The comments posted in response to my previous post on calculating protein got me rereading Lyle MacDonald's book and rethinking the whole question of what we "know" about nutrition.
Partly this is because, after two weeks of eating a low calorie, very low carbohydrate diet containing the nutrients that all the nutritional calculators tell me should have resulted in a weight loss of 2 lbs, I haven't come close to losing 2 lbs. The same thing happened last year when I dieted for an entire month, logging and weighing anything and eating on an average of a measly 1150 calories a day--for an entire month--only to see a whopping 1 lb weight loss that vanished when I started eating more food.
The explanation of why my body pays no attention to what nutritional research says should happen is most likely my age and gender: I'm a lady in late middle age, but over the past 50 years all nutritional research involving weight and diet has been conducted exclusively in healthy young men or, in those rarer cases when the studies included females, young females.
No one has done a well-conducted study in which the nutritional needs and physiology of ladies past the age of menopause has been thoroughly investigated. When I was young, I could lose five pounds in a couple weeks just by not eating bread, potatoes, and dessert. Now I can to eat a lot less than what guys in those famous starvation experiments ate--guys who didn't weigh a whole lot more than I do--and not even lose a pound.
I know age has a lot to do with this. Cutting out estrogen packed weight on me faster than you can say, "Now I know why all middle aged ladies gain weight!"
So it's worth thinking more deeply about what the nutritional research has "proven." The protein calculator I put together was based on information taken from studies of starvation and nutrition conducted on young men which came up with the "fact" that people need 100 grams of carbohydrate to run their brains. They also came up with the idea that any diet providing under 100 grams a day of carbohydrate is ketogenic. This last bit of information is repeated everywhere that the topic of ketogenic dieting is discussed.
But in my many years of ketogenic dieting, I found that I would pack on glycogen--a sure sign I was no longer in a ketogenic state and was taking in excess dietary carbohydrate--as soon as I ate over 75 grams of carbohydrate. NOT 100. The dramatic water weight gain of 2 or 3 lbs I experienced as soon as I exceeded that carbohydrate intake level was predictable and reproducible. So it's pretty clear that for me somewhere under 75 grams is my ketogenic threshold.
If that is the case, then, what does it say about how much glucose my brain needs? Who knows? No one has studied the glucose needs of the brains of old us ladies. It is possible that as we get older, we may make adaptations very much like those of long term ketogenic dieters and be able to run our brains on less carbohydrate and more of something else even when not in a long-term ketogenic state.
Why do the physiologies of old ladies work so hard to pack on weight and manage to do it on such low caloric inputs? Beats me. My guess is that it has something to do with the fact that evolutionary pressures select for the kinds of genes that produce old ladies who can survive on lower amounts of food because their presence enhances their grandchildren's chance of surviving to reproductive age.
If granny eats too much, when times get tough she's not likely to survive--what food there is goes to the males and more aggressive young women who grab it for their kids. But if granny can pack on some fat by living on scraps in the good times, she'll survive the tough times and put her life-accumulated wisdom to the task of keeping the grandkids alive so they can reproduce those genes.
Should Old Ladies Diet?
I've already cited the NHANES data that concludes that a bit of overweight appears to enhance long-term survival and that being thin or a normal weight after a "certain age" predicts an enhanced likelihood of death. So it might make sense to just live with the weight.
I saw this among my mom's friends. The ones who watched their weight and went to the gym are long gone. My mom, whose only exercise program involved walking to the restaurant for lunch and strolling around the plus size department, out lived them all.
That suggests to me that, by denying me weight loss despite my best efforts, Nature is trying to tell me something. On the other hand, the particular weight I'm trying to dislodge packed on extremely quickly--over five founds within two months. At that rate of gaining I was not going to end up in the comfortable "overweight" range, but be heading for "obese" in another year--a status that does not correlate with health and could really mess up my blood sugar control.
So a-dieting I go.
No matter what the weight outcome of this particular diet, the good thing about doing a month or so annually of a stringent diet is that it makes me aware of the bad eating habits that have crept in over the year. I notice all those "daily" pieces of chocolate that turned into five daily pieces of chocolate, to say nothing of the once rare visits to the bakery with the great homemade soup and homebaked bread that got out of control.
A couple weeks of carefully watching everything I eat and eating just about no carbohydrates at all should put me back to where eating that one chocolate a day seems like a treat again and the soup visit happens twice a month, not two or three times a week.
I'm going to stick with this extremely low carb diet for a while longer because eating that way is the only way I can go without insulin, and the change to analog insulins--though it resulted in beautiful blood sugars--seems to be what caused the sudden and unexpected weight gain. As I said before, I can't eat 2-5-5 forever. It's far too restrictive. But I'm heading into week 3 now, and will go through it before deciding on my next step.
Eventually I have to figure out a way to add more carbs and find an insulin regimen that won't pack on the weight. Finding out that 3 oz. of white wine at night is almost as good as very low does basal insulin for controlling fasting BG is a good first step, though I don't know if it will hold up when I start eating more than 5 grams of carbs per meal again. I can do this because the kind of diabetes I have involves a failure to secrete in response to rising blood sugars, but I do still produce a small but steady amount of basal insulin--just not enough to cover any significant amount of carbs at meals any more.
But for now, my diet is doing a good job of resetting my expectations and providing my annual overhaul of my eating habits. If I could lose a couple pounds, that would be nice, too. At least I'm not going to be gaining 5 lbs this month.
January 14, 2008
January 11, 2008
How Much Protein Do You Need on A Lower Carb Diet?
I've replaced my admittedly confusing web page about how to calculate your protein needs on a low carb diet which is found on my Low Carb Facts and Figures site with a new automatic on-line calculator. So now you can easily figure out how much protein you need to eat on your own low carb diet based on your own daily carb intake, your weight, and how long you have been eating a low carb diet.
The assumptions on which it is based are documented on the calculator pages. They are drawn from the research Lyle MacDonald published years ago in his book, The Ketogenic Diet.
You can try out the calculator HERE
The most important thing I learned from Lyle's book is something few nutritionists seem to understand. While it is true that the brain needs some glucose to run properly, since unlike all the other organs in the body it cannot run entirely on ketones or free fatty acids, 58% of the protein grams you eat can be converted into glucose in the liver. So there is no need to eat any carbohydrate at all.
But even more importantly, as Lyle documents in his book, after three weeks in a ketogenic state, the brain adapts and needs much less glucose than before. So while it is true that you need about 100 grams of glucose when you start eating a ketogenic low carb diet--one that provides less than 100 grams of carbohydrate a day--after three weeks on a ketogenic diet your brain needs only 40 grams of glucose.
Dr. Bernstein advises in his book that if you are eating his 6-12-12 grams of carb per meal regimen and are not losing weight, you should cut your protein intake. This should only be done after you have been on the diet long enough to have dropped your protein need, and you are trying this approach do double check that the amount of protein you are eating is enough to keep your muscles repaired.
If you are not eating a ketogenic diet, you will need about 100 grams of glucose to run your brain. You can use the calculator to calculate your protein need in that case, just select that length of diet option for "less than 3 weeks" on a low carb diet.
The assumptions on which it is based are documented on the calculator pages. They are drawn from the research Lyle MacDonald published years ago in his book, The Ketogenic Diet.
You can try out the calculator HERE
The most important thing I learned from Lyle's book is something few nutritionists seem to understand. While it is true that the brain needs some glucose to run properly, since unlike all the other organs in the body it cannot run entirely on ketones or free fatty acids, 58% of the protein grams you eat can be converted into glucose in the liver. So there is no need to eat any carbohydrate at all.
But even more importantly, as Lyle documents in his book, after three weeks in a ketogenic state, the brain adapts and needs much less glucose than before. So while it is true that you need about 100 grams of glucose when you start eating a ketogenic low carb diet--one that provides less than 100 grams of carbohydrate a day--after three weeks on a ketogenic diet your brain needs only 40 grams of glucose.
Dr. Bernstein advises in his book that if you are eating his 6-12-12 grams of carb per meal regimen and are not losing weight, you should cut your protein intake. This should only be done after you have been on the diet long enough to have dropped your protein need, and you are trying this approach do double check that the amount of protein you are eating is enough to keep your muscles repaired.
If you are not eating a ketogenic diet, you will need about 100 grams of glucose to run your brain. You can use the calculator to calculate your protein need in that case, just select that length of diet option for "less than 3 weeks" on a low carb diet.
January 10, 2008
Diet Diary
I've written a bit about dieting on this blog of late because after maintaining a 15% weight loss for over four years with little effort, I found myself packing on weight this winter and realized I better do something about it.
There were a couple reasons for the weight gain:
Whatever the explanation, when I found myself up ten pounds at the end of the year compared to the previous January, I knew I needed to take steps.
I decided to do a very low carb diet because the analog insulins seemed to be causing me to gain weight and because my last attempt at weight loss, after the estrogen fiasco, a carefully weighted and measured low calorie diet with with more carbs, where my blood sugar was very well controlled by meds had not worked.
Because I wanted to eliminate all insulin if possible I decided to eat the classic Atkins induction diet: meat, cheese, eggs, whey protein powder, a large salad daily, and low carb veggies like spinach and green beans. Nothing else.
At first this diet was giving me too-high fasting blood sugars and hence too high post-meal blood sugars. Since the fasting blood sugar I wake up with each morning tends to stay my fasting blood sugar all day, that was a problem. But I accidentally discovered that drinking 1/2 a glass of white wine in the evening knocked my fasting blood sugar down significantly. With that tweak, I was able to stay in the 90s all day instead of the 110-115 range. Though to do this I could not even eat at the 6-12-12 carb level Dr. Bernstein recommends. I've been eating about 3-5-5.
This is no surprise. The reason I started using insulin in the first place is that I was going up to 140 mg/dl eating 12 grams of carbs.
The good news is that I've lost three pounds of water weight and one pound of real fat after twelve days. The bad is that this isn't a way that I can keep eating for a long time as it is too extreme. I'm going to stick with it for another week or two and then take stock.
Meanwhile here are a couple other things I remembered about dieting that might be of interest if you're dieting:
There were a couple reasons for the weight gain:
- Last winter I went off my usual very low dose estrogen supplementation regimen for a few months. Blood sugar control got harder and weight started packing on. When I went back on the very low dose regimen (1/6 of what most women take) the weight I'd put on remained.
- Last summer I developed a burning pain in my upper stomach region which seemed to be linked to metformin, so I stopped taking metformin. That cleared up the stomach problem. It came back when I went back on met, so I stopped it a second time this November. The weight gain I experienced the first time I stopped metformin was modest, but when I stopped metformin the second time and also had to switch to using Lantus and Novolog instead of the R insulin I'd been taking for years thanks to what look like antibody problems with R, my weight gain increased dramatically. I gained about five pounds in two months.
- One last factor that may have played into weight gain is this: In the summer of 2006, for some reason that my doctor never adequately diagnosed despite a lot of tests, I started having a problem with mild nausea that kept me from being able to eat. I dropped five pounds without dieting. This was, I have to tell you, terrifying, given that I'm a cancer survivor and that I had never before in my entire life lost a pound that wasn't the product of a lot of hard dieting work. But tests showed no obvious cancer return and after a couple months, the problem, whatever it was, went away and I went back to eating normally. However, once I could eat again, I gained back those five pounds I'd lost very quickly and it seems like after that regain I've been much more prone to gain weight. So I wonder whether getting down to the the lowest weight I had ever been in fifteen years may have further lowered my metabolic rate and made it easier to gain weight in the future. There is a lot of research suggesting that the more you lose the more your metabolism slows.
Whatever the explanation, when I found myself up ten pounds at the end of the year compared to the previous January, I knew I needed to take steps.
I decided to do a very low carb diet because the analog insulins seemed to be causing me to gain weight and because my last attempt at weight loss, after the estrogen fiasco, a carefully weighted and measured low calorie diet with with more carbs, where my blood sugar was very well controlled by meds had not worked.
Because I wanted to eliminate all insulin if possible I decided to eat the classic Atkins induction diet: meat, cheese, eggs, whey protein powder, a large salad daily, and low carb veggies like spinach and green beans. Nothing else.
At first this diet was giving me too-high fasting blood sugars and hence too high post-meal blood sugars. Since the fasting blood sugar I wake up with each morning tends to stay my fasting blood sugar all day, that was a problem. But I accidentally discovered that drinking 1/2 a glass of white wine in the evening knocked my fasting blood sugar down significantly. With that tweak, I was able to stay in the 90s all day instead of the 110-115 range. Though to do this I could not even eat at the 6-12-12 carb level Dr. Bernstein recommends. I've been eating about 3-5-5.
This is no surprise. The reason I started using insulin in the first place is that I was going up to 140 mg/dl eating 12 grams of carbs.
The good news is that I've lost three pounds of water weight and one pound of real fat after twelve days. The bad is that this isn't a way that I can keep eating for a long time as it is too extreme. I'm going to stick with it for another week or two and then take stock.
Meanwhile here are a couple other things I remembered about dieting that might be of interest if you're dieting:
- Weight fluctuates up and down all the time, but if I average up my daily values each week and pay the most attention at the weekly average weight, I'll see a much clearer picture of my progress.
- Successful weight loss is slow. I went back and had a look at the records from the year I spent losing the 30 lbs and found that after the first month I never lost more than three pounds a month. Some months I lost only two. That means I better accept that weight is not going to drop off at anywhere near the rate I'd like (which is, of course, instantly!)
- No snacks. If you are young and have a real metabolism, you may be able to ignore this, but at my age snacks stall weight loss.
The older we are, the less food our bodies need and that means no nuts, no slices of cheese here and there, and modest portions at meal time. I believe that even on a low carb diet calories matter. Especially for people who in the past were long term low carbers like me whose bodies are no longer shocked and surprised by the switch to a ketogenic diet.
Cutting the carbs eliminates hunger and makes it easy to cut calories way down, but it's very easy to rack up a couple hundred calories by adding even the lowest carb treats. My food scale tells me that I can add three hundred calories of nuts and cheese and not even feel like I have eaten anything. So I don't even try. - Water weight loss is motivating, but not real.
I also found that if I'm not taking metformin I lose a lot more water weight when I cut back on carbs than I do if I am taking it. In fact, the last couple times when I went to a ketogenic diet while taking metformin I didn't lose any water weight at all. This time without met in the mix I lost three pounds the first couple days.
This gives an interesting insight into what metformin might be doing for me--suppressing liver glycogen synthesis? Or it might just mean that Lantus was packing water on me since I also stopped the Lantus when I started the diet.
It's hard to say. Whatever it is, I have to remember that as soon as I go over the ketogenic boundary, I'm likely to put those three pounds of water weight back on, so I shouldn't consider those three pounds as lost weight. Still I feel sleek and thin right now and my clothes fit again, and that does make it easier to not eat.
January 7, 2008
Health Care and Candidates
Whatever your political beliefs, if you have diabetes, health care should be at the top of your concerns when evaluating the campaign promises of any candidate.
I've had a couple random discussions with people of every political stripe lately, and what I've found is that people who have jobs or have spouses who have jobs that provide family health insurance have no clue what the rest of us are up against when it comes to getting insurance. Even worse, many don't realize how the loss of the job might bring with it the permanent loss of the ability to get health coverage thanks to their having a chronic health condition.
One person I know who identifies themselves as a rock ribbed Republican told me they are firmly opposed to any government intervention in health care and that, indeed, they wish they could opt out of Social Security when they turn 65. This person has total health care coverage care of a generous plan their spouse gets from a Fortune 100 employer. What they don't understand is that thanks to both having been diagnosed with preexisting conditions, were their spouse to lose their job, the power of the insurance lobby in their home state ensures that neither of them would able to buy private insurance at all.
If you have diabetes or for that matter, just about any diagnosis at all in your medical records, you have a "preexisting condition". In many states in the U.S. insurers are able to deny coverage to anyone who applies for insurance who has a preexisting condition. To get individual health insurance coverage you will have to give access to all your health records and you may even have to submit to a blood test. Even worse, if you do file a claim for an expensive hospital stay after getting insured, your carrier may refuse to pay it by saying that the claim points to your having had an undisclosed preexisting condition. This isn't hearsay. It has happened to people I know personally.
What exactly constitutes a preexisting condition? For one friend who was 22 years old, it was a single visit to an ER with a mysterious symptom which was diagnosed at the ER as being from a migraine headache. That was enough to keep them from being able to buy into a private health insurance plan. For someone else, it was having a doctor write in their record that they needed to have a hysterectomy. As it turned out, they didn't. But even years after refusing the surgery--with no further medical problems--the existence of that doctor's recommendation kept them from being able to buy into an individual health plan. A diagnosis of mitral valve prolapse--which is extremely common, was grounds for yet another person's health insurance rejection. Pre-diabetes? Forget it. Cancer of any type, you are uninsurable. Taking an antidepressant? That implies a preexistant condition too.
If you have a really serious condition, this lack of access to health insurance may lead to an early death. A recent study found that people with cancer are much more likely to die if they don't have health insurance mostly because they can't afford doctors visits and get late diagnosis, though the costs of chemotherapy may put it out of reach too.
I have a friend who has MS. This friend and their spouse are both self-employed and the family earns a good income. Unfortunately, at the time they bought their current health insurance plan, since they were both healthy they did not include drug coverage in their plan. Now after the MS diagnosis, they are trapped in their current plan with no possibility of buying another. Drugs for MS cost many thousands of dollars a month so the "private sector" insurers stay profitable by excluding new customers with MS from their plans. Unable to get the expensive drugs that show promise of halting the progression of this terrible disease, my friend may end up in a wheelchair years earlier than someone with a corporate job, just because someone checked off the wrong box on their insurance application a few years ago.
Another thing people who have insurance through their jobs don't understand is that just when you reach the decade of your 50s, when employers are most likely to fire you no matter how good your job performance, even if you can buy yourself self-paid health insurance it becomes extremely expensive.
All states I know of allow private sector insurers to use "age banding." That means that someone 30 years old may pay $300 less each month for the identical coverage offered to someone 50 years old no matter what the actual health history of these two people may be.
Massachusetts recently passed a law that makes it possible, and in fact, mandatory for everyone in the state to buy insurance. This is good in that it means that people with preexisting conditions and no employer can buy insurance. But since Massachusetts doesn't outlaw age banding, the monthly premium charged someone 50 or older in the cheaper plans runs about $500 a month per person with quite a lot of deductibles and the cost is predicted to rise steeply next year.
Where a person who has lost their job and has to buy their own insurance is supposed to come up with hat kind of money is a mystery that seems to have eluded the politicians who tout this as an "affordable" plan. For someone earning $100K a year $6,000 might be affordable, but the median family income in towns in the western part of Massachusetts where I live ranges from $35,000 to $51,000. The $12,000 a year it would cost a median income couple in their 50s to buy insurance is a huge bite of that income. For a family faced with a need to buy insurance thanks to sudden unexpected job loss it is out of reach.
When candidates talk about "private sector" solutions for providing health insurance they are talking like plans like that of Massachusetts that allow for-profit insurers to supply age-banded insurance to the public at any cost they decide to charge and passing laws that force everyone to buy this insurance no matter what it costs. Only highly paid politicians who don't have to pay for their own insurance could consider this a good, affordable, solution.
To me it seems ridiculous to think that private insurers who are paying the multimillion dollar salaries of the insurer's executives and the profits of their shareholders before a single dollar gets spent on health claims can solve the problem of offering affordable health insurance.
A health care "solution" that is really welfare for the insurance companies and HMOs is NOT what this country needs. We need to put the brightest NON-lobbyist minds to work on the problem and come up with a way of offering health care that is fair to doctors, hospitals, and people with health care needs.
I'm not holding my breath. The health insurance lobby is funding all the campaigns, so don't expect to see anyone propose a solution that regulates or limits the huge profits of the health insurers anytime soon.
I've had a couple random discussions with people of every political stripe lately, and what I've found is that people who have jobs or have spouses who have jobs that provide family health insurance have no clue what the rest of us are up against when it comes to getting insurance. Even worse, many don't realize how the loss of the job might bring with it the permanent loss of the ability to get health coverage thanks to their having a chronic health condition.
One person I know who identifies themselves as a rock ribbed Republican told me they are firmly opposed to any government intervention in health care and that, indeed, they wish they could opt out of Social Security when they turn 65. This person has total health care coverage care of a generous plan their spouse gets from a Fortune 100 employer. What they don't understand is that thanks to both having been diagnosed with preexisting conditions, were their spouse to lose their job, the power of the insurance lobby in their home state ensures that neither of them would able to buy private insurance at all.
If you have diabetes or for that matter, just about any diagnosis at all in your medical records, you have a "preexisting condition". In many states in the U.S. insurers are able to deny coverage to anyone who applies for insurance who has a preexisting condition. To get individual health insurance coverage you will have to give access to all your health records and you may even have to submit to a blood test. Even worse, if you do file a claim for an expensive hospital stay after getting insured, your carrier may refuse to pay it by saying that the claim points to your having had an undisclosed preexisting condition. This isn't hearsay. It has happened to people I know personally.
What exactly constitutes a preexisting condition? For one friend who was 22 years old, it was a single visit to an ER with a mysterious symptom which was diagnosed at the ER as being from a migraine headache. That was enough to keep them from being able to buy into a private health insurance plan. For someone else, it was having a doctor write in their record that they needed to have a hysterectomy. As it turned out, they didn't. But even years after refusing the surgery--with no further medical problems--the existence of that doctor's recommendation kept them from being able to buy into an individual health plan. A diagnosis of mitral valve prolapse--which is extremely common, was grounds for yet another person's health insurance rejection. Pre-diabetes? Forget it. Cancer of any type, you are uninsurable. Taking an antidepressant? That implies a preexistant condition too.
If you have a really serious condition, this lack of access to health insurance may lead to an early death. A recent study found that people with cancer are much more likely to die if they don't have health insurance mostly because they can't afford doctors visits and get late diagnosis, though the costs of chemotherapy may put it out of reach too.
I have a friend who has MS. This friend and their spouse are both self-employed and the family earns a good income. Unfortunately, at the time they bought their current health insurance plan, since they were both healthy they did not include drug coverage in their plan. Now after the MS diagnosis, they are trapped in their current plan with no possibility of buying another. Drugs for MS cost many thousands of dollars a month so the "private sector" insurers stay profitable by excluding new customers with MS from their plans. Unable to get the expensive drugs that show promise of halting the progression of this terrible disease, my friend may end up in a wheelchair years earlier than someone with a corporate job, just because someone checked off the wrong box on their insurance application a few years ago.
Another thing people who have insurance through their jobs don't understand is that just when you reach the decade of your 50s, when employers are most likely to fire you no matter how good your job performance, even if you can buy yourself self-paid health insurance it becomes extremely expensive.
All states I know of allow private sector insurers to use "age banding." That means that someone 30 years old may pay $300 less each month for the identical coverage offered to someone 50 years old no matter what the actual health history of these two people may be.
Massachusetts recently passed a law that makes it possible, and in fact, mandatory for everyone in the state to buy insurance. This is good in that it means that people with preexisting conditions and no employer can buy insurance. But since Massachusetts doesn't outlaw age banding, the monthly premium charged someone 50 or older in the cheaper plans runs about $500 a month per person with quite a lot of deductibles and the cost is predicted to rise steeply next year.
Where a person who has lost their job and has to buy their own insurance is supposed to come up with hat kind of money is a mystery that seems to have eluded the politicians who tout this as an "affordable" plan. For someone earning $100K a year $6,000 might be affordable, but the median family income in towns in the western part of Massachusetts where I live ranges from $35,000 to $51,000. The $12,000 a year it would cost a median income couple in their 50s to buy insurance is a huge bite of that income. For a family faced with a need to buy insurance thanks to sudden unexpected job loss it is out of reach.
When candidates talk about "private sector" solutions for providing health insurance they are talking like plans like that of Massachusetts that allow for-profit insurers to supply age-banded insurance to the public at any cost they decide to charge and passing laws that force everyone to buy this insurance no matter what it costs. Only highly paid politicians who don't have to pay for their own insurance could consider this a good, affordable, solution.
To me it seems ridiculous to think that private insurers who are paying the multimillion dollar salaries of the insurer's executives and the profits of their shareholders before a single dollar gets spent on health claims can solve the problem of offering affordable health insurance.
A health care "solution" that is really welfare for the insurance companies and HMOs is NOT what this country needs. We need to put the brightest NON-lobbyist minds to work on the problem and come up with a way of offering health care that is fair to doctors, hospitals, and people with health care needs.
I'm not holding my breath. The health insurance lobby is funding all the campaigns, so don't expect to see anyone propose a solution that regulates or limits the huge profits of the health insurers anytime soon.
January 3, 2008
Safe Low Carb Dieting for Weight Loss
I've gotten some mail from a few people who are very concerned about a scammy, dangerous diet that is being promoted in the media right now as being "low carb." Without further publicizing the lying weasel profiting from that particular diet, I thought I'd share a few thoughts about how to construct a healthy low carb diet that you can eat, healthily, for years. I learned this stuff through participating for six years in online low carb discussion boards.
1. A low carb diet should not be a high protein diet.
Your liver has the ability to transform protein into carbohydrate. Key to losing weight on a low carb diet is that you want to lower the amount of insulin circulating in your body. Eating too much protein may not raise your blood sugar--unless you are a Type 1 or a Type 2 whose beta cells are mostly gone--but it may raise the amount of circulating insulin in your body. Insulin is the hormone that tells your body to store fat, so to lose weight you don't want to eat a high protein diet. You want to eat a diet that contains the right amount of protein.
How much protein do you need? Well, you will need protein to repair damage to your muscles. In addition, if you are eating under 100 grams of carb a day you will probably need some protein to furnish the glucose needed to run your brain. Your liver can turn about 60% of the protein you eat into glucose, so you will eat a bit more protein to provide the glucose for your brain.
Beyond the small amount of protein needed for these two functions, any excess protein you eat can stall your weight loss, and even worse, too much protein in the diet causes the infamous "diet breath" that many people incorrectly label "ketobreath". It isn't ketones you are smelling when people are doing very low carb diets incorrectly. It's byproducts of protein digestion.
How much protein will be right for you depends on how many grams of carbohydrate you are eating and your size. I have put together a web page that tells you How To Calculate Your True Protein Need.
2. A Low Carb Diet Should Be a High Fat Diet.
Most of the calories in your low carb diet should be coming from fat. Fat, unlike protein, does NOT raise blood sugar or provoke any insulin response. And now that Gary Taubes has thoroughly debunked the badly conducted, politically motivated research that was used to argue that fat caused heart disease, we can all relax and enjoy the fat we eat.
The exception to the goodness of fats is trans fat. And despite all the labels that claim "no trans fat", any food that lists "hydrogenated" fats of any type on the label does contain trans fat. There are lots of them and you should avoid eating them.
When I was in the active weight loss phase of my year long low carb diet--the one whose 30 lb weight loss I maintained for four years--fat made up about 70% of all the calories I consumed. I'm not a big meat lover, so much of my fat and protein intake came in the form of nuts, eggs, and high quality cheeses.
3. Supplement B Vitamins if You Cut Out Grains
Most of us get our B vitamins, including Folic acid, from grains. So if you stop eating all grains you will have to use a supplement to replace the missing B vitamins. A simple drug store multi-vitamin is all you need. B vitamins are the only vitamins you won't be getting from meat, dairy, and lots of low carb greens, nuts, and berries.
4. Use Morton's Salt Substitute to Replace Potassium
A low carb diet especially in its early phases flushes a lot of fluid out of your body. You can read why this is HERE. The diuretic effect can cause you to lose potassium and if that happens you may get leg cramps.
Sprinkling a bit of Morton's Salt Substitute on your food is all you need to do to correct any potassium imbalance--UNLESS you are taking a potassium sparing blood pressure medicine. In that case, do NOT supplement with potassium. If you aren't sure if your blood pressure medicine is potassium sparing or not, ask a pharmacist. If you are taking a potassium sparing drug you don't have to worry about losing potassium.
If you are low in potassium, the usual symptom is leg cramping which resolves as soon as you consume a sprinkle of the salt substitute which is pure potassium. You can buy it in most supermarkets in the section where the salt is sold.
5. Eat LOTS of Greens and Berries.
If you only eat meat and cheese on your "low carb" diet you are going to end up missing valuable nutrients. If you eat meat and greens and packaged "low carb" foods full of chemicals and hidden carbs, you are also going to miss out on those nutrients--and you are going to end up gaining weight, as many packaged foods include ingredients that are forms of MSG (like hydrolyzed vegetable protein) that make you hungry.
In the old days, people in the low carb community used to tell each other "When you visit the supermarket, Shop the edges" . That's because, typically, fruit, veggies, meat, nuts, eggs and dairy are arranged around the outside edge of the market and all the prepared foods are in the aisles. The more you eat from the edges, the healthier you will be. Frozen veggies are fine, too.
6. Use Whey Protein Powder
Many low carb recipes tell you to use soy flour. Don't. It tastes nasty to many of us, and soy can have negative effects on your thyroid and can disturb your sex hormone balance. Whey protein powder tastes better than soy and has no hormonal effects. I use it in quite a few of my recipes. Vanilla or plain are best for cooking.
If you find yourself feeling depressive after a few weeks of your low carb diet, cut out any of the soy foods you may have added, including tortillas, "low carb" breads, or cereals. You may be amazed at how much cheerier you feel. I sure was.
7. It is Normal to Feel Edgy The First Week or Two
As your body switches over to running on ketones you may feel edgy and have trouble sleeping. This is completely normal and it goes away pretty quickly.
7. Take Advantage of Low Carb Beginner's Luck
The first time you eat a very low carb diet, your body has no clue what is going on and may drop surprising amounts of real weight in the month or two before it figures out what the heck is happening.
This is a one time thing. Once your body gets used to living on a low carb ketogenic diet, you will never again experience this burst of dramatic weight loss. You CAN lose weight the second time you go on a low carb diet--I've done it--but it takes a lot longer and requires a lot more discipline.
Because of this "beginner's luck" phenomenon, if you are low carbing for weight loss for the very first time, stick to your diet very carefully for the first three months. Avoid all commercially prepared "low carb" products. Most of them are full of hidden carbs that will sabotage your attempts to lose weight.
Stick with salad, low carb veg, meat, cheese, and small amounts of nuts. Do the diet straight without taking days off as long as you can because by doing that you will get the best weight loss. After a few months when your body gets used to the diet and weight loss drops to a modest amounts you can be a bit more flexible and experiment with different "low carb" products and the occasional higher carb day. But, at first, give yourself a while to let the diet do its magic!
8. Cholesterol Rises Early in Most Effective Diets
If you have a cholesterol test in the first three months of your diet when you are losing weight at a rapid pace expect to see your cholesterol be higher than it was before. This is normal. The fat in your blood stream is on its way OUT of your body. Many doctors don't know this--fortunately, mine did and explained it to me.
By the sixth month of your low carb diet you should start seeing dramatic improvements in your cholesterol, especially your HDL and triglycerides which are the fractions of cholesterol most closely associated with health.
That should be enough to get you started. . .
1. A low carb diet should not be a high protein diet.
Your liver has the ability to transform protein into carbohydrate. Key to losing weight on a low carb diet is that you want to lower the amount of insulin circulating in your body. Eating too much protein may not raise your blood sugar--unless you are a Type 1 or a Type 2 whose beta cells are mostly gone--but it may raise the amount of circulating insulin in your body. Insulin is the hormone that tells your body to store fat, so to lose weight you don't want to eat a high protein diet. You want to eat a diet that contains the right amount of protein.
How much protein do you need? Well, you will need protein to repair damage to your muscles. In addition, if you are eating under 100 grams of carb a day you will probably need some protein to furnish the glucose needed to run your brain. Your liver can turn about 60% of the protein you eat into glucose, so you will eat a bit more protein to provide the glucose for your brain.
Beyond the small amount of protein needed for these two functions, any excess protein you eat can stall your weight loss, and even worse, too much protein in the diet causes the infamous "diet breath" that many people incorrectly label "ketobreath". It isn't ketones you are smelling when people are doing very low carb diets incorrectly. It's byproducts of protein digestion.
How much protein will be right for you depends on how many grams of carbohydrate you are eating and your size. I have put together a web page that tells you How To Calculate Your True Protein Need.
2. A Low Carb Diet Should Be a High Fat Diet.
Most of the calories in your low carb diet should be coming from fat. Fat, unlike protein, does NOT raise blood sugar or provoke any insulin response. And now that Gary Taubes has thoroughly debunked the badly conducted, politically motivated research that was used to argue that fat caused heart disease, we can all relax and enjoy the fat we eat.
The exception to the goodness of fats is trans fat. And despite all the labels that claim "no trans fat", any food that lists "hydrogenated" fats of any type on the label does contain trans fat. There are lots of them and you should avoid eating them.
When I was in the active weight loss phase of my year long low carb diet--the one whose 30 lb weight loss I maintained for four years--fat made up about 70% of all the calories I consumed. I'm not a big meat lover, so much of my fat and protein intake came in the form of nuts, eggs, and high quality cheeses.
3. Supplement B Vitamins if You Cut Out Grains
Most of us get our B vitamins, including Folic acid, from grains. So if you stop eating all grains you will have to use a supplement to replace the missing B vitamins. A simple drug store multi-vitamin is all you need. B vitamins are the only vitamins you won't be getting from meat, dairy, and lots of low carb greens, nuts, and berries.
4. Use Morton's Salt Substitute to Replace Potassium
A low carb diet especially in its early phases flushes a lot of fluid out of your body. You can read why this is HERE. The diuretic effect can cause you to lose potassium and if that happens you may get leg cramps.
Sprinkling a bit of Morton's Salt Substitute on your food is all you need to do to correct any potassium imbalance--UNLESS you are taking a potassium sparing blood pressure medicine. In that case, do NOT supplement with potassium. If you aren't sure if your blood pressure medicine is potassium sparing or not, ask a pharmacist. If you are taking a potassium sparing drug you don't have to worry about losing potassium.
If you are low in potassium, the usual symptom is leg cramping which resolves as soon as you consume a sprinkle of the salt substitute which is pure potassium. You can buy it in most supermarkets in the section where the salt is sold.
5. Eat LOTS of Greens and Berries.
If you only eat meat and cheese on your "low carb" diet you are going to end up missing valuable nutrients. If you eat meat and greens and packaged "low carb" foods full of chemicals and hidden carbs, you are also going to miss out on those nutrients--and you are going to end up gaining weight, as many packaged foods include ingredients that are forms of MSG (like hydrolyzed vegetable protein) that make you hungry.
In the old days, people in the low carb community used to tell each other "When you visit the supermarket, Shop the edges" . That's because, typically, fruit, veggies, meat, nuts, eggs and dairy are arranged around the outside edge of the market and all the prepared foods are in the aisles. The more you eat from the edges, the healthier you will be. Frozen veggies are fine, too.
6. Use Whey Protein Powder
Many low carb recipes tell you to use soy flour. Don't. It tastes nasty to many of us, and soy can have negative effects on your thyroid and can disturb your sex hormone balance. Whey protein powder tastes better than soy and has no hormonal effects. I use it in quite a few of my recipes. Vanilla or plain are best for cooking.
If you find yourself feeling depressive after a few weeks of your low carb diet, cut out any of the soy foods you may have added, including tortillas, "low carb" breads, or cereals. You may be amazed at how much cheerier you feel. I sure was.
7. It is Normal to Feel Edgy The First Week or Two
As your body switches over to running on ketones you may feel edgy and have trouble sleeping. This is completely normal and it goes away pretty quickly.
7. Take Advantage of Low Carb Beginner's Luck
The first time you eat a very low carb diet, your body has no clue what is going on and may drop surprising amounts of real weight in the month or two before it figures out what the heck is happening.
This is a one time thing. Once your body gets used to living on a low carb ketogenic diet, you will never again experience this burst of dramatic weight loss. You CAN lose weight the second time you go on a low carb diet--I've done it--but it takes a lot longer and requires a lot more discipline.
Because of this "beginner's luck" phenomenon, if you are low carbing for weight loss for the very first time, stick to your diet very carefully for the first three months. Avoid all commercially prepared "low carb" products. Most of them are full of hidden carbs that will sabotage your attempts to lose weight.
Stick with salad, low carb veg, meat, cheese, and small amounts of nuts. Do the diet straight without taking days off as long as you can because by doing that you will get the best weight loss. After a few months when your body gets used to the diet and weight loss drops to a modest amounts you can be a bit more flexible and experiment with different "low carb" products and the occasional higher carb day. But, at first, give yourself a while to let the diet do its magic!
8. Cholesterol Rises Early in Most Effective Diets
If you have a cholesterol test in the first three months of your diet when you are losing weight at a rapid pace expect to see your cholesterol be higher than it was before. This is normal. The fat in your blood stream is on its way OUT of your body. Many doctors don't know this--fortunately, mine did and explained it to me.
By the sixth month of your low carb diet you should start seeing dramatic improvements in your cholesterol, especially your HDL and triglycerides which are the fractions of cholesterol most closely associated with health.
That should be enough to get you started. . .
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