14 Ways to Tell if Keto Is Working for You Besides Weight Loss

 

Based on keto transformation pics on social media, it would be easy to think this very low-carb way of eating is used for just one thing: weight loss. And no doubt, the before and after pictures of people who’ve lost substantial amounts of weight are amazing. But low-carb and ketogenic diets are good for so many other things besides changing the size of your body. Some of these—like lower blood sugar, lower triglycerides, and lower blood pressure—can be shared via pictures of glucometers, home blood pressure cuffs, or printouts of your latest bloodwork. But what about the things we can’t see? What about all the great stuff keto does that you can’t capture in a picture? A picture speaks a thousand words, but what about the great things keto does that you can’t take a picture of? 

People use keto for fat loss, but what if you: 

A) Don’t want or need to lose weight, but you’re dealing with a laundry list of troubling health issues? 

B) Do want to lose body fat but you’re stuck in a stall and the scale hasn’t moved in a while? 

Well, if B is your issue, check out this article I wrote on how to stay motivated during a fat loss stall, and then grab a copy of my book, The Stall Slayer, to help break that stall. (I also encourage you to just stay off the scale altogether for a while.) 

 

Either way, here are 14 ways to know that keto’s working for you that have nothing to do with weight.

New Book -- Free Preview!

OH MY GOODNESS, EVERYONE!

My new book is almost done! The text is entirely written and it’s all laid out and formatted. Just waiting for my designer to put the final touches on things so we can make sure it's ready to go.

WHAT? I wrote a new book? Yes, sir, I did! And you can download a free sneak peek right here. (Download of the pdf will start immediately when you click that link.) 

As you can see, it’s called The Stall Slayer, and in case the title doesn’t make it abundantly clear, it’s about breaking fat loss stalls on ketogenic/low-carb diets. This is the most common reason people write to me for help – “Why am I not losing weight?” So, rather than write out the same email reply eighty-six thousand times (just kidding...not quite that many people have written to me), I decided to put it all in a book. But if you’ve been reading my blog for a while and you know I tend to over-deliver information (for better or worse), then you probably already figure the book is chock-full of helpful information that goes far beyond roadblocks to fat loss and what to do about them. 

What about fasting? What about exercise? What about thyroid problems? What about alcohol?!All in the book, along with lots of other helpful information and education on SIMPLIFYING things and doing what I've come to call “keto without the crazy.”™ Do you need to count macros? Do you need to measure ketones? Should you use MCT oil? If so, why, and if not, why not? 

I was tempted to post the table of contents so you could see all the juicy details, but...well...I’m kind of paranoid and didn’t want anyone stealing the ideas. I’m hesitant even about posting the cover and title here, but my excitement is outweighing the paranoia. 

The preview pdf here has one error...on page 2, my Twitter handle is @TuitNutrition, not @AmyBerger. (This will be corrected for the final version, but I couldn’t wait to get this posted for you and I knew you wouldn't mind this one little snag for now.) 

I hope to have the book out before the end of the year, but there’s a chance it won’t be available until January. That’s not a bad thing, though: considering the avalanche of people who’ll be looking for fat loss tips after the new year, maybe that’s actually the perfect time. *Shrug.* It’ll be available as a pdf, plus a Kindle version, and there’ll also be a print-on-demand option for people like me who still, in 2019 and beyond, prefer to hold a physical book in our hands – one we can highlight, fold down pages in, and simply have the tactile sensations that come along with reading a hard copy. (But remember, if you buy the pdf, you can always print it out at home or have a store like Staples or Office Max print it for you -- much faster! I assume there are similar printing services at office supply stores outside the US as well. [Pro-tip: If you go this route, consider having the store print it in black & white -- much cheaper that way, and even though I love the images in the book, you won't lose anything critical if you don't see them in full color.] )  

Special thanks to my designer, Sterre de Jager, without whom this would not be happening. (Y’all know I can write, but graphic design is not my forte! Exhibit A, this website!) How did I get connected to Sterre? I’ve actually never met her person. Her father is a fan and follows me on Twitter – all the way from the Netherlands! I tell you, friends, the world is a strange, beautiful place. You can find out more about this amazing serendipity in this video, in which I introduce the book.  

I hope you enjoy the preview, and of course, I’ll be making plenty of buzz when the final version is available for sale, so don't worry about missing it.

THANK YOU, as always, for your support and readership!   

Use this link to download your FREE sneak peek of my soon-to-come book, The Stall Slayer: Get my free preview! (Download of the pdf will start immediately when you click that link.) 

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Is Insulin Messing with Your Skin?

Question: Is there anything in the body insulin doesn’t affect?

Answer: From what I’ve seen, no.

If you’re new to my blog or are a newcomer to the science of the clinically therapeutic effects of dietary carbohydrate restriction, you might think of insulin mostly as a blood sugar hormone. People with diabetes have blood sugar that’s too high, so they take insulin to bring it down. Simple, right? Not quite.

I’ve written in past posts that reading and learning I’ve done over the past few years has led to me to the perspective that lowering blood sugar is among insulin’s least important effects. (In fact, insulin isn’t even required to lower blood sugar at all. Your body can do that just fine without insulin…even in someone with type 1 diabetes. Type 1 diabetics do need insulin, just not solely for the purpose of lowering blood sugar. Details on all this here.)

I’ve written articles about insulin as a major factor in the development of gout, migraines, Alzheimer’s disease, PCOS, erectile dysfunction, benign prostatic hyperplasia (BPH, a.k.a. enlarged prostate), Parkinson’s disease, and more. The short list of things we know for certain are damaged by chronically elevated insulin and/or blood glucose (BG) includes the liver, kidneys, eyes, cardiovascular system (heart muscle and blood vessels), ovaries, the brain and nervous system. At this point, knowing what I now know about insulin, I don’t need someone to explain to me why insulin would affect any particular organ, gland, or tissue system; I need them to explain why it wouldn’t.

With this in mind, is it possible insulin is affecting your skin? You can’t see a fatty liver, polycystic ovaries or an enlarged prostate gland from the outside; you need special tests to determine for sure whether you have those. But what about acne, skin tags, psoriasis, and other things we can see just by looking at someone? Could insulin be playing a role here, too?

Tl;dr: If you want a brief summary of this article, read this. And if you have a few extra minutes and want to read one paper that will give you an enormous amount of insight into this topic, read this one. But if you come to my blog because you enjoy digging into the meaty details, stay here and keep reading. 

The PCOS Post: Hormonal Havoc From Hyperinsulinemia

As I mentioned in the previous post, I’ve been plugging away this blog since 2012. It’s hard to believe it’s been seven years, but even harder to believe that in all that time, I’ve completely neglected the topic of polycystic ovarian syndrome (PCOS). I’ve written a ton about insulin, glucagon, thyroid hormones, digestion, cancer, and more, but not one word about PCOS, except for a brief mention in this post. This is a glaring omission, because PCOS is a huge issue for reproductive aged women these days, and, no surprise if I’m writing about it here, it’s intimately tied to chronic hyperinsulinemia and metabolic dysregulation.

A while back I wrote about the effect of elevated insulin on men’s hormones, explaining the concept of a “male equivalent to PCOS,” and I didn’t realize that I hadn’t even yet written about actual PCOS. I don’t know how such a huge gap has existed on my blog for so long, but this is being corrected right now. Whew!

I’ve seen online in various places women saying that they’re at increased risk for type 2 diabetes or metabolic syndrome because they have PCOS. It’s actually the other way around: chronically high insulin (basically metabolic syndrome, whether you know you have it or not) is the main driver of PCOS. The reason so few women who have PCOS are aware of this is … surprise, surprise … most doctors are clueless about insulin’s many functions unrelated to blood sugar and they never bother measuring insulin levels.

Women with PCOS are often given unhelpful and condescending advice.  There is a lot of "blame the victim" that goes on with this condition. I sincerely hope this post does not come off that way. That is the very last thing I intend. I have only one goal here: to provide information. Information that can be empowering to women who have PCOS. If you are living with this condition and you feel disappointed by the help you've gotten from healthcare professionals so far, please know that you can take control. You have more power than you might realize. I hope what follows here is helpful.   

This is a long post (some of you are rejoicing now and others are groaning), so grab yourself a beverage of choice, a bag of pork rinds or some string cheese, and happy reading!

A New Look at Insulin, Glucagon & the Pancreas (a.k.a. ITIS part 9)

“Contrary to popular belief, insulin is not needed for glucose uptake and utilization in man.” (Source)

What? Insulin is not needed for glucose uptake? Did I just blow your mind a little?  If so, hang on to your hat. Lots more of that to come.

As I mentioned in my previous post on the personal fat threshold concept, what I enjoy most about writing my blog is that I get to share with you the fascinating and surprising things I learn. And one thing I can say with certainty is, the more I learn, the less I know. It seems like I barely hit publish on a new blog post before coming across a bunch of papers that teach me even more about the subject in question, or make me rethink what I wrote about it in the past.

One subject I’ve learned more about since I last wrote about it is insulin. If you’re new here, I recommend digging into my 8-part series on insulin. If I do say so myself, it’s some of the most important and educational stuff I’ve written.  But you don’t need to have read that to understand today’s post.

If you’re accustomed to thinking about insulin as a “blood sugar hormone,” you’re about to have your world turned upside down.  What I’ve learned about insulin over the past couple of years makes me think that lowering blood glucose might be one of the least important and impressive things it does.

Another very long post coming your way here, so grab a coffee or some pork rinds, and happy reading!

Before you dive in, though, I recommend scrolling way down to the bottom of this post where it says “End.” You might want to spend a while reading the whole thing, or you might not…that will help you decide. 

Watch Me PRESENT LIVE ONLINE on TUESDAY!

Good news, everyone!

If you haven’t been able to make it to any of the low carb or keto events where I’ve presented in the past, you’re in luck …

You can watch me speak LIVE at the Durham, North Carolina low carb support group meeting on Tuesday, March 5 at 6:30pm. Tune in by going to the Facebook page for HEAL Clinics – they will broadcast it live right there on the page. Dr. Eric Westman, Durham and Duke University’s king of keto, will kick things off, but then I’ll be giving a presentation on keto for mental & emotional health issues.

If you and/or someone you love deal with anxiety, depression, bipolar disorder, mood swings, panic attacks, or any other mental, emotional, or psychological issue, you’ll want to watch if you can. (But no worries if you’re not available at that time – you’ll be able to catch it anytime afterward on the HEAL Clinic page.) I’ll be talking about mechanisms behind why and how ketogenic diets can be beneficial for these conditions. I mean, weight loss? Sure. Diabetes? Old news. Tell me something I don’t know, right? How about physiological and biochemical reasons why keto is a stunningly logical and rational thing to try for anyone dealing with these difficult-to-treat issues?  

It will be very similar to the video I did on this topic for my YouTube channel, but this will be the live version, so hopefully there’ll be some fun interaction with the audience, and I’ll know some of you out there will be watching, too, which will keep me even more energetic and enthusiastic.

More on the support group:

If you happen to live in the Raleigh-Durham area, or within a reasonable driving distance, the support group meets on the first Tuesday of every month at the Durham Hilton near Duke University (3800 Hillsborough Road, Durham, NC 27705). I’m not always there, but I’m there fairly often, and will probably be there more now that I’ve relocated to Durham. There’s a low carb buffet dinner for a reasonable price, but you don’t have to eat; you can just come grab a seat and spend an evening with other people on low carb/keto diets, for free! There’s always a bit of education, some Q&A with Dr. Westman, and often some very inspiring success stories of people who are experiencing the wonderful yet darn near predictable benefits of low carb: fat loss, reducing or stopping their meds for T2 diabetes, total resolution of acid reflux/GERD, reductions in chronic pain and fatigue, improved GI function, restoration of menstruation and fertility after PCOS…y’know, just the regular run-of-the mill stuff that happens to people daily on keto. ;-)

Come in person to the support group on March 5 if you can!

More on HEAL Clinics:

Did you have to learn about low carb/keto on your own? Did you have to fight with a doctor, dietitian, or health coach who told you keto was dangerous, and that you should not eat that way? Did you spend years—decades, maybe—overweight or obese, paying astronomical sums for multiple medications, exhausted, in pain, and generally debilitated with physical and emotional malaise because you simply felt BLAH?

Are you tired of inexperienced people spouting all kinds of nonsense about keto on the interwebs—misinformation that, at best, makes it harder for people to lose weight, but at worst, is actively harmful for people on various medications who need proper medical supervision to implement keto safely? (I am! It’s why I started making my own videos, in fact.)

HEAL Clinics wants to help people to not have to overcome the multiple barriers so many of us might have faced on our journey to finding and successfully implementing keto/LCHF. Dr. Westman is the Chief Medical Officer, and his right-hand woman, the Director of Clinical Protocol, is Jackie Eberstein, RN—Jackie was the head nurse at Dr. Atkins’ clinic in NYC for almost 30 years and she was actually one of Dr. Westman’s teachers! (What, you thought he learned keto all on his own?) Lemme tell ya, dear readers, she is low carb royalty. If you want help losing weight, reversing your T2 diabetes, reducing your insulin needs for type 1, reversing fatty liver, improving PCOS, or anything else keto is a slam-dunk for, there’s pretty much no one with more experience to help you than these two long-time keto professionals.  

HEAL Clinics has two options:

1. If you’re taking certain medications for diabetes, you will need to be seen by one of their medical providers in person to get started. (After the initial in-person visit, follow-ups can be done remotely, I think.) Right now, they have clinics in North Carolina and Virginia, but will be expanding into more states over time. (Note: this doesn't mean you have to live in NC or VA to be a HEAL patient, but you would have to travel there for your first visit.)

2. If you have a relatively “uncomplicated” case and are not on certain meds, you can be seen entirely remotely and don’t have to go to one of the clinics in person.

Learn more about the program here: How It Works

Don’t need help with keto? HELP SOMEONE ELSE! You can actually invest in HEAL Clinics. If you want to make trustworthy, safe, reliable, and effective keto-oriented healthcare and coaching available to as many people as possible—so they don’t have to face the criticism, naysaying, and other negativity you might have experienced when you started out—consider investing so that HEAL can keep expanding. The investment is just that: an investment. It’s not a donation, like it is with a Kickstarter or some other form of fundraising. You will actually own stock in the company. And the sad truth is, with 88% of Americans being metabolically unhealthy, reversing illnesses that are entirely or to a great extent driven by diet is a damn wise thing to invest in. We are awash in a tsunami of type 2 diabetes, cardiovascular disease, PCOS, Alzheimer’s disease, fatty liver, and other conditions caused or exacerbated by chronic hyperinsulinemia. Keto can go a long way to completely reversing these, or at least having some degree of beneficial impact.

Many of us can do LCHF/keto on our own, but some people need a bit more moral support, and some need professional medical supervision. For those people—and so that Dr. Westman and Jackie can train more doctors, nurse practitioners, physician assistants, and other medical professionals so that this kind of care can be available to as many people as possible, consider investing if you have the means. And if you’re not in a position to invest, please let your friends and family know about HEAL Clinics, if you think they would benefit from keto, and you want them to do it correctly and safely.

(Full disclosure: I am a HEAL investor, so yes, I’ve put my own money where my mouth is! And no, there's no affiliate link or anything, so I receive no financial compensation whatsoever if any of you happen to invest. I'm just spreading the word about what I hope we can all agree is a good cause.)

See you on March 5!

Disclaimer: Amy Berger, MS, CNS, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

The Personal Fat Threshold Concept

Hey Kids!

It’s been ages since I’ve posted what I would call a “real” blog post. Something meaty and educational. Something you can really sink your teeth into. The last one was way back in August, when I wrote about whether protein is bad for the kidneys. (Hint: it’s not.) I’ve posted a few things since then, but nothing all that substantial. I’m glad to say today’s post makes up for lost time, because it is LONG. So grab yourself a cup of coffee or tea (or...*gag*...broth, if you must), put your phone on silent, and dig in.

I’m excited to share this with you. So excited, in fact, that I’ve been procrastinating on writing this for no less than 6 months. In looking at the folder of blog post drafts on my computer, I started jotting down notes for this in July 2018. The reason I kept putting it off is that I knew this was going to be a LONG post—massively long, even for me. But then I gave a talk on this topic at a keto event in Canada in December, so I finally had to organize my thoughts and put them together coherently. Once that was done, I figured it would be easier to get this written, since I could just flesh out the details of what was on the slides. Don’t kid yourselves, though. This still took four days to write and edit. (It’s much faster to talk and show images on slides than it is to type everything out in detail in a blog post!) Nevertheless, I’ve wanted to write this for a long time, so here we finally are. And the benefits a blog post has over a talk is that you can read this at your leisure, click on whatever links you’d like to explore further, and go as deeply down any of those rabbit holes as your heart desires. And to any of you who are happy at such a long post and who prefer reading to watching videos, I’m with you. I started my YouTube channel to bring my message of Keto Without the Crazy™ to a wider audience, but I, myself, prefer reading.    

One of the things I love most about writing my blog is sharing with you, my beloved readers, the fascinating and important things I learn as I deepen my understanding of human metabolism and physiology. The reason they call it “commencement” when you graduate with a degree in something is that it’s the start of your education, rather than the end of it. This has certainly proven true for me since getting my M.S. in nutrition.

One of the most intriguing things I’ve come across recently is the concept of the personal fat threshold. I don’t know who first coined this term, but it appears to have been Roy Taylor and Rury Holman, in their 2015 paper, Normal weight individuals who develop type 2 diabetes: the personal fat threshold. Other researchers wrote about the concept long before this paper, but I think Taylor & Holman were the first to use the phrase personal fat threshold. (Their paper is the first place I ever saw it in print, anyway. A researcher named Keith Frayn wrote some outstanding papers on the same topic years before without using the term. I cite his work liberally throughout this post. If you’d like to read the full text of any of the key papers I cite here, feel free to email me and I’ll send you a copy.)

Presentation on Insulin -- Much More Than a Blood Sugar Hormone

Hey all!

Busy, busy, busy for the next few weeks. I’m speaking at Low Carb Houston this weekend, at the Wise Traditions conference (from the Weston A. Price Foundation) in mid-November, and at the keto event in Ontario on December 1. Yowza!

So it might be a few weeks before I can write more blog posts of substance, but I’ll try to pop in and at least post something before I get back to (what I hope are) more meaningful and educational posts.

In the meantime, I want to share a link to a presentation I gave on insulin and chronic hyperinsulinemia. If you enjoyed my 8-part series on insulin a while back (two more parts coming, by the way!), then I think you’ll like this video. The primary message is that insulin is much more than merely a “blood sugar hormone.” Insulin has effects far and wide throughout the whole body. There’s almost no organ, gland, or tissue system that insulin doesn’t affect in some way, including the brain. (Hence the book I wrote on Alzheimer’s disease, and the talks I give on “brain insulin resistance.”)

In this presentation, I talk about chronically high insulin as a driver of several conditions/disorders not typically thought of as metabolic in origin. Aside from type 2 diabetes and obesity (which are so intertwined in some cases that they’ve coined the phrase “diabesity”), there’s gout, hypertension, PCOS, erectile dysfunction, cardiovascular disease, skin tags, migraines, and more. (Possibly even Parkinson’s disease!)

I go into detail on hypertension and gout as two examples of conditions where the underlying cause (high insulin) is ignored in favor of things that often have little to nothing to do with how the disease actually develops (sodium in the case of hypertension, and red meat in the case of gout). But my favorite part is when I talk about insulin’s role in directly inhibiting lipolysis—the breakdown of fat. It explains so elegantly why so many of us had such a very hard time losing body fat when we were eating all the whole grains we were advised to consume, along with our skim milk, fat-free yogurt, and other low- and no-fat carbohydrates, and why things became much easier when we ate in such a way as to keep our insulin levels low for most of the day.

Please forgive the poor sound quality in the video. This was recorded at an event that was organized by one person, and it was her very first time organizing something like this. We’re lucky someone did us the favor of recording it at all! It’s a little bit hard to hear at first, but it gets somewhat better as the video goes on. Please don’t let that stop you from watching. I think it’s educational and might give you some new knowledge about the role of insulin not just in body weight, but in overall health and wellness.

Here’s the link: Insulin Resistance Presentation, Perth, Ontario (10/16/2018)

   

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Gout: Is it Meat, or Metabolic Syndrome?

I’ve never experienced a gout attack, but if common graphical representations are to be believed, it feels like there are shards of broken glass embedded in your joints, or like someone’s holding a flamethrower on full blast and aiming it right at your big toe. For whatever reason, the big toe seems to be the joint that suffers the worst in gout, but the condition can manifest in other joints as well.

Conventional medicine holds that animal proteins and alcohol are major triggers for gout, so typical advice for those who suffer from gout is to reduce consumption of alcohol and animal protein—red meat and seafood, in particular.

Part of the rationale for these recommendations is that gout results from an abnormal accumulation in the blood of a compound called uric acid. At high blood concentrations, uric acid can crystallize and be deposited in the joints, and these uric acid crystals are responsible for the pain, swelling, and other fun stuff that comes along with gout. And a major source of uric acid is the metabolism of purines, which are nitrogen-containing compounds found in proteins (and other substances). Some foods are higher in purines than others, hence the recommendations to eliminate or reduce red meat and seafood in the diet. Beer is also high in purines, and other plant foods are sources of purines as well.

But uric acid is a normal compound in the body. It’s not solely a metabolic waste product; it performs important functions as well. So we don’t want to get rid of uric acid entirely, and we certainly don’t want to eliminate protein from our diets.

So if the body normally produces uric acid, what’s really the problem in gout? Does the body produce too much uric acid, or is the uric acid not cleared away properly?

If it’s the latter, and the problem isn’t with overproduction, but rather, with impaired clearance, how is uric acid cleared from the body, and what impairs this?

Well, to cut right to the chase, the kidneys filter excess uric acid out of the blood so it can be excreted in the urine. And what impairs the kidneys’ ability to do this? Insulin. Yes, dear readers, our old friend insulin strikes again. (I mentioned this insulin and gout connection way back in the insulin series.) Alcohol also reduces the kidneys’ ability to excrete uric acid, so there might be some truth to cutting back on alcohol if you have gout.  

Mankind has been consuming animal proteins for a long time now, and gout is a relatively new disease. Well, “new” since about 300 years ago, which is when more accounts of it started being recorded. At that time, it occurred mainly among wealthy people—the people who could afford to eat rich meats and drink alcohol. But something else these “refined” individuals could afford that most common folk couldn’t, was sugar. Refined sugar.  ;-) 

Interesting, huh? 

Typical old-school representation of gout: a demon shooting fire at the toes.

Notice what appears to be a wealthy looking man eating what might be a meatball, and there’s alcohol on the table.

So what’s the real deal with gout? Is it caused by meat, or metabolic syndrome--that is, chronically elevated insulin?

Read all about it in my latest post for the KetoDiet Blog: Is Gout Caused by Red Meat or Metabolic Syndrome?  I think you’ll find the details interesting, and what’s really fascinating is that a few studies have shown that diets that are higher in protein can actually reduce uric acid levels and frequency of gout attacks—provided that the diets are also lower in carbs. Nice, huh?

If you or someone you know suffers from gout, and you think you’ve been relegated to a life without steaks and red wine (perish the thought!), check out the post to learn why it’s not meat, but rather, chronically high insulin, that causes gout.

As a personal aside, I have a friend who suffers from gout, and he’s a vegetarian. No red meat, but lots of fruit, fruit juice, and grains. And fructose, via its effects on the liver, can be a huge contributor to hyperinsulinemia and gout.

If you’d like to learn more, Georgia Ede, MD, has a fabulous post that covers all of this as well—gout, meat, insulin, alcohol, and fructose, and it’s a highly recommended read: Got Gout but Love Meat?

Also, the must-read book, Good Calories, Bad Calories, by Gary Taubes, originally included a chapter on gout, but it didn’t make it into the version that got published. Fortunately, this “lost chapter” is available online and it’s another educational read on the connections between insulin, fructose, and gout: Gout: The Missing Chapter from Good Calories, Bad Calories

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Does Protein Harm the Kidneys?

Hey kids! My previous blog post laid waste to the myth that a high protein intake is harmful for bone health. This time, it’s my great pleasure to decimate another “high protein is bad for you” thing. Today, it’s kidney function. Many of you have been eagerly awaiting this post. Here’s hoping I don’t disappoint.

Even if you’ve accepted that everything we thought we knew about saturated fat and cholesterol in our diets was almost completely wrong, and you’ve been following a low-carb or ketogenic diet confidently for fat loss, migraines, GERD/acid reflux,  reversing type 2 diabetes, reducing insulin needs and evening out blood sugar for type 1 diabetes, or for some other health issue, maybe there’s still some lingering fear in the back of your mind that the protein you’re eating—especially animal protein—is bad for your kidneys.

We’ve heard this over and over from just about everyone with an agenda to discredit the efficacy of low carb diets. Now, mind you, low carb diets are not, by definition, high in protein, but in walking away from sugars, grains, beans, and starchy vegetables, many of us find that, compared to our former high-carb life, our protein consumption does increase, whether in absolute grams, as a percentage of total calories, or both. Not to mention the growing carnivore movement, where people are eating only animal foods. For these folks, protein consumption almost certainly increases compared to a standard Western diet, and likely even compared to if/when they were following a ketogenic diet.

So with all this in mind, it’s important that we set the record straight about the influence of dietary protein on kidney function.

Is There a Male Equivalent to PCOS? (a.k.a. The Detrimental Effects of Hyperinsulinemia on Men's Health)

 

Insulin has gotten a bad reputation in the low carb and keto communities. But insulin isn’t a bad thing. Too much insulin, too often, is a bad thing. If you ask people whose homes are threatened by wildfires whether lots of rain would be a good thing, you’ll probably get a very different answer than if you ask people whose homes have just been destroyed by hurricane floods. Water is not a problem; too much or too little water is a problem, and it’s the same with insulin.

So I’m not trying to demonize insulin. I wrote an 8-part blog series detailing the gnarly and nefarious effects of chronically elevated insulin (soon to be 9 or 10 parts -- new posts coming soon!), but the operative phrase there is chronically elevated. In and of itself, insulin isn’t a problem. (Just ask a type 1 diabetic.) The bad stuff happens only when insulin is too high, too often. Now that that’s out of the way, on with the show!

We know for certain that PCOS (polycystic ovarian syndrome)—which is “is the most common endocrinopathy of reproductive aged women affecting 6-10% of the population,”—is driven primarily by chronic hyperinsulinemia. (Incidence may be as high as 18% among certain cohorts when different diagnostic criteria are used, putting the number of women affected worldwide at around 10 million.)

“Hyperinsulinemia associated with insulin resistance has been causally linked to all features of the syndrome, such as hyperandrogenism, reproductive disorders, acne, hirsutism and metabolic disturbances.” (De Leo et al., 2004)

In fact, the causal link (not just an association!) between hyperinsulinema and PCOS is so well-known (and so powerful) that metformin—best known as a diabetes drug—is among the frontline pharmaceutical interventions for PCOS. Keep this in mind as you read about the men’s issues here.

Facial hair, acne, oily skin, mood swings, weight gain, menstrual irregularities, and infertility are not the only signs and symptoms of PCOS. These signs & symptoms are driven by the underlying hormonal disturbances, which include: elevated insulin, increased adrenal androgen synthesis (more testosterone and/or DHEA), decreased sex hormone binding globulin (SHBG), increased luteinizing hormone (LH), and decreased follicle stimulating hormone (FSH). And while the stereotypical PCOS patient is overweight or obese, as many as 50% of women with PCOS are not overweight or obese. (Remember, chronic hyperinsulinemia leads to obesity in some people, but not all. There are millions of people walking around with a “normal” body weight, but sky-high insulin levels.)

Since men produce all of these hormones as well, could there be a male equivalent of PCOS?

You bet your bald spot there is!

Let’s take a look at three different areas where chronic hyperinsulinemia has adverse effects on men:

• Early onset androgenetic alopecia (a.k.a. male-pattern baldness)
• Erectile dysfunction
• Benign prostatic hypertrophy (BPH) – enlargement of the prostate gland 

Book Review: The Case Against Sugar

Gary Taubes wrote another book.

Gary Taubes! (*Fangirl squee!*)

Do I really need to say more?

I don’t, but since this is my blog, I will.

TL;DR: I loved this book and you will too. READ IT.

If you don’t read a lot of blogs and websites outside the low carb bubble, then allow me to tell you that there’s a large contingent of people who loathe Taubes. He takes a boatload of criticism, as does anyone who writes something that condemns or exonerates something other people love or hate (e.g., red meat and saturated fats, refined carbohydrates, and raw milk). But put me squarely in the camp that loves his work and is grateful for his meticulous research. (The endnotes and bibliography of Good Calories, Bad Calories are almost as large as my entire book.) I’m not saying he’s right about everything, nor that I agree with him on everything. I’m only saying I’m a big fan and have been for several years.

I had the pleasure of meeting Gary in spring 2017, first at a reading and book signing in Washington, DC, and then a few weeks later at a literary event in Charlottesville, VA. I actually drove him from Charlottesville back up to Dulles airport in my neck of the woods, so we had some time to chat and shoot the low carb breeze. Let me tell you, folks: I read GCBC during my deployment in Iraq, circa 2008. Having always been a sucker for salt & pepper hair, intellect, and a wry and somewhat dark sense of humor, I developed an immediate nerd crush on Gary. Never in my wildest imagination—and mine is pretty wild—did I think nine years later, I’d have him all to myself on the road for two hours.

Get your minds out of the gutter. Nothing happened except good conversation and Gary being an exceptionally good sport about the fact that my decade-old car has seen better days. (He assured me that his car is older and in even worse disrepair. We writers don’t exactly break the bank; not even ones like Gary, who garner big advances and have multiple bestsellers to their names.) Without revealing too much, I’ll say that it was really nice to talk with a writer of Gary’s caliber, and to find out that many of the emotional demons that plague me are not unique to me. Gary deals with his by throwing himself into work; I deal with mine by avoiding work. Neither strategy is all that healthy, long term. But I can look to Gary as someone with a lot of dark thoughts and inner turmoil who still manages to get shit done produce great work. It helps that he has a wife and two sons depending on him, so he sort of has to bring home the proverbial (and literal) bacon. 

As an aside, Gary has spent time in France, and he longs for it. As he talked about it, his desire to be there—and, maybe, to be the person he was when he was there—was palpable. He has also written and spoken a lot about his history as a smoker. I could totally see him as the quintessential ex-pat, sitting at a roadside café in Paris, sipping coffee and reading poetry, complete with a black turtleneck and a cigarette.  

But enough about Gary. On to the book!

Ketogenesis, Measuring Ketones, and Burning Fat vs Being in Ketosis

This post is long overdue.

I cannot tell you how many emails I get from people fretting over their ketone levels. It’s time to set the record straight on this issue. I wish there was someplace I could refer people for reliable information on this subject, but I haven’t come across a blog post or podcast interview that explains things satisfactorily. At least, not to my satisfaction. And that is and always has been my goal in writing my blog: I explain things the way I would want someone to explain them to me, if I were new to all this. And since no one—as far as I know, anyway—has tackled this subject the way I would, I finally had to just sit down and write this. If you feel it’s educational, please share it in the low carb and/or ketogenic circles you frequent, because I know this issue comes up all the time in ketogenic forums and Facebook groups. (And if you know of other good resources on this topic, feel free to provide a link in the comments, and I’ll update this post to include it.)

Okay, here goes.

There are few issues more controversial regarding ketogenic diets than whether you should measure your ketones. There are valid reasons to measure, but there are also a lot—a lot—of misconceptions about measuring ketones and how to interpret the data. So let’s get into when and why it’s a good idea to measure, who doesn’t need to measure, and most important, what the numbers mean. (I said who “doesn’t need to” measure rather than who shouldn’t measure because if you want to measure, then go ahead. There’s really no should or shouldn’t here. But if you choose to measure, you need to understand how to interpret and understand the numbers so you don’t jump to illogical and false conclusions.)     

I will also be covering the difference between being fat adapted versus in ketosis. I tried to do it in a few posts awhile back, but I think I the way I explain it here is much better because I will show you the biochemical pathways involved so you will be able to see how it actually works. My hope is that this will go from a vague concept in your mind to, “Oh! NOW I get it!” And you will understand very clearly how you can absolutely, positively have a fat-based metabolism and lose body fat even if you’re not in ketosis. 

More Than You Ever Wanted to Know About Protein & Gluconeogenesis

My dear readers, the website/blog update has run into some snags. Rather than continuing to keep you waiting, though, I’m going to publish new posts and I’ll worry about transitioning them over later on. And since it’s been a few months since I last posted anything of substance, I’ve decided to drop this enormous, enormous post on you to make up for that lost time—and it might take you equally long to read it. Sorry about that, but hey, I haven’t written anything meaningful since May, so, depending on your point of view, this post is either a gift or a punishment. As I’ve said in the past, if you’re an insomniac or a cubicle dweller with lots of time to kill, you’re welcome. (The rest of you, go get yourself a cup of coffee or tea, come back, and get comfy.)

I’ve been meaning to write this post for over a year, but it’s such a big topic and so much can go wrong that the thought of tackling it all was enough to make me not write it. But it’s gotten to the point that I’m tired enough of seeing the same questions asked and the same myths propagated over and over on various keto and low carb forums that I’ve decided this needs to be done, no matter how painful I might find it. Because seeing nonsense and fearmongering regarding the role of protein in low carb or ketogenic diets is even more painful. So if finally managing to organize my thoughts into some kind of coherent prose means I never have to read the phrase, “too much protein turns into sugar” ever again, it will be worth it.

So that’s what’s on tap today, kids: Gluconeogenesis.

That’s right, friends, it’s time to do some myth-busting surrounding the whacked-out notion that protein—lean protein, in particular (like a skinless chicken breast, or tuna canned in water)—is the metabolic equivalent of chocolate cake. (Or cotton candy, or gummy bears, or any other insanely sugary thing that might raise your blood glucose and insulin far more than protein does.)