Sunday, March 27, 2016

Type 2 Diabetes, a Dietary Disease #321: "Energy In" at the Cellular Level

Sometimes I can be pretty dense, or at least slow to comprehend something I have read or been told. A recent example is my understanding of the definition of Macronutrient Ratios and their application to “energy in.”
I first became interested in my “intake” ratios, that is, in the ratios of carbohydrate, fat and protein that I took into my body via mouth, i.e. what I ate – about 10 years ago. I was a pretty na├»ve “kid” at the time and created my initial ratio using a flawed model. Miraculously, it worked. Somehow, I lost 170 pounds altogether, and I did it without getting sick. In fact, there is not a doubt in the world about it: I got healthier and healthier!
Over the years the ratios changed somewhat, more from what I would call fine tuning than a conscious understanding of the model I was employing. I was just lucky, I guess, because the model was faulty. Anyhow, all of my ratio compositions had 3 things in common: a goal of being close to or in a mild state of ketosis most of the time. They were all very low carb, moderate protein and high fat. I gave special attention to the protein amount, ensuring it was adequate but not so much as to engender unwanted gluconeogenesis. And I was taking 500mg Metformin once a day for that. From the start I ate 3 small meals a day, equally spaced about 5 hours apart.
(One of the early errors I made was how to figure the amount of protein to eat at each meal. I erroneously based it on an amount in grams per pound (or kilogram) of total body weight. That is not correct. It should be calculated on grams of lean body weight (LBW), or “ideal body weight,” not total body weight. You don’t need to eat protein to support fat. Your requirement is based on muscle mass, and other bodily needs for protein.)
Nevertheless, the ratios changed from 7% carbs, 28% protein, and 65% fat to more recently 5% carbs, 20% protein, and 75% fat. All my ratios were based on “intake,” i.e. food by mouth. They did not take into account any energy that my body consumed when it was burning its own fat – the fat stores in my body. And whenever I was losing weight, my body fat was part of the equation and therefore a component of the ratio at the cellular level.
This error in my thinking was brought to my attention three times before it stuck. The first was by my editor. I have a vague recollection that when I first began writing this blog about five years ago, she mentioned it to me in an aside or comment on my writing. I glossed over it, but apparently it stuck somewhere in the back of my brain.
The second was in a chapter in Volek and Phinney’s, “The Art and Science of Low Carbohydrate Living,” in my opinion the best book on the subject for a popular readership. And the third was recently in a very good column, “Don’t Force the Fat,” by the blogger and nutrition consultant, Kelley Pounds, at Low Carb RN (CDE). She uses bar graphs from Volek and Phinney and pie charts from another source to explain the contribution of body fat to the fat portion of the macronutrient ratio during the fat loss phase. As Kelley puts it succinctly, “My formula is low carb + moderate protein + moderate DIETARY fat + BODY FAT = LCHF.” I couldn’t have said it better myself!
Kelley came to this insightful conclusion after some rather blunt introspection: “For a while I wondered how I could be in nutritional ketosis, and either not lose…or sometimes actually gain weight. How can that be if I’m burning body fat?  Then I realized, I was just taking my old overeating habits and changing the source. So while I was keeping my carbs very low, and my protein moderate, I was overeating dietary fat. I was overeating period. I wasn’t listening to my body’s satiation signals…” This is good stuff! You should open the link above and read it.
Kelly concludes, “So while fat is not something to be feared, it is also not something to be gorged on…unless you need to STOP losing weight. That sounds like a good problem to have…I’ll cross that bridge when I come to it,” she says. I know where she’s coming from. “How many of us out there have already reached the point where we need to STOP losing body fat?” Ruefully, I agree. Not many. And now I understand, finally, that my macronutrient ratios were more “extreme” than I’d thought. All I have to remember now (from #319 here) is to 1) strictly follow a low carb diet, 2) eat only when hungry and 3) “listen to my body’s satiation signals.” Simple enough, right?


  1. Hey your post about health will help us. The right choice of the prohormones helps you to increase the strength, endurance, size and mass of your lean body. Thanks for posting.

  2. Hello, danbrown can you please show share with me the diet that you use to take to control your diabetes because my parents are also suffering from the Type II diabetes and they just do not take any fat or sweet and use to take regular exercise and walk. I oftenly take them to Physiotherapy North Ryde because they are always complaining about the pain in their legs.

  3. Diabetes causes neuropethic pain and that can also lead to back pain Canberra to limitize our mobility and just puts us on bed for days and even for months that equally aggravates our our problem of high blood sugar.