Sunday, April 16, 2017

Type 2 Diabetes, a Dietary Disease #376: “I have gone off carbohydrates almost entirely.”

A couple of columns back I told the story of a man I had met only once, and then only briefly, at a New Year’s Eve party. I was, shall we say, sort of “juiced”, and probably rattled on a bit about my Way of Eating (WOE). I related how I had lost a lot of weight, and improved many other health parameters, on a Very Low Carb (VLC) diet. I then apparently gave him a card for my website, The Nutrition Debate. I honestly expected nothing to come of it.
A few weeks later he emailed me, “I have gone off carbohydrates almost entirely…and lost 10 pounds.” I replied congratulating him on his success and his motivation. I asked, “What was the trigger for you?” He said, “My doctor had me tested for diabetes and suggested I might be pre-diabetic – hence the urgency for weight loss.” I asked, “Why Very Low Carb?” He had doubts, he said, but “I am hoping I will do myself more good than harm.”
In terms of mental reservation, given the fat phobia most people have learned from bad government guidelines, and from the medical establishment and the media, that was a fair place for him to be; that notwithstanding, however, my casual acquaintance took the next step. In his words, he foreswore “carbohydrates almost entirely.”
I was thrilled for him and pleased that I had at least been a catalyst. It was just serendipity that I had been there (sort of) at that moment to help him point the gun at the right target, carbohydrates, before pulling the trigger.
My new friend had the 3 keys: 1) the motivation, 2) the courage, and 3) the pertinacity to stay with it. All three are critical, but the “catalyst” for him was my bibulous rant on New Year’s Eve. What’s your trigger?
In my case, in 2002, I had been a diagnosed type 2 diabetic for 16 years and still eating a “balanced” (55-60% carbohydrate) diet as I had been for my whole life. And I had recently gained enough weight that I was too fat to weigh in on the doctor’s scale. So, before a scheduled appointment I stepped on a commercial scale and “discovered” I weighed 375 pounds. I was shocked. That was my motivation. And then serendipity stepped in.
As I opened the door to my doctor’s waiting room, he was standing at the nurse’s station and said, “Dan, have I got a diet for you!!!” Six weeks earlier my doctor had read the New York Times Sunday magazine cover story: Gary Taubes’s ground-breaking, “What If It's All Been a Big Fat Lie.” He tried the diet Taubes promoted. Besides losing 17 pounds in 6 weeks, he liked the effect it had on his lipid profile. So, he suggested that I try it, and I did.
The third factor, your firmness of purpose, or dogged determination, may seem to the uninitiated (or the misled) to be the hardest of the three, but it’s not. After just a few days of adjustment, while you use up your glycogen stores, or immediately if you’re already keto-adapted, it becomes accustomed to eating mostly protein and fat. It no longer craves carbs because your blood insulin level has dropped enough to allow access to your body’s fat stores. It then breaks down body fat when the calories you eat are insufficient to maintain energy balance.
But it can’t do this 1) if you eat enough carbs to raise your blood insulin level and/or 2) you eat more food than you need to maintain energy balance. But you won’t, if you listen to your hunger signals, because when your body is burning its own body fat, you are not hungry. Your body is feeding on its own fat stores, so it doesn’t tell you, “I’m hungry. You must feed me with food-by-mouth.” That’s what makes this easy. You won’t be hungry (after I period of adjustment) because your body is content to feed on its own fat stores. And it makes sufficient essential glucose from amino acids (from digested protein) and from the glycerol molecule freed up when body fat (triglycerides) break down. And in the process it will make ketone bodies, which your brain will love.
So, what’s happening with my new “friend” who lost 40 pounds in two months after “going off carbohydrates almost entirely”? I don’t know, but if he sticks to a Very Low Carbohydrate eating plan, both he and his doctor will be very happy – he a lot healthier and happy with the weight loss and his doctor with his improved lab tests.

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