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.

Cheat Meals on Keto or Low Carb: A New Perspective

I ate 9 grapes.

They kicked me out of ketosis!

I ate a donut!

How soon until I’m back in ketosis?!

I went to the Chinese buffet, and … I don’t know, I just lost my ever-lovin’ mind and ate ALL. THE. THINGS.

Have I completely and totally wrecked *everything?*

Yes, folks, it’s time for a post about cheat meals.

Rather than having to answer the same questions over and over and (attempt to) instill sanity into people time and again, I thought it would be easier to put my thoughts together in one place so that when situations like the above arise, as they inevitably and often do, I can point people here instead of writing the same email response eleventy-six times.

Feel free to link to this post when you come across similar sentiments from low-carb and keto newbies freaking out because they jumped head-first into a stack of pancakes and syrup.

Lots to cover here, but I’ll try to keep it more succinct than usual. (Insert LOL.)

If you’re pressed for time and want a one paragraph summary, scroll down to the bottom for the tl;dr.

New to Low Carb? Feeling Lost? "Paralysis by Analysis?" READ THIS.

Hey Everyone,

As promised, here’s the follow-up to my post on taking an Information Vacation from social media if you're feeling overwhelmed and panicky from confusing keto information coming at you from all sides. Since there will no doubt be loads of people new to this diet in the new year, I figured this was a good time to put this out there.

If you’re new to low carb, or maybe haven’t even started yet, this one’s for you.

If the reason you haven’t started yet is that, despite being an intelligent, grown adult, you can’t seem to make sense of the eight thousand pieces of conflicting information you’ve read about low carb and ketogenic diets, this one is definitely for you.

If you have already started, and still can’t make sense of the eight thousand pieces of conflicting information you’ve read about low carb and ketogenic diets, this is also for you.

You are not alone!

Here’s a quick list of words and phrases extracted from emails I receive from people looking for help with low carb or keto:

• Confused
• Overwhelmed
• Conflicting info
• Stalled
• Frustrated
• No idea what to do!
• Totally lost!

  

If you’re brand new to all this, I have to be honest: I don’t envy you. As I mentioned in a recent podcast interview (probably my most fun and controversial one yet), getting started with a low carb diet was much easier 17 years ago, when I first gave it a try. Back then, the internet existed, of course, but the contingent of people talking about low carb was much smaller. There were only a handful of low carb chat rooms and forums, virtually no blogs, and if I recall correctly, neither podcasts nor YouTube even existed. So there was a lot less information available to newbie low carbers, but ironically, that was a good thing. Because now, while it’s wonderful that low carb and keto have become so popular, and there are more blogs, books, Facebook groups, podcasts, and YouTube channels than anyone can keep track of, unfortunately, for every good, reliable, accurate piece of information about these ways of eating, there are four pieces of nonsense and falsehoods that have to waded through first.

Like I said, I don’t envy the newbies.  

When I was brand new to this, around the year 2000, I had two main sources of information: the bulletin boards at LowCarbFriends.com (which I’m delighted to see still exist, as I haven’t logged in in about nine years), and Dr. Atkins’ New Diet Revolution. (Linking to the 1997 version because the one that got me started—the 1992 version, with the blue cover—is apparently no longer available.)

That’s right: the Atkins book.

Totally Overwhelmed by Conflicting Information on Low Carb or Keto? Take an Information Vacation!

Are you completely overwhelmed by information about low carb or ketogenic diets? Is your neck about to snap from the multiple times you’ve gotten whiplash from trying to follow an endless onslaught of contradictory advice on reduced carb ways of eating?

If your life revolves around weighing and measuring your food, tracking your heart rate, your sleep, your bowel movements, your workouts, the number of steps you take in a day, and more, and you’re afraid that if you let up for even one second, the entire edifice you’re propping up is going to come crashing down around you, this post is for you!

If diving down every low carb rabbit hole you find has become your main hobby, I totally understand. Perhaps, like me, you spent years doing what you thought were “all the right things” to get healthy or improve your physique. And, perhaps, like me, after years—decades, maybe—of that failing you, you discovered the world of carbohydrate reduction. And after learning nearly all the health and fitness tenets you once held dear were false, you now have a desire—no, an obsession—to learn as much as you can, as fast as you can, from as many different sources as you can. No one could blame you! You’ve got years of misinformation to correct, right? Nearly a lifetime of programming to de-program.

However.

However, if your determination to understand the relevant biochemical pathways and mechanisms even better than the people who make their living measuring the amount of insulin secreted by a mouse pancreas, or measuring the ATP synthesized by cultured neuronal mitochondria from rats, has begun to interfere with your overall quality of life—and possibly even the results you’re getting from your low carb diet, because of all the darn stress—it’s time for you to…

My Top 10 Favorite Posts

I missed my four year blogversary!

My blog has existed since August 2012. I would have celebrated sooner, but August 2016 blew right past me. (Probably because I was mired in a deep and longstanding depression, which I thought I was starting to come out of, but which is actually back in full force and only lifted temporarily.)  As of this writing, there are 242 posts. I don’t think I hit my stride until sometime mid-2013, but there are a couple of gems going back as far as September 2012.

For those of you who found me a few years into my blathering blogging, and since new people stumble upon my blog every week, I thought it would be nice to start the new year by sharing a selection of my personal favorite posts for those of you who have only recently tuned in, as well as for any of you who are wondering what the “must read” posts are. (In my opinion, anyway.) I tried to purge all my low carb and keto-related anger in a few posts prior to the close of 2016 so that I could start 2017 on a more positive note. I can’t promise I won’t post any more rants in the future (I think we can all agree I’m not physically capable of holding it in), but I am going to try to stick to things that are a little more scientific, as well as posting tips and insights that are helpful for following these types of diets in the real world.

With no further ado, here are my top ten favorites, in no particular order, except that the first one is probably nearest and dearest to my heart and resonates with me, personally, the most deeply:

Stop Following a Medically Therapeutic Diet "Just 'Cuz" (a.k.a. The Keto Train to CrazyTown)

This is a very long post (even for me). Take it or leave it. You have been warned. Comments have been disabled for this one. Love this post or hate it, agree with some of it, disagree with some of it. Whatever your feelings, you are free to express them elsewhere.  


This will be the last of my emotionally charged posts for a little while. I have to get it out of my system, but once it's out and the new year gets underway, I'll focus on posting things that are more educational and helpful (or intended to be, anyway).

It’s funny. Considering I advertise myself as a low carb and keto-friendly nutritionist, I often find myself recommending that clients eat more carbs. More protein. And that they abandon weighing and measuring every morsel of food and pouring olive oil and melted butter on everything in an effort to arrive at some magical, no-fail, automatic-fat-loss-inducing macronutrient ratio somewhere upward of 75% fat.

I have been threatening promising on social media for a while now that I was going to post an epic rant about some problematic things I see when healthy, fit, active people follow a medically therapeutic diet because they have come to believe they should. (Or worse, have come to believe that they have to, because it’s the only way to be healthy and prevent metabolic illness. 

Now, before I get into things, we’ve got to establish some ground rules:

9 Ketogenic Diet Myths

Let me burst your bubble right here at the beginning. This list is for people who are already following a ketogenic diet or are considering beginning one specifically for the purpose of losing body fat. If you’re looking for a nice, solid debunking of other myths about this way of eating (e.g., “All that saturated fat will clog your arteries,” “All that protein is bad for the kidneys,” “You need carbs for energy,” “I learned in medical school four hundred years ago that ketosis is fatal,” and other such nonsense), here are two excellent debunkings: one from Authority Nutrition, and one from my dear friend Ellen Davis, creator of Ketogenic Diet Resource, which is the single best one-stop-shop, gateway entry I'm aware of for all things ketogenic-diet related. (And I'm not just saying that because Ellen's a friend. I'm saying it because it's true. The reason we became friends is because I came across her site a few years ago, and ... well, the rest is history.)

Why do these ideas need to be called out for the myths that they are?

Well, now that I’m participating more in social media related to low-carb and keto, I’m noticing—and I could be wrong, but I don’t think this is only my imagination—that there are a few falsehoods that have become quite pervasive in our community. So pervasive, in fact, that they persist despite being flat-out incorrect. And because they persist, we continue to see post after post after post on Facebook, Instagram, Twitter, and wherever else, from people at their wit's end because they aren’t losing fat, are gaining fat, or have not had every single longstanding malady resolve immediately upon ditching bread and loading up a cup of coffee with butter and coconut oil, or drowning everything in cheese, as others may have promised them would happen.  

If these individuals are lucky, they stumble upon a group where logic, sanity, science, long-term experience, and the attainment of actual results rule (rather than chasing ketones for the sake of high ketones). If they’re not lucky, they fall head-first into groups where the same-old not-helpful advice is parroted ad nauseum.

With this in mind, here is my own personal list of the top 9 biggest falsehoods regarding ketogenic diets for fat loss, along with "alternate versions," intended to help us see things from a different perspective. There are probably many more out there; these are just the ones that came to me first. If you have some favorites that I've missed here, share them in the comments so we can all collectively cringe! 

A Word About Upcoming Posts

I try to be a voice of sensibility in the vast and overwhelming sea of information regarding low carbohydrate and ketogenic ways of eating. It even says so at the top of my homepage: “A source of sanity in the sea of nutritional madness.” What I know compared to what there is left to learn is like a thimble of water compared to the Pacific Ocean. There’s a lot more—a lot more—I don’t know than what I do know, but I try to share with you the small bits of knowledge I gain as I hang on for dear life while traversing these tumultuous waters. I’ve done it about digestion, cancer, insulin, fuel partitioning, and more. (My Alzheimer’s book has been completely rewritten and updated for a March 2017 release as a print book from a big name publisher, so I’ll continue do it about Alzheimer’s, too.)   

However, I am starting to worry that, due to my penchant for ranting about things that bother me about the low carb and ketogenic communities, I’m developing a reputation for being an angry, hateful, vicious, and vindictive person. I assure you, I am neither angry, nor hateful, nor vicious, nor vindictive. In fact, “in real life,” I am quiet, shy, and, I’d like to think, gentle and kind. Nevertheless, there’s no denying the fact that I do rant a lot. But what can I say? The utter madness being masqueraded as fact in certain spaces provides no shortage of material to rant about. Being a gentle and kind person, I assume the spreading of misinformation occurs as a result of plain ol’ ignorance, rather than deliberate malice and ill intent. Whatever the intent, the end result is that misinformation is being spread, and because of it, people are experiencing setbacks along their roads to better health, fat loss, better blood sugar control, and more.

Why do I care? Well, like I mentioned in my rant post about fasting, as a nutritionist working with clients, I deal with the consequences of what happens when people follow advice that is either straight-up false, or advice that is perfectly appropriate for a certain context, but which is not applicable to their context.

It’s getting old, folks. I’m tired of trying to respond politely to emails from people who are afraid to eat two ounces of carrots in a serving of mixed vegetables, but who think it’s completely normal to put five tablespoons of butter and coconut oil in a cup of coffee. (Or better yet, to drink that 500-calorie coffee in the morning and say they’re “fasting.”) I’m tired of trying to respond politely to emails from grown adults who are restricting themselves to 45 grams of protein a day because they’re afraid that if they eat more than that, they’ll be at less than 80% fat and they’ll mess up their “keto ratios,” and also because the excess protein will be turned immediately into glucose and cause a huge “spike” in their blood sugar. (No, it won’t. Really, it won’t. Seriously now, it won’t.) I’m tired of trying to respond politely to emails from people who are disappointed and frustrated because they’re not losing weight or are maybe even gaining weight, even though they’re listening to their trusted experts online and are eating more fat – adding lots of extra butter to things, eating fat bombs, and shunning anything that even hints at being lean or low in fat. They’re as afraid of skinless chicken breasts as they are of 64-ounce troughs of Mountain Dew. And I’m tired of trying to respond politely to emails from people who, for whatever reasons—and there are many—are convinced that they must, must be in ketosis at all times. I swear, if I read or hear “I got kicked out of ketosis” one more time…

I am frustrated, and good-hearted people out there trying to follow low carb or ketogenic diets are frustrated, too.

In this spirit, I have a few more rants planned (already written, in fact) about the problematic things I see in the carbohydrate restriction community. But I don’t want to be a one-trick pony. I don’t want to have a reputation as an angry person who only ever posts electronic versions of hissy fits. Nevertheless, now that I’m more active in a few Facebook groups, I am confronted with these problematic things every day, and I feel compelled to address them. Since I don’t want to address them over and over and over again, I am going to post these few rants and then be done with them. (For now. Heaven knows there will always be something else that gets a rise out of me, but I’ll try to keep the ranting to a minimum once these next few posts are out of my system.) And get them out of my system I must. I don’t have children. What I have instead are ideas to write about, and they nag me, metaphorically pulling on my pant leg, until I finally give them they attention they require and see to their care and feeding.

I have three such posts in the hopper. You will know them when you see them. One of them—the last one I’ll post—is a candidate for a spot in my top three longest posts ever (alongside the one about my mother and the one about vitamin J). I thought about breaking it up into three or four separate posts, but I’d rather just get it all out at once and be done with it. Plus, that way, if I ever need to respond to someone on social media, or someone who emails me directly, in regard to some of what that post includes, I can just send them a link and it will all be centrally located.

As for what I’m going to write about after that, I’ll continue with more Low Carb Cooking Class (LC3), and I have not forgotten about the series on the metabolic theory of cancer. I do plan to pick it up again, as we have finally, finally gotten to the point where we can talk about the ketogenic diet and have it make sense. And I have been saying for ages now that I’d like to write something about sodium, and how salt is not something to fear, but that’s going to take a while. Before that, I’m going to post a couple of things that I see a need for, if questions on Twitter and Facebook are any indication: a guide to dining out on a low carb or ketogenic diet, and breakfast ideas for people who either don’t like bacon and eggs, or who are “tired of them.” (Yes, apparently such a thing is possible, though I have yet to witness this rare phenomenon in person.) I’m also contemplating sharing my thoughts on “zero carb” diets, as well as my growing suspicion that a plethora of modern chronic illnesses are driven not just by hyperinsulinemia and hyperglycemia, which are both, of course, huge issues, but by chronic nutrient insufficiency. The more I learn about the nuances of certain biochemical processes and the modern food supply, the more I appreciate just how robust the human body is, because frankly, I’m actually surprised there aren’t even more very ill people in our midst. That there aren’t is a testament to the ability of the human body to adapt and overcome and keep on truckin’ even when all indicators suggest someone is about to keel over and die at any moment.  

That’s all. Just wanted to warn you let you know what’s in store for the next few posts. After that, I’ll get back to writing things that might be more helpful for people, and I’ll try to keep my anger out of things. (Although I have to say, while I don’t want a reputation for being angry, my sarcasm and snark seem to go over pretty well, and I’m totally okay with being known for that.)  ;-) 

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.

Obesity is (mostly) a Hormonal Issue: Let's Stop Pretending it's Solely About Calories

When doctors or nutritionists see someone with gigantism or acromegaly, is their first thought, “Clearly, that person just needs to grow less and shrink more”? No. Obviously not. Because it is clear—like, crystal clear, beyond-the-shadow-of-a-doubt, smack-you-upside-the-head clear that these conditions result from hormonal irregularities. You can no more control what results from the hormonal effects of a pituitary tumor hemorrhaging human growth hormone than you can control what results from the hormonal effects of a fourteen year old boy who found a special magazine hidden away in his dad’s nightstand. (Do kids still do that these days, or do they just find it on the interwebz instead?)

People with gigantism or acromegaly aren’t abnormally tall or large because they want to be, or because they somehow willed themselves to be. They are at the mercy of hormones. Like I said, to anyone with half a brain, this is obvious. No one questions this. No one blames these individuals for needing custom-made clothing or other accommodations. No one says, “Well, if they had just not grown so much…if only they hadn’t let themselves get so tall, they wouldn’t be in this situation.” “They'd be fine if they were just less tall and more short.” No one says idiotic things like this because people understand that this is not within someone’s control.

So why, then, when it comes to the outward, rather than upward, expansion of the human body, does it all of a sudden become about willpower, discipline, and “calories?” Why is not more widely recognized that the horizontal growth of the body results from hormonal irregularities just as the vertical expansion does?

Why do so few people get this?

The Complete Guide to Ketogenic Diets

I’ve joined the 21^st Century and have finally started becoming active on a few Facebook groups dedicated to low-carb and ketogenic diets. Some focus on fat loss and bodybuilding, some are exclusively for discussing the science behind the strategy, and some are geared more toward overall health, with members implementing these types of diets to improve, manage, or reverse conditions like type 1 and type 2 diabetes, PCOS, multiple sclerosis, traumatic brain injury, cancer, and more.

Now that I am more active in these groups, I can see why I stayed away for so long. And I’m considering retreating back into my Twitter comfort zone, because if I don’t see the madness and morass of misinformation being propagated on Facebook about ketogenic and low-carb diets, then I can pretend it doesn’t exist. (It’s more difficult to say idiotic and flat-out incorrect things in 140 characters, although it’s certainly possible. [And it happens all the time.])

I realize I am breaking my own rule here and juxtaposing “ketogenic” and “low-carb,” which might give people the impression that these two dietary approaches are exactly the same, and that the words are interchangeable. They are not. However, just for now, I’m using both phrases for the sake of simplicity, since the same inaccuracies abound about both of these.

  

With this in mind, here is a comprehensive and exhaustive list of everything required in order to implement a ketogenic diet:

1. Water
2. Foods that are low in carbohydrate
3. (Maybe) supplemental electrolytes (specifically, sodium, magnesium, and potassium)

  

Here is a list of things that are not required in order to implement a ketogenic diet:

1. A blood ketone meter
2. A breath ketone meter
3. Urine ketone test strips
4. Fasting
5. MCT oil
6. MCT powder
7. Exogenous ketones
8. Coconut oil
9. Coconut butter
10. Erythritol
11. Flavored stevia drops
12. Protein powder
13. 400-calorie cups of “coffee”
14. Fat bombs

Now, the thing is, there are tips, tricks, “hacks” (even though I loathe that word), and other add-ons that can be beneficial—in certain circumstances. As always, context, context, CONTEXT!  (As the theme song to the old 80’s show Diff’rent Strokes said, “What might be right for you might not be right for some.” But I would reverse that:  what might be right for some other people might not be right for you.)  It all depends on your goals, and WHY you are implementing this type of diet. Is it for fat loss? As an adjuvant to conventional cancer treatments? To reduce the frequency of epileptic seizures? To boost ketones to fuel the brain because of Alzheimer’s or another form of cognitive decline? There might be—might be—a role for some of the more esoteric (and expensive!) substances, supplements, and measuring/tracking devices in some of those cases. And some people can truly benefit from fasting, while fasting could be disastrous for others. But in terms of just getting started and mastering the basics, stick with that first list and stop driving yourself crazy.

Again, just so we’re clear: I’m not saying any of the things in the second list are outright harmful. I don’t think they are, and some of them can, in fact, be quite helpful … in the right #CONTEXT. As I wrote about recently: different goals may necessitate a different strategy.

That’s all for now.

Keep calm and keto on.

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.

Not So ... Fast ... (Part 2)

In part 1 of this rant, I got a little hot-headed about having to explain to people who should not be fasting that fasting is not appropriate for everyone. In this follow-up and continuation, I’d like to say a couple more things because these ideas have been nagging at the back of my mind, and they won’t go away unless I get them out. I don’t think anyone will learn anything from this one, and that’s okay. I rarely use my blog as a plain ol’ brain dump with no educational tidbits whatsoever, but I suppose I’m entitled to that once in a while.

Before I start, let’s clarify something:  if you feel good doing what you’re doing with regard to diet, exercise, fasting, and sleep, then keep doing it. But if you don’t feel good, there might be reasons why you don’t feel good. And my intention in writing about some of them (aside from letting off steam, because this is all starting to really get to me) is to bring attention to the mere possibility—just the chance—that any of this might make sense. Please know that this is wildly speculative. I’m thinking out loud. That’s all. My blog isn’t a doctoral thesis I’m required to stand up and defend against a panel of experts geared up to prove me wrong. It’s just my thoughts and opinions, which, as always, you are welcome to read and ponder, or completely ignore. You can even disagree with me; I ask only that you do so in a civilized, polite way to facilitate discourse like the intelligent adults we are. :-)

Not So ... Fast ... (A Rant)

Hammers are great. Except for when you need a wrench.

Wrenches are great. Except for when you need a drill.

Drills are great. Except for when you need a crowbar.

Different job, different tool.

Different need, different tool.

With me so far?

With this in mind:

Fasting is great. Except when it’s not.

I think you’ll find I’m one of the more open-minded people in the low-carb/keto community. (I don’t know if this is good, bad, or meaningless. Maybe I should align myself with one camp and subscribe to that dogma and only that dogma. Then again, there’s enough of that out there already, right? And when Robb Wolf starts talking about eating lentils [as he did on this podcast], and Chris Kresser points out some of the potential dangers of going overboard with vitamin D supplementation, I guess I’m in good company if I’m able [and willing!] to see and respect the nuance some of this stuff requires.) I firmly believe in certain basic principles of nutrition that are forged in unalterable aspects of human physiology and biochemistry, but beyond that, if someone tells me they feel better eating a little bit of rice and potatoes now and then, and that they don’t feel so great loading up a cup of coffee with 4+ tablespoons of butter and coconut oil, who am I to insist they’re lying? Who am I to insist they force themselves to do something they insist makes them feel terrible? (Except bacon. If you’re not eating bacon, you are doing it wrong. [No, just kidding. Shout-out to anyone reading my blog who keeps kosher or observes the laws of halāl!])

So in my non-dogmatic perspective, what’s the deal with fasting?

"Calories Out" -- A Rant

I don’t like that I post so many rants, but what can I say? The nutrition world gives me lots to rant about. Lots. And if I may say, many of the emails I get from you, my beloved readers, specifically mention how much you enjoy my sass and snark. So, if sass and snark are what ye seek, then sass and snark are what ye shall receive! Especially when it comes to today’s topic.

I’ve written before about the complete and utter crapstorm that is the very concept of “calories.” (That post is from April 2014. I’ve acquired a lot of new readers since then, so if you’ve never read that one, do click on over and give it a whirl. It’s a good one, if I do say so myself.) 

Okay, so, calories.

When it comes to losing weight fat loss, we’ve heard over and over again that it comes down to one thing: calories in, calories out (CICO). (Or is that two things?) Or, rather, it comes down to weight loss reduced adiposity being the result when someone takes in fewer calories than they burn. People are so stubbornly wedded to this idea that “Woo” famously calls them CICOpaths, CICOphants, or CICOtards. (With apologies to the reader who took me to task for my “Don’t Be a Ketard” series title, which has been renamed “Being Fat Adapted Versus ‘In Ketosis.’”)

As you know, I try to be careful about how I phrase things. (Case in point: the crossed out stuff in the preceding paragraph.) Part of this comes from me being an English major and language nerd, and part of it comes from knowing that when we phrase things incorrectly, they may not even be relevant. For example, I try to say “accumulate adipose tissue” more often than I say “gain weight.” Because gaining weight and accumulating adipose are not the same thing. If you gain weight, that might be water, muscle, bone, or, for the truly crunchy/hippie among you, a pounds’ worth of leg and armpit hair. And I try to say lose body fat rather than lose weight, because you can lose water, muscle, bone, etc., and when the vast majority of us talk about “weight loss,” what we really mean—and what we really want—is fat loss.

The reason why I’m such a stickler for saying things a certain way is because saying them more precisely/accurately helps us frame discussions in a certain light. And the reason why I’m explaining to you why I’m such a stickler is because we are going to frame today’s discussion in a certain light. One that I don’t think gets anywhere near enough attention in the nutrition and health world (except from me). As far as I can tell, I am one of the only people writing about this particular thing in this particular way. (If I’m wrong, tell me in the comments and share links to relevant stuff you find.)

What the heck am I talking about? What is the point that’s taking me so much prep work and blathering to get to?

Label Madness Monday: Cricket Flour Bars

It’s been a while since we tore apart—figuratively, not literally—a food label. So here goes. A little something light to start your week.

Up today: Exo bars. To be specific, Exo bars that are marketed as protein bars.

Now, I’m not here to bash these things. On the contrary, if you like to keep something semi-wholesome, with ingredients you can understand and pronounce, in your handbag, gym bag, or desk drawer at the office, you could do a whole lot worse than these. However, if what you are actually looking for is protein, then these “protein” bars may not exactly be the way to go. Let’s see why.

Food for Thought Friday: Shut Up, Judgey McJudgerson

Humans: we’re a funny, scary, crazy, strange, terrible and beautiful lot, aren’t we?

Case in point:

I was walking along a scenic trail not far from where I live, enjoying the bright blue sky, the greenery, the fresh air, birdsongs, and generally just feeling grateful to be alive, healthy, and strong, when a man jogged past me. Well, it was more of a shuffle than a jog. Before he passed me, while he was still behind me, I could hear his feet scraping along the ground with each step, almost as though the effort to fully lift his feet was too much. I got the sense that he was struggling. It sounded like he was struggling. And when he did pass me, I got a look, and I continued looking for a while when he was in front of me, until he turned the bend and was out of sight. Indeed, it looked like he was struggling.

The man was very thin, and was sporting two knee supports. (The ones that look like thick, rubbery ACE bandages.) He had the physique of the semi-emaciated marathoner: not a lot of muscle mass, skin hanging loosely, pale pallor to his skin. His face struck me almost as gray, in fact. He looked like he had—in the words of that great phrase—“been rode hard and put away wet.”

As he passed me, several ugly, judgmental, closed-minded thoughts crossed my mind:

Food for Thought Friday: Modern Medicine Rant (Part 2!)

“I know many physicians who enthusiastically endorse a low carbohydrate diet for many medical conditions. The great majority of them have experienced personal health benefits from actually adopting the diet for themselves and that includes me. Although physicians are taught to ignore anecdotal evidence, it is difficult to do when it applies to oneself.”

                          -Keith Runyan, MD, Why Your Doctor May Question a Low Carb Diet

I have the utmost respect for doctors. Not all of them, but most. Getting through medical school, an internship, a residency, and more, is certainly no joke. Heck, just preparing for the MCAT is a challenge. Medical education and subsequent professional life is not for the lazy. There’s a reason I’m a CNS and not an MD. (Yes, I recently earned the CNS designation. Woohoo! I am now among the ranks of such greats as Jeffrey Bland, PhD, the founder of the Institute for Functional Medicine.)

And while I envy the paycheck and the cachet that come along with being an MD (much more impressive at a dinner party than being some lowlife nutritionist), I don’t envy the actual tasks that come along with being a doctor. This is particularly true for those who work in emergency rooms or emergency situations, so I’m not talking just doctors, but nurses, orderlies, paramedics, EMTs, cops, firemen…the whole crew. At my old office job, if I made a mistake, maybe the printer got jammed, or I spilled coffee on my keyboard. (Or accidentally hit “reply all” when sending a particularly scathing email about the boss, hehheh.) In an ER, if someone makes a mistake, someone dies. Someone’s kid bleeds to death. I can’t imagine being halfway through my lunch when someone gets rushed through the doors with a limb three-quarters of the way severed off, or with some kind of freaky implement impaled somewhere you really don’t want anything—freaky or not—to be impaled. I would not want to be tasked with walking out of an operating room to tell a family that their child “didn’t make it.”  

Bottom line: modern allopathic medical professionals see and do things on a daily basis that I cannot imagine in my scariest, don’t-want-to-take-responsibility-for-this nightmares. While I wish I were cool under pressure, and I have lots of daydreams in which I am a totally confident, take-charge-and-save-the-day kind of person, the truth is, I do not want to be the person responsible for knowing exactly what to do in a matter of seconds when someone is literally going to die unless I remember the correct procedure. 

I love medical doctors. Love em!

In the right context, that is. When it comes to trauma, please, for the love of all that’s holy, get me to the nearest modern, big-city, suped-up technology hospital you can. Do not—repeat, do not—call a naturopath, or a chiropractor, or an osteopath, or a nutritionist. I want someone to stop the bleeding, stop the pain, and stop them now.

Really, MDs are pretty awesome. (Especially ones like this, who get it.)

So why do I rail against them so much?  

Constitutional Obesity Resistance Vs. Constitutional Obesity Propensity

Although activity on my Facebook and Twitter accounts might suggest otherwise, I’m not a big fan of social media. I participate in it because I feel like I “have to,” not because I particularly enjoy it. Then again, as I am extremely introverted, it’s a great way to interact with people without having to really interact with them. I can unplug and disengage the second I start feeling uninterested, overwhelmed, or exhausted. That being said, one of the great things about Twitter is that I get to interact with some quite brilliant people whom I would never otherwise have “met,” and I am regularly presented with ideas that blow my mind. (That’s how I came across the stuff about Dr. Kraft’s insulin assays, which inspired the insulin series.) Often, these are ideas and concepts that should be pretty obvious to me, and the only reason they aren’t is that I’ve just never stopped to think about them. And not only are they pretty obvious, but they’re often put out there or tweeted about casually, as if the writer is saying something relatively simple. A one-off post or a couple of lines about something that seems like no big deal and is a total no-brainer to them, but which, upon reflection, turns out to be a huge deal to me.

For example: the registered nurse who goes by the online nickname “Woo” frequently drops knowledge bombs that send me into a hurricane of thoughts. She holds no punches and does not suffer fools. Her writing style takes some getting used to, but she is truly one of the most intelligent and insightful people currently writing about metabolism, endocrinology, calories, ketosis, fat adaptation, body weight regulation, PCOS, and lots of other things many of us are interested in. Time and time again, something she posts makes me see things in a new light. So much light, in fact, that she should buy stock in General Electric, Phillips, or some other company that manufactures lightbulbs, because that is how many of those things go on over my head when I read her work.

Case in point: a few days ago, Woo made the correct observation that, in many cases, children who are put on a ketogenic diet (KD) for epilepsy can actually stop the diet after a couple of years and remain seizure free for life. Something about staying on a KD for some period of time during one’s formative years seems to actually permanently correct the underlying problem, such that the diet can be abandoned later on and the seizures do not return.

Coupling this fact with some observations about people on low-carb and Paleo diets, she came to some rather fascinating conclusions, and proposed an observational study. First, I’ll tell you about the study, and then we’ll work through the rationale for it, via exploring some intriguing things about body weight, and why some of us are so incredibly prone to accumulating excess adipose tissue, while others are not.

The observational study would be intended to test the following hypothesis:

Food for Thought Friday: Modern Medicine Rant

Pop Quiz:

The failure of institutions such as the American Diabetes Association, American Heart Association, and American Medical Association not just to acknowledge the undeniable efficacy of carbohydrate restriction for myriad chronic health complications, but also their failure to do what they should be doing—which is shouting it from the rooftops louder than any ol’ no-name blogger, and actively encouraging people to give it a try—is the result of which of the following:

A)  Stupidity

B)  Willful Ignorance

C)  Conspiracy

D)  Narcissism

E)  Malpractice 

F)  All of the above

Yeah. You can see where today’s rant is headed.

Being Fat Adapted Versus "In Ketosis" (Pt.3/3)

Now that the issues of fat adaptation and fat loss versus ketosis—or the lack thereof—have been clarified, let’s move on to a related issue that drives me crazy: newbie low-carbers freaking out if they eat something that not only takes away that beloved purple, but—gasp!—causes the scale to go up a few pounds.

When a low-carber who doesn’t understand some basics about human physiology gains weight after indulging in a pile of something sweet or starchy, they go absolutely apoplectic. Not knowing any better, they step on the scale the next day, see that their weight has gone up a few pounds, and they Just. Freak. Out. I can’t count how many times I’ve seen people post to forums and message boards either in tears or in a raging anger, because they ate a donut, or a bagel, or two slices of pizza, and gained, say, four pounds the next day. They then fall into thinking that their body is so fundamentally carbohydrate intolerant that after indulging in one carbohydrate-laden meal, they gained, overnight, four pounds of fat. (Never mind that the total weight of the amount of food they consumed for the entire day probably didn't even weigh four pounds, let alone that one bit of carb splurge, so I don't see any logic to how they think this works, but I digress.)

I’m not really sure how to talk about this without expressing grave concern over these well-intentioned folks’ ignorance as to the inner workings of their own bodies. (And by “expressing grave concern,” I mean, “shaking my head at the utter lunacy out there.”)

Time for a quick lesson in glycogen storage. 

Being Fat Adapted Versus "In Ketosis" (Pt.2/3)

In the previous post, we established the difference between fat adaptation and ketosis. Now, let’s revisit the “got kicked out of ketosis” thing. 

People new to low-carbing—and also people not-so-new, but who just don’t understand how this all works—will utter that dreaded phrase when they pee on a ketostick and don’t see their beloved dark purple, or—gasp!—not even a little pink. No color change at all. They will then assume that whatever they ate sometime prior to testing “kicked them out of ketosis,” and they will summarily cross that food item off their menu forever, banishing it to their ever-growing list of forbidden foods. (They will also spread tales of woe on forums far and wide, thereby terrifying other newbie low-carbers into avoiding these foods as well.)

But here’s the thing: ketostix are fickle things. Elevated ketones in the blood, urine, and breath, are fickle things. What else was going on before testing? Was this person very acutely stressed? Did they do an intense workout? Both of these can cause a temporary rise in blood glucose (albeit a smallish one), which might trigger a temporary rise in insulin, which could put a temporary stop to ketosis. Temporary. Note: it will not put a stop to being fat-adapted; only to having excess acetoacetate in the urine or elevated beta-hydroxybutyrate in the blood at that particular moment in time.