UH-OH. CAKE AND ICE CREAM...

This little cutie is my grandson, and he turned three on Wednesday!  And, of course, there was cake and ice cream.  I decided that because I have been so low carb and doing well (blood ketones and blood glucose at great levels), that I would go ahead and have a very small sliver of the cake and a few bites of vanilla ice cream.

I tested my blood glucose an hour and a half later, and it was 117.  Two and a half hours later, it had risen to 141.  By three and a half hours, it was started to drop again - down to 106.

My normal reading are no higher than 91 after eating.  I guess I've learned my lesson.  To keep my blood sugar in normal ranges, I'm just going to have to forgo the wheat and sugar, as disappointing as that is.

Jumping ahead of my story a little bit, it took me three days for my blood glucose to get back into the normal range.  So, eating just a small sliver of cake and a half of a scoop of ice cream raised my blood sugar for three days.

The morning after the birthday party, I tested my blood ketones.  My normal has been an average of 2.4, but that morning it had gone down to 1.7.  The next day, Friday, it was still only 1.8, and this morning it was only 2.0.  Those are still within the target area, but they obviously went down and I want them to go back up to where they were before.  So, for blood ketones, after three days, they are still depressed due to what I ate.

From left to right - my grandson, Will, the Birthday Boy, my father, me, my son, Barry and my granddaughter Annelise.  Four generations!

GOVERNMENT SHOULD STOP PROMOTING UNHEALTHY DIETS - THE EXAMINER

From a recent article in The Examiner:

Federal nutrition programs such as the school lunch and WIC programs adhere to these guidelines. The grain-focused, low-fat nutrition policy has not helped Americans live healthier lives. An estimated 42 percent of the U.S. adult population is projected to be obese by 2030.  (emphasis mine)

 

The Worst Advice.  Ever.

It is wrong for federal guidelines to promote behaviors that might increase our risk of obesity and heart disease. Instead of grains, USDA policy should recommend that we eat mostly vegetables, protein and healthy fats to reduce the prevalence of obesity and its associated health problems, such as Type II diabetes and heart disease. (emphasis mine)  Research shows that a lower carb diet, like the Paleo diet, can result in weight loss, lower cholesterol and triglycerides, improved metabolic syndrome risk factors, and reduced risk of developing heart disease. While critics of low-carb diets suggest that replacing grains with fat and protein will damage our hearts, there is evidence that this is untrue. A long-term longitudinal study, published six years ago in the New England Journal of Medicine, showed that lower carb diets with increased amounts of protein and fat did not increase coronary disease risk.

Read the full article here.

FEED YOUR BABY 7-UP!

I just found these great (great?) ads from the days of old, when we were told that sugar was health food.  You can find more ads like this here.

The small print on this one says: "Babies who start drinking soda have a higher chance of 'fitting in' during those awkward pre-teen years. Start them on a strict regimen of cola and other sugary carbonated beverages right now, for a lifetime of guaranteed happiness!"

A TALE OF TWO MEALS - BACON OR BAGEL FOR BREAKFAST? - MASSIVE HEALTH

I just found this on Massive Health.  So much good info in so little space!

THE MEATRIX - DO YOU WANT TO KNOW WHAT IT IS?

LIFT WEIGHTS, LADIES, AND DITCH THE CARDIO IF YOU WANT TO LOSE FAT

Here is a great article from Body By Science:

It has always seemed to be an automatic assumption that since women do not possess as much muscle mass (or muscle mass potential) as men that somehow resistance training is less important and less well suited for them. As it turns out, proper resistance training is even more important for women because they possess less muscle mass.

There are a couple of new research articles out that I hope will illustrate this point. I will discuss the underlying physiology of my theory on this after we look at these articles. The first article is entitled Effect of Exercise Training Intensity on Abdominal Visceral Fat and Body Composition. The authors are Irving BA, et al. It is published in Med Sci Sports Exerc. 2008 Oct 8.

This article looked at twenty-seven middle-aged (51+/- 9 yrs) obese women with the metabolic syndrome comparing either no intervention, low intensity exercise below the lactate threshold, or high intensity exercise above the lactate threshold. Remember from our discussion in BBS, high intensity exercise is characterized by producing pyruvate from anaerobic metabolism more quickly than the mitochondria can use it. Pyruvate stacks up, and then gets acted on by lactate dehydrogenase producing lactic acid. When this occurs, you are above the lactate threshold.

The really cool thing this article did is that it adjusted the workout times so that the caloric expenditure was identical in both exercise groups. Exercise time was adjusted so that 400kcal was expended per session. This clearly would show that any changes could not be attributed to burning more calories in a particular session. Actually, the calories burned would actually favor the low intensity group since they performed more 400kcal sessions per week.

The subjects’ body composition was evaluated using single slice CT scan at the L4-L5 disc space and mid-thigh to determine abdominal fat and thigh muscle cross-sectional areas. Percent body fat was assessed by air displacement plethysmography (a Bod Pod).

The results were very clear. The high intensity group significantly reduced total abdominal fat, abdominal subcutaneous fat, and abdominal visceral fat. There were no changes observed in the non-exercise group or the low intensity group. The part not mentioned in the study is the most important part. THIS IS VERY IMPORTANT: THE RESULTS ARE CORRELATED WITH INTENSITY NOT CALORIES BURNED. Each exercise session was controlled to expend the same number of calories, AND based on total calories burned, the low intensity group had the advantage since they worked out more days per week. Despite this advantage, the low intensity group did not lose fat. This is a key concept: when it comes to losing body fat you cannot achieve it by “burning calories” in an attempt to influence the calories in/calories out equation. Fat will be mobilized when you use an exercise modality that mobilizes glycogen out of the muscle, creating a need for replenishment via the insulin receptors. As insulin sensitivity improves, serum insulin levels drop and body fat can be mobilized. As this scenario is repeated, triglycerides can be tapped from fat cells to supply energy for high intensity exertion, compounding the fat loss effect.

A similar study was conducted in 2004: The effects of exercise training on abdominal visceral fat, body composition, and indicators of the metabolic syndrome in postmenopausal women with and without estrogen replacement therapy: the HERITAGE family study. Green, JS et. al. Metabolism. 2004 Sep;53(9):1192-6. This study used the same methods for evaluating body composition as the study above. However, the variable studied here is the presence or absence of hormone replacement. There were no significant changes in body composition in either group. The problem with this study is that a low intensity exercise routine was used. Since hormone replacement was the variable studied, it may have been incorrect to conclude it had no value, because it was evaluated in the context of low intensity exercise. If the exercise protocol had been of high enough intensity to actually stimulate results, then perhaps the magnitude of the results would have actually been different with hormone replacement. This illustrates how a study can go awry when it evaluates a given independent variable while using the wrong dependent variables as a backdrop.

Let me take the opportunity to anticipate and address a potential objection to the use of these studies. One objection might be that the high intensity exercise was not done with weights. This is true. But from a metabolic standpoint what is important is that the intensity was high enough to exceed the lactate threshold. Exceeding this threshold is the variable being studied, how that variable is achieved is not important — except that this variable can be achieved much more efficiently and aggressively done the Body By Science way. You must remember that when we use a study to support the premise of BBS, it does not have to be a study that uses exactly the protocol we advocate. We are using studies that look at independent variables that are part of the Body By Science approach. The variable in this case is the concept of high intensity training done above the lactate threshold. Also, Body By Science is not just based on the scientific literature; it is based on an understanding of basic science that has been well ahead of the research curve for over two decades. Stated differently, John and I (and others like us) have relied on an understanding of basic science to construct our exercise philosophy and have shouted our theories from the mountaintops and argued with keepers of the status quo over the decades. Indeed, we have made enough noise throughout the years that our theories are now actually being tested, and there is now data accumulating to support our approach.

These are the studies that you will find referenced in Body By Science.

Let me now discuss the basic science that explains why high intensity exercise is even more important for women than for men when it comes to changes in body composition. The metabolic syndrome and the body composition changes that result from it are due to derangements in carbohydrate metabolism. We evolved from an environment of food scarcity where carbohydrate was the least abundant macronutrient, and where high intensity exertion was required to acquire the food we needed. In our modern environment, carbohydrate is very abundant and high intensity exertion is very rare. Most of the carbohydrates consumed are refined and are quickly/easily absorbed. Our evolutionary background has produced a mechanism for signaling energy storage that is predicated on an abundance of what would be the least abundant macronutrient in our ancestral environment. That macronutrient is carbohydrate. What happens in the metabolic syndrome is something that would have been very foreign to our ancestors. We are exposed to very high levels of carbohydrate. This is rapidly absorbed into the bloodstream causing blood sugar to rise, which triggers the pancreas to release insulin so that glucose can be moved into the cells of the body. This normalizes the blood glucose level, and stores the glucose as glycogen for future use. However, your body has limited glycogen storage capabilities. An adult male can store about 70 grams in his liver, and 220 grams in his skeletal muscle. If more glucose than this is present, insulin will then drive synthesis of triacylglycerol, which will, in turn, result in the glycogen being stored as body fat.

The average American consumes way more than 290 grams of carbohydrate in a 24-hour period, even when they are “cutting back” or “watching what they eat.” As this situation compiles on a day-by-day basis, the body adapts by decreasing insulin sensitivity on the muscle cells. This protects the metabolic machinery of the muscle from being jammed with “glycosylation products” by basically binding sugars to proteins within the cell. As a result, insulin sensitivity on the fat cells remains relatively preserved so that excess carbohydrate can be more efficiently shunted towards fat storage.

At this point your body has now become a fat-producing factory. You are now in the throws of the Metabolic Syndrome. Now your fat cells are a tissue colony with a competitive advantage. Any nutrition you intake now gets shunted directly to the fat cells. You now suffer from “internal starvation.” You may take in 4,000 Calories per day, but none of it supplies your lean tissue. Your muscle mass, total protein and albumin all drop despite a gluttonous intake of food stimulated by your chronically elevated insulin levels. Why a gluttonous intake? Because LOW insulin levels are needed to tap energy out of fat cells, and with insulin levels being so high, immediate energy needs have to be obtained by the intake of more food (acquired by stimulating hunger)…which then gets shunted to the fat cells. AARRGGHHH!! You are now in the vicious cycle of the metabolic syndrome – but it gets worse: Many of the circulating hormones your body relies now will have glucose attached to them and your body recognizes them as foreign and begins attacking them (this is my theory) and the glands that produce them (thyroid hormone being a prime example).

An article from the Journal of Nutrition and Health A discussion of the relationship between selenium, thyroxine and indigestion. Nutr Health, 1998;12:131-4., suggests that agricultural wheat products have a low selenium content which depresses the activity of the diodinase enzyme crucial to the production of thyroid hormone. Whatever the mechanism, hypothyroidism commonly occurs in tandem with the metabolic syndrome. Now the cycle is truly in lock-down mode. When Oprah asks on the cover of her January 2009 issue of “O” magazine, “How did I let this Happen Again?” I think she might find the answer in the above paragraph.



This situation is more likely to occur in women simply because they DO have less muscle mass than their male counterparts. As a result, their glycogen stores become full more easily and more quickly and the process described above occurs more easily and more aggressively. This is why high intensity exercise is even more important for women. Only high intensity exercise activates the adrenaline-stimulated amplification cascade that mobilizes huge amounts of glycogen out of the muscle. This is a survival mechanism that provides emergency energy for on-site use in our muscles. When you work out HARD (as detailed in Body By Science) you activate this process and empty your muscles of excess glucose. This creates a scenario where glucose needs to be replaced within the muscle. This is done by the action of insulin. Insulin receptors on the muscle surface then become restored, serum glucose can then drop and Insulin levels drop. When insulin levels drop, hormone sensitive lipase can then become active and mobilize fat stores for immediate energy needs. You no longer have to rely on a ravenous appetite to meet immediate energy needs. Before, elevated insulin levels would cause you to misinterpret ANY discomfort as hunger. Now, only energy needs that cannot be met by fat mobilization through hormone sensitive lipase actually stimulate hunger AND it is a subtle signal that it is time to eat (rather than a sense of ravenous panic).

Having detailed the role of high intensity exercise in reversing the metabolic syndrome, I must devote some attention to the dietary aspect of the problem. No exercise program (even high intensity strength training) can compensate for a bad diet that is too high in refined carbohydrate. High intensity exercise certainly gives you more latitude in your diet, but it cannot do it by itself. The diet we advocate is basically a hunter-gatherer diet, which focuses on healthy meats, fats, and carbohydrate derived from fibrous vegetables and low-sugar fruits. What is absent are agricultural-based refined carbohydrates.

Anything derived from the seed-head of plants must be ground into flour which is high in rapidly absorbable carbohydrate. Also, seeds of plants contain phytotoxins which help to protect the plant’s reproductive elements from being eaten. These toxins keep animals from reproducing and thriving by disrupting their hormone function. High intake of refined carbohydrate will create the cascade described above. By eating a natural, hunter-gatherer type diet and combining high intensity exercise you can begin reversing the metabolic syndrome.

The important fact to remember is that all of these derangements and their correction occur more quickly in females BECAUSE they have less muscle mass. When eating a modern diet and not exercising, the glycogen stores fill more quickly because less muscle means less storage capacity. When eating properly and performing high intensity exercise, the situation is turned around efficiently because a given amount of glucose mobilization represents a larger percentage of total glycogen stores. Once the situation is reversed, the larger muscle mass represents a larger storage reservoir and more glycogen storage capability. Thus in the future there is more latitude for slip ups before the metabolic syndrome gets a foothold.

When diet and exercise are properly understood, body composition auto-regulates in the ideal range. You are no longer ravenously hungry, to the point that you will often forget to eat. Gone will be the days of weighing food, counting calories, and plodding along on the treadmill for hours. When you eat a proper diet, and partake of high intensity exercise, you set into motion a vicious positive cycle that makes the body you desire easy to achieve.

Compare this to the advice Oprah’s fitness expert gives on page 152 of the magazine shown above when asked to address her relapse:

“Instead of thinking, I’ve failed over and over again, why bother trying again?, take your relapse in stride and stay positive no matter how many attempts it takes you. Each new effort brings you closer to the one that might really work. The key is to stick with it until you achieve your weight and health goals — that’s my definition of a true success story.”

Apparently Mr. Green has not heard the old yarn that the definition of insanity is doing the same thing that has failed you over and over again, and expecting different results this go ‘round. 

So to any woman out there who is fed up with trying the same thing over and over, I offer this suggestion, instead of getting back on the treadmill “one more time,” try this: Alter your diet so that you eat no grain-based carbohydrate: no flour, no sugar, no bread, no pasta, and no high fructose corn syrup. Then go to the gym and perform a workout of leg press, pulldown, chest press, row and overhead press. Lift slowly and smoothly but with as much effort as possible. Go to complete fatigue, or as close to it as you can tolerate. Work out once, or at most, twice a week. Make sure your workouts last no longer than 20 minutes. Then sit back and watch what happens.

– Doug McGuff, MD

BACON IS NOT HEALTH FOOD? SAY IT ISN'T SO!

One of the downsides of being a reasonably intelligent person is that when someone says something that makes sense, it is hard to pretend that you have not heard it.

With all my ups and downs with eating low carb, there have been many times that I wish I could just eat some other way, and maybe do better, but the fact is that I know too much about the "unhealth" of eating in those other ways to ever go back to them, however appealing they may seem at times.

This morning, I read a blog post called "The Bacon Bummer"  posted at The Whole Nine. Although I am always interested in becoming enlightened, this is one time that I wish I could have continued on in blissful ignorance.

After reading the post, I am going to stop looking at bacon as a regular protein source, and start thinking of it more as an occasional treat or as a condiment to add a little flavor to other foods.

Bummer, indeed!

LCHF IS THE S***

This is a riot and so true:

FRED HAHN EXPLAINS WHY RESISTANCE TRAINING PUTS CARDIO TO SHAME

Dana Carpender, low carb cookbook author, interviews Fred Hahn, the co-author (along with the Drs. Michael and Mary Dan Eades) of The Slow Burn Fitness Revolution.

The first part of the podcast is reader input and Dana's take on The Rice Diet, and the second part is Fred's comparison of different types of exercise and which ones are more beneficial. (Spoiler alert - it ain't cardio!) 

Click here to listen to the interview.

IS DIET SODA HEALTHY? - MARK SISSON - MARK'S DAILY APPLE

A recent blog post from Mark Sisson:

Before I begin, I want to make something clear: this is not your standard definitive guide to whatever. I’d like to be able to issue a proclamation regarding diet soda that stands the test of time immemorial, but I cannot. Research is still in its infancy, and exactly what diet soda does to those who drink it – if anything – is incredibly confusing. The one thing I can say with any certainty is that, while it’s unfair to say it will kill you or give your unborn child prenatal tumors or make you impossibly obese, you’re probably better off without diet soda. It tastes weird, the list of unpronounceable ingredients is too long for my comfort level, and I’ve seen one too many unsuccessful dieters that seem to live on the stuff.

There are two things to consider when making any conclusions about diet soda’s place in a healthy diet. Do the ingredients used in diet soda pose a threat to your short-term or long-term (or that of your offspring’s) health? Is it a kind of sugary methadone, impeding healthy eating by making it harder to kick the desire for sweet things in your mouth because, well, you’re constantly putting things in your mouth that mimic sugar? Let’s dig in.

First, the ingredients. What goes into a can of your average diet soda?

Carbonated water, some sort of food coloring, and preservatives like potassium benzoate are all innocuous enough. Nothing to worry about there. You won’t see Mercola issuing dire warnings about Caramel Color No. 76 anytime soon. It’s the other stuff that interests (or worries) us: artificial sweeteners and (to a lesser extent) phosphoric acid. Let’s take a look at the two major sweeteners in popular use, aspartame and sucralose. Are they dangerous?

Aspartame gets a bad rap. High dose rat studies implicate it as a carcinogen, but in exceedingly large amounts. A can of diet soda a day probably won’t give you cancer. Would I avoid it as a pregnant mother? Yes. Would I be wary of drinking several cans a day? Yes. The basic takeaway is that while the clinical evidence of immediate danger upon normal ingestion of aspartame is lacking, inconclusive, or unclear, the vast amount of anecdotal evidence from people linking aspartame to headaches, migraines, panic attacks, and other maladies gives me great pause. I mean, the stuff tastes horrible, and that’s enough for me, but some people appear to have real health issues with aspartame. Not everyone, obviously, but some do. If aspartame appears to give you trouble, don’t let PubMed convince you that it’s harmless. It may very well be safe in the amounts we typically consume in the majority of people, but you can’t ignore your own experiences.

Also known as Splenda, sucralose is a popular sweetener that’s often called “natural” because it’s the product of selective sucrose chlorination. It’s 3.3 times sweeter than aspartame and 600 times sweeter than sucrose. It seems to have less of a disgusting aftertaste than aspartame (it’s all foul to me, though). Like aspartame, most of the studies reporting negative effects used insanely high doses of sucralose. I’m talking doses in the area of thousands of Splenda packets a day for months on end. I’m no fan, but I don’t think normal consumption of the stuff will kill you. There was a study that found normal doses (between 1.1 and 11.1 mg/kg per day; recommended maximum daily dosage is 5 mg/kg) of sucralose negatively impacted the gut flora in rats and lead to weight gain, although a later review called the study’s results into question. I’ll pass, but thanks, expert panel. There’s also the fact that sucralose is usually combined with something called acesulfame-K (potassium), another sweetener that many researchers think needs more toxicity tests. My take? Studies showing negative effects may be overstated or misguided, but why take the risk for that weird chemical aftertaste? Just avoid the stuff to be on the safe side.

And then there’s phosphoric acid. Here’s how the story supposedly goes: phosphoric acid, which soda makers use in place of pricier citric acid, leaches calcium from your bones and reduces bone mineral density. Is it true? Well, it’s become pretty clear that foods containing dietary phosphorus – like meat, dairy, and other “evil” foods – strengthen bones, rather than leach from them. But phosphorus isn’t exactly the same as phosphoric acid, which epidemiological studies have connected with loss of bone mineral density and osteoporosis. One in particular found that only colas (both diet and regular) were strongly associated with loss of bone mineral density. What do colas have that other diet sodas largely do not? Caffeine plus phosphoric acid. A more recent controlled trial found that only fizzy drinks containing caffeine resulted in increased calcium excretion; phosphoric acid content exerted no effect, either alone or in concert with caffeine. I don’t think we can implicate phosphoric acid just yet.

Okay, but remember: we’ve got to be careful when analyzing a food’s worth by singling out one of its constituent parts for good or for bad (although diet soda is by all definitions not food, it is a consumable whose stated purpose is to help dieters lose weight by avoiding sugar). Let’s judge diet soda on that. It may be technically safe to consume, but does it do its “job”? Does it help us lose weight by replacing our sugar intake with non-caloric sweetener intake and reducing cravings?

By most accounts, no. If you look at the literature, diet soda has repeatedly been shown to correlate with weight gain and increased incidence of metabolic syndrome:

One study found evidence of a linear dose-response; the more diet soda people drank, the more likely they were to be overweight or obese. As Sharon Fowler, the author of the study, puts it, “for each diet soft drink our participants drank per day, they were 65 percent more likely to become overweight during the next seven to eight years, and 41 percent more likely to become obese.”

Another study, which I covered a couple years ago, analyzed the diets of more than 9,500 men and women between the ages of 45 and 64 and found that drinking diet soda was associated with a 34% higher risk of developing metabolic syndrome – the perfect storm of high triglycerides, belly fat, insulin resistance, and obesity that’s so popular nowadays. This was an even stronger association than the one between the “high-meat, high-fat” Western diet and metabolic syndrome.

Authors of both studies speculate that diet soda drinking just extends the life of sugar cravings, rather than eliminating it. In this scenario, diet soda doesn’t regulate the desire for sugar; it increases it, and diet soda drinkers are simply replacing those empty calories with real sugar. This makes sense, and I think it’s part of it, but a couple other studies suggest that something else is going on entirely independent of caloric intake:

The dietary habits and weights of a homogenous group of middle aged women were tracked for a year. Regardless of initial weight status and inexplicable by “food consumption patterns,” users of diet soda were more likely than nonusers to gain weight. They didn’t eat markedly different from non-soda drinkers and yet they got fatter. It continues…

A more recent study broke rats up into two groups. The first received ad libitum oral doses of water sweetened with the maximum Acceptable Daily Intake (ADI) of saccharin, aspartame, cyclamate, and acesulfame-K (the same formulae used in commercial sweeteners), while the second group received plain water. Both were given ad libitum access to standard rat chow (which usually resembles the SAD: a disgusting mix of vegetable oils and sucrose). While caloric intake did not change between groups, the rats given non-caloric sweeteners experienced greater increases in bodyweight. The rats apparently weren’t driven to eat more because of confused satiety signals, and yet they still gained more weight. What gives?

Are diet soda drinkers eating more actual sweets to make up for the missing calories? Are their satiety signal hormones being altered by some chemical additive? Or is something in the diet soda actually causing weight gain independent of caloric intake?

We simply don’t know. We do know, however, that our bodies respond to everything they encounter. You lift a weight, you send a message to your body (build more muscle, make bones denser, establish neural pathways for movement!). You put food in your mouth, that elicits a response, even before the food hits your gut, as with the carbohydrate mouth rinse that increases athletic performance. It may be that introducing artificial sweeteners directly to your gut (bypassing the tongue) doesn’t affect subjective satiety or satiety hormones, but that’s not how we drink diet sodas. We taste them. With our tongues. And there is a decent amount of (mixed) evidence that certain artificial sweeteners in certain situations in certain individuals can actually elicit hormonal responses from taste alone, leading to hunger that isn’t really there and perhaps even insulin to handle dietary glucose that was never actually eaten. The details of any effect artificial sweeteners have on our hunger hormones are still being teased out, and the subject demands a dedicated post sometime in the future – so stay tuned for that.

In the end, diet sodas contain potentially harmful chemical additives and phosphoric acid that may or may not leach minerals. The majority of people who drink them to lose weight are unsuccessful, and most epidemiological evidence and some clinical evidence has linked diet soda intake to increased obesity, even irrespective of caloric intake. It may be that tasting sweet stuff without a corresponding caloric dose is throwing off our satiety signals and messing with our normal hormonal response to food, or perhaps relying on fake sugar just makes it harder to give up the real stuff.

Of course, whether they have a place in your diet is up to you. Maybe you’ll buck the trend and lose more weight and experience greater relief from sugar cravings with diet soda. Maybe you have one every few days and no more. If you’re a dedicated diet soda addict, maybe experiment with slowly eliminating it from your diet. Drink a bit less than usual and see how you feel. Try to save your 80/20 allowance for something a bit more fun, like maybe a high quality full-fat ice cream or a hunk of super dark chocolate (which actually has some nutritional merit, like good dairy fat). I’m gonna say that ideally you ditch them altogether, mostly because they seem to reinforce bad habits in most people and because the long term effects aren’t fully known.

Whatever you do, don’t start a diet soda habit after reading this post!

(Click here to read the entire article plus readers' comments.)

THE HEALTHY HOME ECONOMIST GOES SHOPPING AT PUBLIX

A REVERSAL ON CARBS - LOS ANGELES TIMES ARTICLE

Fat was once the devil. Now more nutritionists are pointing accusingly at sugar and refined grains.

Carb consumption has risen over the yeras. So have U.S. obesity levels. (Kirk McKoy, Los Angeles Times / December 20, 2010)

By Marni Jameson, 

Special to the Los AngelesTimes

Most people can count calories. Many have a clue about where fat lurks in their diets. However, fewer give carbohydrates much thought, or know why they should.

But a growing number of top nutritional scientists blame excessive carbohydrates — not fat — for America's ills. They say cutting carbohydrates is the key to reversing obesity, heart disease, Type 2 diabetes and hypertension.

"Fat is not the problem," says Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health. "If Americans could eliminate sugary beverages, potatoes, white bread, pasta, white rice and sugary snacks, we would wipe out almost all the problems we have with weight and diabetes and other metabolic diseases."

It's a confusing message. For years we've been fed the line that eating fat would make us fat and lead to chronic illnesses. "Dietary fat used to be public enemy No. 1," says Dr. Edward Saltzman, associate professor of nutrition and medicine at Tufts University. "Now a growing and convincing body of science is pointing the finger at carbs, especially those containing refined flour and sugar."

Americans, on average, eat 250 to 300 grams of carbs a day, accounting for about 55% of their caloric intake. The most conservative recommendations say they should eat half that amount. Consumption of carbohydrates has increased over the years with the help of a 30-year-old, government-mandated message to cut fat.

And the nation's levels of obesity, Type 2 diabetes and heart disease have risen. "The country's big low-fat message backfired," says Dr. Frank Hu, professor of nutrition and epidemiology at the Harvard School of Public Health. "The overemphasis on reducing fat caused the consumption of carbohydrates and sugar in our diets to soar. That shift may be linked to the biggest health problems in America today."

To understand what's behind the upheaval takes some basic understanding of food and metabolism.

All carbohydrates (a category including sugars) convert to sugar in the blood, and the more refined the carbs are, the quicker the conversion goes. When you eat a glazed doughnut or a serving of mashed potatoes, it turns into blood sugar very quickly. To manage the blood sugar, the pancreas produces insulin, which moves sugar into cells, where it's stored as fuel in the form of glycogen.

If you have a perfectly healthy metabolism, the system works beautifully, says Dr. Stephen Phinney, a nutritional biochemist and an emeritus professor of UC Davis who has studied carbohydrates for 30 years. "However, over time, as our bodies get tired of processing high loads of carbs, which evolution didn't prepare us for … how the body responds to insulin can change," he says.

When cells become more resistant to those insulin instructions, the pancreas needs to make more insulin to push the same amount of glucose into cells. As people become insulin resistant, carbs become a bigger challenge for the body. When the pancreas gets exhausted and can't produce enough insulin to keep up with the glucose in the blood, diabetes develops.

The first sign of insulin resistance is a condition called metabolic syndrome — a red flag that diabetes, and possibly heart disease, is just around the corner. People are said to have the syndrome when they have three or more of the following: high blood triglycerides (more than 150 mg); high blood pressure (over 135/85); central obesity (a waist circumference in men of more than 40 inches and in women, more than 35 inches); low HDL cholesterol (under 40 in men, under 50 in women); or elevated fasting glucose.

About one-fourth of adults has three or more of these symptoms.

"Put these people on a low-carb diet and they'll not only lose weight, which always helps these conditions, but their blood levels will improve," Phinney says. In a 12-week study published in 2008, Phinney and his colleagues put 40 overweight or obese men and women with metabolic syndrome on a 1,500-calorie diet. Half went on a low-fat, high-carb diet. The others went on a low-carb, high-fat diet. The low-fat group consumed 12 grams of saturated fat a day out of a total of 40 grams of fat, while the low-carb group ate 36 grams of saturated fat a day — three times more — out of a total of 100 grams of fat.

Despite all the extra saturated fat the low-carb group was getting, at the end of the 12 weeks, levels of triglycerides (which are risk factors for heart disease) had dropped by 50% in this group. Levels of good HDL cholesterol increased by 15%.

In the low-fat, high-carb group, triglycerides dropped only 20% and there was no change in HDL.

The take-home message from this study and others like it is that — contrary to what many expect — dietary fat intake is not directly related to blood fat. Rather, the amount of carbohydrates in the diet appears to be a potent contributor.

"The good news," adds Willett, "is that based on what we know, almost everyone can avoid Type 2 diabetes. Avoiding unhealthy carbohydrates is an important part of that solution." For those who are newly diagnosed, he adds, a low-carb diet can take the load off the pancreas before it gets too damaged and improve the condition — reducing or averting the need for insulin or other diabetes meds.

Americans can also blame high-carb diets for why the population has gotten fatter over the last 30 years, says Phinney, who is co-author of "The New Atkins for a New You" (Simon & Schuster, 2010).

"Carbohydrates are a metabolic bully," Phinney says. "They cut in front of fat as a fuel source and insist on being burned first. What isn't burned gets stored as fat, and doesn't come out of storage as long as carbs are available. And in the average American diet, they always are."

Here's how Phinney explains it: When you cut carbs, your body first uses available glycogen as fuel. When that's gone, the body turns to fat and the pancreas gets a break. Blood sugar stabilizes, insulin levels drop, fat burns. That's why the diet works for diabetics and for weight loss.

When the body switches to burning fat instead of glycogen, it goes into a process called nutritional ketosis. If a person eats 50 or fewer grams of carbs, his body will go there, Phinney says. (Nutritional ketosis isn't to be confused with ketoacidosis, a dangerous condition that can occur in diabetics.)

Beyond the fat-burning effects of ketosis, people lose weight on low-carb diets because fat and protein increase satisfaction and reduce appetite. On the flip side, simple carbs cause an insulin surge, which triggers a blood sugar drop, which makes you hungry again.

"At my obesity clinic, my default diet for treating obesity, Type 2 diabetes and metabolic syndrome is a low-carb diet," says Dr. Eric Westman, director of the Lifestyle Medicine Clinic at Duke University Medical Center, and co-author of the new Atkins book. "If you take carbohydrates away, all these things get better."

Though the movement to cap carbs is growing, not all nutritional scientists have fully embraced it. Dr. Ronald Krauss, senior scientist at Children's Hospital Oakland Research Institute and founder and past chair of the American Heart Assn.'s Council on Nutrition, Physical Activity and Metabolism, says that while he fundamentally agrees with those advocating fewer dietary carbs, he doesn't like to demonize one food group.

That said, he adds, those who eat too many calories tend to overconsume carbohydrates, particularly refined carbohydrates and sugars. "It can be extremely valuable to limit carbohydrate intake and substitute protein and fat. I am glad to see so many people in the medical community getting on board. But in general I don't recommend extreme dietary measures for promoting health."

Joanne Slavin, professor of nutrition at the University of Minnesota and a member of the advisory committee for the 2010 Dietary Guidelines for Americans, is less inclined to support the movement. The committee, she says, "looked at carbohydrates and health outcomes and did not find a relationship between carbohydrate intake and increased disease risk."

Most Americans need to reduce calories and increase activity, Slavin adds. Cutting down on carbs as a calorie source is a good strategy, "but making a hit list of carbohydrate-containing foods is shortsighted and doomed to fail, similar to the low-fat rules that started in the 1980s."

As nutrition scientists try to find the ideal for the future, others look to history and evolution for answers. One way to put our diet in perspective is to imagine the face of a clock with 24 hours on it. Each hour represents 100,000 years that humans have been on the Earth.

On this clock, the advent of agriculture and refined grains would have appeared at about 11:54 p.m. (23 hours and 54 minutes into the day). Before that, humans were hunters and gatherers, eating animals and plants off the land. Agriculture allowed for the mass production of crops such as wheat and corn, and refineries transformed whole grains into refined flour and created processed sugar.

Some, like Phinney, would argue that we haven't evolved to adapt to a diet of refined foods and mass agriculture — and that maybe we shouldn't try.

To read the full article, click here.

THE WAR OF THE COOKIES

I don't know what it is about cookies that make them so nearly irresistible to me! I'm sure it is mainly emotional and has to do with a sense of "reward" and "fun" when I get to have one. Or seven.

I may not have won the War of the Cookies yet, but I won a battle today.

I went to my granddaughter's preschool Christmas program this morning, which was actually written by 4-year-olds (my favorite part - Angel: "You are going to have a baby." Mary: "I will do what God wants." Angel: "Good luck with that.").

I don't know why I did not anticipate that the after party would be a cookie-rich environment. It was, and I chose not to eat even one cookie, but had a cup of tea instead. Here were the thoughts that went through my head:

This morning, my body fat was the lowest so far on Atkins. If I eat cookies, and it goes back up, I will be mad at myself later.

If there was a sugar bowl there instead of cookies, and everyone was eating pure sugar as a treat, would I do that, too? No. (I found out later that a 2" chocolate chip cookie has the same amount of net carbs as 1.5 tsp. of refined sugar, and will increase my blood sugar with equal speed.) Okay, the obvious answer to that is that the cookie tastes better than plain sugar. Must be all that yummy refined flour!

The cookies looked good, but so what?

This is not the last chance I am going to have to eat cookies. I don't have to resist cookies for the rest of my life. Just this morning at this event. (I borrowed that one from Bill W.)

Any time I want cookies, I can always go to the store and buy some. But will I do that? No. So if I won't buy them at the store, why would I eat them at a party?

Each time I resist an unhealthy food, it builds my resolve and increases my strength to turn away the next time, not to mention the neural pathways that are being formed that will make it more "second nature" as time goes on.

You know what I found out in the end? The longer I stayed at the party, the easier it got to ignore the cookies. By the time I left, I was not feeling deprived at all.

THE CURE FOR DIABETES - ADAM CAMPBELL - MEN'S HEALTH MAGAZINE

What if the American Heart Association endorsed the trans-fat diet? Problem, right? Look at what the American Diabetes Association is spoon-feeding people with diabetes: sugar. Not to worry: We've got the solution right here.

It's a wonder no one has tried to have Mary Vernon's medical license revoked.

Since 1999, the 52-year-old family doctor has been treating diabetic patients in Lawrence, Kansas, with an approach that was abandoned by most physicians in the 1930s. Worse, this Depression-era remedy is the opposite of the current guidelines established by the American Diabetes Association, a nonprofit organization that spent nearly $51 million on research in 2005, and so should know a thing or two about how to handle diabetes.

There's no question that Dr. Vernon is trouble -- but for whom? Not her patients, that's for certain. They just won't stay sick. People walk into her office afflicted with type-2 diabetes and, by every objective medical measurement, walk out cured. There's $51 million that says that isn't supposed to happen, not in a clinic in Kansas, and definitely not as a result of cleaning out the refrigerator.

"My first line of treatment is to have patients remove carbohydrates from their diets," explains Dr. Vernon, a petite, energetic mother of two who also serves as the president of the American Society of Bariatric Physicians. "This is often all it takes to reverse their symptoms, so that they no longer require medication."

That's it?

That's it -- a simple strategy, but one that's  controversial. If Dr. Vernon and a growing cadre of researchers are correct about carbohydrates, we may be looking at an epic case of ignorance on the part of the medical community. That, however, pales next to the implications for the American Diabetes Association, namely that the very organization dedicated to conquering diabetes is rejecting what could be the closest thing we have to a cure.

To read the remainder of this article, click here.

PLANTS BITE BACK - WESTON A. PRICE FOUNDATION

The carnivorous piranha plant shows that plants can bite back.

Eat food. Not too much. Mostly plants. That’s Michael Pollan’s response to the question of what we should eat, and few people seem to doubt that answer today. Whether it’s Whole Foods Market’s decision to downplay animal products or vegan actresses touting “kind diets,”it sometimes seems as though every educated man, woman and child in the United States believes that plant-based diets hold the key to personal and planetary health.

Sorry, folks, but it’s not so simple.   Mother Nature put a surprising number of all-natural anti-nutrients and toxins in grains, nuts, seeds and beans.   Phytates, for example, block seeds from sprouting prematurely. Protease inhibitors, saponins, lectins and phytoestrogens harm insects, animals and other predators that would otherwise eat too many of them. If evolutionary theories are correct, wounded plants produce extra inhibitors and other anti-nutrients to save the plant species.  The idea is to cause predators—including plant-eating humans—to experience slowed growth and diminished reproductive ability.  Not having the capacity for flight, the plants fight back with chemical warfare.

Although it might sound like a “rotten idea,” squirrels are smart to bury nuts in the ground, then dig them up and eat them weeks and months later. Similarly, people in traditional cultures all over the world process their grains, nuts, seeds and beans by a process akin to pre-digestion before cooking and eating them.

To read the full article, click here.

WATCH "FAT HEAD" MOVIE IN ITS ENTIRETY RIGHT HERE!

NOVEMBER 25 - DAILY REPORT

I did not track my food yesterday, and I overate low carb food, specifically pecans and three squares of dark chocolate.  I was preparing Thanksgiving food all day, and did really well with what I was supposed to be eating, but being around all the food for all that time started getting to me and I started getting cravings.  By late afternoon, I was snacking on small handfuls of toasted pecan, and lost control.  I made a run to the store in the late evening and "found myself" buying the dark chocolate bar.

I gained 3.2 pounds since yesterday morning, and Thanksgiving eating has not started yet!  At this moment, my plan is to not overeat today.  My sister arrived with about 15 pounds of homemade cookies, and, after gaining the 3.2 pounds, my feeling is that is it not going to be hard to resist all of them.  I know that most of what I gained yesterday was water weight, but it has still given me the kick in the butt I need to get me to eat sensibly today.  We'll see how that works out!

MY CYBER CHAT WITH TOM NAUGHTON OF THE MOVIE "FAT HEAD"

--> A couple of years ago, in response to watching the movie Super Size Me, I completely stopped eating at fast food restaurants and I've never looked back.  Tom Naughton's response to watching the movie was a little more extreme:  He set out to make his own documentary, exposing the obvious (to him) inaccuracies, inconsistencies and downright deceptions in that movie.

The result was Fat Head, a factual and comic look at Super Size Me, written by, produced by and starring Tom Naughton, a stand up comedian, sit down writer and first time film-maker.  Not only does Tom rip Super Size Me to shreds, but he also shines a very informative spotlight on the whole low carb nutritional movement.  I just got my copy a week ago, after watching all the teasers for the same on youtube, and I loved it.  However, because of the way I am "wired", I wanted to know more about what Tom thought on a few low carb confusions of mine.

I contacted Tom, asking if I could grill him a little, and he graciously told me to fire away.  In pretty short order, I got some very interesting and thought-provoking answers and observations from Tom, which helped me fine tune my own understanding of the way I have chosen to eat - high fat, moderate protein and low carb.

Following are some Q & A from Tom and me. 

Rebecca:  How is fat stored in the absence of insulin?  Most of the things I have read talk about how the over-release of insulin causes glucose to be stored as fat.  I have also read that protein that is not needed by the body is converted to glucose and stored as fat.  But what happens when a person eats overeats fat?  I asked that question of Gary Taubes in his recent interview with Jimmy Moore.  Gary answered by saying he has a problem with the word “overeat” and then he really didn’t answer the question.  He said that what is enough for one person might not be enough for another person.   

So I am trying to rephrase the question so that it is clear:  Say a person is eating a certain amount of fat, protein and carbs (very low carb), and they are maintaining their weight on these amounts of each macronutrient.  Then, they suddenly increase their fat intake only by a large amount.  Do they begin to gain weight?  And if so, why?  If fat storage is driven by insulin, and fat does not provoke an insulin response, then how does that fat get stored?  

I have heard some say that excess fat beyond what the body needs will just cause the body to raise the metabolism to burn it off.  I have heard some say that the body does not use the excess fat, but just excretes it.  I have heard some say that the excess fat is a “calorie bomb” and will be stored as fat, but they do not say by what biological mechanism this happens.  

Dr. Atkins said that we can eat as much fat as we want, because it will not cause insulin to be produced and there will be no way for the fat to be stored.  But then he says that if we eat way too much, it will cause weight gain.  How? 

Tom:  Unless you’re a type I diabetic, your body will always produce some insulin in response to food, and good thing too, or you’d waste away and die.  Carbohydrates generally provoke the greatest insulin response, but protein provokes an insulin response too.  I’m not aware of any experiments in which subjects lived on a diet of 100% fat, so I can’t say whether or not it’s possible to gain weight on fat alone, but we don’t eat fat alone; we eat fat with protein. 

So my guess is that while you’re less likely to store calories as fat if you’re eating nothing but fat and protein, it’s still possible to gain weight if you eat enough, because the protein could provoke an insulin response sufficient to store some fat.   

Rebecca:  What is the difference between “Calories In Calories Out” and “Creating a Calorie Deficit”?  I have heard many people talk about how 3500 calories equals a pound, and that to lose a pound per week, all you have to do is cut 500 calories from your daily food.  Or cut 250 calories per day and increase your activity by 250 calories each day for the same result. 

Many low carb people will say that this theory is wrong, because a calorie is not a calorie is not a calorie.  The body will react to 100 calories of high glycemic index carbs differently than it will react to 100 calories of butter.  I know that I, personally, will maintain my weight on 1100 calories of high carb, low fat food, and I will also maintain my weight on 1800 calories of low carb, high fat food.  So I do believe that there is a “metabolic advantage” to eating low carb and high fat.   

Also, many will say it is wrong because the body can adapt through homeostasis or thermogenesis, and keep the body from losing weight.  I heard this analogy recently:  It's kind of like the Borg on Star Trek, where a phaser weapon works against the alien Borg creatures once, but then they adapt, and soon the same phaser blast no longer does anything. 

I started a thread on the Atkins Forum called “My Body is Not a Piggy Bank!  (Do Calories Matter?)” and I posted information that I got off of Adam Kosloff's website Why Low Carb Diets Work.  On that website, Adam attempts (and does a great job, I think) of crystallizing Gary Taubes’ ­Good Calories Bad Calories into an easily read and understood form.  Gary told Adam that he thought it was good. 

If anyone can prove that homeostasis and/or thermogenesis are real,  it is me!  Without changing my activity, I have both gained and lost weight eating 1400 calories and 2000 calories and everything in between.  And all of this high fat, moderate protein and very low carb (never more than 40 total carbs and as low as 20 total carbs). 

Tom:  To lose weight, you still have to create a calorie deficit. The idea behind low-carb is that the fat cells are open for business, so if you create the need to tap them, you can. Otherwise, simply eating less can encourage your body to slow your metabolism.   

Calories In Calories Out assumes the number of calories you burn stays more or less constant. It ignores adaptive thermogenesis, the process by which your body can dramatically raise or lower your metabolism in response to the foods you eat, hormones, etc.  So according to the Calories In Calories out crowd, if you simply eat less, you’ll automatically lose weight matching the equation 3,500 calories = 1 pound of fat. However, if your fat cells aren’t open for business and you simply eat less, your body will respond to starvation at the cellular level by slowing your metabolism. That’s part of the reason so many diets fail, and also the reason some people who try to grit it out end up losing muscle instead of fat. Likewise, people who literally can’t seem to gain weight (my son, for one) have metabolisms that ramp up if they eat more. 

If your fat cells are open for business, your body can make up for a fuel shortage by burning body fat, so it won’t experience cellular starvation and won’t slow your metabolism. But any way you slice it, you need to give your body a reason to tap those fat cells. I’ve seen people accuse the low-carb doctors of either denying the need for a calorie deficit or just now admitting to it, but Drs. Eades & Eades wrote about the need to create a calorie deficit way back with their first Protein Power book, which was published in 1997.  

Research has shown that people who go on low-carb diets often end up eating less spontaneously. There’s a reason for that: once the fat cells are opened up, they supply a bigger share of your energy, so you don’t feel the need to eat as much. 

Rebecca:  It seems like you are saying that Calories In Calories Out does not work if the fat cells are “closed” but it does­ work if the fat cells are “open”.  Or maybe it works when the fat cells are “open” but you make sure not to drop your calories too low and cause the body to “shut” the fat cells again.

But doesn’t “creating a calorie deficit” also ignore adaptive thermogenesis?  If the fat cells are “open” does that turn off adaptive thermogenesis, or is it still possible? 

If I am understanding this correctly, the difference between Calories In Calories Out and Creating a Calorie Deficit is really only a matter of semantics.  You could basically say that if you are eating high carb and low fat, Calories In Calories Out will not work.  But if you are eating low carb and high fat, Calories In Calories Out will work.  Isn’t Creating a Calorie Deficit really the same thing as Calories In Calories Out, provided, of course, that you are acknowledging that all calories are not created equal? 

Just eating less and exercising more (Calories In Calories Out) will not make a person lose weight IF they are eating wrong.  But if they are eating right, eating less and exercising more will make them lose weight (Calorie Deficit).  Please help me to understand this better!   

Tom:  Well, it’s a big, complex subject, but I’ll try to make it as clear as possible.  The Calories In  Calories Out crowd believes that 1) Body fat is passive and 2) All calories count the same.  Therefore, they make goofy statements such as “If you just cut 100 calories per day from your diet, you’ll lose 10 pounds per year.”

They see the body as a bank which has a set number of daily expenses (your basal metabolism).  Every calorie consumed is a deposit, and every calorie burned through activity is a withdrawal.  So in their view, if your basal metabolism is 1500 calories and you burn an extra 500 calories through activity, eating more than 2000 calories will always cause weight gain, and eating fewer than 2000 calories will always cause weight loss. 

We know this is poppycock because people like my wife and son weigh exactly the same year in and year out.  They can’t possibly be consuming EXACTLY the right number of calories every year.  My son easily consumes more than a million calories in a year.  According to simple calorie math, if he over-ate by a mere 7,000 calories, he’d gain two pounds – yet that never happens.  So unless he’s eating exactly the right number of calories every year – with 99.3% accuracy – his body must be adjusting his metabolism up and down in response to his diet to maintain his weight. 

In fact, my son twice tried to gain weight by eating quite a bit more, but it didn’t work.  Other people have tried to starve themselves thin but couldn’t lose anything close to what the simple Calories In  Calories Out math says they should have lost. 

That’s what Taubes explained in his book. It’s important to understand that despite what some of his critics have said, Taubes does not believe calories can magically disappear or that the laws of thermodynamics don’t apply to the human body.  (We’re talking about a guy with a degree in physics, after all.)  In any system, the body included, the inputs and outputs must match.  However, Taubes believes that 1) Body fat is an active driver of your metabolism, 2) the amount of fat your body wants to maintain is determined by hormones, and 3) the body responds to different sources of calories in different ways. 

Body fat drives metabolism by providing you with a supply of fatty acids for fuel.  To keep your blood sugar level, your body needs to alternately store and retrieve fat – storing fat when blood sugar is high so the blood sugar will be consumed first and brought down to a safe level, retrieving fat as blood sugar drops so blood sugar isn’t over-consumed and pushed too low.  The amount of body fat you need for this system to work depends on how efficiently your fat cells can release fatty acids, which in turn is a function of several hormones.  Insulin, of course, is a prime mover in this system because high levels of insulin can slow down or block the release of fatty acids.  If your fat cells are slow to release fat, your body will work to make them bigger, because bigger fat cells can release more fatty acids, thus allowing you to keep your blood sugar stable. 

So if hormones are telling your body to maintain a certain level of body fat, it will fight your efforts to gain or lose.  It fights by adjusting your metabolism up or down.  So you cut 100 calories per day from you diet, just like the experts suggest, and nothing happens.  Why?  Because if hormones are telling your body to remain fat, your body will respond by making adjustment to the calories it expends. 

The Calories In  Calories Out crowd doesn’t account for those adjustments.  They also don’t account for the fact (despite plenty of clinical research) that the body tends to raise its metabolism in response to certain nutrients, such as proteins and medium-chain triglycerides – the fat found in coconut oil. 

Here’s an analogy:  To the Calories In  Calories Out crowd, the gas I put in my car is calories in, the gas my car burns while idling is basal metabolism, and the gas my car burns while moving is calories expended through activity.  In their minds, this equation never changes.  But of course, we all know you can buy a car that gets 35 mpg, and three years later it’s only getting 28 mpg.  That doesn’t violate the laws of thermodynamics, and it doesn’t mean the energy in no longer matches the energy out.  It means something has changed inside the car’s system and it’s no longer using the energy in exactly the same way.   

There is no getting around the fact that to burn away body fat, you need to create a need for your body to consume the fat – an energy deficit.  But merely cutting calories may not do the trick, because your body can adjust your metabolism down, thus reducing or eliminating the deficit.  That’s what Taubes was trying to explain:  The calories in can cause adjustments in the calories out.  If you don’t solve the hormonal issues first, shrinking your fat cells will simply produce a situation where your body can’t retrieve fatty acids quickly enough to feed your cells and keep your blood sugar level.  Then your body will fight like crazy to avoid shrinking the fat cells any more – again by slowing your metabolism. 

So for the calorie deficit to work in the long term, it must be combined with a hormonal environment that allows your body to efficiently retrieve fatty acids from your fat cells.  That’s where keeping your insulin levels low comes in. 

Rebecca:  If I am Creating a Calorie Deficit, why am I still 36% body fat, even though I eat high fat, moderate protein and very low carb? 

Even though it makes sense, in theory, that I need to “burn” more calories than I take in, I have not been able to make that theory a reality in my body.  It seems that every time I either increase or decrease fat and protein (carbs always staying very low in all cases), there is no rhyme or reason to why I either stay the same weight, or lose weight or gain weight.  

Remember my "Borg" analogy? Well, my body is the Borg, and it wants to weigh 143.4 pounds and Resistance is Futile!  When I decrease my intake of food in order to create a calorie deficit, it will sometimes give up a little fat, but then adapts and starts storing fat again, bringing me back to 143.4 pounds or more.  There was one time that I increased my food intake from 1600 calories to 2000 calories, and dropped several pounds in a week, but then my body adjusted my metabolism (I’m assuming) and all the weight came right back, with a little more just for good measure, to teach me a lesson. 

In your Jimmy Moore interview,Tom, you said that people can look up exactly what you ate and how it caused you to lose a certain amount of weight.  If you were to look at my food diary, you would see no rhyme or reason to the weight I have lost, gained or maintained relative to the food I happened to be eating at the time or the amount of exercise I was getting or not getting.   

I recently just gave up and ate 1800 calories per day for a few months without a change.  My weight stayed the same.  I then dropped down to 1400 calories, and did not lose weight.  I have been doing this now for two weeks, with no change in my weight.  But didn’t I create a calorie deficit?  And 1400 calories for a 5’3” woman is certainly not starving, I would think… 

How can a person (me!) create a calorie deficit when thermogenesis is at work, it seems, to keep my body at a certain weight?   What is the likelihood that a person has no control over their weight, and no matter what they eat or how much they exercise, they will not lose weight? 

Tom:  Okay, this is the answer nobody wants to hear, but here goes:  Short of starvation that would ruin your health, it may not be possible for you to be as thin as you would like to be.  As I explained above, your body needs to be able to store and retrieve fatty acids to keep your cells fed and your blood sugar level.  The amount of body fat required to do that job depends on how quickly and efficiently your fat cells release fatty acids.  Think of it this way:  if you’ve got weak batteries, you need more of them to produce the same charge.  So unless you can make your fat cells more efficient, your body is going to fight you tooth and nail to maintain your current level of body fat – because it NEEDS that body fat to avoid cellular starvation between meals, especially when you’re sleeping. 

You may be able to make your fat cells more efficient through changes in hormones – thyroid recovery, adrenal recovery, insulin sensitivity recovery, etc. – but if you’ve suffered irreversible damage to any of those, there’s a limit to how much body fat you can or should lose. 

I once managed to semi-starve myself down to 165 pounds, but the love handles and bit of belly fat in the front still didn’t go away.  I started burning up my own muscles instead.  My arms, legs and chest got skinnier, the belly didn’t.  At some point, my body refused to sacrifice the body fat it needed.  I just didn’t realize at the time that it did, in fact, need the fat.   

So I can only suggest looking into possible fixes for hormone problems, keeping your carbs low (which you apparently already do), and engaging in hard exercise to improve your insulin sensitivity a bit.  Beyond that, I believe the smartest thing to do is to accept that what matters is health, not body size.  As Dr. Mary Vernon said in a lecture I attended, “From a health standpoint, I don’t care how fat you are.  I care about what you’re burning for fuel.” 

Rebecca:  What do you think of the BodyBugg?  I have a friend who uses one, and he says it accurately tells him how many calories he is burning off each day so that he can create a 20% calorie deficit and lose weight consistently.  He eats high fat, moderate protein and low carb.  I feel that if I got one (out of desperation!), it would tell me that I am burning calories, but I still would not lose weight. 

Tom:  Never seen one.  Since the body will adjust your metabolism to keep you fat if you don’t solve the hormonal issues first, I don’t see the point of counting every calorie. 

Rebecca:  What other processes are at work in the body to store fat due to hormonal imbalances other than insulin? 

Estrogen dominance, low progesterone, low testosterone, low thyroid, high cortisol and low melatonin will all cause weight gain.  Why?  (By the way, I have all of these, and having my hormones balanced with natural, bio-identical hormone replacement has not helped me lose weight.)  Do people with these imbalances gain weight because the imbalances cause excess insulin to be produced?  And if that is so, and a person is eating very low carb, what the heck is the insulin driving into the fat cells?  Fat and protein? 

Tom:  I don’t believe they all work directly through raising insulin.  From what I’ve read, they all have an effect on how efficiently your body can release fatty acids for fuel.  Testosterone, for example, aids in lipolysis – the release and burning of fatty acids. Insulin, however, can block the actions of hormones that aid in lipolysis.  If you can’t release fatty acids quickly, your body doesn’t want to give up the body fat it needs.  

Rebecca:  It's disappointing to me that I am actually a success story in the new Atkins book, A New Atkins for a New You.   

Tom:  I take it you don’t feel successful at the moment?

Rebecca:  The answer to that is resounding NO!  I have done everything right.  I have exercised, I have lifted weights, I have eaten low carb, I have had my hormones naturally balanced with bio-identical hormone replacement.  I am one of the top three contributors on the Atkins Community Forum, where some of my articles are used in the forum “stickies” so that newcomers will see them.  I am profiled in The New Atkins For a New You.  I was interviewed by Jimmy Moore for his podcast this past September.  I have this health and nutrition blog. 

And sometimes I feel like a hypocrite.  I spend all my time telling everyone I know that low carb is the way that human beings were designed to eat, but eating this way is not causing me to lose more than just a few initial pounds of fat.  I started out at 46% body fat and now I am 36% or so, and I am stuck.  I did get down to around 33% over a year ago, but it has steadily been going back up since then.  

Tom:  I hear you.  I’d love to have arms with veins that pop and six-pack abs, like my son.  But it’ll never happen.  I stopped a life-long weight gain and reversed it to a significant degree, but I know I damaged my metabolism as a young man, and it will apparently only recover so far.  I have to focus on the fact that at age 52, I’m stronger than when I was at 25, I can walk for miles in hilly terrain without getting fatigued, I kick my wife’s behind in racquetball even though she’s 14 years younger, my blood pressure is low, my triglycerides are low, my HDL is high, and I’m the only one of my friends in my age bracket who isn’t taking some awful prescription drug. 

You are NOT a hypocrite, Rebecca.  You cannot compare yourself to people whose bodies are happy to be thin.  (If I compared myself to my wife and son all the time, I’d go bonkers.)  You can only compare who you are now with who you would’ve been if you hadn’t taken steps to improve your health.  So I don’t compare myself to my son.  The only person I compare myself to is the one I used to be.

Rebecca:  Can fat tissue be damaged beyond repair?  I have heard some say that the basic problem is that fat tissue function is damaged.  Do you think that there is a possibility that, in some cases, adipose tissue has been damaged beyond total repair?  Is there a chance, when there are no other possible issues at play, that a person cannot be capable of creating a calorie deficit in order to lose weight?  Gary Taubes said something to that effect in his recent interview with Jimmy Moore.  He said that, in some people, there will be excess fat that will not go away, no matter how well they eat. 

Tom:  I think Gary’s right, for the reasons I have already talked about here.

Rebecca:  So you think that a person can be fat and healthy?  In your Jimmy Moore interview, you talked about the difference between being overweight and being unhealthy, using members of your family and yourself as examples:  You are a little overweight and yet you have normal blood sugar, and others in your family are normal weight and yet have Type 2 Diabetes.  Do you believe that being overweight causes disease, or that disease ­leads to overweight?  My father’s doctor has always told him to avoid gaining weight in order to avoid Type 2 Diabetes.  His mother, my grandmother, was overweight most of her life and developed Type 2 Diabetes in her 60s.   

I think of myself, and realize that I have low triglycerides, good HDL and slightly high LDL, but normal blood sugar, and low inflammation markers, like C-Reactive Protein and Homocysteine,  and yet I am 36% body fat.  If I stay this fat, will that lead to developing Diabetes and Coronary Heart Disease, or can I stay fat and remain healthy, as long as I eat right (low carb) and exercise?  Should I only care about my health, and not try to lose weight, and if I do that, will this fat, healthy body of mine lead me down the road to ill health? 

Tom:  My father-in-law is lean, athletic, and a type 2 diabetic.  My maternal grandmother is on the skinny side, but also became a type 2 diabetic.  Clearly, body fat is not the cause of type 2 diabetes, or we wouldn’t see lean type 2 diabetics.  It’s far more likely that many people eat diets that both make them fat and create insulin resistance at the same time.  Others can eat the same diet and become insulin resistant without becoming fat.  

Having said that, there is some evidence that the fat that accumulates in your liver may accelerate insulin resistance through the production of inflammatory cytokines. 

Rebecca:  So basically, does staying slim keep you healthy, or does staying healthy keep you slim (chicken/egg)?   

Tom:  Proper diet can aid in keeping you both slim and healthy.  Losing weight may assist in keeping you healthy by removing inflammation-producing visceral fat from your liver. 

Rebecca:  Tom, why do people get fat?  I know that Gary has a book coming out about this, but I am interested to hear your take on it.  I have heard it said (maybe by Gary) that we don’t get fat because we sit on the couch and eat too much – we sit on the couch and eat too much because we are fat.   

In other words, we aren’t fat because we eat too much and don’t get enough exercise. We’re not just lazy gluttons.  It’s not just Calories In Calories Out.  There is actually something wrong in the adipose tissue that is driving us to eat (specifically carbs) and causing us to stay inactive and keeping our metabolism slow. 

I know that I did not change the way I was eating or exercising, but when I hit thirty, I just started gaining weight.  I now blame hormonal imbalances, of which I’m sure insulin was one.  I was also eating a high carb and high fat diet, except when I was trying to lose weight, and then it was high carb and low fat. 

What do you think? 

Tom:  Metabolic derangement happens first.  The result is weight gain and lethargy.  When Dr. Robert Lustig treated kids for cancer, they nearly all become fat and lazy soon after.  Realizing something hormonal must’ve happened, he tested them and ended up giving them a drug to suppress excess insulin production.  Bingo; they lost weight and became active again, without anyone harping on them to eat less and exercise more. 

Rebecca:  I've been doing a lot of reading lately about cholesterol, because my husband's is high.  Based on what I've been learning, I am beginning to wonder:  Does serum cholesterol even matter? 

Since starting low carb 20 months ago, my cholesterol has gone from around 200 to around 220.  I’m sure it would not surprise you to know that my doctor wants me on statins.  I refused.  I did agree to start supplementing with red rice yeast, but now I am wondering if I should even be trying to lower my LDL.  I have been reading a lot of things in books and on the internet that say that as long as triglycerides are low, and inflammation is low, you could have a high LDL and it doesn't matter.  Some doctors believe that, ten years into the future, cholesterol will not even be considered a marker for heart disease.  What do you think? 

Tom:  Don’t try to lower your LDL.  High LDL protects you against infections and cancer.  It’s only a problem if you’re producing small, dense LDL, which is unlikely if you have low triglycerides and high HDL.  Also, LDL isn’t usually measured; it’s calculated.  If you have low triglycerides (below 100), that calculation will nearly always overestimate how much LDL you have.  Your doctor probably doesn’t know this, but there’s never, ever been an association shown between high cholesterol and heart disease in women.  In senior citizens, those with high cholesterol have the longest average lifespans, primarily because they have a lower rate of cancer.

Rebecca:  Thanks, Tom!  I really appreciate you taking the time to answer my questions!   I know that we all hope that low carb wisdom will prevail - and hopefully in our lifetimes!

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