Six common beliefs addressed, Part 219

1. Diabetics are recommended snacks which they don't need.

This is because it helps them manage their blood glucose better when they are on diabetes medications.

Diabetes medications lower blood glucose levels but they continue to do this, even while the person is fasting, and their blood glucose is already lowering naturally. This can cause for blood glucose to drop too low. Eating prevents this. This is why snacking is encouraged. Not because it helps treat the diabetes. It just helps prevent the medications side effects.

2. I have been eating less than 10 grams of carbs a day and stopped taking my insulin. I also recently started fasting for 48 hours at a time. My blood glucose has not stabilized! In fact, it's worse than before. I can't get a single reading below 140 mg/dL, even after all that fasting. 

Sir, mam, you are a diabetic. I have no idea why you are eating less than 10 grams of carbs a day or why you stopped your insulin. I am really hoping, praying actually, that your doctor was the one who stopped your insulin, but I highly doubt that if your blood glucose is so out of control. I don't know what you are doing or who told you to do this. I get people from many groups and pages sending me weird questions like this. I have no doubt that someday, any day now, someone will drop dead. I see it coming. It's inevitable.

Stop the shenanigans. The way this should have been addressed is by you starting on a classic low carb diet of no more than 100 grams of carbs a day. You would have first discussed this with your doctor so that your blood glucose could be monitored, and your medications lowered or eliminated as needed. Then, with time, as you gauged your results, you would have modified your diet to meet your goals. Did you do this? Absolutely not.

Instead, you decided to go online and begin on a ridiculously low amount of carbs (fad diet) and also stop your insulin to boot. Then to make matters worse, you threw in a long fast as well. Just because. If you are on prescribed insulin, it was because you are a full-blown diabetic. You are lucky though that your blood glucose hasn't gone to 500 mg/dL. This means you didn't crap out on the gamble you took with your own health and life.

This will not improve with time. Not on the protocol you are on now. Your body will just continue making sugar on its own from the massive stress you have put it under. You will be one of those "keto" practicing diabetics, that have been able to "lower their blood glucose" while still having Dawn Phenomenon and hyperglucagonemia. You know, the ones who are always chasing symptoms and fasting longer or eating more fat to try and budge their numbers a few points down? Basically, they are striving to keep the same diabetes they started with five years ago. In about five more years, you will be back on insulin and fully diabetic once again.

Why don't you address your problem in a more sustainable, long-term way that will actually reverse your condition with time? Look at the right-hand column of this blog and choose a proper protocol under 'Recommended Diets'. 

3. It is difficult to get weight loss advice.

Because there is no one way to "lose weight". When people refer to "weight loss" they are usually talking about "fat loss" specifically. Losing fat is at the sole discretion of your leptin expression which is controlled by your neuroendocrine system. This varies with each individual. Many factors play into this, including how much body fat we are actually trying to lose.

Simple weight management can always be addressed by targeting calories. Overweight/obesity can only be addressed by targeting multiple factors. That gets complicated. Very complicated. This means that unfortunately there is no simple advice that can be given to achieve this.

• Weight loss – easy to do. Weight is water, muscle and fat. Anything that temporarily affects these, will cause the scale to lower. You can simply dehydrate for two days, and you will lose weight. In fact, this is how certain athletes try to "make weight" even though it is a dangerous practice. Weight loss is best achieved with calorie restriction. The lowering of calories automatically causes water and lean muscle mass to be lost through the temporary lowering of blood glucose which lowers insulin. That's why all diets will promise you a five-pound loss in the first week, guaranteed.
• Fat loss – hard to do. Fat is fat. It is stored in your fat mass. Your fat mass is an actual organ. It is a large endocrine modulator. It's loss is determined by leptin. Leptin expression is only affected if blood glucose is properly regulated for a long enough period of time to affect insulin expression. Leptin is a slave to insulin. Only then will leptin sensitivity be restored and body fat is burned if there is no hypothalamic damage.

What is healthy fat loss? Healthy fat loss is when fat is lost at a steady, slow rate. This is because what you are actually trying to achieve is not "fat loss" per say but a fat burn and storage balance. You want the body to burn mostly fat and not store too much of it. This can only be achieved through a healthy and balanced interplay between your fat mass, metabolic hormones and brain. It is mostly out of your control as it is governed by your hypothalamus. You can only set the stage for this to be more likely to occur than not and that stage's foundation is proper blood glucose regulation.

You do this through following a lifestyle that promotes this balance. It includes diet, exercise and stress management. By stress we are specifically referring to metabolic stress which is managed through circadian rhythms to help regulate blood glucose.

This is why there is no specific advice to be given. You can only learn how your body works and what it needs in order to work properly. Anyone that says otherwise is giving you a load of BS. That's why diet programs are all BS.

4. Don’t fat people burn a lot of calories? Wouldn’t what's a surplus for thin people actually be a deficit for a fat person? If that's the case, why is everyone recommended the same number of calories?

That’s why we don’t guide ourselves by calories. Fat people burn a lot of calories from everything but body fat.

5. Can a person who is not overweight/obese maintain their weight using calorie information only? I have a friend who is slim and always reads the calorie information of everything she eats. It seems to work well for her.

Yes. Healthy people respond well to elementary nutrient information such as calories. Of course, these calorie counting people also pay attention to which macros are supplying their calories, as they know that's where the magic occurs. But overall, they can rely on calorie information alone to maintain their weight stable regardless of macros, as long as their blood glucose continues to be well regulated.

This is because healthy people aren’t overweight/obese, so their metabolism works well even with simple nutrient information. Their weight fluctuates very little and small weight fluctuations respond to calorie information, as that's what mainly causes these fluctuations. So, these people are targeting the actual cause of their weight fluctuations.

6. How are low fat diets supposed to work?

Low fat diets work through leptin, just like low carb diets work through insulin. Your coach will tell you that they work through the overall control of calories but that's not true. It's actually leptin and insulin manipulation. All weight loss and gain is mitigated through insulin. All fat loss is mitigated through leptin.

It is assumed that people who are overweight/obese are "leptin resistant", so they don't burn fat properly. This would mean that if you lower their fat intake, they will see benefits. What would be the point of intaking more dietary fat if you aren't using what you already have, right?

It's sort of like the same premise of low carb diets. If you are insulin resistant, what would be the point of adding more glucose, to the body, if you aren't burning what you already have? The assumption actually works.

Lowering the fat intake of overweight/obese people, who might be leptin resistant, does cause some weight loss. Unfortunately, they don't lose enough to not be overweight/obese. With time they also regain what they lost back again.

The problem is that you can manipulate insulin for the long term but not leptin. That's why low carb diets work better than low fat diets. Leptin is a slave to insulin so if you don't control your insulin first, you won't get much from leptin control in the long run. You control insulin through the proper regulation of blood glucose.

The best protocol then would be low fat and low carb. That's basically a protein sparing modified fast, right? Right. So, it's not surprising that's the protocol that works best. It's just that it's difficult to adhere to for the long term. It's sort of like calorie restriction. Very hard to maintain and eventually has to be changed in order to continue with results and help keep the results you already achieved.

To solve the problem, instead of making your protocol low fat, you can instead use fat as a lever. Remember, it is being assumed that overweight/obese people are leptin resistant but that's still just an assumption that can't be applied across the board. There are many overweight/obese people who are leptin resistant but there are some who aren't. The minute they control their blood glucose regulation and obtain proper insulin expression, their weight drops rapidly. This is why it's not a good idea to jump on low fat first. You jump on low carb first and then lower your dietary fat according to your results. This is because too little fat, for too long, causes what you are trying to avoid or reverse - "leptin resistance".

This is the same thing that occurs when you lower calories for too long. The body goes into "starvation mode". "Starvation mode" is simply a trendy way of saying "leptin resistance". The body is actively trying to stay fat and get fatter. It does this through chronic leptin under expression.

The good thing is that you can continue to be low carb forever and have no such negative side effects to metabolism. You can be zero carb, forever, and have zero problems because insulin just doesn't work the same way leptin does.

So, remember the diet that will most likely achieve results is low carb, adequate protein and fat as a lever (moderate). Some people can eat more fat than others and still see results. Don't sabotage your weight loss journey by making everything too low. Only one thing can go very low – carbs.

Six common beliefs addressed, Part 212

1. I have been on a low carbohydrate protocol for a while now and I'm doing great. I have recently had some stress in my life due to relationship issues. This has "sidetracked" me. I do not have an issue with my protocol, I just have a hard time staying focused and not getting sidetracked easily. 

I have no clue as to how to reply to these types of questions and that's why I usually avoid them, even though I receive many of them weekly. I will make this one an example so that hopefully other people will not send me more of these vague issues for me to decipher.

If you have been consistently doing everything that you need to do, and you don't have an issue with your protocol, then what is the problem exactly?

I am not sure what type of "relationship issues" you have been having but life often carries lots of issues. I don't know what that has to do with your protocol though, since diet and exercise are actually a very small part of daily life. A lot occurs between these two events. To put it in context, you spend more of your life sleeping rather than eating and exercising.

I also do not understand why life stressors cause people to become sidetracked from their diet and exercise. Again, the two smallest parts of daily life. Why doesn't it affect everything else? I don't even know how "relationship issues" can affect your protocol to begin with. Though it's difficult to imagine how, I can still see it possibly taking time away from your exercise routine, but your diet? Don't you have to eat every day anyway, regardless of what's happening?

This is a blog that contains general information on strategies that might help treat or prevent metabolic disease. The first requirement, for anyone who reads this blog, is the ability to follow a protocol consistently. This is not a weight loss blog. This is a blog that requires a lot of reading, researching on your own and, most importantly, doing without excuses.

2. Should protein be determined by ounces or grams? 

Many people are having trouble trying to figure out protein. They just assume a piece of meat is "protein". It's not. Meat contains protein but it is also water and fat.

If your protocol uses ounces, then you determine whatever the recommended ounces of meat are, by using a food scale. If your protocol uses protein grams, then you have to determine how many grams of protein are in your chosen cut of meat. Type and cut of meat will affect how much protein it contains.

I know it's hard to determine this because often times real food doesn't have labels. Thank goodness most people have a smart phone, so you will have to do your Googles. You can use Google search or an app to determine how much protein is contained in your chosen cut of meat, depending on the amount. You can do this using ounces or pounds.

The good thing is that once you do this one time, you won't have to do it again, for the same cut of meat of the same amount. So, this isn't something that will be a continuous hassle for you.

3. I was told that low fat products are unhealthy because they are filled with sugar in order to make up for the missing fat. 

That is only true of processed foods. Let's be honest here, for something to be labeled as low fat/fat free, it must be processed by default because the only foods on planet earth that are naturally low fat/fat free, are most whole vegetables and fruits. These do not come with a label. Nothing else natural, except for water, is low fat/fat free.

So, for example, low fat/fat free cereals, snack bars, cookies, etc. are usually loaded with sugar in order to make up for any lowering or elimination of their fat content. It's a way to make these "foods" more palatable. These "foods" are also loaded with sugar because sweet things sell. If it wasn't for sugar, what would cereal taste like? None of these grain based, processed foods have any flavor to them. That is why sweet is the "go to" flavor added to all of these items in order to entice people to buy them.

Low fat/fat free labeled foods, like most dairy, are not loaded with sugar to make up for the missing fat. Yogurts are loaded with sugar because this dairy is sold as a "snack" so again, sweet things sell. The rest of low fat/fat free dairy usually does not have any added sugar.

The elimination of fat only concentrates the products own natural sugar, increasing its sugar content by volume, irrespective of calories. The more fat removed, the more concentrated the sugars become. This is why it is not a good idea to eat low fat/fat free versions of these foods as they were intended to come with fat. That's how the body recognizes them.

Artificially altering the macronutrient composition of food is never a good idea. The fat in full fat dairy should not be of any concern because dairy is to be used as a garnish only, not as a main meal, making its fat content irrelevant. There was a time when only full fat dairy was available, and obesity was very rare.

If your protocol is calling for low fat/fat free foods, it's because it is a calorie centered protocol. They are trying to manipulate daily calorie intake by reducing/eliminating the fat calories from food, simply because these low fat/fat free food versions are easily available as alternatives.

The best way to approach this problem is not through the consumption of altered Franken foods but by simply eating the real thing properly. You never want any food that is primarily fat or primarily carbohydrate to become the main course and replace protein.

4. I try to eat grass-fed meat whenever I can, but I really do not like it. It's not just me either. My entire family prefers conventional (grain-fed) meat. Grass-fed meat seems to be constantly pushed in low carb circles though.

You don't have to do a thing but regain leptin expression. Leptin doesn't care what meat you eat.

Yes, many low carb people push grass-fed meat, for varying reasons, but the main one is just to be trendy and "in the loop". Unfortunately, the more things try to change back, to how they once were, the more we are reminded as to why they changed in the first place.

Some people do not notice any difference between grass-fed meat and grain-fed. Others find they prefer the taste of grass-fed. People like you and me, really prefer grain-fed. I am sure there are a lot of people like us so I can see why grain-fed beef became so popular. Insulin resistance is truly delicious. Just ask the Wagyu ranchers.

I have tried all kinds of grass-fed meat from different sources. Some have been expensive, and others have been pretty economical. Regardless of where it comes from, grass-fed meat usually has a "gamey" after taste and dry texture which I don't particularly like. Even at the same fat percentage, grass-fed meat still has a drier texture than grain-fed. It's not bad enough to be intolerable, so I still occasionally buy grass-fed meat, but I do prefer grain-fed.

Aside from the palatability issue, let's talk about health. Grass-fed meat has a better fatty acid profile and ratio. There is no doubt about that. Grain-based fats interfere in lipolysis (the breakdown of fat). The fat in grain-fed meat, which is mostly corn derived, tends to increase liver fat, progressing metabolic syndrome further. The same does not occur with grass-fed meat of the same fat percentage. So, there is certainly something in grain-based fat that interferes with the liver's processing of fats. Of course, there is still a question as to how carbs in the diet, alongside grain-based fats, contribute to this effect.

For this reason, I wouldn't be too concerned over this. Diets that are low in carbs and eliminate grains and sugar, still produce metabolic benefits even in the presence of grain-based fats. So, whatever is going on with these fats, might simply be exacerbated due to a high carb diet.

All of this simply means that you don't have to eat grass-fed meat if you don't like it. You can replace it with wild game or try pastured meat. Pastured meat is usually a blend of grass and grain. The very best meat I ever ate was pastured, local meat. It tends to be expensive and/or difficult to find, depending on where you are, so that's something to keep in mind.

Other than that, you can simply continue eating grain-fed meat, just buy it leaner. The beauty of grain-fed meat is that even the leaner versions still have a great texture. That way you can limit the intake of their fatty acid profile.

Buy grass-fed dairy instead, to get their beneficial fatty acid profile. Dairy is naturally mostly fat so you will get more bang for your buck buying it grass-fed. Most people prefer grass-fed dairy once they've tried it. For example, I prefer the texture of grass-fed butter versus grain-fed butter. Conventional grain-fed butter has an oily texture which grass-fed does not. Grass-fed butter is very creamy instead. The taste of grass-fed whole milk is superior as well.

Doing it this way allows you to have the best of both worlds. You can get the taste you want from the grain-fed meat and the fatty acid profile you need from the grass-fed dairy. It might also give your wallet a break.

5. Type I diabetics do not have to be careful of their diet because they already have to take insulin anyway.

This blog's focus is not Type I diabetes but the answer to this question pertains to Type II and that's why I'm replying.

If a Type I diabetic has to continue dosing insulin to counteract ice cream sundaes, what will eventually occur is that they will lose control of their blood glucose regulation, gain body fat and develop Type II diabetes (double diabetes). It is very difficult to dose insulin correctly when you have such large disparities between postprandial and fasting blood glucose. This results in the need for more insulin than normal, postprandially, which causes frequent hypoglycemia during fasting.

It's this issue, which is the single most important clue we have, occurring in vivo, of how Type II diabetes develops. Type II diabetes develops when the body is under a high insulin demand in order to clear dietary (postprandial) blood glucose. This interferes with proper blood glucose regulation during fasting, which ultimately deteriorates insulin sensitivity and function in tissues and organs to varying degrees. It also abnormalizes insulin expression, making the fat mass particularly insulin sensitive at the expense of other tissues and organs.

Problems with blood glucose regulation, particularly while fasting (time in hypoglycemia), causes metabolism to go into a "pseudo starvation mode" that only helps spare and build body fat, while keeping the blood glucose set point very high. This puts an even larger demand for insulin and the cycle now feeds itself.

Whether insulin is being produced by your own body or being injected from an external source, a high insulin demand will eventually lead to Type II diabetes. You simply cannot regulate blood glucose properly in the presence of over expressed insulin.

6. Legumes are healthy and superior to grains.

No. Legumes, just like grains, disrupt proper blood glucose regulation over time because of their high carbohydrate content (starch). It doesn't matter what nutrients or fiber they contain. It doesn't matter that they have protein, and it certainly doesn't matter that they happen to be high in calories. They still have a lot of starch which is basically glucose. So, at the end of the day, they interfere with proper metabolic function and so they can never be "healthy".

Legumes also tend to replace animal protein containing foods because they are relatively inexpensive, compared to meat, and commonly found precooked making them more convenient than meat. Both of these cause legumes to not be eaten appropriately. The only appropriate way to eat legumes is to keep them a garnish only.

Six common beliefs addressed, Part 13

1. Do low fat diets never work?

I am leery of anyone who makes a claim that such and such diet
"never works". No diet works. They all fail. The only diet that works is the one that can effect your blood glucose regulation, profoundly and consistently enough, to effect insulin and leptin function. That's all. 

What diet can achieve that is left to the individual because there is no
"one size fits all" diet. Whether a diet can achieve, what I described above, depends on how the individual's blood glucose reacts to treatment. So far, it has been shown to be quite a battle that ends too often in failure. 

Remember, I can speak the truth because I am not selling, promoting or sponsoring anything on this blog. This blog is for educational purposes only. I am just here to let you know, that until you can obtain and sustain proper blood glucose regulation, you will not reach your goals. How you go about obtaining and sustaining it, is up to you. I can only point out the most logical direction to take. Try and see. 

All weight loss is mitigated through insulin. Low fat diets work like any other diet, because they help lower insulin through their effect on blood glucose. 

Low fat diets can be beneficial for people who have certain metabolic abnormalities, where the turnover of proteins and/or the mobilization of fatty acids, for fuel, is compromised and/or inefficient. They also may benefit people who have conditions that make the consumption of fat problematic. These can be genetic lipid and inflammation abnormalities or gallbladder disease and other digestive conditions.

If you benefit from the restriction of fat, then you can follow a low fat diet. The premise should be the same as with a low carbohydrate diet - to achieve the proper regulation of blood glucose. Some things that can help with this are:

• Base your diet on whole foods, not novelties. 
• Sugar and grains should still be avoided. Starches should come from whole food sources only.
• Getting enough nutrient dense foods, on this diet, is priority number one, since nutrient density is often found in fatty foods. The reduction of these foods can reduce nutrients as well.
• Consuming adequate amounts of lean proteins, will avoid issues with satiety. Because protein rich foods usually come accompanied by fat, they are often mistakenly avoided, causing protein deficits and loss of lean muscle mass.
• The limited amount of fat, in these diets, should still come from natural sources and not industrial "vegetable" oils.
• Make sure the diet is low fat, not no fat. No fat can cause health issues. 
• A daily fasting regimen should still be followed.

Carbohydrate restriction should always be primary, but if you are having difficulty losing weight, are gaining weight and/or are unable to improve metabolic markers on a carbohydrate restricted/higher fat diet, try a moderate carbohydrate/lower fat approach.

2. Are carbohydrate the only thing that causes insulin resistance?

No. 

Anything that interferes with proper blood glucose regulation will eventually lead to insulin resistance. "Insulin resistance" is simply a blanket term for abnormal insulin release/function/expression on varying tissues and organs at differing rates. Usually it is seen as a resistance to insulin in the liver and muscles and a high sensitivity to insulin at the fat mass. 

Many things can cause abnormal blood glucose homeostasis. Chronic health conditions, medications, age, gender, activity levels, hormonal state (menopause, perimenopause) can all impact your body's ability to regulate its blood glucose correctly. 

Diet can exacerbate the negative effects on blood glucose, that all of the above can cause. Diet is also the easiest of all of these to control. In the modern diet, carbohydrate is the most common culprit to blood glucose abnormalities. 

3. Can only high insulin levels store excess fat?

Human metabolism is much more complex than these myopic views. 

You can still store fat with low insulin levels, because insulin is required for storing fat, but it doesn't end there. The Acyl Carrier Protein has a very important role in the regulation of fatty acids and it has the ability to store fat as well.

You also have to get out of the mindset of only seeing obesity through the lens of a "storage" (in) problem. It is actually mostly a "burning" (out) problem. The body is simply not burning enough of the fat it has. This means that any storage will become problematic at that point. If not enough fat is being burned, then even the smallest amount of storage will automatically cause an increase of it. The burning of fat is solely a leptin problem. 

4. Eating a "high fat diet" means you can eat all the fat you want. Eating a "high carbohydrate diet" means you can eat all the carbohydrates you want.

No. 

"High" is not describing the amount that's eaten, it's only describing the macronutrient profile of your meal. Eating a small plate of pasta is still high carbohydrate. Eating a slice of bacon, is still high fat.

5. Can I chose a high carbohydrate diet instead of a high fat diet to achieve metabolic health?

You could achieve metabolic health with any diet that obtains and sustains proper blood glucose regulation. Vegetarian and vegan diets are high carbohydrate diets that have normalized blood glucose in many their followers. Of course, both of these diets, when followed correctly, at typically low in sugar.  

On this blog, high carbohydrate diets are not recommended simply because of their ability to interfere in proper blood glucose regulation over time. If you are already having abnormal blood glucose, the last thing you want to do is introduce even more glucose to further the problem. So because I am giving out information to people who are already suffering from metabolic problems, I prefer to give them a more targeted approach they can try.

6. Protein always causes my blood glucose to rise.

Protein can cause postprandial blood glucose to rise for people who have metabolic disease, but not for the healthy. Insulin resistance is the cause as to why this is the case. The two common pathologies are described below.

• Certain amino acids, in protein containing foods, stimulate an insulin response, because insulin allows the uptake of these amino acids into the cells that need them. Insulin release can cause blood glucose to drop too low, if it’s unmitigated, so the counter regulatory hormone glucagon, releases stored glucose, from the liver, to counteract this effect. Because of insulin resistance, glucagon is not well controlled by leptin and releases this glucose at an exaggerated rate, causing blood glucose to rise after a protein meal.
• Because of this poor insulin function, there is a general lack of lean muscle mass, which causes for glucose to remain in the bloodstream, for a longer period of time, since there is not enough muscle to uptake it.

As an interesting side note, this effect doesn't just occur with protein. It also occurs with carbohydrates. When you eat a potato, the high blood glucose you measure, postprandial, is mostly coming from your own liver, rather than the actual potato. Once again, glucagon has an exaggerated response to the presence of insulin. The new generation of diabetes medications will be targeting glucagon, rather than insulin, for better blood glucose control.