Six common beliefs addressed, Part 268

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Six common beliefs addressed, Part 50

1. I read that high cholesterol is associated with long life.

Yes, but only if the cholesterol's profile is optimal. Meaning a high, healthy non oxidized HDL, low remnant cholesterol and healthy, non oxidized LDL.

Remember total cholesterol numbers are not indicative of lipid health, whether they are high or low.

2. There are no advantages to using saturated animal fats.

Saturated animal fats are much more stable than plant fats and the body uses them more efficiently. Butter keeps you leaner than "avocado oil", if it is not eaten in excess.

Plant fats, especially "oils", have been shown to be implicated in more subcutaneous fat deposition. Though subcutaneous fat is protective, as it is a buffer to visceral fat, when it becomes too large, it's a signal that trouble is on its way.

3. Metabolic slowdown is a myth, because early humans never had to deal with it.

Early humans also had a starvation response and so do hunter/gatherers of today. Metabolic thrift is an evolutionary adaptation that occurs to all humans and it's been responsible for our survival. But, only in modernity does it have pathological consequences. The difference is time dependent. 

Short term metabolic slowdown from temporary disruptions to blood glucose homeostasis, is not pathological. For example, a famine or food shortage. Long term metabolic slowdown from permanent disruption to blood glucose homeostasis, is pathological. For example, Debbie Cakes and caffeine. 

So, the starvation response only becomes a problem when it occurs without the starvation. In true starvation, there are only two outcomes - death or the starvation stops. In pseudo starvation there are only two outcomes - get fatter and become diabetic. It appears metabolism is highly resilient to temporary disruptions in blood glucose but highly adaptive when this disruption becomes chronic. 

4. Everyone has initial success on low carbohydrate diets, but they end up back where they started a few years later.

We see this occur all of the time. If not to ourselves, to others. Someone will try every treatment available and improve a few things, but continue to have metabolic abnormalities and obesity. Others have fantastic initial success, but slowly over time, begin to develop the signs of metabolic abnormalities and increasing weight, even while continuing their initial protocol. This is extremely disheartening and frustrating for many people. To add insult to injury, many are accused of cheating, when they haven't been.

We know that dietary interventions are similar to medications, in that blood glucose control begins to wane with time. The best results are achieved in the first year and then begin to degrade afterwards. This has been seen again and again with all dietary interventions used to treat diabetes. This is why the American Diabetes Association (ADA) does not stand behind any one diet as treatment, because they all fail long term. This is something that has been seen in multiple studies that track the effects of diets on disease and weight loss in the long term.

The reason for these failures are not well understood. Usually when failure is discussed, it's in the context of non-adherence. Though we know that diets are usually not sustainable, this problem also affects those that do adhere to them. A nail in the coffin to the whole "you are not adhering" sleight of hand is medications. Medications also fail with time, but can be increased or changed, as the disease progresses, to try and keep blood glucose controlled for longer. This somewhat delays the fail, but there will be failure nonetheless. So, the cause of the fail doesn't seem to lie in the treatments, but with the body itself.

It's almost as if the body appears to adapt to any intervention it’s presented with and goes back to its pathological state eventually. This has caused some people to come up with crazy strategies like the "You must keep your body guessing" BS. 

Why does this occur? It appears that the metabolic adaption to keep blood glucose, insulin and weight set points to high cannot be reversed in the long term. This appears to be the result of an inability to sustain proper blood glucose regulation over time. There are several causes for this and they feed off each other so its a vicious circle, so to speak. Metabolism is on a "death spiral". 

• Being less obese - Continuing to have a high body fat percentage puts you at risk for metabolic disease. For some people, this body fat catches up to them regardless of their initial success in losing "some weight". This is especially true when remission dependence is relied solely on diet with no exercise. Many diabetics prefer dietary interventions, rather than exercise regimens and that simply won’t cut it. Body fat must be eliminated and replaced with muscle. High body fat continues placing a high insulin demand, on the body, furthering the disruption of blood glucose.
• Ongoing insulin resistance - Some people are unable to acquire insulin sensitivity of certain organs and tissues, because of high body fat, which continues putting a high insulin demand, on the body, furthering the disruption of blood glucose, which in turn causes more body fat. Acquiring "some insulin sensitivity", through lower blood glucose, is not enough. Ongoing insulin resistance only further exacerbates catabolic counter regulation, causing the body to make more glucose. It appears that age and length of illness determines this effect. Obesity and insulin resistance are time dependent diseases. A time will come when it will be harder and harder to achieve remission.
• Hypothalamic damage - A metabolism that doesn’t respond to treatment is one that will continue in its maladaptive state. Abnormal leptin expression, due to blood glucose and insulin abnormalities leads to hypothalamic damage, which causes the body to no longer regulate its fat mass, thyroid function and metabolic rate. This not only progresses the disease, it further increases body fat percentage. You can’t lose body fat if the brain does not see it.

This means that remission is very difficult as it is depends on multiple systems that depend on each other. This is the reality that many in the "low carb" world never mention and hide every chance they get. They stubbornly believe their diet is magic pixie dust for diabetes. That is simply not true. Unless that magic pixie dust dissolves body fat, it is worthless. So, now we see that both treatments, diet and/or medications, fail because neither can sustain long term blood glucose regulation.

5. Does extended fasting result in eating less?

This statement is based on two common misconceptions:

Misconception #1 - Fasting works because of caloric restriction.

Fasting works because of its affects on blood glucose which in turn affects insulin. This affects weight (water and lean muscle) temporarily. This is true of all diets, including caloric restriction. So, nothing really "worked" as your fat mass is never touched. 

Misconception #2 - Fasting is a segue to caloric restriction.

This is false, as the person always over compensates when they eat again, making their calories at best even, or at worst, greater than if they would have eaten the entire time.

This is an effect of extended fasting and it's part of metabolic thrift. The body responds to extended fasting, as if it's caloric restriction on steroids. This is because it was not made to fast for very long periods of time and when it was forced to, it had to get fatter to survive.

As you can see, extended fasting did nothing but interfere with your blood glucose regulation over time. Over compensating or binging after a fast, always disrupts blood glucose homeostasis further so whatever your initial benefits were with "weight loss" will be hindered in the future with "fat gain". 

6. Do ketogenic diets require a fasting protocol?

Ketogenic diets are "fast mimicking" diets, because they fool the body into thinking it’s fasting, when it’s not. They do this through the release of ketone bodies and lowering of insulin. Both of these effects are interpreted by the body as “starvation”. For this reason, there is no need to incorporate a fasting regimen to a ketogenic diet, especially if you are obese, since the obese have an exaggerated starvation response. You can eat three meals a day with no snacks, in between, and fast for 12 hours, instead.

If including a fasting regimen is achieving results in weight loss and improved metabolic markers, then that’s great, but fasting is not required for these diets. For some, fasting alongside these diets, results in adverse health effects. So, if the ketogenic diet is not giving you results, instead of blaming the diet, watch your fasting.

Six common beliefs addressed, Part 31

1. "Keto" is only practiced correctly, if you eat foods that are "keto".

This blog does not follow "fad keto", which is being promoted by obese "keto" proponents and low carb zealots. This blog only supports true ketogenic diets and they can range anywhere from moderate carbohydrate restriction to 0 carbohydrate.

Ketosis simply means you are burning fatty acids and that can be done through varying degrees of carbohydrate restriction. There is no one size fits all to ketosis. The carbohydrate amount, which a person can still sustain ketosis in, is very individualized and based on their own personal degree of carbohydrate tolerance. Many foods can still keep you in ketosis, even with a higher carbohydrate amount, if the overall diet is ketogenic.

I have written an article detailing ketogenic diets, which can be found here.

2. I can lower my blood glucose while fasting, so this means fasting is "curing" me.

"Artificial" blood glucose control simply means that blood glucose lowers and becomes normal, only during the period these protocols are actively being practiced. One popular artificial intervention is extended fasting, but other ones include medications, exogenous insulin and caloric restriction.

None of these common artificial control methods will result in long term, proper blood glucose regulation or "cure". They are all just means to achieve a temporary end result. If you stop your artificial control protocol, your blood glucose will begin to creep upwards. Inability to have normal blood glucose, without taking a pill or injecting insulin, is not normal, as diabetes is not caused by medication deficiency. Inability to eat 2 - 3 meals a day, everyday, without hyperglycemia is not normal. Blood glucose regulation that is dependent on any of these interventions is not indicative of "cure".

Because there are so many artificial ways of lowering blood glucose, there are many people who are, once again, losing their blood glucose control over time. Medications and exogenous insulin will eventually need to be increased, as the body's resistance continues to rise. The body develops resistance to fasting, as metabolism adapts to starvation, and the person has to continue fasting, longer and longer, until they can no longer fast long enough. Caloric restriction cannot be sustained forever and the person eventually has to eat normally again. Once these protocols have to be increased, beyond sustainability, and they eventually all have to be, they stop working and blood glucose begins to rise again, as the disease is unmasked. This is because all of these protocols are only meant to lower serum blood glucose (palliative).

For this reason, you have to implement a lifestyle intervention to tackle metabolic dysfunction, at its root, instead of chasing symptoms. Lowering of serum blood glucose, alone, does not mean you are cured, because low blood glucose in the context of active metabolic disease, is useless and actually worsening the problem. So, any program or protocol that claims they have "cured" you, simply because your blood glucose is lower, while following it, is a liar. At least your conventional medicine doctor is upfront and honest when he makes you aware that the medications he is prescribing only mitigates symptoms and are not "curing" diabetes, since diabetes is a chronic and progressive disease of which they do not have a cure for, but the quacks online are hoodwinking you.

Metabolic syndrome/diabetes is only in remission when you can naturally sustain proper blood glucose regulation, without the need of any extreme protocol. Not only do you have to lower serum blood glucose, but you also have to stop the body from making blood glucose when it doesn't need it, make its own glucose when it does and obtain insulin's normal pulsatile function.

3. My "fasting muscle" is getting stronger, the longer I fast.

Yes, and it's helping you get fatter.

Every time you do long fasts, it becomes easier and easier to do them, because your "fasting muscle", also known as your fat cells, are getting better and better at withholding energy and telling your brain to stop burning it. They are also demanding more storage, when you eat again, so they can become bigger and stronger, preparing them for the next long fast.

In fact, your entire hormonal profile switches to "starvation mode", so that your body becomes primed to hold onto and store fat more efficiently. So, when your "fasting muscle" gets stronger, you are actually getting fatter. Extended fasting is like a gym membership for your fat cells. Remember, the fatter you are, the more you can fast. It's nature's way of adapting our metabolisms to help keep us alive during famine.

4. I am so insulin resistant than I can't even eat leafy greens.

The carbohydrates in leafy greens is mostly cellulose (fiber). Cellulose is not sweet (fructose) and it functions differently from starch (glucose), though it also contains glucose. Though we have enzymes to break down starch into glucose, the glucose in cellulose cannot be broken down and so it is not accessible to the body.

There are a lot of obese people, out there, that claim they cannot even consume cellulose, because "they are so insulin resistant". But, what's really triggering their out of control blood glucose, after eating, is the presence of food itself. Any food consumption is causing a glucose dump from their own liver, due to insulin resistance. It is insulin resistance that's driving up their blood glucose, not cellulose, as the body cannot break it down.

5. I only have high blood glucose after meals, so I am "cured" of diabetes, since my blood glucose is normal afterwards.

This type of high blood glucose is the direct result of hyperglucagonemia. It simply means the body is producing glucose, when it shouldn't be.

Glucagon is a counter regulatory hormone to insulin. Both of these hormones mitigate each other, through a complex feedback loop system of which leptin is also involved. But, when there is insulin resistance of the glucagon producing alpha cells, of the pancreas, glucagon is not well regulated and is overexpressed, leading to the liver dumping out glucose, even when it's not needed.

While a large percentage of all high postprandial blood glucose is coming directly from the liver, it can be more noticeable when following a carbohydrate restricted diet. This may be a surprise to many, as most have been misinformed and led to believe that if they aren't consuming carbohydrate, in any form, their blood glucose should automatically remain low. That is not true. High postprandial blood glucose is caused by insulin resistance, not carbohydrates, though carbohydrate restriction can help to not further exacerbate this effect and avoid prolonged insulin release.

Though hyperglucagonemia occurs with carbohydrate intake, it tends to be more controlled, since the glucose in the carbohydrate, stimulates a greater and longer release of insulin. This helps mitigate the body's out of control catabolism, because it takes a much higher insulin level to stop catabolism than to facilitate glucose entry into cells, as that is mostly done by various glucose transporters, not insulin. When you are carbohydrate restricted, you do not produce a greater and longer release of insulin. Rather, your insulin levels begin to normalize. Fat does not stimulate postprandial insulin levels by much. Protein, on the other hand, does stimulate insulin, but not enough to stop exaggerated catabolism. It is this out of control catabolism that is the culprit for high postprandial blood glucose, even in the absence of all glucose in the diet.

Like I have stated before, insulin is anabolic, but it can be more accurately described as anti-catabolic. It prevents the body from breaking itself down, and everything you eat, into glucose and ketones. But, this is dependent on sufficient insulin spikes, which people with metabolic syndrome/diabetes do not have. Their insulin is chronically high and they lack its normal pulsatile function. This chronically high insulin causes poor insulin sensitivity of the glucagon producing alpha cells. These cells are usually the first to succumb, to the resistance, as they work specifically with insulin spikes and are in very close proximity to insulin producing beta cells.

This is why insulin spikes are normal and necessary. It's asinine to avoid foods that spike insulin using an "insulinogenic foods" chart. If you have metabolic syndrome/diabetes, trust me, your insulin is not spiking, so don't waste your time. All healthy people have insulin spikes, after eating, and low insulin levels while fasting. Unfortunately, people with metabolic syndrome/diabetes do not have either.

If you are still experiencing high blood glucose, after eating, your protocol is not addressing your blood glucose regulation properly.

6. Carbohydrate restriction only hides metabolic dysfunction, but does not "cure" it.

Carbohydrate restriction, when used alone, is only a palliative therapy for metabolic dysfunction, but not a cure. There is no known cure for obesity, diabetes or metabolic syndrome. 

Metabolic dysfunction is very complex, as it's a condition affecting multiple systems of the body including fat mass, leptin, adiponectin, glucagon, adrenal counter regulation, ceramide flux, energy flux, triglyceride synthesis, mitochondria, etc. It also affects the anabolic and catabolic processes of the body. You can't just make it disappear with the "magic pill" of going low carb.

Having said that, carbohydrate restriction is one of the most profound treatments that a person with metabolic dysfunction can implement, as it allows them to take initial control of their metabolism and begin lifestyle strategies to obtain remission. Carbohydrates interfere with proper blood glucose regulation, which in turn affects insulin in a pathological way, irrespective of gram amounts and calories. No other macronutrient behaves this way. Not fat. Not protein. Only carbohydrate. Even low to moderate consumption of carbohydrate can produce metabolic abnormalities.

That is why the removal of carbohydrate has such an immediate effect on metabolism, of which is unmatched by the removal of fat or protein, restriction of calories or any other dietary intervention that has been tried. Carbohydrates cause the initial metabolic abnormality, which is the erratic ups and downs in blood glucose, so it's the first thing that has to be eliminated.

Carbohydrate restriction is also a great way to prevent metabolic dysfunction from ever occurring in the first place, especially in an environment of consistent and predictable food availability. First World environments of abundant food access are the best fit for carbohydrate restriction. It allows you to eliminate excess energy by restricting the macronutrient of least importance, while still being able to eat everyday. This automatically rids the diet of nutrient/protein poor, convenient, processed junk food, which only exacerbates obesity.

Six common beliefs addressed, Part 24

1. Is Alzheimer's really caused by insulin resistance?

Alzheimer's is a very complex disease. It is comprised of many different pathologies, each of which contributes to its onset and progression. The exact cause of Alzheimer's is not known, though it seems to have some heritability. Because of this, Alzheimer's falls under the umbrella diagnosis of "dementia". Dementia is a syndrome, not a disease. There are many abnormalities in Alzheimer's and it is very difficult to discern which one came first. For the sake of simplicity, let's describe Alzheimer's as a progressive disorder that causes brain cells to degenerate and eventually die. 

One of the things that degenerating and dying cells do not do is use energy effectively. After all, they are dying. Healthy cells do not have this problem. Insulin nasal sprays have been shown to improve Alzheimer's/dementia symptoms but not stop the progression of the disease. Insulin facilitates glucose entry into cells so it improves the cells ability to metabolize glucose temporarily. This of course, can improve cell function, but the cell is still dying. This is what led for some people in the low carb community to make the claim that Alzheimer's is "insulin resistance of the brain". This is not true. The dying cells are simply exploiting the extra insulin and improve temporarily.   

2. Does cancer really feed off sugar? 

Cancer cells use glucose and glutamine for fuel. Both are created by your own body. The body creates all the glucose it needs so it does not have to be dosed exogenously. 

Glutamine is the most abundant free amino acid in the body. The body produces all the glutamine it needs, in the muscles, so it's not dependent on diet. As long as cancer has glutamine, it can continue "living" just fine. Depending on the type of cancer and what stage it’s in, it can also use fat for fuel.

As you can see, cancer is very complex. For this reason, I always advise to receive your cancer treatment from a cancer specialist, not from someone online, especially if they are promoting diet as the sole cause and curator of cancer.

3. As long as I am insulin sensitive, I won't get fat.

The obese are insulin sensitive, at the fat mass. The way you do not get fat is by maintaining proper blood glucose regulation, so that you never develop insulin resistance. 

4. The body cannot go into "starvation mode". It's not real.

Chronic caloric restriction and chronic extended fasting cause metabolic adaptations, that are harmful in the long term, through the development of adaptive energy conservation (starvation mode). When the body is put through these conditions adiponectin, an adipokine released by your fat cells, induces an anti-inflammatory effect that causes for fat cells to become more insulin sensitive. This appears to be a great thing, but it is actually going to make you fatter once nutrient/energy conditions change.

Inflammation reduces insulin sensitivity, in the cell, so that it stops up taking energy. Healthy individuals, with no metabolic disease, maintain a healthy level of inflammation at the adipocytes. It's a form of localized insulin resistance, that is beneficial and regulates weight. Leptin uses inflammation in order to signal the cells to stop up taking energy, so this energy can be burned instead.

If this anti inflammatory effect persists, in the long term, through the chronic stimulation of adiponectin, you are priming and honing your fat cells to store even more fat, once you begin eating normally. This is because the body is adapting and preparing itself to face "starvation", once it occurs again. This is why people who yo-yo diet tend to put weight back on, and then some, once they go off their diet. The dieting has actually helped make them fatter.

Don't be fooled, everyone will go off their diet. This is because you can't calorically restrict forever and you can't fast forever. You will have to eat normally again and when you do, the body will store even more fat than before.

This is why I don't promote "dieting" on this blog, nor extended fasting. I only advise a proper carbohydrate restricted diet, that can be followed for life, and a fasting protocol that is sustainable. This prevents the yo-yo affect that has dire, long term consequences.

5. How can fat weigh less than muscle?

We often say this to make things simpler for the person who is concerned about their scale weight, but there is always someone, out there, that will nitpick and try to put you to task, for this statement. So, the more technical way to describe it, is as follows:

A pound of fat weighs the same as a pound of muscle, but because of their different densities, an inch of fat weighs less than an inch of muscle. This is why a fatter person might weight less than a leaner person. Even if two people have the same scale weight, one can still be fatter than the other. The one with more body fat, is unhealthier.

6. I use to eat fat ad libitum and never had to worry about it. Now I have stalled in weight loss.

When you improve blood glucose regulation, you will lose weight, even with a higher dietary fat intake, since you just eliminated carbohydrates from the diet, which no longer disrupts blood glucose or has to compete with fatty acid oxidation.

When glucose is present, fat burning slows down. Remove the glucose, fat burning ramps up and the body is able to burn both dietary and stored body fat. But, soon, as your weight decreases, you will stop burning body fat and the body burns dietary fat instead, causing a weight stall. If the dietary fat is excessive, you will not burn enough of it either and you will begin storing it. Now the weight stall becomes weight gain.

So, as weight begins to stabilize and insulin function continues improving, the macronutrient ratios you started with, must be changed, if you still have more weight to lose. You need to lower your fat intake and up your protein intake. This further lowers basal insulin and forces the body to acquire its fat fuel from your own body.

If you want to maintain your weight loss and stop losing, then and only then, can you up your dietary fat intake.