Six common beliefs addressed, Part 232

1. The hormones in food are the cause of children looking older and developing quicker.

Hormones are actually very expensive and usually not used in foods. There are certain foods like soy that mimic human sex hormones and can alter development but for the most part, sexual development is determined by body fat. The higher the body fat, the sooner you develop as the body believes the environment is abundant and offspring are more likely to survive. Body fat speeds things up including your own demise.

2. People who are doing everything right on "keto" still gain weight over time. A lot of doctors say that it works initially but then it creates "issues".

Okay there are several assumptions being made here.

First "doing everything right" is up for debate. I don't know what that means because I don't know what type of "keto" these people are following. If they are doing the fad "keto", found online, then it's wrong. Just because it's on Facebook, doesn't mean it's right. If you are on a "keto" protocol that allows you to eat astronomical amounts of fat, you are doing "keto" wrong and so therefore, you will gain weight.

What "issues" are being described? That these people regain weight? Well, I already explained before that if they are doing "keto" wrong, they will gain weight but if they are doing "keto" right and still gaining weight, that's not a "keto" issue, that's an obesity issue. That occurs with all diets, not just "keto". All diets cause weight regain with time. 

You have to be careful when following diet promoting "doctors". You need to understand that all diets are only palliative treatments for obesity as overweight/obesity has no known cure. So, when you see a doctor talking down on other diets, it's because they are trying to sell their own as all diets have the same success rate for "treating" obesity.

3. Calorie advocates disagree that some medicines cause weight gain since it's all about calories.

"Calorie people" don't know what to think anymore. That's what happens when you try to serve two masters - calories and some other mysterious, unknown, agent. Of course, that "agent" are metabolic hormones, but they refuse to admit this so let's just call the agent elves instead. That should make them feel better.

Most calorie people will agree that some medicines come with elves which cause weight gain, but this is only because of the presences of calories. This is fundamentally, at its very basic level, true since if you were in a gulag, you wouldn't be gaining any weight regardless of what medicines you were on, but this doesn't help you in the real world. No one here is in a gulag.

Some medicines affect blood glucose homeostasis and so they end up causing overweight/obesity. This can be minimized by following an appropriate diet containing the correct macronutrient composition to prevent further blood glucose disruption. This should better help you not gain so much weight while on certain medications.

4. I have done all kinds of calorie restriction, low carb, "keto", carnivore, Paleo and fasting but I haven't lost a single pound. Actually, all I do is lose five or ten pounds and then regain them. I have been this way for years. Will I ever lose weight?

I don't know. I like to approach things with the mindset that the person can lose weight but that's never guaranteed. We can't be defeatists but we also have to be realists. The reality you have to face is that you, like everyone else, can only be as thin as how much leptin expression you can regain and most importantly sustain. Period. It's not the calories. It's not nitpicking diets. It's leptin.

People who have/had insulin dysfunction, like metabolic syndrome and/or diabetes, can’t seem to regain or sustain their leptin expression for long or at all. This is because leptin is a slave to insulin function and some people are just unable to regulate their blood glucose enough to normalize insulin expression.

So, all I can tell you is that at least you're not gaining weight. Even if you don't lose any, you are still managing your weight. Instead of hopping around from diet to diet, trying to figure out what works, stick to one because you will achieve the same results with all. Follow the diet you are most comfortable with so that you can continue on it for the long term.

5. My HbA1C has lowered with Metformin. It is no longer in the diabetes range and my doctor is very pleased by this. He tells me he wishes all of his diabetic patients can lower their HbA1C to my level of 5.2. I think that eating low carb has helped with this. I was told by low carb advocates that I am no longer diabetic.

No. You are still diabetic. You are still on Metformin. 

I don't want to rain on your parade because sustaining an HbA1C level of 5.2 while being diabetic is a good thing, so you can be proud of that since most diabetics simply aim for an HbA1C below 9. Usually that is based on their doctor's advice.

Unfortunately, diabetes is not a disease of high HbA1C. It is also not a disease of any one isolated, blood glucose reading. Surprisingly, it is also not a disease of insulin, per say. At least, not directly. It is a syndrome of large disparities in blood glucose regulation which deteriorates insulin function over time, causing a high HbA1C. This causes metabolism is adapt to a "starvation mode" that is extraordinarily difficult to reverse as it affects multiple glucoregulatory systems in the body.

This is why diabetes medications, whose goal is to lower HbA1C, do not stop the progression and the ultimate complications of diabetes. The disease continues on. This lowering of HbA1C is not indicative of proper blood glucose regulation. Let me explain.

You can have very high postprandial readings and then the abnormal drop in blood glucose during fasting, creates a pseudo "lower HbA1C". Just because your HbA1C can indicate an "average blood glucose" does not mean that you actually sustain blood glucose at that average number. It's simply taking your highest and lowest blood glucose reading to determine the average. In other words, if your HbA1C indicates that your average blood glucose is 120 mg/dL, it doesn't mean that's your actual reading at any given time. You can be anywhere well above or below that consistently.

This is why patients on diabetes medications have to be very careful during fasting and they are recommended to never fast. This is because that's when the medications can cause a very low drop in blood glucose, much more so than it would ever drop normally. This is sort of like how diet lowers cholesterol. It does that through the lowering of HDL but the pathology of oxidized and dysfunctional LDL persists, and heart disease still occurs regardless of total cholesterol number. These interventions are just altering numbers, not the disease.

Diabetes medications are basically trying to prevent blood glucose from going so high that you end up in a diabetic coma. They are not treating the disease or normalizing blood glucose regulation. They are actually not helping it at all. In fact, and this is going to be controversial to say, if you take what the pathology of diabetes is, which is large disparities in blood glucose, you can say that the medications are making this worse. Medications drop blood glucose lower than it would ever drop during fasting causing an even greater disparity, since they never really halt blood glucose from rising above normal after meals.

I'm not suggesting a stop to medications, as they actually will keep you living longer with the condition than if you didn't take them. I am just saying that at least they aren't helping to achieve remission and at most, they are enabling its progression. Remember you are living longer with the condition. Not without it. After all, the body doesn't care what your "average blood glucose" is. It only cares about the 190 mg/dL after meals and the 60 mg/dL while fasting. That's all it sees.

So, keep this in mind and continue with an anti-diabetic lifestyle as these medications are only going to take you so far. You have been able to keep your HbA1C in check due to your diet as it would be much higher if you just lived life like you weren't a diabetic, which is what the American Diabetes Association (ADA) pushes for. That's really the most dangerous message that the ADA puts out, by the way. You can never live life like you aren't diabetic. Ever. At least, I wouldn't recommend it as that would be certain death.

6. Diet is more important than exercise.

I like to emphasize that both diet and exercise work in conjunction to achieve the best outcome but if I absolutely had to make a hard line choice, between one or the other, I would pick exercise.

Many people are surprised by this, especially the obese since they love to focus on anything that doesn't make them have to move an inch, so diet is always their main target. But the results are clear and have been proven over and over again - exercise is the most metabolically protective thing that you can follow even in lieu of diet.

This has been seen time and time again in metabolic studies. Diabetics have been able to improve their metabolic markers and even get off medications, through exercise alone, without an iota of diet change. Athletes also prove this daily. You can be an athlete with a piss poor diet and still remain protected from obesity and metabolic dysfunction for most of your life span. That's how protective and far reaching the effects of exercise are. Humans can adapt to just about any diet, but they cannot adapt to being sedentary.

This can even be seen in aging. Someone who was an athlete when young, has better outcomes as they age. You can tell, just by looking at them, that they were mostly active throughout their life. These people can delay their diabetes until they are age 80 rather than age 50. This is seen in overweight/obesity as well. Athletes may eventually succumb to diabetes in their older years, but they sure do never succumb to overweight/obesity. Exercise wards off body fat and keeps it off.

Why would this be important if they still succumb to metabolic dysfunction? Because it is much easier to achieve remission of diabetes if you are not overweight/obese.

Of course, eventually, your metabolism will cave under the strain of a bad diet, whether you exercise or not. Athletes have also proven this often as their health deteriorates with age, but you can certainly delay these outcomes significantly through exercise and if they do occur, you can reverse them easier. The same can't be said with a bad diet without exercise. That causes metabolism to rapidly fail.

So as far as metabolism is concerned - exercise is king as it addresses both insulin and leptin.

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 188

1. Sugar causes hair loss. 

No. Protein deficiency can cause hair loss. Certain thyroid conditions and/or age can cause hair loss. Gender can cause hair loss, which many men can attest to. Other medical conditions and/or medications can also cause hair loss but not sugar.

Sugar causes diabetes/overweight/obesity. Diabetes can cause protein deficiency since you need proper working insulin to get protein into cells. But sugar itself never directly decreases anything, including hair, except for overall health.

2. Diabetics who start "keto" can stop taking their medications. 

Do not stop any medication that you are on as it can cause serious health problems, especially as a diabetic.

Diets are only complimentary to conventional treatments. They are a way of eventually, hopefully, not needing anymore medications with time. But you do not stop your medications and just follow a diet. It doesn't work that way. You don't even know if this diet will help you or not.

Make sure that you tell your doctor the diet you are following and track your blood glucose closely so that medications can be reduced if the diet does begin working for you.

3. There is no confirmation that "keto" will cure fatty liver disease. 

Ketogenic protocols are the only known cure for fatty liver disease. Virta Health is a good resource for these published papers on fatty liver disease treatment which they have posted on their website. 

Of course, this dietary protocol would only work if your fatty liver disease was caused by fructose consumption, not alcohol. 

4. In order to get the benefits from the fat in meat, you have to consume it even if you don't like it. 

You don't have to eat the fat if you don't like it. The benefits come from the protein in the meat, not from its fat. Fat is a necessary nutrient but a little goes a long way. Eat the natural fat in foods you enjoy like dairy. You can keep meat lean.

5. There is no good way of reducing uric acid.

Elimination of all forms of fructose. I recently wrote about gout so you might want to reference my past posts.

In summary, people who consume a lot of fructose have metabolic syndrome. Metabolic syndrome causes chronically and abnormally high insulin levels (hyperinsulinemia). Hyperinsulinemia impairs kidney function which does not allow for the proper elimination of waste, including excess uric acid. For this reason, gout can be described as a sign of impending kidney disease from metabolic abnormalities.

After you eliminate all fructose from your diet, you need to discuss with your doctor, a better treatment plan to control your gout flare ups.

6. My doctor never told me to stay away from processed foods. He just told me to work on "losing weight".

Doctors really don't have to state the obvious, but they do anyway, even when it falls on deaf ears. You very well know that your doctor telling you to "stay away from processed foods", was not going to keep you from them. Let's be realistic here.

But aside from that, "processed foods" is too vague a term and leaves too much up for interpretation from the patient. What your doctor should have told you is that you need to normalize your blood glucose regulation and that can be tracked using a blood glucose meter. After all, if Twinkies keep your blood glucose under control, then it really doesn't much matter if they are processed or not.

Six common beliefs addressed, Part 55

1. Carbohydrate restricted diets will not affect athletic performance.

Unfortunately athletes, or any other person, who requires high intensity performance, will have a very difficult time on low carb, since carbohydrate is the fuel required for explosive energy demands. So, unless your sport/activity is steady state like running, climbing, hiking or cycling, low carb will affect your performance. Gluconeogenesis is just not enough to sustain frequent, high intensity, energy requirements. Certain athletic activities simply require carbohydrates in order to replenish enough glycogen stores to continue performance at peak level.

This is not something that the average person has to be concerned with, as the body's normal state does not require significant amounts of fuel from glycogen. Hunter/gatherers do not "play sports". They aren't athletes. They only do steady state exercises, of long duration, which use fat as the primary fuel. This is why we have a large fat storage capacity and a small glycogen storage capacity. We evolved this way, because activities that required glycogen were a rare and unusual occurrence, so there was no need to develop a large storage system for it.

This puts the athlete between a rock and hard place. They must bypass the natural metabolic state of the body, to increase their performance in order to succeed with these unusual, man-made activities. This is why so many athletes end up with terrible health later in life. It takes a lot of dietary diligence to keep a balance of enough glycogen, for performance, but still keep blood glucose regulation in check. Remember, glycogen was meant to be used on rare occasions, not chronically.

Since low carb will most likely not be an option for athletes, they will have to watch their diet very carefully and their metabolic markers. They really need to know, with as much accuracy as possible, how their blood glucose homeostasis is being affected over time. Acquiring fuel from complex carbohydrates, can delay, not halt, any negative metabolic effects.

Athletes should follow a blog dedicated to athletes. This blog will not be of much help, since my advice is not designed for athletic performance.

2. Do low carb diets "cure" the thyroid though reduced inflammation?

No. Low carb is beneficial to the thyroid through reduced insulin levels. Chronically high insulin causes a state of hyperthyroidism and eventually this can lead to thyroid malfunction.

3. The body cannot have too much glucose as glucose is only stored as glycogen and those stores have a limit.

Glucose, in the body, is stored as glycogen for fuel, but that's not the only glucose it has. The body also has intracellular glucose and in excess, it can be harmful to the cell. This excess intracellular glucose triggers further disruption in blood glucose regulation. This causes certain metabolic effects, which promote excess body fat production and storage.

If glucose only became glycogen and stayed as such, there would be no metabolic dysfunction. The problem occurs when glucose can no longer be stored as glycogen, because those stores are exceeded. Then it starts becoming fat and that eventually becomes disease.

4. Can medications make you fat?

Yes. Certain medications disrupt blood glucose regulation by affecting different feedback loops in the body. Antidepressants, glucocorticoids and biologics are some of the most commons ones known to have this effect. 

This is why if you are on medications, which are known to facilitate weight gain, you must follow a dietary regimen that helps reduce this effect. Consuming a fattening diet alongside fattening medications is a recipe for disaster.

5. You should listen to your body on when to eat. Eat "intuitively" and not "by the clock". 

If the clock is being used to restrict meal times, then it’s beneficial. If the clock is being used to eat "round the clock", then it’s detrimental. People bring me all kinds of crap they read on low carb pages and groups, across the internet. "Not eating to the clock" is one often cited BS, that you will probably come across.

I get a kick out of obese "keto" advocates advising other obese people to "let their bodies choose when to eat" instead of the clock. Isn’t that what they have done their entire lives, so far? Allowing an obese person to decide when to eat usually means eating constantly or never eating. Both practices disrupt proper blood glucose homeostasis. The obese do not have the hormonal balance required to eat “intuitively”.

You can listen to your body about when to eat, if you have adequate and intact satiety signaling because this means you have a healthy metabolism. Then, and only then, can you ignore the clock. In the meantime, I recommend you keep that clock handy and have an appropriate eating and fasting schedule in place that you can consistently follow. 

6. "Keto" is so easy.

Obese people claim that living "keto" is easy, but I constantly see them trying to make up ways of avoiding it through the creation of  mock "keto" foods and slathering real foods with franken sauces.

Consuming real food, though satisfying, can be boring for most people. This can make the diet unsustainable for many, in the long term, especially when they require constant palate stimulation, as is the case for many obese. This is typical of a society where food becomes the only pleasurable pastime. That’s when they start needing "keto" pies, ice cream, sauces, pizza and all kinds of "reinvented processed foods".

You must get use to the natural taste of real food and forget sweetness in order to sustain the diet long term and follow it correctly. That is the only way to adapt your palate to your new diet. There is nothing easy about that. There is only commitment.

Six common beliefs addressed, Part 51

1. Are bananas deadly?

People love to point at something and yell “Witch, burn at the stake!” But, being overly dramatic will only cloud your critical thinking skills.

Bananas are not the devil, nor the cause of obesity/diabetes. They are simply an unnecessary food, which disrupts proper blood glucose regulation. Modern bananas have been cultivated to contain more fructose than they otherwise would and they will only end up replacing much better food options, if you insist on including them in your diet.

So, if you have metabolic disease, put the banana down and if you are healthy make sure bananas are only part of an overall low sugar diet so you can keep blood glucose levels healthy.

2. Dietary cholesterol does not raise serum cholesterol.

You might have heard this before. Low carbers love to quote Ancel Keys, the father of the 'Diet Heart Hypothesis', admitting to this very fact. It makes them think they have discovered a "Gotcha!" moment, where Keys admits he was wrong.

But, there is no "Gotcha!" moment and no admittance of anything. It is absolutely true that dietary cholesterol does not raise serum cholesterol, because it’s dietary fat that raises cholesterol, not dietary cholesterol.

3. Medications have no role in treating metabolic disease.

For some people, lifestyle changes alone are enough to achieve remission, but for others they're not and they must resort to medications. Medications should only be complementary to lifestyle interventions, for individuals that have had no, or too little, results from dietary treatments alone. Medication should never be your sole course of treatment, because they will not be able to improve blood glucose regulation on their own. Do not think medications can do your job for you.

For people who must take medications, dietary and exercise interventions must be included, as part of their therapy, to avoid further deterioration of health.

4. Will fasting help lower my weight set point?

Weight set point is determined by leptin and leptin does not respond to fasting, except in one way - lower insulin levels.

Leptin is a slave to insulin and normalizing insulin levels helps normalize leptin, but fasting without a significant effect on insulin will not help regulate leptin. If anything it makes leptin worse. That’s why you need a fasting protocol that lowers insulin without adversely affecting leptin. That’s only achieved through fasts of short duration. 

5. The world is obese, so there is no more world hunger.

World hunger is on the decline. Some people have made the claim that it no longer even exists and the only hunger left is the one created by governments, since we have the ability to feed the world. But, this is a misnomer. One of those "half truths".

Yes, there are plenty of calories available, to feed the world and then some, but the entire planet is protein starved. Hunter/gatherers consume three times more protein than a Westerner on a typical modern diet. So, everyone has plenty of calories, but poor metabolic health to show for it. When it comes to nutrition, it’s not about quantity, it’s ultimately about quality.

6. If you fast for weight loss, drinking tea or coffee is fine, but if you fast for autophagy, then it should be water and salt only.

Fasting is when you consume nothing but water. Period. As long as you are consuming anything with taste or calories, you are by definition, no longer fasting. There is a more appropriate term for drinking while fasting, it's called liquid dieting. Consuming low liquid calories is not fasting, it’s caloric restriction juicing. Changing the definitions of things to fit a narrative won’t work.

Obesity is a condition of poor blood glucose regulation, so if you are tasting things and consuming calories, while fasting, you are stimulating blood glucose. You will not become adapted to not eating if you continue this annoying and very asinine practice. The path to correcting something is to change it, not coddle it.

Autophagy is a process that the body goes through daily. It has nothing to do with obesity. There are different levels of autophagy that the body performs and they are triggered by different conditions. Whether the body does it effectively or efficiently is based on metabolic status. You will not obtain a good metabolic status if you keep eating/drinking while fasting, which is basically snacking. Keep your focus on obesity and keep the silly marketing ploys for day time TV.

Six common beliefs addressed, Part 19

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

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

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

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

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

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

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

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

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

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

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

No. 

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

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

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

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

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

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

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

6. Is coconut water good for electrolyte imbalances?

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

Six common beliefs addressed, Part 17

1. The sick are the only ones who should eat healthy.

Everyone needs to eat healthy, because you never want to get sick and then try to fix the problem. Prevention is worth a pound of cure. If you want to keep your good health, then you have to begin implementing the lifestyle that will help you acquire it now. We were all healthy once.

2. Can fat turn into glucose? 

If needed, the body can turn fat into glucose through gluconeogenesis. It does not just use protein to do this. Excess fat is stored and is only converted to glucose in a tightly regulated way. This is demand driven, not supply driven. That is always the case for gluconeogenesis.

Triglycerides are derived from the foods we eat and the glycerol in triglycerides can be converted back to glucose. So, even though fat cannot be directly converted into glycogen, it is possible for stored fats to be broken down into glucose, which can then be converted into glycogen.

3. Can weight loss, by fasting, reduce loose skin?

Natural weight loss is what reduces the risk of loose skin. When weight loss occurs very rapidly and unnaturally, it tends to develop large amounts of loose skin. I never had loose skin during my weight loss, because I did it naturally and at the pace that my body wanted it. Little by little, my body "ate" all of it.

There has not been any proof that fasting will prevent the development of loose skin, but there has been studies that have proven fasting has no affect on it. Though there is protein catabolism, from fasting, most of these proteins are broken down from the musculoskeletal system, not the skin. Skin proteins appear to be preserved during fasting, so it doesn't reduce.

We can see this, in real time, with the results of bariatric surgery patients. All of them have been basically put through a forced fast, from their surgery, but they have all had issues with excessive loose skin. This extreme weight loss from rapid metabolic change is the most likely culprit. The body just cannot catch up with this unnatural rate of change.

The amount of loose skin you can have, after weight loss, is also dependent on age, fat cell health and genetics. Some of us just have looser skin than others and there are differences in the amount of subcutaneous fat that we all store. If you want tighter skin, exercise will be your best bet to get it. There are also several supplements available that can help with loose skin.

4. I automatically refuse any medication my doctor prescribes.

You have the right to refuse any treatment, including medication, that a doctor recommends, but it's vital to make an informed decision and not one based on something you read or saw on the internet. Medication should only be rejected after you do your research and have the appropriate discussion with your doctor.

Good topics to discuss are:

• Why is this medication being prescribed?
• How does the medication work?
• What are its side effects and long term effects?
• How long will you be expected to take it?
• What real benefits will you derive from it?
• What real risks will you have from not taking it?

Getting answers to these important questions will help you make a better decision, rather than just automatically rejecting treatments that can be beneficial for you.

5. Do I need to add resistant starch and fat to improve my diabetes?

Metabolic syndrome and diabetes are not caused by resistant starch or dietary fat deficiencies. It is caused by poor blood glucose regulation.

There is no magic pill, out there, that cures diabetes. The only thing that reverses it is obtaining and sustaining proper blood glucose regulation. 

6. Is leptin only responsible for raising metabolic rate?

When you have too much body fat, you make too much leptin and develop leptin resistance. This is the most common form of leptin dysregulation for people who are obese, but you can also have poor leptin signaling at the level of the fat cell itself or the brain, irrespective of leptin levels.

Leptin is not only responsible for satiety and the ability to increase basal metabolism, but it is also a very important regulator of glucagon.

If you are leptin resistant, then glucagon will automatically be over expressed and continuously release too much glucose from the liver, which in turn can raise insulin levels. High insulin levels will dysregulate blood glucose even further and the whole cycle begin again. This can be exacerbated further after eating, as glucagon rises to mitigate postprandial insulin levels. If glucagon did not do this, rising insulin would clear too much blood glucose and cause hypoglycemia. 

The problem is that now, glucagon is "running wild", with no control from leptin or insulin, because the metabolic dysfunction has left the person resistant and with inadequate expression of both hormones. When glucagon is left to do its bidding, with no control, blood glucose rises to very high levels as glucose is being dumped from the liver, in an exaggerated rate, and other substrates (proteins, lactate, glycerol) are also being converted to glucose, in response to the presence of insulin. That's why postprandial blood glucose is always the highest.

You must improve both insulin and leptin sensitivity to improve metabolism. Insulin sensitivity is improved with a carbohydrate restricted diet and an intermittent fasting regimen. This will help control blood glucose better and lower insulin levels to normal.

Leptin sensitivity is improved with the correction of body composition, which is done through exercise, avoidance of "starvation" and the right macronutrient profile of adequate protein, moderate fat and low carbohydrate. This will help leptin expression and the loss of body fat. If you have high body fat, you are particularly sensitive to excess dietary fat, as your leptin will not respond to it by increasing metabolic rate and you will end up storing it. Unlike insulin, leptin responds to food intake over the long term, so it takes time to correct its dysregulation. 

So, be careful how you address your insulin resistance. You do not want to swap one resistance for another. Leptin takes a very long time to regulate, is much more complicated to address and it's dysregulation can become permanent as it can lead to hypothalamic damage.