Retrospective #396: “Intransigent Resistance”

An acquaintance called me recently to say she had been talking to a mutual friend who had said that I had helped her lose 30 pounds (and 2 bra sizes!), by eating low carb. LOL. She (the acquaintance) asked my friend how she did it? Well, my friend suggested, the acquaintance should call me and ask. So, she did, and I was glad to help.

I am always pleased when my low-carb, moderate-protein, high, healthy (saturated) fat message is heeded. I offered to lend the acquaintance my favorite books to learn about the physiology of low carb, suggested the best websites for a neophyte to visit, and offered to mentor her, answering any question she had, as I had done for our mutual friend.

It turns out that the acquaintance – let’s call her Pam – is a very busy woman and doesn’t have the time to learn about the science. She just wants to know what to eat, and what not to eat. Apparently, Pam had read that I had lost 60 pounds in 9 months 15 years ago, by following “Atkins Induction” (20 grams of carbs/day). Then, a few years later I had lost another 110 pounds following Dr. Richard K. Bernstein’s “6-12-12 Program,” in which you eat just 30 grams of carbohydrate a day. For some unknown reason (a bias against Atkins?), Pam decided she wanted to try Bernstein.

So, I loaned her Bernstein’s “The Diabetes Diet” and his encyclopedic “Diabetes Solution.” I also told her I had recently become an acolyte of Dr. Jason Fung, fasting advocate and author of “The Obesity Code,” about Intermittent and Extended (full-day) fasting. I had unsuccessfully (due to my Insulin Resistance) tried 16-8 for about a year, in which I ate just one meal a day, or a small lunch and then supper within an 8-hour window, thus fasting 16 hours a day.

More recently, because I eat Very Low Carb and am therefore already FAT-ADAPTED, I transitioned easily to full-day fasting and have so far lost about 50 pounds. Concerned that I would be hungry or lacking in energy, I started off with alternate day fasts (Tuesday and Thursday). But because I am FAT-ADAPTED, I was neither hungry nor lacking in energy. My body transitioned easily from fed to fasting states, using glucose from the fed state and then fatty acids from body fat and ketone bodies, during the fasting state. Ketones are the by-products of fatty acid breakdown. They are the perfect brain food. Because of that smooth and natural transition, my metabolism continued to run at full speed. In fact, my sense is that I am actually more “pumped,” more energized, in my fasting state.

I then described what I eat on my 300 kcal/day Fasting Regimen: Just coffee with heavy cream for “breakfast” and a wine spritzer at the supper hour. Pam asked, “Don’t you drink more water during the day?” I said, “Only if I am dehydrated from working outside on a hot day.” “You should, you know,” she advised. I said, “I do drink some brine from the pickle jar” (to maintain my electrolyte balance). Pam was apoplectic.

In a later email exchange, I told Pam that she would have to cut way back on fruit to eat Low Carb. To eat Very Low Carb, she would have to virtually eliminate fruit. Fruit is basically just sugar. Fruit juice is worse.  It’s nature’s candy. Pam replied she had a serious problem with constipation and didn’t want to give up fruit on that account. I replied that that was a rationale I had never heard before and that I did not understand. When she didn’t explain how they were associated, I suggested it was an irrational justification, a rationalization, if you will. The silence was deafening.

I then suggested taking magnesium as a mild laxative and sleep aid. Most older adults are deficient in magnesium and should probably take a supplement. Pam then said she currently takes 400mg a day and her cardiologist doesn’t want her to take more. Her cardiologist! That was new information to me. I replied that I take 500mg a day, 200mg both morning and night plus 100mg in a multivitamin. And I had never experienced constipation on a Very Low Carb diet

Finally, to ease her bowels, I suggested increasing her fat consumption. She said, “Thank you” and signed off. I guess she, and maybe her cardiologist, think the US Dietary Guidelines still limit dietary fat to 30%, or worse, cause CVD. That’s not true, of course, but change is a slow process, especially with the medical community. And that affects the patient population, at least those who still follow “doctor’s orders.” Sometimes intransigence in both communities shuts down the process completely, ergo “Intransigent Resistance.”