Six common beliefs addressed, Part 270

1. Do I have to "adapt" to ketones in order to use them?

No. Ketones are a quick energy source and are created to primarily replace glucose so people who are the most glucose dependent will be the easiest to get into ketosis. This is why it is not difficult for diabetics to go into ketosis. It is quite easy for them to produce ketones. It is the people who can use free fatty acids directly that tend to have lower ketosis.

2. Is insulin resistance always the cause of too much glucagon expression or can other things be implicated as well?

Glucagon overproduction is the outcome of low or insufficient leptin which is the direct result of abnormal insulin release/expression (hyperinsulinemia/insulin resistance). Leptin helps regulate glucagon. Abnormal insulin release/expression always results in a starvation adaptation which destroys leptin expression in tissues like the liver as well as the brain.

This is why, on this blog, we describe the timeline of obesity/diabetes as blood glucose dysregulation first, insulin degradation second and finally leptin resistance as the end result.

3. Does glucagon only release glycogen from the liver or does it also convert protein into glucose?

Glucagon releases stored glycogen into glucose which is then released into the blood stream. It also breaks down protein into glucose energy. Leptin resistance always ensures that protein is wasted into glucose due to hyperglucagonemia. So basically glucagon is responsible for glycogenolysis and gluconeogenesis.

Now, I often make the statement on this blog that glucagon will "break down everything you eat into glucose" simply because this is the easiest and most simplified way of describing the process above, to someone who has zero understanding of metabolism and how it works. But, we know that there are a lot of pedantic people out there that get caught up in the minutia of semantics, as though I am giving a dissertation at a medical conference, rather than just simplifying metabolic processes for the layman on a blog.

So for the sake of these people's sanity, and prevent any comments "correcting" me, I will be more precise and mention on this post that glucagon itself does not have the ability to directly convert protein into glucose. It simply regulates the breakdown of glycogen and the synthesis of new glucose molecules, in order to maintain blood glucose levels. Protein is not a direct substrate for glucose production. Amino acids can be used as substrates for gluconeogenesis, but this process is indirect and occurs through the action of other enzymes and metabolic pathways, not directly mediated by glucagon.

But at the end of the day, on this blog, the only thing that matters to YOU is that glucagon will break down everything you eat into glucose, due to insulin resistance. Period. The details do not matter. Glucagon does this irrespective of the nuance. This is not a blog for medical students or biochemists. This is a blog for the average obese person, who is struggling with their symptoms, to try and gain some understanding of what's happening to them so they can have a better chance of correcting it. For this reason, it makes zero difference for them to know the exact, complicated pathways of glycogenolysis and gluconeogenesis. All they need to know is that glucagon is the cause and it is regulated through insulin and leptin, both of which are malfunctioning in them. This gives them something they can target to better address their condition. So it doesn't matter how it happens, it just matters that it happens and it's happening to you.

4. I read on a weight loss group that ghrelin is responsible for over eating and so it causes weight gain. Does lowering ghrelin truly cause weight loss and should that be the target to achieve my goals?

Ghrelin is often referred to as the "hunger hormone" but the research on this has not been straightforward. There has been contradictory findings in studies. Studies show that ghrelin is actually low in the obese and in binge eaters compared to healthy individuals. Yet, ghrelin is released by the stomach to stimulate appetite so it would make sense that its reduction would result in lower appetite. How can one hormone do two different things?

This is actually very common in the many systems of the body. Hormones can have the opposite effects depending on their concentrations and cross talk with other chemicals and systems in the body. This is why I am so leery of blaming any one hormone for any one process as the body uses redundancies for many of its functions. Why make multiple hormones to do many things, when the same one can do all these things depending on the information it receives from the individual's overall neuroendocrine state? You can think of hormones as traffic cops. They can either stop, speed up or redirect traffic flow depending on the road/driving conditions.

So the only thing you need to concentrate on is your blood glucose regulation. None of this other flim-flam will help. It might be fascinating. It might be interesting. But it is not useful. The diet industry always has a new culprit for overweight/obesity every single day and this can be seen on tabloid magazines everywhere. At the end of the day, the only true mitigator of overweight/obesity/diabetes is blood glucose regulation. In that context, ghrelin has been shown to stimulate both cortisol and growth hormone, both of which cause hyperglycemia so at least we know that over production of ghrelin will disrupt blood glucose.

Don't target anything except your blood glucose regulation.

5. How is leptin a "slave to insulin"? You have mentioned this many times before but I am curious to know the mechanism behind it.

If insulin is low, leptin will also be low. Usually, when leptin is high, it means insulin is also high or the fat cells are highly insulin sensitive. For the overweight/obese, the former is the case. 

This is why sometimes insulin levels do not correlate with the level of obesity. Some obese do not display hyperinsulinemia through serum insulin levels but their insulin expression is always high at the fat cells. Some thin people have hyperinsulinemia but their insulin expression is not very high at the fat cells. This is the case with certain ethnicities who develop diabetes at much lower body fat percentages.

So leptin always tracks closely with insulin and it is affected by insulin release/expression. Normalizing insulin is enough to normalize leptin and weight.

6. Does calorie restriction really cause a longer life span?

Sort of.

When calories and protein are chronically restricted, it down regulates the sympathetic nervous system (SNS). This leads to lower blood pressure, heart rate, glucose release and thyroid hormone conversion. Basically everything slows down. These effects have been shown to increase life span in test animals.

We don't know what the implications of this are for humans. When humans are starved, their health is significantly impaired regardless of any increase in life span. This most likely has to do with our large brains which require a significant amount of nutrients and calories. It is easy to starve a mouse and increase its lifespan, without any health consequences, since mice do not live long anyway. Humans on the other hand have a median life expectancy of about 72 years. That's a lot of time for things to go wrong. Increasing that time through starvation only makes more things go wrong.

Six common beliefs addressed, Part 269

1. Why do low carb advocates only concentrate on carbs and protein but not fat intake? They act as if fat is benign to their condition.

Because low carb advice online is all about postprandial blood glucose numbers. Fat is the only macronutrient that does not cause a rise in blood glucose after consuming it so they assume this means fat does not affect their condition. They do not understand obesity or diabetes.

Obesity and diabetes are conditions of poor blood glucose regulation. Disparities in blood glucose are the seed that allow the condition to begin but insulin response is ultimately what allows the condition to take root.

Carbs and protein only affect your short term insulin response but it's your high body fat that puts a high insulin demand on your body in both the short and long term. Dietary fat affects long term insulin because it must be stored, so while you are fasting, your insulin is still being stimulated, both by the fat on your body and the fat you just ate. This is pathological for blood glucose regulation. You cannot control your blood glucose properly in the presence of higher than normal insulin release and expression. It will only drive your fasting blood glucose too low.

For this reason, on this blog, we do not chase postprandial blood glucose numbers alone. We look at overall blood glucose regulation and that can only be obtained by eating a diet that does not affect blood glucose and insulin homeostasis. That diet is low in carbs, moderate in fat and adequate in protein.

2. Do low carb diets work because you can't store fat while being in ketosis and ketosis causes no hunger?

Negative. You absolutely can store fat while being in ketosis. Ketosis makes it less likely but it absolutely can occur, particularly if you are leptin resistant and are consuming too much dietary fat. This is why some ketogenic protocols cause weight gain, rather than weight loss. When people are starving they have complete access to their body fat and are in ketosis, yet they experience extreme hunger.

The advantage of low carb is that it allows the body to lower its weight set point through the stabilization of blood glucose which lowers the insulin demand. This in turn helps the central nervous system allow leptin signaling to communicate fat stores to the brain and maintain healthy body fat levels. Proper leptin expression is what induces satiety through the burning of body fat.

3. If carbs are what causes my blood glucose to rise, then why is it that protein, without any carbs, also causes my blood glucose to rise?

I have touched on this before but I will do it again since there is so much misinformation on what this is from the low carb community. I think it is the most asked question and the one least replied to correctly. To put it simply, this is caused by "hyperglucagonemia".

People who are diabetic have insulin resistance of the pancreatic alpha cells. Their alpha cells have lost sensitivity to blood glucose concentration. For this reason, they lack sufficient first phase insulin release (spike) to properly suppress glucagon. When they eat carbs, their liver constantly releases glucose because they cannot properly regulate glucagon.

This experiment has been done on Type II diabetic animals in laboratories. The result has been consistent across the board - their insulin spike is missing, yet they still have higher than normal insulin levels. You cannot suppress glucagon without a sufficient insulin spike. Now they have both high insulin and high glucagon. Their ratio is less than 1:0. This causes for the liver to not store incoming glucose and to keep producing glucose as it deems you are starving, regardless of the meal you just ate.

Aside from that, diabetics have also impaired incretin function. This means that their gut hormones do not respond properly by releasing insulin and lowering glucagon as needed. People with metabolic syndrome and prediabetes have a similar experience, just not as severe but the mechanism is the same.

Because all of these failing glucoregulatory systems, blood glucose rises postprandial whether you eat carbs or protein. Both require bolus insulin and insulin resistance does not allow for blood glucose to be cleared properly and it also causes for other hormones to release even more glucose in its presence. The only solution to this is improvement in insulin sensitivity through proper blood glucose regulation. You do this by remaining low carb and dividing your daily protein intake into three meals. That way you are not consuming too much protein at once, disrupting insulin to glucagon ratios further.

4. I have never heard my doctor use the term "diabetes reversal" but yet low carb people keep repeating it on all their groups and pages. Are they really reversing diabetes?

No. The reason you have never heard this term anywhere else is because it doesn't exist. It's a scam. They created it so now they get to define it anyway they see fit. For example, for them diabetes reversal is "getting off insulin" or "lowering your blood glucose" or "lowering your HbA1C". None of that means a thing. None of it.

Until you can properly regulate your blood glucose, meaning you do not release glucose when you don't need it and release it when you do, you have not put your diabetes into remission. You also have to be able to maintain a healthy body fat percentage because that is the proof that you are regulating your blood glucose properly. Everything else is nonsense.

5. I have been low carb for a while but it seems like I am slowly but surely losing control over my blood glucose. My postprandial blood glucose keeps rising, ever so slowly but surely. What is going on with me?

Glucagon. Glucagon usually increases over time in insulin resistance. The alpha cells of your pancreas become resistant to the inhibitory effects of insulin and they continue to produce glucagon, when they shouldn't. Basically hyperglucagonemia.

This is very similar to what occurs to Type 1 diabetics who also cannot stop producing glucagon simply because they have no insulin. Their glucagon "goes wild" and so is yours. Glucagon breaks down stored glycogen into glucose which is then released into the blood stream and you can measure it with your meter. Glucagon is only suppose to release glucose from the liver, when your blood glucose is low but with metabolic syndrome/diabetes, glucagon does this all the time, particularly in the presence of insulin and lowering of blood glucose.

Metformin works by suppressing this hepatic glucose output. Why is yours continuing to rise? Because you are still insulin resistant. Your low carb diet has never affected your blood glucose regulation profoundly enough to regain insulin sensitivity. As long as you are insulin resistant, you will continue to experience these issues. You might want to revisit your diet and your overall lifestyle, in order to try and pinpoint exactly what is contributing to your blood glucose dysregulation.

I am inclined to think it's the fat content of your diet since usually when people mention "low carb", it's because they are following the fad low carb diet they find online which encourages the intake of astronomical amounts of fat. Excess dietary fat will continue to stimulate a prolonged insulin release which affects fasting blood glucose. You will never be able to regulate your blood glucose if this continues.

6. Why is my antidepressant causing me to gain weight? Almost everyone who has been prescribed these drugs, refuses to take them because of this side effect. How can a medication cause weight gain? Does it have calories?

Basically drugs that increase serotonin without increasing dopamine will lead to weight gain. Like I have said before, dopamine is a powerful metabolic regulator. It is involved in the seasonal adaptation of energy conservation. Basically, dopamine signals to the body when it is time to store for winter. This is why dopamine levels fluctuate with the seasons and can affect your mood.

The mechanisms of action dopamine has on blood glucose are very complex and go beyond the scope of this blog as I try to keep the information on here as reader friendly as possible and I do not want to get into a lot of technical jargon that will be tuned out or become difficult to understand. This is not a biochemistry blog. Let's just say that dopamine is involved in signalling starvation to the body and this affects fat storage/burning.

For this reason, it is imperative to keep dopamine levels normal and balanced so metabolism is better regulated. Staying away from sweet taste is a good start but you also have to talk to you healthcare professional about any psychotropic drugs you may be taking that could be affecting your serotonin/dopamine ratios as this will eventually degrade your insulin function over time.

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 267

1. Is glucose worse when it has fructose, like sugar does? Would this mean that potatoes are less bad than sugar?

Sugar is particularly obesogenic compared to any other carb because of two things - its sweet taste and it's half fructose. In fact, the fructose is what causes the sweet taste, so it's the fructose that is the main culprit.

• Fructose has a sweet taste and the state of sweet disrupts blood glucose homeostasis through its affects on dopamine/serotonin. Antidepressants like serotonin re-uptake inhibitors (SSRIs) have long been known to affect weight because of this.
• Fructose is a hepatotoxin like alcohol, and creates liver fat. This liver fat exacerbates and perpetuates metabolic conditions.

But glucose all by itself without the fructose, as is the case with potatoes, still impacts blood glucose because it adds extra glucose to a system that likes to keep its blood glucose under strict control. Anything that disrupts blood glucose homeostasis will result in metabolic dysfunction over time.

So you don't want to look for items that are "less bad" because there is no such thing as "less diabetes". You either have it or you don't.

2. My wife recently had a terrible bout of non-stop seizures. She was in intensive care for three weeks. She has always had seizures but they were well controlled until this set back. What I found interesting is that her morning blood glucose would always be in the 60s mg/dL. I have read on your blog that blood sugar this low is not normal. Could this be contributing to her recent health problems?

I am not a doctor so I cannot tell you what could have caused your wife's recent bout of seizures. It could have been a number of things. I have migraine with aura. I can sometimes detect triggers but most times cannot.

What I can tell you is that blood glucose dysregulation plays a very critical role in controlling conditions like migraine, seizures and other neurological issues. This is because the brain suffers first when there is a lack of blood glucose homeostasis. There are certain cells in our body that require glucose to remain alive and functioning. Some of those cells are in the brain. 

Disturbances to blood glucose homeostasis causes an energy crisis in the brain exacerbating neurological conditions. When I was able to better control my blood glucose, my migraines subsided. Insulin plays a vital role in getting glucose into these glucose dependent cells. Insulin resistance interferes with this process. Improving insulin sensitivity through the stabilization of blood glucose should be priority number one if you want to better control neurological conditions.

You are correct that a fasting blood glucose of 66 mg/dL is not normal. It is hypoglycemia and it will be very difficult for your wife to control her seizures if her blood glucose is on a roller coaster. I do not know why her blood glucose is dropping this low. It can be for a number of reasons, including seizure medications.

So I suggest you talk to her doctor about your concern and see if he has any answers for this. Other than that, your wife is going to have to diligently watch her diet and exercise routine. Lifestyle factors are the main contributor to blood glucose abnormalities.

3. I am sick of slim people talking about "junk food", "preservatives" and "additives". Is it true that people are obese because of preservatives in food?

No. I have spoken about this in other posts.

I feel your frustration because I am also sick and tired of this misconception. Obesity is not the result of preservatives, additives, chemicals or anything else found in conventional food. You can become obese off completely natural and organic, whole grain and fermented wheat products.

People start going through a rabbit hole of nonsense when they follow this type of advice but the diet sphere has always been ripe with this type of foolery. There are plenty of thin people eating Doritos and pizza boats daily. Just visit your local university's dorm room. It will be very difficult for you to find an 400 lbs. person on campus. There are many athletes that eat sheer "junk" on the daily and are perfectly slim. There are many people who are extremely picky with their food and only want the healthiest choices available and are still 400 lbs.

Obesity is the result of blood glucose dysregulation. Nothing else. It doesn't matter what food you eat as long as it doesn't interfere with blood glucose. The reason that "junk food" has gotten a bad rap is because it is usually filled with sugar, grains and plant based oils which all further contribute to blood glucose dysregulation.

No one knows for how long any individual can retain their blood glucose control while eating so called "junk". Look at low carb people. They eat clean and are still obese and unable to take control of their blood glucose. So controlling blood glucose and keeping it under control is dependent on a lot more than just food. Many individualized factors are at play here.

4. I want a real hack that I can use and it be effective. I LOVE McDonald's breakfast and I want to be able to eat it daily without it causing me obesity or diabetes. I know that's a lot to ask for but it's not like I'm asking for money and it's not every meal. I just want my breakfast! It's so convenient and delicious!

I know you think I'm going to reply that I can't help you and have no hack. But I actually do. In fact, it is the only real hack that exists.

If you understand that obesity/diabetes is rooted in blood glucose dysregulation, then the only thing you have to do is keep your blood glucose control and you will be free of developing either condition. But how? McDonald's and other fast food is notorious for interfering with blood glucose control and this is why everyone knows these foods are very obesogenic. But they are also very delicious. Is there such a thing as having your cake and eating it too?

Well, there is no magic pill you can take that can help you preserve your blood glucose regulation after eating biscuits and pancakes at McDonald's but there is a magical thing you can DO. All you have to do is walk five miles to the McDonald's, eat your breakfast and as you take the last bite, get up and walk five miles back home. The exercise will prevent your postprandial blood glucose from ever rising in a significant enough way to later cause hypoglycemia from prolonged insulin release. It's not even using insulin to clear the blood glucose!

This shows the actual curative mechanism of exercise rather than just the palliative mechanism of diet. With diet you are always hiding and avoiding but exercise causes an actual mechanical, quantifiable effect. This effect has been exploited by athletes, the world over, and this is how they can have McDonald's endorsements, and actually eat their food, with no adverse effects.

There is your hack, which will actually work. It would work if you are diabetic as well, it just depends on how well controlled it is, how many medications are being taken and what stage it's currently at.

But like all short cuts in life, you can run into problems. Walking a total of ten miles a day, everyday, can become unpredictable. Weather, illness, injury, age, work and other responsibilities can all get in the way of having the stamina and time to put into this endeavor. Remember, you can never fail one time or you will lose control of your blood glucose as you're basically walking on a tight rope to maintain it. You would need a lot of dedication and determination to be consistent with this hack. Even athletes eventually retire and become diabetic.

5. I usually like to go to the Dunkin' Donuts before work. I really like their coffee. While there I also get a breakfast sandwich, because I cannot have the dougnuts. I have to modify the sandwich so it's low carb by telling them to remove the bread and double the egg. The egg now becomes the "bread" so I can hold the sandwich. There is just one issue. They double the price. Low carb followers always talk about the modifications you can do at any restaurant but they leave out how pricey it can get. Prices have gone up anyway and this diet is going to break the bank.

Yes. That's why you want to avoid eating out as much as possible because you are already going to be spending more on food regardless. Might as well get more bang for you buck buying food you can prepare at home.

With low carb you can go to any restaurant and modify the food to fit your diet but prepare to pay more. Restaurants have always used carbs as filler. Carbs are cheap and create the illusion of a large portion. This makes you believe you got your money's worth, when you have to unzip your pants just to stay seated after a plate full of bread, pasta and salad. It is all smoke and mirrors though. When you remove all those carbs, you realize you are eating a plate of air and being robbed.

At the Dunkin' Donuts, tell them to ring each item of the sandwich separately. For example, they can ring up 2 eggs, one sausage patty and one cheese individually, rather than the whole sandwich and it will come out cheaper. Whether they are willing, or aware they can ring up the order that way, is another story.

All you have to do is just shop smarter when you do have to eat out. Stay away from fast food. It is not a bargain and usually ends up costing you more than a real restaurant, because you have to modify the menu and buy triple to make up for what's taken away.

6. Why does eating rice and beans or potatoes cause the feeling of being so full but it wears off so quickly?

Rice, beans, potatoes, pasta, all of this starch, causes a rise in blood glucose which makes insulin follow suit and this tells the body that enough food was eaten so hunger subsides and the feeling of being full increases. The problem is that excess insulin release to clear all of that glucose, continues dropping blood glucose while fasting causing the hunger to return in order to prevent hypoglycemia.

Blood glucose is what the body uses to determine its nutrient availability and whether it needs to be hungry or not. Not calories, not buffets, not portions, not micronutrients but blood glucose's influences on insulin. That is the main and sole determiner of how hungry and how fat you get.