Six common beliefs addressed, Part 200

1. Eating fat helps with satiety.

The macronutrient of satiety is protein. The only time the body becomes “hungry for fat”, is if you were going through “rabbit starvation”. Then there would be a fat deficiency and the body would be continuously hungry until the deficiency was addressed.

Fat is an essential nutrient. You can only make so much of it by breaking down your own muscle mass. You have to intake fat through the diet somehow. In Western society you will be hard pressed to find someone going through “rabbit starvation” unless they were stranded up in the mountains and can only hunt wild game. Even so, it is easy to eat the fatty organs of an animal and obtain fat that way. For everyone else, you do not ward off hunger by eating fat. If you are eating modern fare, you are getting plenty of fat.

The majority of people in modern society are protein starved and that's where their hunger is coming from. This is especially true if you are overweight/obese. You never want to ward off hunger with fat. That is like warding off hunger with carbs. It works the same way. You need to consume enormous amounts of fat or carbs to ward off hunger temporarily, only to face more hunger again in a few hours. This merry-go-round will make you astronomically obese. You have to get off that ride. You were already on it when you were eating carbs. Don’t get back on it by eating fat. The results will be the same.

2. I was told that the minimum grams of fat a day are 30.

Only if you are on a low fat diet. That would be the absolute minimum, but we don't advise low fat diets on this blog. We advise 50 grams of fat day, as the minimum, instead.

3. You should consume medium chain triglycerides (MCT) oil.

Not if you are overweight/obese. If you are under a doctor’s supervision because you are following a classic ketogenic diet, then MCT oil would be a part of your protocol since it allows you to meet your caloric requirements, on a very restrictive diet, and you would need to produce ketones for your brain to use as energy. Other than that, stay away from it. You should not be in the habit of consuming isolated fats. Eat proper meals.

4. All of these "low carb doctors" are now on the covers of tabloid magazines.

That's because they will never be able to be featured in a medical publication. They are quacks so tabloids are the only place they can be featured.

5. I read a lot of headlines that claim someone “lost weight” and “cured their diabetes” or that there is a diet that “speeds up your thyroid”. 

Those magazines also feature new dessert recipes while trying to promise you different cures for obesity. It is all quackery. Just like the answer to the question above, all of this stuff is on tabloids because it is not taken serious by any legitimate medical source.

You do not “lose weight” and “cure your diabetes”. You lose weight and lower your blood glucose OR you obtain proper blood glucose regulation, lose body fat and put diabetes into remission. Those are the only two options. The third is to remain diabetic.

Many people who are overweight/obese have been diagnosed with diabetes because all a diabetes diagnosis requires is high fasting blood glucose. People who are overweight/obese, not only have a high insulin demand, due to their high body fat, but their insulin has lost its proper function due to blood glucose dysregulation. Losing weight lowers this insulin demand and this helps it regain some of its proper function. More importantly, the fact that weight was lost, means there is better blood glucose control. Unfortunately with time, it has been seen that blood glucose will once again lose its regulation because the diabetes was never “cured”. There is no cure for diabetes. This is why there are plenty of people who are not overweight/obese and also have Type II diabetes. Would weight loss cure their diabetes too? I don't think so.

Diabetes is a very complex metabolic adaptation with several contributing factors but no known cure. One contributing factor is high body fat but that high body fat is caused by a complex hormonal interplay that is not resolved by simply lowering blood glucose or losing weight.

"Speeding up your thyroid" is absolutely meaningless as your thyroid is a slave to your metabolic profile. Like I have said many times before, a "fast thyroid" can make you fat or make you thin. A "slow thyroid" can make you fat or make you thin. The thyroid simply behaves according to the metabolic environment it’s in, unless there is an actual disease affecting its function.

6. A “BBBE” is a good “weight loss hack”.

There are no "weight loss hacks" if the weight you want to lose is body fat. If you just want to "lose weight", then you can hack off a leg or dehydrate yourself until you're a few pounds "thinner". Obesity, on the other hand, is a condition that can only be treated with long term solutions and hacks are not long term. Well, unless you really hacked off your leg. That would be permanent.

BBBE (beef, bacon, butter and eggs) is just like all the other alphabet soup fad diets out there. It works by lowering insulin, causing a release of retained water. That is what causes the initial "weight loss". This doesn't even put a dent on body fat as diets that are high in fat, only contribute to more fat storage for those who are not leptin sensitive. If you are obese, there is a high probability you are not leptin sensitive because if you were, then any other diet would have worked for you already and you wouldn't be entertaining the tabloids for new ones.

Six common beliefs addressed, Part 193

1. You are eating too much if you aren't "losing weight" on carnivore.

You are either eating too much fat, gaining muscle or not eating enough.

I don't know what's going on when people describe their woes as "not losing weight" and/or "gaining weight". Weight is muscle, water and fat. I have no clue which ones of those you are losing, gaining or maintaining. You need to determine your body composition. The goal of metabolic health can only be achieved through the loss of body fat, not through body weight fluctuations. Muscle and water do not perpetuate diabetes, body fat does.

As far as "eating too much" is concerned, you again need to focus on dietary fat. You need to eat at a caloric surplus to build muscle and at a deficit to lose "weight", but you need to eat the correct macronutrient combination to lose body fat. Eating correctly is adequate protein, moderate fat and low carbohydrate. This is the composition that will best promote proper blood glucose regulation.

You need to be careful of the fat that is coming with your chosen cuts of meat. You might be eating meat that is too fatty for fat loss to occur. If that's not the case, then you are building muscle while losing fat. This usually presents itself as "not losing weight" or "gaining weight" since muscle is denser than fat. The only way to know that is to take waist measurements, in order to get an idea of what you are losing and gaining.

2. "Eating For Your Blood Type" is a good diet to follow. 

Every day a hole is dug for a new sucker to fall into and if the old adage 'A sucker is born everyday' is true, then we can expect to be walking over a sucker the minute our foot hits the ground every morning. The new hole is 'The Blood Type Diet'. I'm going to give a very brief overview of what the 'Blood Type Diet' is for those lucky enough to not know yet.

This scam was created by naturopath (no surprise here) Peter J. D'Adamo who claims that the foods you eat "react chemically" with your blood type -- O, A, B, or AB. So, he designed a diet "based on your blood type" which would (could, should) help you "digest food more efficiently, lose weight, have more energy and even help prevent disease". Basically, the same promises every other charlatan makes. We have heard this all before.

D'Adamo also gives the same advice we hear ad nauseam, from every corner of the diet circus, on "organic", "free range", "fair trade", "grass fed", "humanely sourced", "cage free", "slave labor free", "local farmers", etc. Basically a boat load of highly expensive crap making you bound to fail before you even begin since your wallet will collapse much faster than your belly. I guarantee it. But, D'Adamo doesn't care because he's not really selling this crap to you, he's selling it to the ones who can afford him. Every scammer has a shtick. They either tell you that you can achieve health eating $1 hot dogs or you can only do it by eating $800 a pound mermaid steaks. It all depends on who they are trying to market to. They all have a core audience who supports their BS.

I don't recommend any gimmicks or fads. There are certain genetic variables in all of us but generally, unless you have alien DNA, you will benefit from an low carbohydrate, moderate fat and adequate protein diet for better metabolic health. This is because all humans, on earth, evolved under that macronutrient composition regardless of genetic differences.

You can certainly tweak the types of fat for your genetic makeup. You can also tweak the types of carbs. But all roads will lead back to the same basic principle of low carbohydrate, moderate fat and adequate protein for better metabolic health. That is all.

3. There are many different opinions on how much disparity there should be between postprandial and fasting blood glucose.

This is one of the most highly contested topics, when it comes to diabetes. You will get multiple different answers, depending on who you ask. In fact, many cannot even agree on what "normal blood glucose" is. Because of this, the current guide is pathology. This means that the blood glucose number with the least pathology is considered "normal". A lot of diabetics fall in that range. They simply have high blood glucose without any current pathology. This is why what's considered "normal blood glucose" keeps rising yearly, just like what's considered "normal cholesterol" keeps dropping.

So, since no one truly knows, let's guide ourselves by the most common consensus. The current consensus states that "normal blood glucose" is between 70 - 99 mg/dL, while fasting, and postprandial blood glucose, at the 2 hour mark, should be less than 140 mg/dL. This means that there should not be a persistent disparity in blood glucose, between fasting and postprandial numbers, of more than around 40 points. This is if you start with the highest fasting blood glucose number of 99 mg/dL.

What we know, for a fact, is that healthy individuals have a fasting blood glucose of around 84 mg/dL and a postprandial blood glucose, at the 2 hour mark, of guess what? Around 84 mg/dL. This means they have no persistent disparities in blood glucose at all. Their blood glucose returns to baseline before 2 hours and it doesn't go lower than 84 mg/dL after 2 hours.

But most importantly of all, their fasting blood glucose does not go much lower than 84 mg/dL at any time, not just around meals. People with metabolic syndrome have much lower dips in blood glucose, sometimes all the way to the 60's and even 50's mg/dL, particularly during the night time fast. This is why they wake up with raging Dawn Phenomenon.

This is very important to note because in the healthy, insulin does not continue clearing blood glucose while fasting. This means their insulin release was never above normal postprandial because their blood glucose never went above normal. This preserves normal blood glucose regulation and that is the key to remaining metabolically healthy.

4. There are so many different diets, that they can't all fail. 

Here is the diet world in a nutshell:

• Caloric restriction/fasting – These diets restrict calories from all sources.
• Low carb/ketogenic/carnivore – These diets restrict or eliminate calories from carbohydrates exclusively.
• Low fat/"heart healthy" – These diets restrict calories from fat, particularly saturated fat.
• Protein sparing modified fasts – These diets restrict calories from both carbs and fat.
• Vegan/vegetarian/plant based – These diets restrict or eliminate calories from animal protein and fat exclusively.

All of these diets, just like the caloric restriction/fasting ones, can also restrict total calories, alongside the targeted ones. So, it doesn't matter what fancy name the diet mongers give their diet or how technical they are in describing it to you. It doesn't matter what they promise it can achieve or how different they claim it is from other "diets". That's all a sales pitch. Every diet's foundation is based on one or more of the above five principles. Period.

The naïve person believes that the calorie restriction, in all these diets, is what will induce weight loss and so it doesn't matter how the calories are restricted or from what source as long as they are restricted. This is why they believe that all diets work. In reality, all diets work because of one thing - their affect on insulin. They all lower insulin levels to some degree. This causes an immediate mostly water weight and some lean muscle mass loss.

Since poor insulin function deteriorates leptin expression over time, we can hope that by improving insulin function, leptin expression will be regained and fat will be lost. Well, that's not the case. Poor insulin function deteriorates leptin but regaining insulin function does not seem to affect leptin much, especially in the long term. This means that normalizing insulin works much better in reversing simple weight gain than obesity. It doesn't appear to make a dent on obesity, at least not significantly enough to no longer be obese. When it does, it's very rare and the long term prognosis is poor. This can absolutely be due to not ever being able to acquire true insulin function or blood glucose regulation simply begins to deteriorate over time. Who knows. We can only speculate.

All of these diets have one other thing in common - they promise weight loss but they can never promise fat loss because none of them do a thing to improve leptin expression. Nada. Nothing. Zilch. Zero. It's as if you did nothing at all. Protein sparing modified fasts are the only diets that have had better success in addressing leptin but again, the long term prognosis is poor. Low carb diets come in at a close second.

This means you have to be realistic when following any diet. Instead of focusing on only the "diet", you need to focus on blood glucose regulation because that's the culprit of metabolic disease. Hyperglycemia causes heart disease, kidney damage and neuropathy. Hypoglycemia causes diabetes. You need to follow a diet that prevents/minimizes blood glucose disparities so you can preserve its proper regulation through proper insulin function. Period.

Addressing your metabolic health, in this manner, will help you keep in mind the other things that affect blood glucose regulation besides diet, because there are many of those. This is why obesity/diabetes is a lifestyle "disease", not solely a dietary "disease". Diet is just one part of lifestyle.

5. Now that Jimmy Moore is "gone", can low carb be saved?

There are a lot of people who believe that Moore solely caused for low carb to be viewed as a joke but the reality is that low carb has been plagued with quackery since its inception. Because of the diet's profound affect on metabolism, it has been exploited by all kinds of charlatans, who sell it as a "miracle cure" for every ailment you can think of. Moore was not the first, nor will he be the last to do this. There are plenty of quacks left, who represent low carb, and more are on the way. Right now though, the ones who are desperately trying to feed off Moore's carcass are his disgruntled ex-followers and naysayers.

These people, who hated Moore from the beginning and low carb in general, are on a frenzy to grab Moore's soapbox to spew their own dietary nonsense and grievances. Most of these people are either trying to sell their own diet, and low carb is their competitor, or they are bitter that the diet didn't work for them and are now on a vendetta.

Don't be duped by either clan. They are both full of BS. Remember, you are not going to get thinner by swapping one charlatan for another.

6. MCT oil will help with abdominal obesity.

Medium chain triglycerides (MCT), like those found in saturated fats from both animals and certain plants, are beneficial in the sense that they are burned easily for fuel, not adding to your waist line. They are also easily metabolized by the liver and won't add to liver fat storage. They tend to lower LDL and increase HDL, in most people, while also improving cholesterol composition. This is unlike polyunsaturated fats, which appear to be stored more easily in the liver and subcutaneous, while also causing a pseudo drop in cholesterol without changing its composition or even making it worse. But MCTs are not a magical "cure" for anything.

Downing MCT oil is not going to help you. Proper leptin expression is the only thing that can help you. This is not acquired through the consumption of MCT oils.

Six common beliefs addressed, Part 176

1. There is something seriously wrong with Maria Emmerich. She looks horrible. Niesha Berry, Dr. Berry's wife, seems to be going down that same road. Her recent photos are scary. All of these "keto" people either stay or become more obese or they become like skeletons.

I see this comment in many low carb forums so I will address it here. 

First off, I don't know either of these women. I don't follow them or their work. I have never met them. I don't know their medical history so I don't even know if they might be suffering from some type of medical condition, at the current moment, which might be the cause for how they look. 

Both of these women look cachexic, particularly Emmerich, but I can only reply in the context of what is known about them from their online public personas. What is known about Emmerich specifically, is that she pushes a very nutrient poor diet, based on her "cookbooks" and low carb rhetoric. Her meals are composed of endless, high fat, desserts. As far as Berry is concerned, she has little by little deteriorated into the world of fad dieting as well and doesn't fall far behind Emmerich in the low carb rhetoric and misinformation.

So since this public knowledge is the only thing I can take into consideration, because it's the only thing I know about these women, I can tell you that the way they look is a direct result of a nutrient poor, protein starved diet that has resulted in the massive loss of lean muscle mass, especially for Emmerich. This is particularly true because neither of them were morbidly obese at any time in their life.

Emmerich obviously has intact leptin expression and is obesity resistant. This is why the massive amount of fat she eats daily, if she really does eat it, does not cause weight gain. That of course, does not necessarily mean she is lean. Judging by her photos alone, you can tell that this person has such a low percentage of lean muscle mass that she very well can automatically be left with a high fat mass by ratio. You do not have to look fat to be fat. The moment that your fat mass surpasses your lean muscle mass, at any weight, you are obese by default.

We don't know what the true ratio of lean muscle mass to fat mass Emmerich has because she won't ever share that. We also don't know what her metabolic function is. We are just left with a person that looks very unhealthy. This is why you have to be very careful who you take dietary advice from. You can end up looking like these women or worse. Since you might not have their leptin expression, you can go in the opposite direction and end up at 500 lbs., following their mostly fat based diet.

Metabolic function is a double edged sword. It can either make you very obese or it can make you waste away. Remember, the metabolisms of both the obese and these women, is blind to its weight set point. This is why both extremes are dangerous states to be in.

That is why we do not believe you can be "healthy at any size". That does not exist. We do not promote that you remain obese as long as your blood glucose remains low or that you try to get to the lowest weight you possibly can as long as you can keep your blood glucose low. You are only truly healthy when you have the right lean muscle mass to fat ratio based on your gender, body frame and age.

Body fat is extremely important. It is the largest endocrine organ in the body. It regulates your thyroid function, your leptin expression, your insulin release, your glucose homeostasis and your reproductive hormones, amongst other functions. You cannot sustain a large, abnormal loss of body fat, for a prolonged period of time, and remain metabolically stable. You also cannot carry around a large amount of excess body fat and remain metabolically stable. Both are bad.

2. Any success in weight loss is due to leptin sensitivity.

Yes. There is no fat loss without proper leptin sensitivity. I happened to be an obese person that reacted to a dietary intervention, quite rapidly, and was able to lose weight. I only experienced two weight loss stalls, which I was able to surpass easily. This means that I was leptin sensitive throughout my weight loss. I was able to reach leanness.

This is not surprising to me as I have always been leptin sensitive throughout my life. I know this because I have been overweight, for most of my life, but have always been able to drop weight quickly and become lean, through small changes in my eating and/or exercise routine, particularly with eating more rather than less. I was never the type of person that purposely pursued weight loss though. These drops in weight I experienced, throughout my life, were the result of natural changes in my lifestyle and not the result of any dietary protocol purposely used for weight loss.

Of course, now that I dropped so much weight, it will be interesting to see if I can keep my leptin sensitivity. After all, it's not about what you can achieve but what you can keep.

It is not well understood what causes some people to have great leptin sensitivity and others not. It is also not well understood what changes leptin sensitivity over time. For instance, many people lose their leptin sensitivity as they get older. Substantial weight loss can also make you lose your leptin sensitivity. We know that profound changes in metabolic function and increases/decreases in fat mass affect leptin, but why some people are more affected than others is unknown. This is why it is a misnomer to assume that all fat people are "leptin resistant". That is not necessarily the case. Most are, but not all. Some fat people can lose weight rather rapidly when the conditions for weight loss are met. Yet, others cannot.

Many things seem to be correlated to poor leptin sensitivity. They include lack of exercise, chronic caloric restriction (crash/starvation diets), fructose consumption, early life onset of obesity and a highly insulin sensitive fat mass (poor insulin function). As you can see leptin function is dependent on many factors and is highly individualized. This is why diets don't work and the diet that may work for one, may not for another. Maybe, in the future, advances in obesity research will make leptin therapy a standard in obesity treatment and weight management. As of now, that is not the case as the correlation between leptin serum levels and obesity is not linear. This means that leptin function, just like insulin, is much more complicated than just measuring serum levels. Leptin's ability to interreact with the brain, regardless of serum levels, is the confounder.

3. Fasting can improve leptin sensitivity.

No. Starvation studies have consistently shown that leptin levels decline rapidly in response to fasting and this causes profound changes in energy balance and hormone levels. Low leptin levels induce overfeeding and suppress energy expenditure, thyroid and reproductive hormones, along with immunity. Aside from the decline of leptin levels, there appears to be a chronic suppression of leptin expression, which only keeps you fat and helps you get fatter.

This is precisely why fasting is not used as a treatment for obesity, by any serious obesity expert, even though we have known about fasting since we have known about eating. Believing in fasting and caloric restriction as treatments for obesity is akin to still believing in bloodletting.

4. I am on a Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and they give me a lot of cereal but very little eggs. I want to drop the cereal and feed my family more healthy. 

Find someone who is willing to trade you eggs for cereal. More people like cereal than they do eggs as cereal requires no cooking time and many are on egg restricted diets anyway. So, just like people buy food stamps, they will also buy cereal, especially if WIC is giving you a lot of it.

5. Medium-chain triglycerides (MCT) oil will cause a weight stall as the body tries to burn through it before accessing its own fat stores. You should switch to another type of fat.

Though not all fats are metabolized the same way, all fats do the same thing when they are eaten beyond your macronutrient allotment and there isn't proper leptin expression - they get stored. Switching from one fat to another will not make a difference in this effect. You need to follow proper fat macros instead.

6. People who have trouble accessing body fat should eat more dietary fat or "they will feel terrible".

Negative. That would be like saying that if you have trouble metabolizing glucose (diabetes), you should eat more of it or you will feel terrible.

If you want to lose body fat, you have to burn it. In order to burn it, you need to force the body to do so. Making concessions based on false beliefs will not allow that to ever occur.

The only thing that causes the inability to access body fat is called obesity. The only thing that reverses obesity are long term protocols designed to acquire proper blood glucose regulation.

Feeling terrible on a protocol is not because you have "trouble accessing body fat". If you are obese, you already had that trouble since before you started your protocol. Feeling terrible on any protocol means that it is not appropriate and you are either running a deficit in protein, electrolytes, calories or all three.