NUTRITIONAL KETOSIS SHORT WEEK UPDATE

Since I only started Nutritional Ketosis again four days ago, I just want to post this update and talk about how I will eat in this coming week.

On the first day - July 15, 2015 - I did a full day's monitoring of my blood sugar, to get a baseline for the future.  Here are the results:

(click chart to enlarge)

As you can see, my average blood glucose for the day was only 79, which is great, and the highest it went all day, even after eating, was only 90.  Well within optimal range!  I also added a chart above that shows what I ate at each meal, so I can see how the macros of fat, protein and carbs impacted my blood glucose.  The levels that I ate on this particular day did not cause any problems.

Here is what I actually ate on that day:

(click chart to enlarge)

So food is good, blood glucose is good, but what happened to my body composition in the past four days?

July 15, 2015
Neck - 12"
Bust - 36"
Waist - 31.75"
Belly - 39.75"
Hips - 40.25"
Thigh - 22.5"
Calf - 14.25"
Scale weight - 146.2 pounds
Body fat - 52.7 pounds - 36%
Lean mass - 93.5 pounds - 64%

July 19, 2015
Neck - 12"
Bust - 36"
Waist - 31.625"
Belly - 39.5"
Hips - 40.125"
Thigh - 22.25"
Calf - 14.125"
Scale weight - 144.4 pounds
Body fat - 51.6 pounds - 35.8%
Lean mass - 92.8 pounds - 64.2%

In the past four days, I have lost 1.1 pounds of body fat, but I have also lost 0.7 pounds of lean mass.  I would rather have lost less weight on the scale in order to have not lost muscle.  This muscle loss came after eating only 66 grams of protein for the day.  I was basically having only Bulletproof Coffee for one meal and splitting my protein allowance for the day between the other two meals.

The reason for partitioning my macros this way is to make sure that I am eating at least 30 grams of complete protein at each of my two main meals.  The idea for this came from Dr. Donald Layman, PhD.  In this video, Dr. Layman explains why it is necessary to eat at least 30 grams of protein at each meal in order to achieve protein synthesis.  Dr. Layman says that it is necessary to eat three meals per day, with at least 30 grams of protein at each meal, but I am questioning if this is a good idea for a Type 2 Diabetic.  Most of the ketogenic diabetes blogs I am following say to eat much less than 90 grams of protein per day to keep high blood sugar at bay.  So I am going to experiment on myself with a new n=1.  I am going to "sneak up" to eating more protein at each meal, until I get up to the 90 grams of complete protein (this would be protein that contains all the essential amino acids, but not the protein that comes as part of the vegetables that I eat, which are incomplete proteins), or until my blood glucose starts increasing, whichever comes first.  So here is my plan for this coming week:

Breakfast (Bulletproof Coffee with whey protein isolate):
437 calories
43.5g fat (89.7%)
10.7g protein (9.8%) of which 10g are complete protein
0.6g net carbs (0.6%)

For lunch and dinner, I will eat whole foods.  For each of these two meals, I will budget 30g of complete protein, plus whatever small amounts of incomplete protein are contained in vegetables.

I will budget no more than 5g of net carbs for each meal.  If I fall short on carbs at lunch, I will not try to make it up at dinner.

As far as fat goes, I am a little on the fence about it.  Part of me thinks that I should hold the fat low in order for my body fat to get burned, and part of me thinks that I should keep fat higher, to make my food more palatable, and to keep more in line with a true ketogenic diet.  Two schools of thought.  Looking back at my old food and weight loss logs, I see that having more fat did not stop weight loss or muscle gain, so I am not going to restrict fat.  I am also not going to force fat in order to get it up to a certain percentage of my food intake.

What I am going to do is eat the amount of fat that seems right for each meal, and let the grams fall where they may.  For instance, I am having quite a bit of fat at breakfast.  If I eat a salad with protein for lunch, I will add enough oil in my homemade salad dressing to balance the apple cider vinegar I use.  That seems to be about 4-1/2 teaspoons of oil for the 4-1/2 teaspoon of vinegar.  If I eat protein with a cooked vegetable, I will use a tablespoon of fat of some kind on my meat, and another tablespoon on my vegetables.  For "dessert", I will treat myself to one of my fat bombs, which is one of the recipes I contributed to "The Fat Fast Cookbook".  (shameless plug)


Lunch (green salad with homemade dressing and some sort of protein):
560 calories
43.9g fat (70.6%)
36.1g protein (25.8%) of which 30g are complete protein
5g net carbs (3.6%)

Dinner (cooked protein and vegetables with butter, oil, lard, etc.):
621 calories
52.2g fat (75.6%)
32.8g protein (21.1%) of which 30g are complete protein
5g net carbs (3.2%)

The total for the day, based on this example:

1618 calories
139.7g fat (77.7%)
79.5g protein (19.7%) of which 70g are complete protein
10.7g net carbs (2.7%)

(Edit at the end of the day)  Here is a chart to show how I ate today and how it affected my blood glucose, which is not much!

(click to enlarge)

My plan for the future is to try to keep increasing protein each week.

Week 1:  70g of complete protein (10 breakfast, 30 lunch, 30 dinner)
Week 2:  80g of complete protein (20 breakfast, 30 lunch, 30 dinner)
Week 3:  90g of complete protein (30 breakfast, 30 lunch, 30 dinner)

By the time I get to Week 3, I should be up to the 30g of complete protein per meal that Dr. Layman recommends that I eat.  It remains to be seen if my blood glucose will stay under control doing this.

Oh, I almost forgot...

WHAT ABOUT HUNGER???

As soon as I started eating this way, I noticed that the only time I am hungry is first thing in the morning on the days I have to get up at 4 am but do not have breakfast until 8 am.  Why do I wait to eat?  Because I just can't eat a full breakfast before dawn, and if I did, it would mean getting up even earlier that 4 am to prepare and eat before leaving for work at 5 am.  Not only that, but I am not able to have lunch until I get home around 1:30 pm, and if I ate at 4 am, there would be a 9-1/2 hour break before lunch.  So, I have a cup of broth at 6 am at work, then have a cup of coffee at 7 am, then eat the breakfast I brought from home at 8 am.

Calorie reduction makes me hungry.  This way of eating suppresses hunger.  On the four days a week that I do not leave the house to go to work, I eat around 8 am, 1 pm and 6 pm.  I do not snack at all in between, and I am never hungry.  Being in a state of ketosis will do that for you!

I'll try to post again in a week to let you know how it went for the week.

Thanks for reading!

This photo, by the way, was taken by my wonderful husband on our 40th Wedding Anniversary on October 27, 2014.

ENJOY EATING SATURATED FATS - THEY'RE GOOD FOR YOU

HOW TO EAT MORE FAT - MARK'S DAILY APPLE

A great new post from Mark Sisson:

The leaders of the dietary establishment either keeled over or started arming themselves with pitchforks as I wrote that title. (It’s a good day to enjoy the subversion, I think.) On a serious note, let me unpack this worthy question – one I tend to get often: how does one incorporate more fat into a day’s eating? This common inquiry usually comes from someone new to the Primal way of eating; someone that has just started ditching grains and sugars and is having a hard time replacing carbs with the fats they’ve always been told to avoid. And replace, at least in part, they must, or experience the inevitable crankiness and hunger (and possible failure) associated with not eating enough food.

Of all the things we do for our health, I think we all find this to be one of the more enjoyable efforts – at least once we get the hang of it. Go as clean as you can of course – pastured and organic or as close to it as you can obtain and afford. (It ensures better nutrition and fewer toxins.) But let’s not get caught up in details today. I’m ready to dig in. Are you?

Read the rest of the article here to find out Mark's take on eating more fat and how to do it.

NUTRITIONAL KETOSIS - WEEK 3 RESULTS

It's been three weeks since I started my experiment with nutritional ketosis.  I am still eating higher fat and lower protein and very low carb.

After two and a half weeks, I decided that I needed to change things up a little bit.  Starting to gain weight and inches this past week is showing me that I may need to scale back on the fat a little bit.  I've been sharing results with some folks over at the Low Carb Friends forum, who are also testing blood ketones and glucose, and they've been nice enough to give me some quotes from the Phinney/Volek book that talk about nutritional ketosis.  Evidently, the book says to only keep fat extremely high if you are a high-performance athlete.  Last time I checked, I was not one of those.  The book says that you will always keep your protein and carbs at the same level, and increase or decrease fat based on your weight gain or loss desires.

So, two days ago, I started cutting back on fats.  I also increased my carbs, but only a little bit - 7 grams.  After a week of this, we'll see how I am doing.

Here are some of my charts:

In summary, in the past 3 weeks:

I lost 1/4" around my neck, 1-7/8" around my waist and 1/2" around my hips.

I lost 3.2 pounds on the scale (lost 4.8 pounds of body fat and gained 1.6 pounds of lean mass).

I went down 2.5 percentage points on my body fat.

I went down 0.037 points on my waist-to-hip ratio.

If you want to know exactly what I am eating, look here, and then you can click the page numbers at the bottom to see each individual day.

Because I changed the way I was eating halfway through the week, my averages are a little skewed. Here is the average of what I actually ate last week, but I am leaving out Wednesday because the cake and ice cream thing completely threw everything off.

1740 calories

159.3g fat (82.4%)

54.5g protein (12.5%)

22g carbs (5.1%)

Just in case you are curious, this is what Wednesday looked like, after eating normally all day and then adding the cake and ice cream:

2635 calories

213.2g fat (72.8%)

61.5g protein (9.3%)

117.3g carbs (17.8%)

The weird thing about this is that these are the breakdowns of what the USDA tells us we should be eating.  They would want me to eat even more carbs than this, and obviously, a lot less fat.

For the coming week, my food will look like this:

1539 calories

135g fat (79%)

54g protein (14%)

27g carbs (7%)

I tested my blood ketones six times this past week.  Here are my results since I started testing:

I did not test my blood glucose three times per day like I did last week, because I could see that the way I was eating was keeping my blood sugar stable.  So I tested now and then, and these are my averages, not including the day that I ate cake and screwed everything up, and as you can see, I still have not fully recovered from that sugar load on July 25th:

I am continuing my experiment.  I am definitely in nutritional ketosis, so the only thing that remains is for me to find out the right amount of fat to eat so that I lose my excess body fat.
 

RELATED POSTS:
Nutritional Ketosis - Week 1 Results

Nutritional Ketosis - Week 2 Results
Less Protein - More Fat - "The Optimal Diet"

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!

TESTING BLOOD KETONES WITH JIMMY MOORE

Recently, Jimmy Moore, in his Livin' La Vida Low-Carb Blog, shared that he started a new n=1 experiment that was inspired by his reading of the new book The Art and Science of Low Carbohydrate Performance (2012) by Stephen Phinney and Jeff Volek, who also authored The Art and Science of Low Carbohydrate Living (2011) and, along with Eric Westman, The New Atkins For a New You (2010).

In this newest book, the subject of blood ketone testing is explained in detail.  In the "olden days", we had to use urine testing strips for testing ketone levels, and the results were less than consistent.  Back in 2000, my husband, Bill, lost around 30 pounds eating very low carb but never turned a strip purple, which is supposed to show evidence of ketosis.  I, on the other hand, did not lose any weight, and my testing strips turned as dark a shade of purple as they could.

Today, there is a new over-the-counter system available to test blood ketone levels.  Although designed for diabetics, this system can easily be used by people like myself and any other non-diabetic who wants to get to the bottom of why they are not losing weight eating low carb.  Jimmy Moore explains here how he is testing his blood for evidence of ketone bodies with a handy dandy hand-held meter which is very similar to the blood glucose meters that you can buy in any pharmacy.  One drawback is that, although the meter is pretty cheap, the testing strips for ketone measuring are pricey at $5-$6 per strip, but I guess it would be worth it to achieve the results that you have coming to you!  Typically, one strip is used each day.  You can find the meter and the strips on Amazon.com here and here.

I bought my meter from Amazon, but I bought my strips here, because they were much cheaper.

Jimmy explains how it has become obvious to him, after testing his blood for ketone bodies, that although he has been diligently eating low carb all these years, he has probably been eating too much protein for his system.  And anyone who has been low carbing for any amount of time has heard that excess protein, beyond what the body needs, will be turned into glucose and will hamper ketosis.  Even a zero- or nearly-zero-carb diet will not produce weight loss if too much protein is being eaten.  I'll let Jimmy tell you the details of just what exactly he is eating now, but suffice to say his protein intake is less and his fat intake is more, along with his regular low carb.

Jimmy spent a few days visiting with Tom Naughton this past week, and Tom was able to witness first hand the new way Jimmy is eating and losing weight, and blogged about it here.  Tom bought one of the meters, too, and is hoping to shed those last couple of pounds himself.

Obviously, I have found this very interesting!  Anyone who has read this blog knows of my struggles to get rid of my remaining visceral fat.  Although I am thrilled that I have lost 17 pounds of body fat in the last three years of low carbing, currently, I am still carrying around an extra 20 pounds of body fat that I would love to get rid of, once and for all, and the idea that this might just be the answer has me, well, pretty excited!

Today, I tracked my grams of fat, protein and carbs for the first time since last summer.  Drs. Phinney and Volek advise that you should be eating between 0.6 and 1 gram of protein for each of your pounds of lean body weight.  With my goal of lean body weight at 99 pounds, I should be eating between 59 and 99 grams of protein per day.  In the past, I've tried 99 grams per day and more, but the results were bad, so this time, I will go to the low side and see how that works.  Today, I ate 160g of fat (84.7% of total calories), 47g of protein (11.1% of total calories) and 18g of total carbs (4.3% of total calories).  I was not hungry all day, eating mostly fat with a little bit of protein and carbs for breakfast and lunch, and a normal-ish dinner of salmon patties and salad.  I also did some interval training outside (6 intervals of slow walking interspersed with fast-as-I-could-go sprints) before it got too hot outside to bear.

I really want to buy the meter and the strips to see if I am in ketosis, but money is tight and I have not decided whether I need to spend the money yet.  If I start losing weight by just eating this new way, I may skip the meter all together.  But I love data, and I probably will not be able to resist forking over the cash to do at least 10 days worth of testing.

I started out this morning at 147.4 pounds on the scale, with a body fat percentage of 36.3%.  I wonder what I will weigh next week?  Golly, I hope this is the answer I have been looking for!

FAT BOMBS!

At the Low Carb Meet & Greet yesterday, we were talking about Fat Bombs - you know, those little treats we make ourselves for when we need a little extra fat.  There are lots of recipes out there, and this one is mine:

These are the five ingredients for my Fat Bombs, which you stir together well:

3/4 cup melted coconut oil
9.5 Tbs. (150g) almond butter
60 drops (about 3/8 tsp.) liquid Stevia
3 Tbs. cocoa
9 Tbs. melted salted butter

Pour a scant 2 Tbs. into each of 24 candy or mini muffin molds.  I use a silicone candy mold that I bought at Michael's Crafts.  If you prefer, you can use those little paper mini muffin cups, lined up on a cookie sheet.

I place my candy mold on a small cookie sheet first, and then fill it, then put it in the freezer.  If you try to put it in the freezer without first putting it on a cookie sheet, you'll be sorry.

Freeze for at least 30 minutes, then pop out the Fat Bombs and store them in a bag or other container in the freezer.  You can keep them in the fridge, but as soon as you hold one with your hot little fingers, it will melt really fast.  Frozen, it melts slower.

Nutritional info for one Fat Bomb:
145 calories
14.7g fat (91.2%)
1.53g protein (4.2%)
1.67g carbs (4.6%)

VAT (Visceral Adipose Tissue vs. SAT (Subcutaneous Adipose Tissue)

MY LOW FAT DIET REALLY WORKS!

LCHF IS THE S***

This is a riot and so true:

SATURATED FATS ARE HEALTHY TO EAT - US WELLNESS MEATS

Finally, more evidence that points to what we already knew...

Dietary intakes of saturated fats are not linked to cardiovascular disease, so says a meta-analysis from across the world. 

The conclusion that dietary intake of saturated fat was not associated with an increase in coronary heart disease or cardiovascular disease was reported in the American Journal of Clinical Nutrition this past February, 2010.

This study accumulated data from almost 350,000 subjects in twenty-one different studies. The data from these study subjects showed the development of approximately 11,000 cases of Coronary Heart Disease (CHD) or stroke. However, there was no link established between the subject's saturated fat intake and the incidence of CHD, stroke, or Cardiovascular Disease (CVD), and this did not change when the researchers focused their research to consider age or sex, or the quality of the study. 

"Our meta-analysis showed that there is insufficient evidence from prospective epidemiologic studies to conclude that dietary saturated fat is associated with an increased risk of CHD, stroke, or CVD," wrote the researchers, led by Dr Ronald Krauss from the Children's Hospital Oakland Research Institute in California. 

"[However,] nutritional epidemiologic studies provide only one category of evidence for evaluating the relation of saturated fat intake to risk for CHD, stroke, and CVD. An overall assessment requires consideration of results of clinical trials as well as information regarding the effects of saturated fat on underlying disease mechanisms, as discussed elsewhere in this issue. Nonetheless, a summary evaluation of the epidemiologic evidence to date provides important information as to the basis for relating dietary saturated fat to CVD risk," the researchers said.

The study, funded by the US National Dairy Council, Unilever, and the National Institutes of Health, challenges the mainstream majority thinking that saturated fats are detrimental to heart health. 

The old "lipid hypothesis" tried to show a direct relationship between the amount of saturated fat and cholesterol in the diet and the incidence of coronary heart disease. This lipid hypothesis for heart disease received a huge amount of publicity and public favor, in spite of the fact that other studies showed this hypothesis to not be true many years ago. 

In the last 50 years, big food processing companies jumped on the bandwagon and pushed the lipid hypothesis even further into the mainstream. Oddly enough though, prior to the 1920's, coronary heart disease was very rare in America. Americans ate lots of lard, butter, beef and cheese, but heart attacks and strokes were uncommon.

While vegetable oils and hydrogenated fats were pushed as the "healthy choice" over saturated fats for the next forty years, the incidence of coronary heart disease actually increased dramatically, so much so that today, heart disease remains a primary cause of death in the U.S. With the advent of the revised food pyramid, grains and carbohydrates pushed those numbers up even higher. 

If heart disease had any connection to saturated fats in the diet, how could it be that the use of saturated fats has gone down, while the use of processed vegetable oils like margarine, shortening, and trans fats-as well as sugar and grain-based processed foods have increased dramatically? 

Clearly something has been amiss here. 

Oils like canola, corn, soybean, and sunflower have been pushed as the healthy substitutes over saturated fats. It is these oils, though, that contribute to inflammation in the body, and upset the ratio of Omega 3 fatty acids and Omega 6 fatty acids.

Diets high in vegetable oils -especially hydrogenated vegetable oils, cause a variety of health problems, including inflammation. This inflammation leads to an increased tendency to form blood clots, which leads to heart attacks and strokes, now at higher than ever levels in the U.S. 

Most of the fat in our bodies and in the food we eat comes in the form of triglycerides, which are made of three fatty-acid chains attached to a glycerol molecule. Elevated triglycerides in the blood are usually linked to a higher than average potential for heart disease, but triglycerides do not come directly from dietary fats. Triglycerides are made in the liver from sugars that have not been burned for energy. Excess sugars in the body are from starchy carbohydrates, particularly refined sugar and white flour. It appears that triglycerides and vegetable oils and excessive Omega 6 fatty acids are causing much of the problem.

So you see, saturated fats are not the villains they have been portrayed to be, nor are they the cause of today's diseases; in fact quite the opposite is true. 

Saturated fats play an important role in the body in several ways: 

• Saturated fatty acids make up at least 50% of the cell membranes. They give cell walls their necessary stiffness and integrity.

• Saturated fats are extremely important for bone health. For calcium to be effectively utilized in our bones at least 50% of dietary fats should be saturated--so skim milk will not help your bones.

• Saturated fats are vital to the liver and help protect it from toxins such as alcohol and other drugs. 
 
• Saturated fats strengthen the immune system. 

• They are needed for the proper utilization of other essential fatty acids - Omega 3 fatty acids are better retained in the tissues and utilized by the body when the diet is rich in saturated fats as well.

• The fat around the heart muscle is actually highly saturated. The heart draws on this reserve of fat in times of physical stress. 
 
• Saturated fats lower a substance in the blood called Lp(a), or Lipoprotein(a), that indicates a tendency towards heart disease. 

• Short- and medium-chain saturated fatty acids have important antimicrobial properties. They protect us against harmful microorganisms in the digestive tract. 

The scientific evidence is beginning to pile up and does not (and never did) support the assertion that saturated fats clog arteries and cause heart disease. 

So while saturated fats have not yet been exonerated in the mainstream public, the tide is beginning to turn. You as an educated consumer, and your own health advocate know the truth about saturated fats vs. the evils of vegetable oils and refined foods. Enjoy your grass fed steaks, butter, cheese and lard and know you are doing your body good.

References:
Mary G. Enig, PhD, and Sally Fallon, "The Skinny on Fats", Weston A. Price Foundation, Jan, 1999.
Stephen Daniells, "Saturated Fats Not Linked to Heart Disease: Meta Analysis", Food Navigator.com, February 2010.
P.W. Siri-Tarino, Q. Sun, F.B. Hu, R.M. Krauss, "Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease", American Journal of Clinical Nutrition, February 2010.

To visit US Wellness Meats, click here.

For another great article on the importance of eating saturated fat by the Weston A. Price Foundation, click here.

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.

DOWNLOAD MY SIMPLE FAT PROTEIN CARBS CALCULATOR HERE

I just put my calculator online, so it can now be downloaded directly to your computer.

The calculator is very simple, and helps you figure out how much to eat each day on Atkins. The instructions are included in the calculator.

Although you may need to make adjustments as you go along, this calculator will give you a starting place.

To get the calculator, click here and then be sure to click "Download" to be able to input your own numbers:

If you have any questions after you download the calculator, post them here.  Have fun!

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

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!

To visit Tom Naughton's blog, click here.