Tips for starting (or restarting) Low carb Diets Part 1

As anyone who has done it knows, getting started on a low-carb diet can be a little rough.  Not for everyone, but for some.  All too often these little front-end bumps in the road–coupled with the spirit of the times in which the well-intentioned but ignorant friends and relatives of low-carb dieters tell them their diet is going to croak their kidneys, clog their arteries and weaken their bones–can be enough to make many people abandon the most sincere efforts.  Drawing on my almost 30 years of experience treating patients using the low-carb diet, I can give some tips and tricks for dealing with these difficult early days.

Listen to your body?

The surest road to failure in the first few days of low-carb dieting is to listen to your body.  The whole notion of listening to your body is one of my major pet peeves.  In fact, just hearing those words makes me want to puke.  In my experience, they are usually uttered by females with moist, dreamy looks in their eyes, but not always.  I just read a ton of comments in recent Paleo blog post in which vastly more males than females actually wrote this drivel.

Listening to your body is giving the elephant free rein. If you’re three days into your stop-smoking program, and you listen to your body, you’re screwed.  If you’re in drug rehab, and you listen to your body, you’re screwed.  If you’re trying to give up booze, and you listen to your body, you’re screwed.  And if you’re a week into your low-carb diet, and you listen to your body, you’re screwed.  Actually, it’s okay to listen to it, I suppose, just don’t do what it’s telling you to do because if you do, you’re screwed.

Okay, end of rant.  I just had to get it out of my system.  You just can’t imagine how many times people who have tried low-carb diets then abandoned them early on have said those words to me.  Wait.  I’m about to get started again. Stop!

Low-carbohydrate adaptation

Probably the best explanation of low-carb adaptation (also called keto adaptation) was written by a Lt. Frederick Schwatka (pictured above left) over a hundred years ago.

When first thrown wholly upon a diet of reindeer meat, it seems inadequate to properly nourish the system and there is an apparent weakness and inability to perform severe exertive, fatiguing journeys. But this soon passes away in the course of two or three weeks.

Lt. Schwatka was a doctor, a lawyer, and an explorer of the Arctic, the Great Plains and northern Mexico.  The above quote comes from his book on the unfruitful search for the Franklin party in 1878.  (For all his experience and gifts, and understanding of low-carb adaptation, the good doctor listened to his own body a little too much and did himself in with an overdose of morphine at age 42.) You can read more about Lt Schwatka, low-carb adaptation, and his time with the Inuit in a post I wrote a few years ago.

The period of low-carb adaptation is that time between starting a low-carb diet and feeling great on a low-carb diet.  It can take anywhere from just a day or so to two or three weeks.  During this adaptation period people tend to fatigue easily, experience a slight lack of mental clarity and be tormented off and on by the unbidden lust for carbs that seems to rise up out of nowhere.  Why does this happen early on with a diet that ultimately works so well to increase exercise capacity, mental clarity, and feelings of satiation?

It happens because both your body and brain are going through a profound change in the way they get their energy.  You can’t run your car designed to burn gasoline on biodeisel…unless you install a converter.  Then you can.  We humans have the design for our carb to fat converters coded in our DNA – the low-carb adaptation period is simply the time it takes for the converter to be built and installed.

Our bodies are simply giant piles of chemicals heaped together in a human-shaped form.  Most of the chemicals will react with one another, but only extremely slowly.  If we didn’t have something to help these reactions along, life wouldn’t exist.  The helpers are called enzymes.  These enzymes – which are large folded proteins – catalyze all the chemical reactions that allow us to function.  Mix a couple of body chemicals together and you might have to wait twenty years or more for them to interact or combine in some way to form another body chemical product.  Throw the correct enzyme into the mixture, and you get a reaction in a fraction of a second.

When you’ve been on the standard American high-carb diet, you’re loaded with enzymes ready to convert those carbs to energy.  You’ve got some enzymes laying in the weeds waiting to deal with the fat, but mainly dealing with it by storing it, not necessarily burning it.  All the pathways to deal with carbs and their resultant blood glucose are well-oiled and operating smoothly.  Then you start a low-carb diet.  Suddenly, you’ve idled most of the enzyme force you have built to process the carbs in your diet while at the same time you don’t have a ready supply of the enzymes in the quantities needed to deal with your new diet.  It would be like a Ford automobile factory changing in one day into a plant that made iPads.  All the autoworkers would show up and be clueless as how to make an iPad.  It would take a while – not to mention a lot of chaos – to get rid of the autoworkers and replace them with iPad workers.  In a way, that’s kind of what’s happening during the low-carb adaptation period.

Over the first few days to few weeks of low-carb adaptation, your body is laying off the carbohydrate worker enzymes and building new fat worker enzymes.  Once the workforce in your body is changed out, you start functioning properly on your new low-carb, higher-fat diet.  The carbs you used to burn for energy are now replaced to a great extent by ketones (which is why this time is also called the keto-adaptation period) and fat.  Your brain begins to use ketones to replace the glucose it used to use pretty much exclusively, so your thinking clears up.  And the fatigue you used to feel at the start of the diet goes away as ketones and fat (and the army of enzymes required to use them efficiently) take over as the primary sources of energy.  Suddenly you seem to go from not being able to walk out to get the morning paper without puffing and panting to having an abundance of energy.  Because of this low-carb adaptation period, we never, ever counsel our patients to start an exercise program when they start their low-carb diets because a) we know they’ll be too fatigued to do it, and b) we know that in a short time they will start exercising spontaneously to burn off the excess fat on their bodies once the skids are greased, so to speak.

Anyone with good sense contemplating a low-carb diet would ask the question, How can I make this low-carb adaptation period as short as possible?  Good question.  Why would anyone want to prolong the agony?

The secret to making it shorter is in the second part of what Lt. Schwatka wrote about low-carb adaptation.  Immediately after the above quoted sentences, he follows with:

At first the white man takes to the new diet in too homeopathic a manner, especially if it be raw. However, seal meat which is far more disagreeable with its fishy odor, and bear meat with its strong flavor, seems to have no such temporary debilitating effect upon the economy.

In other words, the white man, used to flour, sugar, boiled meat and all the other staples of the mid 19th century American diet, balked at the consumption of raw meat, especially raw and malodorous seal and bear meat.  And so took it in tiny portions (in a  “homeopathic manner”) instead of going face down in it.  Compared to reindeer meat, both seal and bear meat are loaded with fat, which is why the consumption of those fattier meats didn’t produce the “temporary debilitating effect.”  In those who did eat the fattier meats, the low-carb adaptation period was very short or even non-existent.

Eat more fat

If you want to reduce the time you spend in low-carb adaptation, crank up the fat.  If you go on a high-protein, moderate-fat diet (Schwatka’s reindeer diet), your body will convert the protein to glucose via gluconeogenesis, so you’ll still have glucose to keep the glucose worker enzymes busy and will prolong the conversion to fat and ketones as your primary energy source.

So Rule Number One to reduce the time spent in low-carb adaptation purgatory is: Don’t be a wuss when you start your low-carb way of eating.  Keep the carbs cut to the minimum and load up on the fat. Eat fatty cuts of meat, cooked in butter or lard if you want, and force your body over to using the fats and ketones for energy as nature intended. I mean, don’t try to be noble by eating boneless, skinless chicken breasts – instead insert some pats of butter under the skin of a chicken leg and thigh before cooking, and wolf them with your fingers while the fat drips down your arms.  Do not trim the fat from your steaks – eat them from the fat side in.  If you leave anything on your plate, make sure it’s the meat and not the fat.  If you don’t already, learn to love bacon, and don’t cook it ‘til the fat is all gone: eat it wobbly.  Wallow in Mangalitsa lardo.  And whatever you do, for God’s sake, don’t listen to your body during this adaptation period or you’ll never cross the chasm between fat and miserable on your high-carb diet and slim, happy, energetic and low-carb adapted on the other side.

In my next post, I’ll give you the rest of the tips and tricks to get through low-carb adaptation that MD and I have learned in our combined 50 plus years of taking care of patients on low-carb diet. And I’ll include a recipe worthy of killing for that you can prepare to help you get through.

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We don’t get fat because we overeat; we overeat because we are fat

Has anyone read “Why We Get Fat and What To Do About It” by Gary Taubes? It is a research book about how the body holds onto fat with the conclusion being avoid grains and the fat will fall off. I was so intrigued I began testing this hypothesis on my family. We are all converts now.

I have summarized the book below as it's not an easy read; mainly a research book examining years of ‘ignored’ research that proves its point. In this summary, I borrowed heavily from the author’s blog where he defends himself after a contentious appearance on Dr Oz.

I will give you the author's hypothesis up front, explain his main points and at the end tell you the “What to Do about It” part.

Hypothesis: “We don’t get fat because we overeat; we overeat because we are fat.”

Unlike what we have been fed by science and media since the 1960s, it is not fat that makes us fat. Nor is it gluttony or sloth as moralists like to guilt trip us to believe. It is hormones that make and keep us fat: Insulin, estrogen, testosterone and more. Some people are genetically predisposed to accumulate fat, others to burn it. It depends on hormones, most of which are out of our control; all except Insulin. Insulin is the one hormone that we all can consciously control through our diet by cutting carbohydrate rich foods: all grains, all sugars, corn syrup and starchy vegetables. This is a good thing as Insulin is the biggest bad guy and needs to be controlled; especially in those who are already fat.

You see, what makes fat cells fat is Insulin. “Raise Insulin levels and we accumulate more fat in our fat cells. Lower Insulin and fat is released from the fat cells so our lean tissues burn it for fuel.” So regardless of our predisposition to get fat, we can lower our fat by lowering our carbohydrate intake. But, “there’s no one-size-fits-all prescription for the quantity of carbohydrates we can eat and still lose fat or remain lean.” “For some, getting lean might be a matter of merely avoiding sugars… And for some, weight will be lost only on a diet of virtually zero carbohydrates”

In a nutshell; “Carbohydrates drive Insulin drives Fat.” This fact is found in European research from the early 1900s on; but after the end of World War II Americans turned their back on it. Around the 1960s we came up with ‘faulty’ science touting low fat diets and exercise as means to lower body fat. Obesity rates have risen steadily since then.

Making matters worse, “a blanket recommendation to eat fruits and vegetables and whole grains, as Oz prescribes and now Weight Watchers and the U.S. Dietary Guidelines, ignores this aspect of human variability completely. It assumes that people who are predisposed to fatten can tolerate the same foods and benefit from the same very mild dose of carb-restriction that the naturally lean can.”

The fact is; the more fat you have; the more fat you accumulate. To understand why; think of it as the evil doings of two culprits: LPL and Insulin. “LPL is the enzyme (in less technical language, the thing) that works to pull fat from the circulation into whatever cell it happens to be sitting on. If that cell is a muscle cell, the fat is used for fuel. If it’s a fat cell, the fat is stored.” Obviously, the more fat you have, the more likely the enzyme will be sitting on a fat cell when it dumps its load. Next the evil culprit, Insulin, comes along; like an overzealous prison warden, he builds more and more prisons that are impossible to escape from. In other words, Insulin — “creates new fat cells… and it inhibits the escape of fat from the fat cell and its use for fuel.”

Now here is a catch 22; with all our fat locked up so we can’t burn it for fuel, we need more fuel for our bodies to burn so that we can move. This is the fact upon which the author based his hypothesis: “we don’t get fat because we overeat; we overeat because we are fat”. Regardless of how much we eat, if our fat cells are hogging it all; our body will demand more. It will harangue us, “Feed me, FEED ME!” Like that plant in Little Shop of Horrors, it’s insatiable.

So what does it do, if you don’t feed it enough to make up for what it is hoarding away in its fat cells? It slows you down, so you won’t burn so much of its precious little fuel: fat…, hungry… and too tired to move. Sound familiar?

You just can’t fool Mother Nature. So what can you do? According to all the research; there is only one thing; fire the prison warden. How? Avoid the foods that increase Insulin levels. Basically, the foods that were absent from human diets during the 2.5 million years of evolution leading up to the industrial era (a scant 300 years ago) that we are still poorly adapted to — easily digestible starches, refined carbohydrates and sugars.

The good news is, we can do this without going hungry. We are advised that if we eliminate carbs, we can eat fats and protein till we are full and still lose weight. In addition, if we avoid sugars and artificial sweeteners, we will eventually lose our cravings for carbs.

If all this is true, which I plan to test on myself; it will explain why I have hung onto my baby fat (i.e. post pregnancy weight gain) despite having always exercised, eaten whole grains and avoided fatty food. While I have dropped a few pounds, I expected more dramatic results in the past 4 years since I became a Pescetarian (a vegetarian that eats fish). I admit I was a vegetarian that also ate sugar every day.

I know it is true that we do crave the carbs that feed the monster. But according to a study of carb deprived kids, they lost their cravings after 12 to 15 months. I think that’s too long to suffer so I am cheating with Shakeology. I’m not sure how that may skew my test results, but I don’t care; after only one month, I no longer craved sweets or coffee and my Reflux settled down. It only has 17 carbs so I don’t see any reason to give it up. If I am going pull off a 50 lb fat loss and win the Beachbody Contest, I need all the help I can get!

I like to think that it is not our fault that so many of us are fat; but I believe it will be, if there is a proven way to reverse it and we don’t try.

Meanwhile one thing we can all do is give a break to the many people (a third of our population) who struggle with obesity. Fat isn’t a reflection on one’s character! As a friend of mine said after reading this, “I might have to stop being so judgmental!” Now there’s an idea whose time has come!

Do it, just for the health of it!

Tani-Rae

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