Hypoinsulinemia, The Working Hypothesis – Joe Lovely, April 2013, JOE@JLOVELY.COM
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I stopped eating carbohydrates in November 2011. I would best describe my dietary plan as a high fat consumption lifestyle (not a temporary diet), with normal to high protein intake and very low carbohydrate intake. Minimizing carbohydrate intake decreases insulin levels and dietary fat is used by the body appropriately. When insulin levels are low, stored body fat is broken down. False hunger and overeating is nonexistent when insulin levels are low. Fat ingestion is necessary to maintain important physiological processes. When insulin levels are elevated, body fat accumulates and inflammatory processes increase.
Bottom line: Limit carbohydrate intake to less than 20 gram per day, to maintain ketosis. Count all carbs except non-digestible fiber – there are no ‘good carbs’.
It is not ‘per guidelines’ – be sure to talk it over with your doctor if you try it – my physician agrees with a lot of this – he checked my labs every 4 months and everything keeps getting astonishingly better:
— I have lost 100 pounds in about a year
— triglycerides from very high levels down to 50 now
— LDL and small LDL particle size falling from very high to normal now
— HDL from 30’s to the 60’s with low amount of exercise
— fasting glucose from high 90’s down to low 80’s
— I was likely in the initial stages of fatty liver disease -elevated ALT and AST for years- now liver function tests are normal.
Now I sleep great, eat great, never feel hungry and have high energy levels.
It is a meat, cheese, eggs, salad greens, wine and whisky life – Enjoy!
My Initial Low Carb Resources:
www.garytaubes.com and his books = background info; where I started.
www.marksdailyapple.com ; another favorite – the main resource of my daily food decisions and exercise plans
www.atkins.com Induction Phase; here are the details on how to start, what to avoid, what to eat and what to expect – it is not entirely pleasant or easy at first 5 to 10 days, but once I was ‘fat adapted’, I felt great.
www.awlr.org – statistics and other people’s success stories
Hypoinsulinemia, The Working Hypothesis
This is my working hypothesis…and it is working. I learn or experiment with a few new details each month. I think this may be interesting to any healthcare professional, nutrition or fitness enthusiasts, regardless of their personal health status. I bring nothing novel or unique to the topic other than my personal experience. The credit to my success goes to Gary Taubes, Peter Attia, Mark Sisson and the many low-carbers that post their experiences online.
My ‘working dietary hypothesis’ is best described as Nutritional Ketosis and Intermittent Fasting. Some people may refer to it as a Very Low Carb (VLC) Paleo or Caveman or Atkins diet. I first learned from reading Gary Taubes books, his website www.garytaubes.com , internal medicine grand rounds September 2011 (Gary Taubes was here and reviewed his recent book) and there are similar YouTube presentations of Taubes and Peter Attia online. This area of health controversy, in some ways, parallels global warming arguments. A good overview can be seen on www.nusi.org . Taubes’ books are an amazing example of scientific literature review fundamentals and highlights how things can go wrong when inappropriate associations are mistaken as causal. Taubes also organizes all the available associations, or lack thereof, to form new hypotheses. I believe dietary carbohydrate restriction will radically change the current conventional medical wisdom and practices, and decrease the severity and incidence of many human illnesses.
My favorite blog and main source for my personal working hypotheses is written by Peter Attia, MD. He is an extreme athlete, pragmatic thinker and communicator on a very low carb diet: http://eatingacademy.com/start-here
Bottom line and simple message: limit carbohydrate intake less than 20 gram per day to maintain ketosis. Count all carbs except non-digestible fibers — there are no ‘good carbs’ other than non-digestible fiber.
People at their goal body fat percentage and with no signs or elevated markers of metabolic syndrome may maintain low carb health benefits with an intake of 100 – 150 grams of carbohydrate per day.
Simple sugars and grains are never acceptable.
Low carbohydrate intake will keep insulin levels as low as possible to minimize fat storage and allow lipolysis. With insulin levels being low, dietary fat intake does not immediately go to adipose tissue for storage; dietary fat is naturally incorporated into physiological and metabolic processes that depend on fat as a substrate. Physiological mechanisms of satiety function better without carbs: false hunger, cravings and overeating decrease greatly after 5 – 10 weeks on low carb diet. Using fatty acids and ketones as a primary energy source is more efficient than using glucose and glycogen for most people in most situations: Peter Attia and Mark Sisson have several web pages dedicated to that discussion.
If interested in the ongoing ‘signals’ that may be associated with ‘carbohydrate toxicity’
Google: ‘marathon winner low carb diet’.
Google: ‘type 3 diabetes’, yes type three
Google: ‘skinny fat’
Here are the main points of what I have done:
-eat beef, pork, fish, fowl, seafood, cheese, and eggs only
-no concerns with portion size initially, eat every 4-6 hours so you never get hungry the first few months
-replace high carb ketchup and salad dressings with low carb mayonnaise, sour cream, cream cheese, and buffalo wing sauce – always checking label for carbs some brands are zero carb – some are not
-sauces with cream or butter make everything better; I use them liberally
-20 net carbs or less allowed per day to maintain ketosis (don’t count fiber carbs); which means 12 carbs per day from green leafy vegetables and 8 carbs for incidental carbs from things like cheese or salad dressing
-every vegetable needs to be investigated – there is no easy way to classify by group, most have too many carbs to trifle with
-the veggies I enjoy on this diet are pickles, lettuce, spinach, broccoli, Brussels sprouts (I eat a lot with butter and or a butter/mustard sauce).
-Onions and tomatoes are only safe in very small quantities
-no fruit, no grains, no milk, no beer (my summer cocktail is now whiskey on the rocks!)
-no sorbitol/xylitol sweeteners since they may increase insulin levels
-investigate cheese closely – most are low carb, but not all
-Atkins, Livestrong and fatsecret.com have good websites to check the carb content of foods via internet / iPhone
-I take generic Metamucil capsules as needed for fiber replacement
-I eat liver pate or braunschweiger at least once a week for ‘vitamins’ (nueske’s liver pate is great with wine and cheese)
-I lost a lot of weight while drinking diet soda, however, now I have eliminated most of my diet soda and artificial sweetener intake because I am of the opinion that artificial sweeteners impair my overall taste perception. I believe it may lead to inappropriately craving sweet food or not enjoying the full natural flavor of other foods. Artificial sweeteners may elevate insulin levels in some people.
-try a full fat latte: ask for a medium latte with 4 shot espresso with steamed heavy cream (no milk; no half and half)
-I try to eat oysters, shellfish or salmon 2 or 3 times a week for natural fish oil (try bacon wrapped oysters)
-grass fed is best: pork, beef, free range chicken and eggs; grass fed dairy products have ‘better’ fatty acids than the same products from animals that eat grains
-I take a generic centrum silver, generic B-complex with C, fish oil and vitamin d supplements noted on www.eatingacademy.com
Foods I usually eat:
-breakfast: 4 eggs +/- cheese or butter, 4 bacon topped with the Sriracha chili sauce or the buffalo wing sauce
– lunch or dinner at work is when I get my daily salad – I load up on the spinach and add a lot of eggs +/-ham, bacon; a few cucumbers, parmesan cheese and either Caesar, blue cheese dressing or olive oil with balsamic vinegar (salads are more enjoyable now since I am using full calorie dressings with cheese and bacon)
-I drink a lot of coffee each day, and a lot of cold water
-I drink a glass or two of red wine most nights with dinner (more on special occasions): red wine has little or no carbs; brut champagne has 9 grams per bottle on average–ethanol IS calorie dense and is used as an energy source before fat…ketosis does not stop, but lipolysis will slow when ethanol is on board
-my usual snacks are wine, cheese, prosciutto, shrimp and buffalo wings (investigate all sauces – some are low carb, many have added sugar)
-my daily total caloric intake is widely variable – some days I have well over 3000 calories per day; other days, it is easy to forget a meal due to not being hungry; my taste perception has changed – I now can detect and enjoy the natural sweetness in almonds, leafy greens, spices, etc.; I do not enjoy sugary desserts like I used to (I ate a few chocolates and cookies around Christmas and the kids birthday and fell out of ketosis a few days and felt blah; a few bites of kids ice cream or dessert lately causes no harm but would not recommend that the first 3 or 4 months).
Another significant issue I believe is that carb intake does not provide appropriate satiety, which promotes overeating; see the blog considering wheat addiction: http://www.wheatbellyblog.com/featured-articles/
After about 10 days of ketosis and before I lost much weight, it seemed that inflammation (that I originally attributed to being overweight, out of shape and over 40…) left my body seemingly overnight — I began sleeping better, joint pains disappeared, sinus congestion went away, I stopped needing migraine prophylaxis and my lifetime of oily skin and severe acne has ended — I feel like my overall energy has increased. There are thousands of similar success stories on the web links on this page.
I was a very active bicyclist, raquetballer and weightlifter in my 20’s, however, I did not exercise formally the past decade. I started recently in the fall of 2012 (AFTER most of my weight loss). I am following the ideas of Taubes (classic cardio primarily makes you hungrier…), the book Body By Science (MC Guff/Little: get long rest after lifting heavy), Starting Strength (Rippetoe – basic powerlifting) and PRIMARILY the Primal Blueprint at www.marksdailyapple.com/primal-blueprint-fitness
Despite plateaus of staying at the same weight for many weeks at a time, I have continually decreased my clothing size each month for more than a year – I surmise that during these plateaus my muscle mass is increasing and body fat percentage continues to decrease. Muscle maintenance and muscle building is nearly as important as restricting carbohydrate intake – focusing on BMI, the definition of ‘obesity’ and ‘over weight’ can lead people astray…it is better to focus on body fat percentage and muscle mass percentage – see articles on the term ‘skinny fat’ – some people that have a BMI under 30, do not look ‘fat’, and are not considered overweight or obese, and may also be fairly athletic and active – but they also have signs, symptoms or significant laboratory markers suggesting a diabetes, metabolic syndrome, cardiovascular disease or inflammatory syndromes. This is where I may consider carbohydrates a toxin that can increase the severity or incidence of many diseases irrespective of being overweight or normal weight.
My energy, sleep quality, every aspect of my health and day to day feeling, is as good or better now at age 43 as it was when I was 25 – everything—and now I am spending 80% less time ‘exercising’.
After about a year of ketosis and most of my weight loss I began intermittent fasting once or twice a week; I think it helped me break out of plateaus and I feel that it actually helped with gaining strength and energy with exercising – eating nothing but water or coffee for 16 – 24 hours really induces euphoric feelings when you are ‘fat adapted’ – see Peter Attia and Mark Sisson’s pages for intermittent fasting ideas after achieving ketosis several months.
I have come across several variations on this phrase:
‘Eat like a predator, not prey.’
…eat protein and fat until you are full; it is OK to skip a meal. Predators are carnivores that eat the grazing herbivores; lions eat meat in large quantities at variable intervals, lions eat the fatty muscles and organs and leave the lean meat for scavengers; lions don’t eat bread and potatoes; lions don’t count calories.