Thursday, June 29, 2017

Type 2 Diabetes, a Dietary Disease #387: 15 Years on a VLC Diet

In August 2002 my doctor asked me to go to a website I’d never heard of, study a diet plan described there, and then start the diet when he returned from vacation two weeks later. He wanted to monitor me closely.
The impetus for his interest in this website was the cover story of the July 7, 2002, New York Times Sunday Magazine that he had read a month before, “What If It's All Been a Big Fat Lie?” by Gary Taubes. The cover photo was of a ribeye steak with a big pat of butter on top. He had tried the diet himself…and it worked.
The website was Atkins and the diet was the startup phase called “Atkins Induction” in which the dieter goes “cold turkey” from eating the Standard American or Western Diet to consuming just 20 grams of carbs a day. That’s very low. Today anything below 50g/d is described as Very Low Carb and up to 100 as Low Carb.
Very Low Carb (VLC) is similar to the Very Low Carb Ketogenic Diet (VLCKD) and also to the Low-Carb, High-Fat (LCHF) diet. LCHF stresses quality saturated and monounsaturated fats. All eschew vegetable and seed oils.
Followers will differ in their precise definitions, but most agree that they are all characterized by being LOW carb, MODERATE protein and HIGH fat. The high fat part is still the most controversial and easily the hardest for neophytes to accept. Despite being a hard sell, high fat is an important part of the plan.
We have been told for more than half a century that consuming fat, especially saturated fat with cholesterol, is a risk factor for heart disease. That guidance was not supported by good science and today is increasingly coming under review and criticism by a growing number of reputable sources. But the AHA, the Standards of Practice of the medical specialties, the government Dictocrats who influence payments by Medicare/Medicaid and private health insurers, and most practicing physicians are still wary and way, way behind the curve, as is the mass media. So, in this context patients generally do what their doctor tells them to do. I did.
And who can blame them? I just got lucky. My doctor had been trying to get me to lose weight for years. I saw his staff nutritionist and tried to follow the low-fat (high-carb!), “BALANCED” diet she prescribed for me. It didn’t work. Whenever I lost weight, my metabolism slowed, I was hungry, and I re-gained. And I felt like crap. My body told me to eat for energy balance. It didn’t like to starve. I didn’t like it either. So I failed, repeatedly.
What was different about this diet (Very Low Carb: 20 grams a day)? I wasn’t hungry. I didn’t crave food. My body was in energy balance and didn’t slow down because, when it needed energy, it switched from the food I ate to the food it had stored. It could do this because the food I ate was VERY LOW CARB. This meant that after the level of glucose (from carbs) in my blood dropped, the level of INSULIN in my blood also dropped. The insulin wasn’t needed to transport glucose to my cells. So, seeing lower blood insulin, the brain got the signal to switch from using glucose for energy to burning body fat for energy.
The key to weight loss w/o hunger: low carb → lower glucose → lower insulin→ access to body fat for energy.
Everybody’s level-of-carb threshold is going to be different. Among other things, it depends on the level of Insulin Resistance (IR) you have developed over a lifetime of eating 60% carbohydrates the way we have been told to do since 1977. That’s 300 grams of carbohydrates a day on a 2,000 kcal diet and 375 grams on a 2,500 kcal diet (for men). So, everyone who eats just 20 grams of carbohydrates a day will lose weight easily and without hunger. In the first 9 months I lost 60 pounds, and kept it off. It was life changing. Life saving, I think.
This is not an endorsement of Atkins, especially since it has changed so much since I did it 15 years ago. I later moved on to Bernstein (30g carbs/day) and lost 110 more. Today I am still 170 lbs. lighter than I was in 2002.

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