Sunday, August 25, 2019

Retrospective #190: “Can (sic) I ask you a personal question?”

I walked up to the bar at the jazz club to get a refill, and a woman in her 40s, sitting at a nearby table with her mother and her mothers friend, struck up a conversation with me. I engaged the brazen (lonely?) hussy, gave her my “business” card (“The Nutrition Debate”) and began immediately to proselytize about Very Low Carb eating. She indulged me, with indifference bordering on insouciance, and then said, “Can I ask you a personal question?”
Two thoughts crossed my mind: How much had she had to drink? And why am I feeling on the defensive? Anyway, I said “sure.” It could be interesting, and, as my readers know, I do not guard my health and medical privacy. I am thrilled to share the news about how changes in what I eat over the last 17 years have transformed my health.
I wont repeat all the statistics here. For new readers, though, I have been a Type 2 for 33 years, and 17 years ago I weighed 375 pounds. After changing what I ate from the Standard American Diet (“balanced” and very high in carbs), I lost 170 pounds, my blood glucose went from “uncontrolled” on 3 oral meds to “well-controlled” (“non-diabetic”) on a minimum dose of Metformin. My cholesterol also improved very dramatically, my blood pressure improved (on fewer meds) and my inflammation marker also dramatically improved. So, I said, “Ask away!”
To my surprise, she asked, “How can you drink on your diet?” Relieved, I went into a boring explanation of how many carbs are in 2 glasses of wine (my “limit”), how much ethyl alcohol, etc. It must have sounded like a rationalization, but she was satisfied. Short answer: I am not an ascetic; I am a hedonist. I do not eat (or drink) to survive; I eat and drink for pleasure. Bottom line: I had better like what I eat (and drink) or 1) I wouldn’t like doing it and 2) I wouldn’t be able to do it indefinitely as a “lifestyle change,” which is needed if I am to succeed long term.
This is not just about my former glutenous and bibulous lifestyle. It’s true I had to change what I ate to save my health. But I am not an ascetic, so I had to find an “alternate” lifestyle with equal or greater gustatory rewards. Eating is not a volitional thing. This is about a driving force that controls the urge to “consume food just for pleasure” and not just to “maintain energy homeostasis.” This is called “hedonistic hunger.” Im not making this up.
I had just read an article in the Journal of Clinical Endocrinal Metabolism titled, “Hedonic eating is associated with increased peripheral levels of ghrelin and the endocannabinoid 2-arachidonoyl-glycerol in healthy humans: a pilot study.” The story line: the hunger hormone (ghrelin) and opioid receptors in the brain regulate eating behavior based on palatability. Its not will power, folks. So, the “trick” to sidestep cravings is to transition from a high-carb dietary, engineered by processed food manufacturers for maximum palatability, to an equally hedonistic lifestyle based on energy homeostasis. Eat for pleasure, but just enough to be healthy. The key is to avoid feeling hungry.
Cravings, as we know them, are signals from the stomach (ghrelin) and the brain (hypothalamus) telling us to eat. The signals are, frankly, sometimes almost impossible to resist. Our response: to eat low energy density foods (carbohydrates) with high palatability. But, if you eat a breakfast that enables you to go all day long without feeling hungry, because your blood glucose has been stable all day long, you will not have hunger cravings.
The body will regulate energy homeostasis using different mechanisms. You body is “happy” to burn body fat for energy if you dont eat carbs. It is designed to work that way. We didnt evolve eating “three squares” a day. We ate “catch as catch can” and sometimes went days working off stored energy from a previous feast. It’s natural.
This PubMed Abstract concludes: “The present preliminary findings suggest that when motivation to eat is generated by the availability of highly palatable food and not by food deprivation, a peripheral activation of two endogenous rewarding chemical signals is observed. Future research should confirm and extend our results to better understand the phenomenon of hedonic eating, which influences food intake and, ultimately, body mass.”
I always ate for pleasure, but I was hooked on carbs. I craved carbs; now, I still eat for pleasure, but I am not craven. I eat foods that satiate (fat and protein), and so I am not hungry between meals. In fact, I often skip lunch. 

Saturday, August 24, 2019

Retrospective #189: The New Nutrition Facts Labels

My feed to Jimmy Moore’s Livin’ La Vida Low-Carb blog recently brought me a piece about the proposed new Nutrition Facts labels announced by first lady Michelle Obama at a White House press conference. It looked interesting, so I Googled the New York Times’ story on it. There are four major changes in the draft proposal.
1) The calorie count per serving will be displayed more prominently. That’s a good thing, but as Jimmy points out, total calories is about as useful as total cholesterol is in a blood test, which is “not very” or “not at all” for many. With cholesterol, the components (LDL, HDL and triglycerides) matter more than the total. So it is with calories.
2) “Added sugar” (from external sources not naturally found in the food) will be listed separately. This is a good first step, and it may have the effect of having food manufacturers lower the amount of added sugar in processed foods. It should make people aware of how many foods have added sugars in them, and how much. But, after flour and water, sugar, in some form, is always the 3rd ingredient in a loaf of bread. Would the new labels consider this sugar “added sugar” or an essential ingredient in the basic recipe for bread? We’ll have to wait and see.
Of course, this change will not address nor change the fact that a) a 12oz glass of Minute Maid orange juice has just as much “natural” sugar (36g) as a 12oz. regular Coke has “added” sugar (39g), and they are both equally bad. Both “natural sugars” and “added sugars” will have the same effect on your blood glucose level. “So, what difference, at this point, does it make?” (Clinton/Benghazi reference; hehe).
Anyway, it is time to take advantage of the present and growing level of awareness about the amount of sugar we eat and capture the moment in these new food label changes. Except for the trans fat change, enacted in 2002 that took effect in 2006, it’s been about 20 years since the last major changes.
3) Serving sizes will increase. This is a very good thing, for the food categories covered. The New York Times piece, however, says it will affect only “17% of the approximately 150 categories of packaged food.” Everyone agrees the present serving sizes are a joke and a charade, so this change is also long overdue. Examples given to the press included a) a serving size of ice cream will increase from ½ cup to 1 cup. That means those pint containers are meant for 2 people, folks. Don’t forget to share! Also, a muffin serving size will change from 2oz to 4oz, and a 20oz beverage will be just one serving. Two straws, anybody?
4) “Calories from fat” will be deleted. That’s a good thing. It singled out fat unfairly. It stigmatized fat and favored carbohydrates, which includes sugars. Now, with the seeming shift from vilifying all fats to vilifying “added sugars,” the USDA/HHS is “turning the Titanic,” first addressed here by me in an eponymous column in 2011.
Regrettably, the USDA/HHS still lumps dietary cholesterol and saturated (good) fat and artificial trans (bad) fats together on the label and do not require that unsaturated fats (especially polyunsaturated) be listed on the label. They frequently are, but they, unlike cholesterol and saturated fat, are not required. And regrettably, they do not require that quantities (e.g. added sugar) be listed in measures with which Americans are familiar, i.e., teaspoons instead of grams. Did you know, for example, that a 12 oz Coke or 12oz glass of orange juice has the equivalent of 10 or 9 teaspoons of sugar in it, respectively?
Finally, and most importantly, it is regrettable that this proposal is still based on the same macronutrient recommendations that have also long been outdated on the Nutrition Facts label: 60% carbohydrates, 30% fat and 10% protein.  That’s 300 grams (1,200 calories) of carbohydrate a day, 50 grams (200 calories) of protein, and 67 grams (600 calories) of fat. If we are going to eat a healthier diet, isn’t that where the changes should begin? And, let’s face it, if we didn’t ever eat another packaged and processed food that had a Nutrition Facts label on it, wouldn’t we already be healthier? In the meantime, it is eerily scary but accurate, I think, to view these label changes as rearranging the deck chairs on the Titanic while our nation’s state of health continues to sink.

Friday, August 23, 2019

Retrospective #188: “Older Patients with T2DM and Co-morbidities…”

A story in, “Older Patients with T2DM and Co-morbidities Don’t Feel Heard,” got my attention. Diabetes in Control is a weekly digest of articles primarily for physicians who treat patients with Type 2 diabetes. The lede was, “Most adults with T2DM have at least one co-morbid condition, and almost half of them have three or more.” The most commonly reported chronic co-morbid conditions were hypertension, arthritis, retinopathy, hypercholesterolemia (high cholesterol), coronary artery disease, and neuropathy.
The source for the story, a study in Clinical Diabetes, was making an important point about patients being heard. All patients in the study were ≥ 60 years old, white, highly-educated and had good glucose control.  That’s me. It relates how difficult it is for a “new” patient to get the attention and cooperation of a physician when, in his or her professional opinion, the “proper care” differs from the patient’s opinion.
This is, after all, seen as justified by the physician. The patient is just a layman with no professional liability for malpractice, no risk of sanctions from medical practice boards, or loss of reimbursement from Medicare and supplemental insurance for not following professional practice standards and guidelines. But I’m spoiled. My doctor (now deceased), who treated me for over 20 years, set me on the course of eating Very Low Carb and oversaw the complete turnaround of my progressively worsening T2DM from “out-of-control-on-3-oral-diabetes-meds” to “in-remission” on a minimum dose of  just one oral (Metformin). He has my everlasting gratitude.
My “new” doctor is also great. He reviewed my “history” and told me to just, “Keep doing what you’re doing.”  That’s great! My physician (and I) determine the risks and benefits of me not following “treatment guidelines.”
But not every doctor is willing to do that. The Control piece said: “Many participants also felt that their preferences for care were not taken into account by their provider. Participants also reported feeling that their care was not addressed to their individual needs and medical history, and desired more tailored treatment regimens specific to their needs. Generally speaking, patients want to have more interaction with their providers so that they can discuss the difficulties they are experiencing and vocalize their preference for treatment.”
It concludes, “Effective patient-provider communications and shared decision-making have been shown to not only improve patient satisfaction, but also increase adherence to treatment plans and improve health outcomes.”
Setting aside the “empathy” and “older age” aspects of these criticisms (I personally have not felt either in my interactions), I note how “their [the patients] preferences were not being listened to,” is a recurring theme. Two things came to mind. 1) I am dead set about not taking a statin (again). I did 5 or 6 years ago (before I knew better), but my doctor discontinued it. Today, however, especially with the new AHA/ACC guidelines, I am still considered (by most doctors) a candidate for a statin. Personally, I consider my latest lipid test lab results to be stellar: TC = 207, HDL = 90, LDL = 110, TC/HDL ratio = 2.3 and triglycerides = 34. And my Trig/HDL ratio (0.38), a powerful statistical indicator of cardiovascular risk, is also stellar. And, when they were last tested, my LDL particles were Pattern A (large, buoyant and fluffy). Many doctors would not prescribe a statin with these lipid “labs,” but some would, and the new AHA/ACC guidelines dictate that I should take one. But “my preference” is a definite “NO!”
Then, 2) theres the question of diet. What should I eat? Should I follow what has worked for me for the last 11 years, resulting in my losing and keeping off (currently) 145 pounds? Or, should I eat what the AHA or the Dietary Guidelines for Americans tell me to eat? Once again, “my preference” tells me that I know more about what diet I should eat than the USDA/HHS. My n = 1 experience, aided by frequent testing, has taught me what to eat.
As reported in the Medscape Physician Lifestyle Report 2014, 68% of overweight or obese doctors eat a Typical American, AHA, or Mediterranean style diet. Just 14 percent eat a “Weight Loss (calorie restricted or otherwise) Diet,” 5% a “Paleo” style diet and 11% various other diets. I suppose, Very Low Carb, LCHF, Keto or even Atkins Induction were included in the 11% various other diets, but most physicians wouldn’t admit to such heresy.

Thursday, August 22, 2019

Retrospective #187: Chronic Systemic Inflammation

This is a primer for the layman (by a layman) on “Chronic Systemic Inflammation.” Chronic means “persistent, long-standing, long term.”  It is in contrast to “acute” which means “with a rapid onset and/or a short course.” Systemic means “throughout the body,” as when you have a fever. Inflammation is the body’s response to an “injury.” I put injury in quotes because, while we understand the outward manifestation of the body’s “acute” inflammatory response to stubbing a toe (pain, swelling, etc.), we are often unaware of the presence and dire consequences of “chronic, systemic inflammation.” It is a continuing “injury” that is often undetected, and can be very serious.
To be clear, our body’s response to an acute injury (i.e., pain and swelling), is actually a good thing. It means our immune system has swung into high gear to defend itself against the “injury.” The biological process is technical, so suffice it to say they involve a temporary mobilization of “hormone-like” proteins, e.g., cytokines and macrophages. But enough of that; my eyes glaze over when I write about those little buggers. The point is: when the body has completed a repair to the injury, the inflammation goes away and everything returns to normal.
Chronic systemic inflammation is a whole other thing and is mostly unrecognized. So, why should we care? Dr. Art Ayers, a PhD biomedical researcher with a special interest in inflammation and disease, puts it this way: “Inflammation is the foundation for cancer and degenerative/autoimmune diseases. Small changes in diet and exercise, e.g. omega-3 oils, vitamin D, low starch, and maintaining muscle mass, can dramatically alter predisposition to disease and aging, and minimize the negative impact of genetic risks.”
One of the most common markers of chronic systemic inflammation is a blood test: the high-sensitivity C-reactive protein (hsCRP). Results in the range of 3.1 to 10mg/L are considered “Higher Relative Cardiovascular Risk;” 1.0 to 3.0 “Average Relative Cardiovascular Risk;” and <1.0 “Lower Relative Cardiovascular Risk.” When I started eating Very Low Carb in September 2002, my hsCRP had never been tested. Here are my scores for the last 16 years:
Note that my doctor, an internist/cardiologist, shortly after starting me on Very Low Carb in September 2002, tested my CRP twice in the first year. Both times the result put me at a “Higher Risk” (6.4 & 5.8mg/L). He didn’t test me again for 3 years, and by this time my CRP-based risk had dropped to “Average” (2.5mg/L). The next test, 3 years later, my hsCRP had dropped further to 1.8mg/L. The next 5 years he tested my hsCRP just once a year, three of them <1.0 (0.7, <0.1 and 0.4), a “lower” CVD risk. I think my doctor had noticed the big difference that Dr. Ayers mentions in “Cooling Inflammation,” his blog. I think he was particularly interested in the effect the Very Low Carb diet (and my 170-pound weight loss) had on Chronic Systemic Inflammation. Now he tests only every other year.
How did I lose 170 pounds and lower my hsCRP? Well, you can start by reading my two previous blog posts, #185, “Your Diet is Very Restrictive” and #186, “Your Diet is Very Restrictive Part 2.” And there’s more to come.
Note 1: The Google heading “Inflammation” includes the following: “Chronic inflammation is widely observed in obesity. The obese commonly have many elevated markers of inflammation, including: CRP (C-Reactive Protein).” “Waist circumference correlates significantly with systemic inflammatory response,” and “C-reactive protein (CRP) is generated at a higher level in obese people.” VISCERAL FAT (abdominal fat around the internal organs) IS VERY INFLAMMATORY. “Mild elevation in CRP increases risk of heart attacks, strokes…and high blood pressure.”
Note 2: A common cause of Chronic Systemic Inflammation is periodontitis, an inflammatory disease affecting the tissues that surround and support the teeth. “Periodontitis is caused by microorganisms on the tooth's surfaces, along with an overly aggressive immune response by pro-inflammatory cytokines, lymphocytes & macrophages against these microorganisms.”

Wednesday, August 21, 2019

Retrospective #186: “Your Diet is Very Restrictive” Part 2

I realized, after writing the last column, I had told you only half the story. Yes, my diet is “very restrictive,” including in two additional ways I didn’t mention: 1) I try to avoid all vegetable and seed oils, specifically polyunsaturated soybean oil, corn oil, Canola, sunflower and cottonseed oil, etc.; and 2) I try to avoid all grains and everything made from them. That means I eat very little fried food and virtually nothing that has been made with flour.
I do eat monounsaturated oils (olive oil and avocado) and saturated fat oils (specifically coconut oil and MCT oil). I select fatty cuts of meat (beef, lamb and pork) and chicken with the skin on, and fatty cold-water fish (sardines, herring, tuna, char). I also eat lots of eggs from pastured hens raised by a local farmer. Forget about dietary cholesterol! I wish I could say I ate beef from grass-fed, grass-finished beef and even butter from grass fed cows, but alas, I do not. I also try to eat offal (liver or kidneys) once a week.
Is this a challenge? Sure, at times, especially when dining out. In restaurants the workaround is often to order from the appetizer menu. Sometimes I will order a salad and an appetizer, or two appetizers. That avoids the proverbial starch that seems to accompany most main dishes. Of course, almost every kitchen will gladly give you a double portion of vegetables instead of a vegetable and a starch, but I don’t want double of anything. It’s too much food. Small meals, remember? Also, when you order from the appetizer menu, you don’t get a bread basket. That helps.
At home, the workaround for all the “forbidden goodies” in the house is not to open the freezer (where my wife keeps ice cream), or the pantry where her chips and crackers are stored. Out-of-sight/out-of-mind really works for me. Our eyes are powerful hormone stimulators. I bet there’ve been more than a few scientific papers written on how visual stimulation excites the brain (think sex, guys) and prepares the glands.
But the shift in the balance from saturated fat (Lard) to polyunsaturated fats (Crisco) and manufactured oils over the last 50-100 years is wholly unrelated to carbohydrates. Of particular interest in the very heavy shift in the ratio of Omega 6 (linoleic acid) to Omega 3 (linolenic acid) in our diet from roughly 1: 1 to as much as 30:1 over this time period. That’s why it is important to seriously cut back on vegetable and seed oils (linoleic acid) and increase the Omega 3s (e.g. with supplemental fish oil). But you can’t “fix” this problem with fish oil alone; you have to cut back dramatically on the polyunsaturated vegetable and seed oils you eat, starting with fried foods.
It is also important to eliminate fried foods because “vegetable” oils, already damaged in manufacturing by pressure, heat and chemicals, are then reheated repeatedly in fryers. These oils are also damaged by daylight and quickly become rancid. Saturated fats do not. So, cook with butter, coconut oil and lard, not vegetable oils! Use olive oil as a salad dressing or drizzle to add flavor and richness, and you will be eating well indeed.
As Dwight Lundell, MD, in Jimmy Moore’s good book, Cholesterol Clarity (pg. 35), quoted in #185, said, “The population will become split between the smart and the dumb. The smart ones will begin taking their health into their own hands because they’re already seeing that what we are doing now is not working.”
Moore then commented as follows: “I am a huge proponent of people taking responsibility for their own health. We are all unique individuals with different needs and yet we are treated like lemmings by the medical profession when it comes to our health. I get why so many people abdicate personal responsibility with their health; it’s so much easier to just do what we’re told. But that approach clearly doesn’t work: Science changes all the time, and medical and nutrition specialists simply can’t keep up. How can they possibly have all the answers? There’s no way around it. If you want to be healthy, it’s up to you to make it happen! Educate yourself, and then act on what you learn. You must be the final arbiter of your own health.”
So, what are you waiting for? Want to be healthy? Take charge of what you eat. You will see a world of difference.

Tuesday, August 20, 2019

Retrospective #185: “Your Diet is Very Restrictive!”

A friend who saw my blog on Facebook said, “Your diet is very restrictive.” I objected! I was being defensive, of course, but my diet is very restrictive, especially to someone who eats “without restriction” and gets away with it. And that appears to be a fairly large segment of the population. It includes everyone who is of normal weight or who is not diagnosed as a Type 2 or Pre-diabetic or with Metabolic Syndrome. And who gets that diagnosis?
Lest those who appear to be healthy take comfort from this, Dr. Dwight C. Lundell, MD, author of The Cure for Heart Disease and The Great Cholesterol Lie, on pg. 36 of Cholesterol Clarity, by Jimmy Moore with Eric C. Westman, MD, says, “Our diet is not working because 70% of us are overweight and obese, we have 29 million diabetics and 75 million pre-diabetics, and the rest of us don’t even know we’re pre-diabetic”(my emphasis).
Lundell continues, “People are realizing that what we are doing is not working, and they are looking for other ways around this. That’s where do-it-yourself healthcare and self-monitoring will become the norm.”
And do-it-yourself healthcare begins with diet. Even if you’re overweight (the 70%), it is your diet that you should address to “fix” your health. And if you are among the 30% “who don’t even know [you’re] pre-diabetic,” then it is your diet that you need to address to “fix” that. If I haven’t made myself clear yet: Everyone needs to look at their diet and change it. But how? That’s the question. The best way is “self-monitoring” of your health markers.
The markers to monitor are blood glucose (fasting & A1c), HDL cholesterol, triglycerides, LDL particle size and type, and chronic systemic inflammation (hs C-reactive protein or hsCRP). Forget Total Cholesterol and LDL cholesterol. Of course, you’ll need to see a doctor to get these tests, so ask for a copy of your labs, and LEARN YOUR MARKERS.
So, how do you fix these markers? By changing your diet. I am not talking about eating less and exercising more. A growing consensus is emerging that the dietary advice we are still getting from our government and our healthcare providers is what is causing the diabetes and obesity (“diabesity”) crisis. Of course, I knew I was a Type 2 diabetic when I changed my diet 17 years ago (in 2002). I was diagnosed in 1986. And, at my cardiologist doctor’s suggestion, I changed my diet to Atkins Induction (20g of carbs a day) and lost 60 pounds in 9 months (without hunger). I later switched to Richard K. Bernstein's 6-12-12-Plan and lost 110 pounds more. Total: 170 pounds.
But the big change from eating Very Low Carb (VLC) was in my diabetes health and my lipid (cholesterol) chemistry. The first day on VLC I had a hypo (low blood sugar; symptoms: sweating, light-headedness), so my doctor eliminated one of the oral diabetes meds he had prescribed. The next day I had another hypo, so he cut the other two diabetes meds in half, and a few days later, he cut them in half again. Eventually I eliminated one of those two, and today I take just a minimum dose of Metformin. Of course, my A1c’s dropped to the mid 5s, and a new doctor today would say I was “non-diabetic.”
Even more amazing were the changes in my lipid chemistry. My average HDL more than doubled (from of 39 to 81). My average triglycerides declined by 2/3rds from 137 to 49. Total Cholesterol remained about the same, and my LDL inched up slightly but now they are Pattern A (the large/fluffy buoyant type). My latest TC: 207; LDL: 110.
So, how do I do it? By eating a “very restrictive” diet, obviously. I’m not perfect. I cheat all the time. But I have a paradigm that I strive to follow, My target macronutrient ratios: 75% fat; 20% protein; 5% carbohydrate. Just coffee with a little heavy cream for “breakfast.” One or 2 small meals a day, spaced at least 5 hours apart; no eating less than 3 hours before bedtime; no snacks, except sometimes a small VLC snack an hour or so before dinner.
Lunch (when I eat it): kippered (smoked) herring from a can, or a can of sardines in water or olive oil. Dinner: a small portion of protein and one serving of a low carb vegetable, tossed in butter or roasted in olive oil.
My cheats: a glass (or two) of red wine before supper and bread in a restaurant. At home I drink iced tea with stevia; in a restaurant, a cocktail (or two). Water would be better, of course, but my diet is not that restrictive. 

Monday, August 19, 2019

Retrospective #184: “VLC = Not So Much Thinking”

My editor made this comment in the margin of one of my columns recently, and it occurred to me she had made (as usual) a really cogent observation. The full comment was, “I suppose that making people think about food choices is the key, but VLC = not so much thinking. That’s a real plus for me.” It’s all the more interesting since neither she nor her husband is diabetic; but she really knows about good nutrition and metabolism.
Of course, making people think about food choices IS the key to healthy eating whether you’re diabetic or pre-diabetic or just overweight. I think it is also the way everyone should eat…in part because it is the way we all used to eat. We were healthier as a population before the advent of manufactured and processed foods. That’s a fact.
But I also know that what turns many people off about VLC is the prospect of counting carbohydrates. If it’s not counting calories, it’s counting carbs and fat and protein. I admit, I used to do it compulsively (which is my nature), but it’s not necessary. That’s my editor’s point. It’s not necessary to do that. (Am I repeating myself?) All you have to do with this Way of Eating is 1) understand the basic principles and 2) adhere to them.  Not so much thinking.
Of course strict adherence is a daunting prospect for some, but with an open mind (and strict adherence) you will learn that hunger will not be a driver of non-adherence. You will not be hungry, if you adhere to the principles. It’s that simple. It may take a few days, but your hunger will disappear. Your hormones will take over. They will detect that since you’re not eating carbs, there must be none available. Your hormones don’t know about your stash. With props to Claude Bernard, your hormones operate entirely within the milieu intérieurinside the body.
Your hormones are acutely attuned to what you put in your mouth for energy. If you only eat a few carbs, your body uses those, with protein and fat, and then it will use your body’s stored carbs (liver glycogen) for energy. And then, if you don’t eat too much fat, it will use your body fat for energy. Voila! Bingo! You’re losing body fat and all you had to do was eat VLC and wait for your hormones to take over.
So, “not so much thinking” works, so long as you know what foods are carbohydrates and which foods have more and which have fewer. There is a learning curve for that, but it doesn’t require so much thinking. It just requires effort (strict adherence). I started on Atkins Induction and stayed on it for 9 months, losing 60 pounds. Notice I didn’t mention that Atkins Induction is just 20 net grams of carbohydrate a day. You don’t need to know that. You just need to strictly eat just what Atkins Induction says you can eat… and strictly avoid what foods you can’t eat.
And if you want to succeed, please don’t give yourself a “holiday” or day off. I don’t mean, nor do I expect, that you won’t cheat. I do. I just mean don’t plan on cheating. If you’re not hungry, you won’t have “cravings,” and you’ll actually have more energy, and you’ll feel better, and you’ll be losing weight and your lab tests will keep improving.
But don’t think that you can succeed if you only do this VLC 5 or 6 days a week. It won’t work. You can’t fool your body. It’ll think you found your stash, and everything is now hunky dory. It will stop burning your body fat and start saving it, and banking more for the next “famine.” It doesn’t know we now live in a veritable cornucopia of “food.”
And the trigger for this new “hunky dory” hormonal message will be that silly Reese’s Cup you picked up on the checkout line. “Eye candy.” It will trigger a glucose and then an insulin response, which means it will shut down your fat burning metabolism and restart the fat storage and glucose burning metabolism that causes the pancreas to secrete and pump insulin to carry the sugar energy (glucose) to your cells. I repeat: Your. Fat. Burning. Stops. And your body, thinking the cornucopia is flowing again, will expect more food by mouth and more “sugar.” Your hormones will send you “I’m hungry. Feed me” signals. And you’ll have to start all over again, and it could take a few days to lose the water retained by the kidneys with the sugar and start burning fat again. That discouraging.