reversal is not acquired through lower blood glucose.

We stay away from the blood glucose seesaw on this blog. Diabetes is a very complex metabolic dysfunction that involves multiple energy regulating systems in the body. It is extremely difficult to put into remission so avoiding getting diabetes, in the first place, should always be the first course of action. This is why you are never too healthy to follow a healthy lifestyle.

Six common beliefs addressed, Part 163

1. I have a family member who was overweight and prediabetic. They went on "keto" and they now look sick. I can see all of their bones and even their tendons. They appear frail too. Is this the result of too low protein and not enough exercise?

Some people lose a lot of weight and their family and friends swear up and down that they look "sick" when they are just slim. We are so used to seeing people who are overweight that they begin to appear normal to us and slim people appear abnormal. But, I don't believe that is what you are describing. You are describing someone who has lost too much body mass.

I have seen this occur a few times before but it is rare. Yes, there are cases where this can be the result of a very low protein diet and lack of muscle building exercise but not always. This is actually the result of obesity and its long term effects on insulin and leptin expression.

There are some overweight/obese people, who experience temporary super leptin sensitivity when they treat their metabolic dysfunction through diet and exercise but it can also occur after bariatric surgery. The hormonal changes which induce the weight loss are like a "shock" to metabolism and the person loses a significant amount of weight. In fact, they lose so much weight that they end up going well below their body mass threshold and might appear gaunt and boney, even cachexic. This is because they aren't just losing body fat but they are losing a good amount of muscle as well as this sudden shift in metabolism causes stress, which in turn causes muscle wasting. For those who were once obese, this muscle wasting can be quite exaggerated.

After some time, this super leptin sensitivity usually reverses without any changes made to lifestyle. The reversal is caused by a shift in leptin, once again, where the sensitivity is lost and this can result in a return to obesity. As you can see, the metabolism of the obese is "blind" to its threshold. They gain weight well beyond their threshold and they lose it well beyond their threshold as well. This shows that weight loss is not the cure for obesity as obesity is not just "being fat", it's a metabolic dysfunction. In fact, weight loss can cause a doubling down effect of obesity.

This effect is the consequence of leptin resistance which is not fully understood. No one knows what the long term effects of leptin resistance are for weight management in the ones who can achieve sensitivity. The outcomes do not look good.

The very few who are able to sustain this sensitivity continue to have very low weight and it doesn't reverse. This low weight continues to be the result of an abnormal body composition. When they were obese, they had high body fat and low lean muscle mass. Now they have low body fat and low lean muscle mass. It is like they can sustain super leptin sensitivity, while still being insulin resistant and the resistance has finally spread to their fat mass.

But this will not be the case for the vast majority of these people. Most will simply return to obesity. Why? Because losing weight below your threshold would cause what? A reinforcement of the starvation response. What is overweight/obesity? A starvation adaptation. So once again, leptin sabotages your weight loss. It causes so much weight loss that the body panics and the starvation response is heightened causing an exaggerated under expression of leptin and weight regain once again over time.

So your family member has to monitor this carefully. People tend to become very happy with their weight loss but it can be a Trojan horse. Remember, the cure for obesity is not weight loss, it's acquiring metabolic homeostasis instead.

2. My father is in his 70's. He has never been overweight/obese. Instead he has been slim his whole life. He has blood glucose issues, which he has controlled very well and has never reached the stage of diabetes, but yet he has developed kidney disease which causes him blood pressure issues. His blood glucose is the reason for his kidney problems, according to his doctor. I don't understand how someone without diabetes or obesity can still develop the same pathologies as a full diabetic.

Your father is suffering the consequences of long term metabolic syndrome.

Metabolic syndrome does not always end in diabetes but it always ends in pathology. Diabetes is simply the stage of metabolic syndrome, when blood glucose remains chronically and abnormally high. This commonly occurs at the end stage of metabolic syndrome but not for everyone. There are a few who simply do not ever develop diabetes. Remember, metabolic syndrome/diabetes are syndromes. This means they only manifest similar related symptoms which can vary between individuals. Not only do the symptoms vary but the progression and prognosis varies as well.

This has been researched extensively and there still isn't a consensus as to what causes these differences between individuals. Some claim it's the fat cells. The more fat cells you have, or can expand, the longer you can ward off diabetes as metabolism begins accumulating fat in order to protect you from its dysfunction. Your father proved that's not necessarily the case as he's slim and still was protected from diabetes regardless. We do know that fat is somewhat protective but obviously doesn't always live up to its purpose.

Some say it's genetics. Still others say it's the ectopic fat accumulation that ultimately decides your fate. Who knows because the reality is that no one does as there have been conflicting results with the studies that have looked into this. What we do know is that metabolic syndrome/diabetes are extraordinarily complex and everything I have mentioned so far is implicated in its progression in some way or form.

What this tells us though, is what I have been saying on this blog for a long time. We see it In vivo with your father. Metabolic syndrome/diabetes are not "diseases" of high blood glucose. They are adaptations towards high blood glucose and this begins with improper blood glucose regulation. Instead of just high blood glucose, the most likely culprit for these differences between individuals is related to insulin expression over time and how it adapts to disruptions in blood glucose. How much insulin sensitivity can you maintain, in the presence of abnormal blood glucose control, and for how long and how does it effect other hormones (leptin) in the long run? This ultimately determines how adaptable your metabolism becomes to starvation (high weight, insulin and blood glucose set points) which in turn effects how much blood glucose regulation you lose over time.

Your blood glucose does not have to be very high for insulin function to deteriorate. Just like lower blood glucose will not magically cause you to regain insulin function. It all has to do with blood glucose disparities. These disparities can happen at any blood glucose range. It appears that some are more sensitive to these fluctuations than others.

The kidneys are exceptionally vulnerable to insulin dysfunction and this is why kidney disease is so prevalent with metabolic conditions, especially in diabetes. Hyperinsulinemia impairs kidney function. Impaired kidney function does not allow for the proper elimination of waste, including excess uric acid. You can see this kidney failure begin to occur decades before diabetes sets in with the presence of gout. Gout is an early marker for kidney disease. These gout "flare ups" are the first sign of what's to come. High blood pressure, as well, is one of the markers of metabolic syndrome and extremely common. It is also a sign of compromised kidney function as insulin is anti diuretic, damaging the kidneys over time. In fact, high blood pressure medications are most commonly diuretics. They work on your kidneys to lower blood pressure and they themselves will cause the development of kidney disease.

All of this tells us that you have to protect proper insulin function long before you develop diabetes and preferably before you even develop metabolic syndrome. The best way to retain your insulin function is to follow a diet that does not cause disparities in blood glucose because those disparities are a snowball effect for your metabolism to begin going down hill.

3. Ever since I lost weight and my blood glucose and insulin levels lowered, I have noticed a terrible stress response to just about everything. If I get even the slightest bit nervous or upset, I have a surge of stress hormone release that causes shaking and headaches. 

If you have been checked out by a doctor and no condition was found that might be causing this, then this may be the body's reaction to lower blood glucose and insulin levels.

People assume that the "cure" to their "disease" will be a very positive experience, where they will feel great and all their previous ailments will magically disappear. That is not the case. In many instances, the cure is worse than the disease. At least, it will feel that way in the short term. Why? Because losing weight is only half of the problem. That's why weight loss is not the cure.

When metabolism adapted over time, to be in a state of hyperglycemia, all hormones were primed and honed for just this very outcome. When blood glucose drops to normal levels and insulin no longer remains chronically high, the body must re adapt to its "new normal". This will not occur painlessly. The body will use any situation, including emotional stress, for the release of stress hormones. It is trying to ramp up glucose release for higher blood glucose. The problem is that little by little it will have less and less of an ability to do this. You might then feel a release of adrenaline, more than anything else. Every system of the body does not adjust at once. Adjustment occurs in stages, just like the adaptation process itself, occurred in stages. Each system broke down with time and now each system corrects itself with time.

This is why metabolic syndrome/diabetes are not true diseases but adaptations described as "syndromes". It takes a long time for the body to adjust and in the interim you will feel symptoms you might not have noticed before. I know that I, personally, went through the worse time of my life while I was losing weight and lowering my blood glucose. I had poor health when I was 300 lbs. but I really went through the wringer while losing them. I had never even been to the ER at 300 lbs. and I went five times during their loss. I had all kinds of symptoms. Good thing that I stuck to it because I believed nothing bad could be happening if I was losing body fat and stabilizing blood glucose. It's difficult to believe you can feel great while going through hell but that's precisely what happened to me.

I suggest that you also keep an eye on your electrolytes and make sure that you are supplementing adequately. This is one the main reasons people feel terrible when their insulin lowers. Losing control of your electrolytes can not only make you feel awful but it can put you in the hospital. Recommendations for electrolyte supplementation can be found here.

4. I started fasting and at first, it seemed to be working, but I have actually been gaining weight and my body has increased its set point. Now it's become impossible to lose any weight and when I do, I just simply go down to that set point and no more. Fasting caused this.  

Yes. Unfortunately, it did.

Most people don't understand how this can be true since they are still holding on to the notion that calories drive obesity so if you are fasting, and no calories are coming in, how in the world can you possibly gain weight and become even more obese from calories that were never eaten?

This is because calories are not what drives obesity. Blood glucose dysregulation does and food is not the only thing that dysregulates blood glucose. Starvation does too. Starvation prolongs your time in hypoglycemia. Like I have mentioned before, its the lows in blood glucose that drive the condition. Metabolic syndrome/obesity/diabetes are all adaptations to starvation (hypoglycemia). When you starve for real (fasting), these adaptations double down in order to make you fatter and "protect" you. This is why you have to be very careful that the fasting protocol you are using is not contributing further to this process as it would make you fatter.

Choose a real intermittent fasting protocol. Do not fast for longer than 72 consecutive hours, once a week, and only choose that protocol if you are morbidly obese - over 50+ lbs.

5. Are low fat diets unhealthy?

No. Low fat diets are just as healthy as any other diet and can be metabolically sound if they are followed correctly. You just have to make sure that when you reduce fat, you do not replace it with carbs, which is usually how these diets are followed.

The reason that we do not include low fat diets in our list of recommended protocols is because carbohydrates disrupt blood glucose homeostasis more than any other macronutrient, so it makes sense to make it your main target. Low carb diets also eliminate junk and fast food, when followed correctly, and this automatically lowers the fat in your diet. The Standard American Diet (SAD) is a high carb/high fat diet. When you eliminate the carbs, you reduce the fat since they usually come together in SAD fare.

6. All symptoms of insulin resistance are the result of carbohydrate intake.

No. You can develop insulin resistance in other ways. Any condition that disrupts blood glucose homeostasis, preventing your insulin from working in pulses, will cause insulin resistance over time. So, just being overweight/obese will cause insulin resistance since having excess body fat puts a high insulin demand on the body. You also become insulin resistant naturally as you get older since insulin is no longer needed for "growth".

Carbohydrates are simply the most common contributor of excess body fat, in the modern diet, because they make the bulk of the food we eat. Carbohydrates disrupt blood glucose homeostasis and this ultimately causes insulin malfunction and the accumulation/preservation of body fat.

Six common beliefs addressed, Part 159

1. Our teeth are not like felines, so we aren't carnivores. 

This is not an anthropology blog but I decided to reply to this anyway as it's subject matter that has been brought up ad nauseum and I want to settle it once and for all. Humans are omnivores but can live just fine as carnivores. Felines are obligatory carnivores, which means they cannot live as omnivores.

Humans don't hunt using their teeth. I have yet to see a hunter/gatherer take down a wilder beast with their jaws like a lion. Humans use their big brains to acquire meat. Felines don't have very big brains or arms and hands, with an opposing thumb, so they don't make tools to help them hunt. We have yet to see a lion using a bow and arrow. Felines are entirely dependent on their teeth and claws. This is why they evolved to have them and they are quite sharp. I have experienced this when my own cat hunts me and tries to take me down in my own home.

 

 

Humans on the other hands have the ability to hunt, with tools and strategy. Some hunter/gatherers even use other animals to hunt for them. So humans are quite cunning. We don't need impressive incisors to take down another animal. Surprisingly other animals, including a large variety of primates, who do not hunt nor eat any meat, have very large incisors. These are used for social communication rather than hunting.

So a better way of determining what diets animals eat is to look at their intestinal tract, rather than their outer appearance, as that can fool you. We might not have the teeth of a feline, but we have almost an identical intestinal tract. This means that we evolved eating the same foods - meat.

2. "Keto" will help you gain weight. 

Yes. You can gain weight on "keto", but you will have varying results depending on your metabolic state.

If you are already thin, it will be very difficult to gain weight on "keto" because gaining weight from dietary fat, when you are obesity resistant, is nearly impossible. Leptin will burn through all of your fat and you won't see much weight change. High carb diets, on the other hand, will allow you to gain weight easily, but will put you at a much higher risk for metabolic dysfunction. So high fat is definitely a safer choice for weight gain, it just might not happen.

Because of this, the very best way to gain weight is through protein intake. That way you will be gaining weight as lean muscle mass, rather than fat.

3. The South Beach Diet is a good protocol to follow.

The South Beach Diet is a moderate to low carb diet that prioritizes protein and allows more "healthy" fats than low fat diets. They define "healthy fats" as monounsaturated like olive and avocado oil.

This diet does not eliminate any particular type of carbohydrate. For instance, you can consume "complex carbs" to hit your carb goal for the day. Aside from vegetables and fruit, complex carbs are defined as whole grains and beans. Of course, this diet emphasizes the "benefits" of fiber like so many other mainstream diets do. Those benefits are still questionable but supposedly there.

This diet has three phases, with Phase 1 eliminating all carbohydrates and alcohol and Phase 3 slowly allowing them back in "in moderation". What exactly is "in moderation" is never described. Typically this is the case every time that term is used.

Of course, like with all diet plans, they provide correct information in Phase 1. This is what will allow you to claim that the program works because it technically does at that point. Then they sabotage you by Phase 3, to ensure you remain happy, returning to your usual fare, and you will be a returning customer. After all, the diet did work in the beginning, so you will be more open to trying it again. It's simple bait and switch.

The South Beach Diet is plagued with highly processed products for you to purchase. This is also typical of diet programs. After all, they are there to make money and this is the stuff that makes it as this is what people want.

Do I recommend this protocol? Absolutely not, unless you stay in Phase 1 forever. Phase 1 is much better than the "keto" fad diet that is going around the internet. In fact Phase 1 can be almost described as a relaxed protein sparing modified fast/Mediterranean diet hybrid that is absolutely ketogenic. So, if you stay away from their products and follow Phase 1 for life, this would be a good protocol to follow, especially if you are having issues with your lipids and are stalled and/or gaining weight on "keto".

4. You can eat carbohydrates and remain in ketosis if you consume exogenous ketones.

Exogenous ketones will allow you to remain in ketosis, even if you eat carbs. But the same is true for eating massive amounts of dietary fat. The only time that ketosis is helpful is when you are burning your own body fat, not dietary fat and not exogenous ketones.

5. Low carbohydrate diets will cause mosquitos to no longer be attracted to you.

Mosquitoes are initially attracted by the carbon dioxide we exhale. That's what helps them identify that we are there. Once the mosquito gets closer to you, it is stimulated by a number of factors like body heat and even blood type. There are up to 400 chemical compounds on the human skin that can attract mosquitoes, which is why research into this has resulted in a multitude of conflicting results.

There are even different attractors depending on mosquito species. For example the Aedes Aeypti, a common human biting species, is attracted to levels of lactic acid in sweat and certain bacteria that lives on the surface of skin. Because this is so complex, to this day, there is still no definitive answer as to why some people are "mosquito magnets" while others aren't.

So, what does this have to do with low carb diets? Absolutely nothing. The only possibility is that low carb diets change serum lipid profiles or lactic acid levels or skin bacteria or all three, in some people, and this might make them more or less susceptible to mosquito bites.

Do not risk yourself to this idiocrasy. Use common sense. Dress appropriately to protect yourself from mosquitos and if you are going into the deep woods, use a mosquito repellent. Remember, mosquitoes are vectors for many blood borne diseases. Some of them can be quite nasty so reduce your risk by avoiding bites.

6. Going low carbohydrate will "bulletproof" your immune system.

The human immune system is very complex and varies by individuals. There is no such thing as "bulletproofing" it.

You can only do things to help keep it healthy, such as not being deficient in calories, protein, vitamins and minerals. You should adopt lifestyles that reduce your risk for acquiring conditions that compromise your immune system such as metabolic conditions and kidney disease. Controlling the progression of auto immune diseases, which ultimately compromise your immune system if you end up having to take biologics, is vitally important. Reducing your risk for certain common cancers, which will also cause you to receive treatments that compromise the immune system, such as smoking cessation and keeping active are good interventions. Basically, you can help your immune system by remaining as healthy as possible, for as long as possible, because co morbid conditions effect your immune response.

The only thing that has been shown to actually make the immune system stronger, not bulletproof, is exposure to a wide array of bacteria and viruses. That's the only way the immune system learns what it has to fight off or not because it produces a multitude of antigens. So kids that play in the dirt are healthier than kids who play on a sanitized surface. Everything else is quackery.

Six common beliefs addressed, Part 150

1. I love breakfast but I'm scared to eat it because I keep reading that breakfast is a "scam" on low carb pages. 

Oh dear. This question seems to always come up, every once in a while, like the living dead who refuse to stay in their grave. I don't know why it won't just stay dead. It's probably because low carb advocates recycle this one, every so often, and people who are new to these diets see it for the first time and then come to me with it. Hopefully, after this post - "God grant it lie still". 

Low carb advocates have a "thing" about breakfast because most breakfast foods are produced by companies like Kellogg’s, who they have deemed to be the devil incarnate. Don't fall for it. They just want Kellogg's revenue for themselves. 

There have been numerous studies done on different meal timings and eating early has consistently been shown to be anti obesogenic. In fact, the fattest people in the world are the ones who have the least hunger in the morning. This is why lack of morning hunger is usually a sign of active obesity. Contrary to popular belief, obese people are oftentimes the least hungry people over all so it is not surprising that they aren't hungry in the mornings. 

The exact mechanism and cause for this is not well understood, but circadian rhythms and hormone homeostasis are involved. It seems like the more body fat you acquire, the less hunger in the mornings. Insulin function/Dawn Phenomenon seems to be implicated in this, but again, it is not well understood precisely how. It seems like more energy is stored with later eating than earlier eating and this energy allotment appears to be different between the overweight/obese and the lean/healthy. So we won't make assumptions on the exact cause since there are no definitive answers. This is why I get a kick out of people adamantly advising on breakfast or not. 

The only thing we know for sure is that, regardless of cause, force feeding yourself in the morning is not going to magically make you thinner because your hormonal profile will remain the same. For this reason, on this blog, we encourage you to have breakfast if you are hungry in the mornings. This can be a very good sign. But if you aren't hungry in the mornings, then skip breakfast and have your first meal later. It doesn't pretty much matter. The only thing that matters is if you can regain and sustain proper blood glucose regulation, not if you can show off how late you can eat.

2. There are many ways of making your diet work. You can always try different hacks to get results. 

When a weight loss coach, counselor, advisor, whoever, has to come up with a "hack", then you know for certain that their diet, and everything else they are trying to sell, is a farce. So let me help out. There are no weight loss hacks. Actually I take that back. There is one. Stop drinking any liquids and take a laxative and you will be a few pounds lighter in a couple of days. Athletes do this all the time to make weight requirements. Teenage girls do this all the time to fit into their prom dresses. Just keep in mind that this is dangerous and absolutely not recommended nor advised on this blog. But technically, that is the only hack for weight loss known to work. 

All hacks are just as unhealthy and dumb as that one, but worse - They are ineffective. There are no hacks for treating overweight/obesity. None. Not even liposuction, much to my husband's dismay. True overweight/obesity treatments are based on long term lifestyle changes that require consistent adherence and application. Anyone that is trying to "sell" you a hack, is a quack. 

3. Carbohydrates are the preferred energy for the body. 

False. 

The body runs mostly on fatty acids. It is a misconception that carbs are the "preferred fuel" for the body. The origins of this misinformation is from the fact that the body makes its own glucose when it needs it for the specific cells that must use glucose for energy. People who learn this fact assume that because the body makes glucose then it must be because it prefers glucose. If not, then why would it go out of its way to make it itself? But it doesn't prefer it. It simply needs it. It must keep a steady and highly regulated amount of glucose in the blood stream in order to function properly. 

The only thing that prefers carbs is the tongue, not the body. And the only reason the tongue prefers carbs is because carbs have been sweetened and made into fun foods. Believe me, the tongue does not prefer plain boiled potatoes. It prefers Doritos or Debbie Snacks. So it's not the carbs per say, it's the junk that is preferred. 

4. If your loved one has cancer, you should make them eat "keto" in order for them to be cured. 

First, "keto" is not a cure for cancer. As of this post, there is no cure for cancer. 

Second, you can't force someone to follow a diet they don't want to. "Keto" and low carb diets in general, when followed correctly, are elimination protocols. The person who tells you they aren't is a chaffle eating liar. Elimination means the person has to be willing to give up the foods they are accustomed to. Sometimes the food items that have to be given up are staples of culture, tradition, religion, whatever. They have to be eliminated regardless, if the person wants to follow the diet properly and achieve results. This can be a difficult decision for anyone but especially for someone who is already having health issues. They might not want to be bogged down with an entirely new way of eating and having to give up their favorite foods, which might be the only thing they find stability in at this time in their life. For this reason, don't force people. People are allowed to follow whatever diet they want. 

"Keto" and low carb diets are only for people who are ready and committed to following them. The worse thing you can do is mix a Standard American Diet (SAD) full of crackers, breads, pastas and sweets with a low carb/"keto" diet. That is usually what occurs when the person is not committed to following the diet and is only following it to get someone off their back. 

5. You can still follow "keto" if you aren't a big meat eater and are also allergic to nuts and dairy. 

If you can't eat nuts and you can't eat dairy and you refuse to eat meat, then what else is left? Air? You just eliminated all of the foods that comprise a very low carb diet. You can absolutely salvage the diet without the nuts and diary but you can't salvage it without meat as that's the center of the diet itself. A situation like this, requires for you to find another diet all together. One that you can follow. I don't know why people like to put themselves into these predicaments. It's like me saying that I am allergic to all plant foods and find algae disgusting but I would like to follow a vegan diet. It's not happening. 

I hate to say this but this type of statement makes me doubt that the person making it is serious about resolving their health. It just seems like a person who wants to be a part of whatever fad is going on at the moment and follow the crowd mindlessly. A person who is serious about their health, wouldn't even bother following "keto" or low carb since they are aware of their limitations. Instead of asking for a nonexistent resolution, they would have been seriously looking for an alternative. 

6. Coffee is "good for you" and you should drink it with butter.  

Coffee and everything else on earth is only good for you until it turns bad. This is why we don't make claims that anything is definitively good or bad except for one: sugar. Sugar is always bad. We can say that coffee is not necessarily "good for you". It is just not been shown to cause any adverse health effects in the majority of people. 

Studies on the effects of coffee have had mixed results. We do know that black coffee is better than orange juice, but so is plain tea. So basically anything, including muddy rain water, is better than orange juice at this juncture. Coffee can be the same as orange juice if it is loaded with added sugar and/or fat, so we know that coffee is only as benign as what goes in it. 

Some people are exceptionally sensitive to the caffeine in coffee. In fact, I wouldn't advise caffeinated coffee to anyone who has metabolic syndrome/diabetes. You don't want caffeine interfering further with your blood glucose regulation. If you want to drink coffee, drink decaf and add no sweeteners to it of any kind. Limit the amount of cream you use by keeping to your daily fat macros. Do not make "Bulletproof Coffees" because they aren't bulletproof and they certainly aren't obesity proof.  

Some people prefer butter in their coffee to cream. To each his own. There is no requirement to use butter or cream or anything in your coffee. What shouldn't be in your coffee is sugar or artificial sweeteners of any kind. Also remember to not drink gallons of coffee a day. Coffee should be reserved for your eating window and should never be had during fasting, even if you only drink it black. 

The best way to stop the snacking habit is to simply not taste anything during your fasting time. Give the tongue a break. Remember it's connected to your brain. Please allow your brain to not sense anything coming in for some period of time. Limit your coffee to two cups a day and by cups, I mean literal, measured cups. Not the coffee cup you bought on eBay that is as tall as your forearm. A cup = 8 fluid ounces.

Six common beliefs addressed, Part 147

1. Is whole milk obesogenic?

People always make definitive statements about a specific food item but things do not work that way. Milk can be very slimming or can be very obesogenic depending on how its consumed and the metabolic state and overall diet of the person consuming it. For example, if you swap orange juice for milk, then milk is very slimming. But if you drink milk with your dinner, then it can be very obesogenic. If you are already overweight/obese, then it can affect you more. 

Milk is the most nutritious food on the planet. It creates a significant rise in insulin through its whey protein content. This rise in insulin is for the building of lean body mass as milk is the only food that a growing mammal has access to until their teeth and stomach fully develop. Knowing these facts about milk, we can now guess what kind of effects it can have on metabolism. Let's see how milk can become obesogenic: 

• It is extremely difficult to become fat off milk alone but adults do not consume milk alone. Adults are already grown and eating solid food, so adding milk to their diet can add additional dietary fat that can easily go over their daily fat allotment. Milk drinking should be limited to one cup a day and no more. 
• People usually say they like milk but what they really like instead is what they add to it. Adding any sweet flavoring to milk will make it extremely obesogenic, regardless of its calories. Sweet taste is a signal to the body to store whatever is being eaten. 
• People who are actively gaining weight or stalled, can do without the milk. This has nothing to do with the lactose in it. This has to do with the fat in it. Milk is very high in fat. 
• Everything else the person eats, alongside high insulin levels, contributes further to fat storage. A good quality whey protein should only be supplemented in order to reach your daily protein goals and it should not be taken in the form of milk. Whey protein supplements do no contain fat, they are only protein. 

As you can see, access to milk has always been advantageous but the advantages only go so far before the 'Law of Diminishing Returns' sets in. In other words, milk is only good until it becomes bad.  

2. "Keto" advocates are extremely fat. 

This is true and if I had a dollar for every time I see this statement, I would be retiring this blog and renaming it from 'Journey to Metabolic Health' to 'Journey Through Hawaii'. I don't even know if the people saying this are just trolling or they are truly confused. I am going to give them the benefit of the doubt and assume it's the latter, since I understand that it's pretty strange to see morbidly obese people swearing up and down that their diet "works". 

People who are new to ketogenic diets, or simply low carb diets in general, see these obese low carb/"keto" proponents and are stunned. Then they come to me for answers before they walk away from these diets all together. I can tell you one thing off the bat - These people are not following a proper ketogenic or low carb protocol, regardless of what their mouths say. Their middle is saying otherwise. 

All of these obese "keto" and low carb advocates are simply eating "franken diets" of very low protein, exuberantly high fat, artificial sweetener/fat laden desserts while also replacing Standard American Diet (SAD) favorites with low carb or "keto" versions. They are also sitting on their recliners all day, complaining about the Dietary Guidelines and how jogging won't get you to slim while rejoicing over their new "lower blood glucose". 

None of these people are representatives of true ketogenic or low carb lifestyles. Swapping out Brayer's Ice Cream for Rebel Ice Cream does not make you low carb. It makes you a fool who is simply following a "ketofied" version of the SAD diet and remaining just as fat. 

3. I am frustrated because I am trying to help two of my friends with low carb but one of them continues eating apples and potatoes and the other one keeps flip flopping through different protocols. She is now asking me about "resistant starch". I have seen them go through the fasting phase, rice phase and dozens of different low carb doctor phases. 

Don't waste your energy on these type of people. I know you want to help but you can't help anyone who can't help themselves or you will be carrying around dead weight. 

Some people just like to play games and think they are too smart for anyone to notice. They want to be coddled and become the center of attention so they can make their problem someone else's problem too. These two are not serious about losing any weight or getting healthier. They are simply dabbling and experimenting while using your energy to do so. 

Low carb is not rocket science. It's actually so simple that you can get the gist of what to eat in less than 30 minutes. I write blog articles as a hobby, for those who want more information, but you don't need to read a single thing I write to know what to eat on low carb - meat and above ground vegetables. 

The gaslighting begins when that's not enough for the person and they desperately try to find a way to make a low carb diet that includes carbs. That's all these two are trying to do. They just try to play it off as being "confused" or "researching". But I see right through those games. Focus on yourself. Addressing obesity/metabolic syndrome is a full time occupation and it's done solo as no one else can do it for you. 

4. I have seen products that are marked "keto" but when I read the ingredients, they contain sugar, grains and other carbs. These things are not "keto".

Ketosis is a metabolic state where you mainly burn fat for fuel. It's not a specific product or list of ingredients. Any food on the planet can be "keto", as long as it allows you to burn fat as a primary fuel. The products that you are talking about have been formulated to be "keto". So regardless of their ingredients, if the serving size is followed, these products allow for the person to remain in ketosis if their overall diet is ketogenic. 

I need for people to understand something, which seems to continue being misunderstood - Ketogenic diets do not eliminate any specific foods. You can eat sugar on a ketogenic diet. The only requirement that a ketogenic protocol has is to keep you in ketosis, or in other words, primarily burning fat for fuel. For instance, you can live off honey and still be in ketosis if you eat very little of it and that's all you eat in the day. Starvation causes ketosis. Exercise causes ketosis. Sleeping causes ketosis. 

Ketogenic diets followed for the improvement of metabolic health and the treatment of obesity, should not be followed for the sake of sustaining ketosis, per say, but because they are very low in carbs. This helps stabilize blood glucose. Only through stable blood glucose can you burn body fat in the long term. This fat should be coming from your body's own fat stores. Because of this, the quality of the diet must be top notch so these "keto" products should be avoided as the obese respond particularly negatively to processed foods and simply can't just "eat to their macros". This has nothing to do with ketosis itself. It's just a fact of the overweight/obese. So just because the overweight/obese must monitor their food quality, does not mean that sugar is not "keto". 

5. I am going crazy reading through every single ingredient in foods.

Stop reading. The foods you should be eating do not come packaged with labels to read. Eat like they did before the food industry began. Reading a label should not drive you crazy as buying bottled, canned, boxed, bagged or packaged food, of any kind, should be an extremely rare event. 

6. Even if you make "keto" sweets at home, there are good brands of already made products so you can have the occasional treat on hand.

We don't deal with those types of eating habits on this blog. We only advise serious protocols for the treatment of metabolic dysfunction and obesity. We don't coddle, make excuses or concessions for behaviors that interfere in that treatment. Having "treats on hand", whether home made or store bought, is not in any protocol that we recommend.

Six common beliefs addressed, Part 146

1. People can have different results, even while following the same diet.  

This is because some people are able to regain and sustain proper blood glucose regulation and others aren't. There can be genetic and epigenetic reasons for this. Of course, those cannot be controlled so we will only discuss what can be controlled here. 

 

First, low carb only works when it is followed correctly and adhered to consistently. People generally do not do this. If you want to regain and sustain proper blood glucose regulation, you have to stop the habits and behaviors that contribute to it. Here are some of the mistakes people make when following low carb and every single one of these affects blood glucose homeostasis to varying degrees and through different pathways: 

• Artificial sweeteners - This is not going to cut it, so cut it out. The taste of sweet is enough to continue dysregulating blood glucose.
• Snacking - Drop all the snack foods. Snacks have no place in a healthy diet. Eat real meals, at meal times only.
• Low carb recipes - Stay away from "recipes" and use meal ideas instead. Low carb is just different combinations of the same food items - meat and vegetables. 
• Reduction/introduction of junk food - Stop replacing the Ritz crackers with chaffles. It doesn't work that way. The diet is about elimination not replacement.
• Taking the weekends off - You are either on low carb or you're not. Low carb is a full time commitment, not a Monday through Friday hobby.
• Bouncing from one protocol to another - Choose a protocol and stick with it. Stop jumping from protocol to protocol aimlessly. Stay focused and work on getting results, not on "following a diet".
• Introducing dumbassery to the mix, like "fasting" - Don't layer one protocol on top of the other. Jumping from fad to fad is not going to achieve anything in the long run and obesity is a long term problem that requires a long term solution. Every time some new BS appears on social media, people are clamoring for it. If you are doing this, then it's because you can't commit to any protocol.
• Lack of exercise - You can't eat yourself to health. You have to rise from the recliner and get active.
• Caffeine - As long as you continue caffeinated drinks, coffee or tea, you will not be able to control blood glucose and so the problem will never get better. 

If none of the above is the issue, then you can focus on other factors that could be hindering progress such as: 

• Length of obesity - The longer you have been obese, the more difficult it is to reverse this adaptation. This is especially true when you have a history of yo-yo and crash dieting.
• Level of metabolic dysfunction - Metabolic syndrome is time dependent. The longer you have it, the more difficult it is to reverse. The closer you are to diabetes, the worse the outcome as there are several pathologies going on at once that cause metabolism to spare fat mass rather than lose it.
• Age - There is a natural increase in insulin resistance as you age. There is also greater tendency to lose muscle mass and have difficulty rebuilding it. All of this contributes to excess body fat and the inability to lose it easily.
• Hormonal status - Decreases and imbalance in sex hormones, as you age, make the loss of body fat even more difficult.
• Cause of obesity - Obesity from sugar is much more difficult to reverse than obesity from starch. The taste of sweet causes changes in the hypothalamus that impact the ability for the brain to gauge its fat stores and burn it.
• Co-morbid conditions/medications - Auto immune conditions and other inflammatory diseases, along with the medications used to treat them, interfere in the treatment of obesity. 

All of the above issues interfere with leptin expression and/or the stress response. No leptin expression = no fat loss. Greater stress response = more fat storage. You cannot control a lot of these but they can still be taken into consideration when choosing a treatment. For example, you may be getting older and this causes muscle mass loss, which can be reduced with the right supplementation of protein. You can also improve declining sex hormones with the help of a healthcare professional.

2. You have to eat liver and other organ meats on carnivore. 

You don't have to do anything but breathe. 

You can obtain a lot of nutrient density from eating organ meats but you don't have to. I know that we generally are not accustomed to these meats and forcing yourself to eat them can make meal times a nightmare. You don't want to discourage yourself further from low carb dieting by trying to down some pig kidneys. All you have to do is follow low carb period. 

If you have doubts about your nutrient status, get tested for deficiencies and/or take a good quality supplement. 

3. It is difficult to follow "keto" because "keto" products are expensive. 

You don't need to buy anything to follow a ketogenic diet and you certainly don't have to support any "keto" advocate either. Let them find a real job. Put that money towards your own food. Buy fresh meat and vegetables and nothing else is needed. 

4. Low carb advocates usually recommend to not use sunscreen.  

Most quacks advocate for low carb. They run the gamut from thyroid quacks, anti vax quacks, cholesterol denying quacks, supplement selling quacks - you name it, they are out there. This is precisely why these diets are not taken seriously. 

This blog isn't about skin care but since we advise on exercise, our recommendation has always been that you generally do not need to use sunscreen unless you are spending an excessive and prolonged amount of time in the sun. 

Like all other animals, when the sun begins to bother us, we seek out shade but some people are unable to do this because they work construction or landscaping, play certain sports, or perform some other outdoor activity where they have no choice but to remain in the sun, regardless of the heat. Any activity that forces the person to stay under the sun, with no shade, risks damage to the skin and these are the only people that should use sunscreen. 

Even better than sunscreen is protective clothing. So if your work forces you to be out in the sun for long periods of time, make sure you wear adequate clothing to protect yourself and/or use sunscreen. If you are fishing or spending time on the beach, also wear appropriate clothing and/or sunscreen. Take an umbrella or some other equipment with you that can provide shade. Exercise early in the morning or in the evening after sunset. 

Use common sense and avoid getting burned. Sun burns are not good. Not only are they very painful and uncomfortable, but all it takes is one third degree burn to damage the cells of that area of the skin for life, making them more susceptible to skin cancer in the future. 

5. Many food manufacturers are now making items labeled "keto". 

Food manufacturers are just that - food manufacturers. This means they are out to make money by selling you things. This is true of any company that manufactures things. There is no conspiracy theory behind it. 

Food manufacturers go wherever their customers go. It's a supply and demand chain. When everyone wanted low fat alternatives, these food manufactures came out with the demanded products. When people wanted more natural/organic alternatives, they did the same. Every time a new fad diet comes out, the food manufactures oblige. It just so happens that there is a "keto" craze going on right now, which is thankfully on the decline, so many food manufactures are following suit and producing "keto" products. 

This should not be of your concern. People have a right to eat as they wish and companies have a right to deliver what people want and make money off of it. It's called free market capitalism. Your concern is to stick to natural, non manufactured food - meat and vegetables. Your food should have no labels on it. You are only responsible for yourself. 

6. There is no way you can follow a protein sparing modified fast (PSMF) for the long term. 

Yes there is. Dr. Naiman's 'Low Energy Diet' takes the basic premise of a PSMF to create a protocol that can be followed long term. You can read about it here.