Telling People They Don’t Exist – still

Motivational Poster - Support

Motivational Poster – Support (Photo credit: Raymond Brettschneider)

Inconvenient people challenge our mind-set and push our comfort zone.

This is not about shaming. It is about something subtly different – which is discounting other people’s experiences when they don’t match your own – even to the point of shunning.

Re-posted – Originally posted May 20, 2012.

One of my pet peeves is when people are, in effect, told that they don’t exist.

An example?  I get a migraine and flu-like symptoms if I eat even a tiny amount of gluten.  I don’t have celiac disease, I have gluten sensitivity. This has a major impact on the day-to-day living of my life and is something I can never afford to forget, ignore or down-play any time I am around food. Yet, to the vast majority of my own medical colleagues I don’t exist. They recognize the existence of a person occupying the space my body is in. However, what they see there is a person who isn’t me as I know myself to be. They see some deluded or self-deluded not very competent person who holds a questionable and likely false belief that places them in the ranks of the crackpots who think they are harmed by wheat, in the absence of laboratory proof. The recent recognition of gluten sensitivity as a medical condition (see this post) has not received wide-spread attention and is likely to be slow to be incorporated into routine medical practice.

People who have gained substantial health benefits from following a low-carb lifestyle are often treated in the same way. Many people report how frustrated they have felt when their doctors, their friends or work colleagues, or family members have discounted their stories and/or, even worse, discounted them as individuals for the decisions they have made and the “obviously false” conclusions they have come to.

But consider, does it ever happen the other way?

A few months ago I had an experience that has stayed in the back of my mind since.  On one of the blogs about low carb nutrition, I was reading an older post and the looong list of 50 or more comments under it. There was a lot of back-and-forth commenting among the contributors and with the author.  There was a good spirit of comradery evident. Everybody who raised a question, interesting idea or dilemma was responded to  — that is, everyone except one soul. One person posted a comment asking for insight or helpful comment on her situation – asking, that is, for help.  This soul was ignored as if she had leprosy. Her comment fell into a black pit.  The others resumed their conversations as if she didn’t exist.

Her social crime for which she received shunning – she dared to report that she was having little progress with weight loss despite a persistent and apparently well-applied very low carb/ketogenic diet. The post was old and the comments section had been closed, so I couldn’t respond to her myself.  I don’t think there was any attempt here to shame – just that her existence was inconvenient.

It is easy to love the idea that going low-carb is a sure-fire ticket to weight loss heaven.  This idea makes people smile and feel confident and enthusiastic.

The up-side  — the enthusiasm helps the knowledge spread.

The down-side  — since there is and never will be a sure-fire ticket to weight loss heaven, some individuals can feel unrecognized and discounted. Also, people who are broadly knowledgable about weight control issues recognize this as a false concept and this contributes to lack of respect for the message that low-carb nutrition is a valuable medical intervention (thus limiting the spread of the knowledge).

Low-carb nutrition and nutritional ketosis are very powerful and broadly beneficial tools that can help with weight loss in many ways. There are people who need other tools in addition or instead. Also, the benefits of low-carb nutrition can be swamped or over-ridden by other factors  – for example, certain medications or high stress states.

Many people do spectacularly well when adopting low-carb nutrition as a means to weight loss. Many others do very well or at least do well.  Messaging that focuses on dramatic weight loss, though, can mean that people miss the knowledge of how low-carb nutrition may benefit their health even in the absence of substantial weight loss.  It can mean that people get discouraged and miss out on the many other potential benefits.

“The reasonable man adapts himself to the world.  The unreasonable man persists in trying to adapt the world to himself.  Therefore, all progress depends on the unreasonable man.”  – George Bernard Shaw

If you have benefited from low-carb nutrition, or someone you love has, you might owe a debt to someone somewhere in the past who was not able to achieve success with weight loss with the use of the knowledge and advice they then had access to. The knowledge and understanding of low-carb nutrition is only available to us today because of the determined efforts of one individual after another, acting in response to this lack of success.

If you have a story of fabulous, easy success to tell  – please share it, share it!  Be proud, strut, jump up and down.

I would like to encourage the practice of avoiding suggesting that because it was easy  – or even just that it was possible – for you, that this means it would be or should be the same for all others.

That “unreasonable person” whose response isn’t the same as others’ is a person we can all learn from.  Their situation may be just about to spur some new understanding that will benefit us all some day.

Addendum:  I realize that I might have left that sounding as if there was only one incident that concerned me. Unfortunately, I have more than once read posted comments that flat out stated that since that person had achieved a great outcome with controlled carb intake, that this meant all was solved for everyone else if they would only just get with the program – again meaning that anyone still visibly overweight could be judged on the spot as someone who just wasn’t trying hard enough. I guess being addicted to feeling superior is something that doesn’t show at the waist band.

Addendum Oct 30/12 – Part of what was on my mind leading up to this post was Jimmy Moore’s blog post April 30th about the criticism he received. Now, that is a bit different situation, because it involved much more than discounting. But, it is a perfect illustration of the point I make toward the bottom of this post about all progress being due to the “unreasonable man” and that the people who have the most difficult time are the people who can show us another part of the path forward. This turned out to be oh-so-true in Jimmy Moore’s case – as we have watched unfold over the past 6 months. This post (May 20th) was several weeks before Jimmy’s famous first post about his nutritional ketosis experience – which was posted June 14th. So, at the time this was originally posted, Jimmy had not announced his new successful strategy  – so it seemed that he was still in a situation where his body was “unreasonably” not responding to the best strategies he knew of at the time – strategies that worked fabulously for many other people.

Ketogenic diet for a body weight control system gone bust?

Body Snark Free Zone Sign

Body Snark Free Zone Sign (Photo credit: The Lingerie Addict)

Body Weight Control System Gone Bust?

If you can’t fix it, patch it …

Nutritional ketosis may work as a patch for you.

For decades there has been interest in the idea that a person’s body weight control system can start to mal-function. This has been thought to be part of the reason that it can be very difficult for people who have been obese to return to a normal body weight and maintain that over time.

This topic became prominent again last week with the publication of a paper that sheds a tiny bit of light on the matter.

To read about this study, see:

Obesity-programmed mice are rescued by early genetic intervention.”

“effectiveness of treatment to normalize body weight and adiposity declined progressively as the level of obesity at the time of Pomc induction increased. Thus, our study using a novel reversible monogenic obesity model reveals the critical importance of early intervention for the prevention of subsequent allostatic overload that auto-perpetuates obesity.”  LINK to FULL TEXT

The meaning of all this is just that it supports the notion that a person’s body weight control system can start to malfunction in a way that doesn’t just recover when the cause of the weight gain has been corrected.  It doesn’t prove this and doesn’t tell us how this might happen or what to do about it.

If you can’t (for now) fix it, find a work-around.

The goal in the long run is to have the best functioning of your body that is possible, within the context of what you find worthwhile. That includes the best functioning of your body weight control system – which is expressed in the functioning and balance of the appetite/satiety system.

There are countless things that can interfere with the proper functioning of these systems – leaving you fighting a tendency to gain weight or having great difficulty in losing weight without chronic hunger (or, on the other hand, being too thin or too easily loosing weight).  Some of these things can be changed and some can’t.  Hopefully , over time research and new understandings will keep shifting these interfering things from the “can’t do anything about it” group to the “this is what you can do about it” group.  Some things might theoretically be in the “you can change it” group, but those changes might be out of reach (currently) for the individual.  Some examples of that may be certain medications that are currently essential for that person or chronic poor sleep they are (currently) unable to find a way to remedy.

The core strategy, from the start and ongoing, is to do as much as you are (currently) able, or (currently) know how, to support the best functioning of your body weight control systems. All too often, though, that is not enough to allow a person to meet their body weight goals (without sustained hunger). Yes, the core strategy still is to keep trying to find ways to improve your health, including ways to improve the proper functioning of your body weight control systems. But if you are still struggling with your weight health or hunger, is there something more you can do while you are waiting for the perfect answer or personal perfection (not recommended)?

I think that nutritional ketosis is, for most people, a valuable option here. I have addressed this topic in more depth in my recent post:

To take this from concept to real life, consider the personal stories posted on

Another Low Carb and Happy Story

Bicycle Lane

Bicycle Lane (Photo credit: snofla)

I am enjoying Meghann Douglas’s blog Meghann’s Meltdown. It took me a while to get it about the title – she has lost over 100 pounds.

She incorporates a lot of activity, such as swimming and biking, into her day.

From one of her recent posts:

http://www.meghannsmeltdown.com/blog/2012/9/19/data-the-key-to-taking-control.html

“I resisted keeping data logs for a long time.  ……  As the importance of the carbohydrate/insulin imbalances became clearer to me, the more important it became to accurately measure and track those carbohydrates.  “Close enough” is not enough.  It’s work to monitor closely enough to stay under 50 grams of carbohydrates per day.  The difference in how I feel makes it worth the while.  The reduction in pain is worth it.  Thank goodness for online programmes and their phenomenal databases.  Calculating & balancing my own ration is vastly improved from all those livestock rations I used to balance!!!!

There’s another important side of this.  You need to keep that food log in order to be sure you’re actually eating ENOUGH.  This is a totally oddball concept to work your head around.  I have literally spent my life counting calories and fighting my own hunger (real or imagined) and the cravings.  Your biggest nemesis is that magic number you’ve chosen to never exceed.

Balancing our own low-carb food plan has almost completely eliminated ALL cravings.  Even further than this, you can forget to eat because you just don’t feel hungry.  You can look at things you couldn’t walk past before and honestly not even want them.”

Ketosis in a Nutshell – Part 5, A Hunger Haven

English: life saving ring hanging on wall ‪Nor...

Being in nutritional ketosis reduces hunger.

Just that.

It is worth taking a full pause and letting that sink in if you are not already well familiar with this.

You don’t have to be overweight for nutritional ketosis to have this effect:

– you don’t have to be trying or wanting to lose weight

– you don’t have to have metabolic syndrome

– you don’t have to have blood sugar problems

– you don’t have to have insulin problems

– you don’t have to have any problems with carbohydrates.

You don’t have to be a person who would otherwise be interested in a low carbohydrate diet in order to have this response to being in nutritional ketosis.

As mentioned in Part 2, this is simply a normal usual aspect of how your body functions when adapted to being in a sustained state of nutritional ketosis – that is, when “keto-adapted”. (list of terminology is at the bottom of Part 1 of this series)

In any situation where persistent hunger is interfering with achieving health goals, consideration can be given to a careful trial of nutritional ketosis. This would also likely be true in many or most situations where the urge to eat was felt or interpreted as “cravings” rather than as “hunger”.

It won’t be appropriate in all situations and it will not suit all people.

“Reduces” hunger  – not “eliminates” hunger

  • nutritional ketosis is part of our normal physiology, so we can adapt to different food availability situations. It would not be very pro-survival if it made people totally disinterested in finding or eating food. Your body doesn’t want you to be so disinterested in food that you become malnourished, start to waist away or starve.
  • in nutritional ketosis, if you ignore or over-ride your body’s signals to eat or to consume fluid you can go into an unhealthy state of higher ketones and dehydration that can be associated with loss of appetite (and vomiting, nausea and sleepiness) – but this does not happen under normal circumstances where a person is not fasting or skipping meals. It has been noted to happen sometimes during the initial transition to ketosis in the treatment of epilepsy – but this transition has traditionally been done with an initial period of fasting. Under “normal circumstances” you are responding to your body’s signals for food and water – not refusing available food when you are hungry (no surprise if this turns out to be not a good idea).

We don’t know a lot about this so far:

  • people vary in how easily they go into ketosis (how much they need to restrict carbs and whether they need to consciously restrict protein)
  • people vary in the level of blood ketones they have on similar food intake
  • people vary in how they feel at different levels of blood ketones, even when there has been a period of adaptation
  • people vary in how much they have a lessening of hunger when keto-adapted, although there tends to be more appetite suppression at higher ketone levels
  • people vary in how much their bodies use their own body stores of fat for fuel

As we understand it for now, the lessening of hunger and the use of body fat stores go hand in hand.  If body fat stores are being mobilised from the fat deposits, and being burned for energy, there will be less hunger signals saying “eat more”.  If, for some reasons (or many reasons) the fat stores are not being mobilised, the body will signal for more food intake.

Contrary to rumour, there is nothing about being in ketosis that guarantees weight loss.  You can be well-established in a state of keto-adaptation and not lose weight while eating to satiety.  You are still in a state of burning primarily fat for fuel, but it is fat from the food you eat, rather than from your body.  Having ketones in your blood or urine does not indicate where the fats are coming from that you are burning.

I don’t think there has been any research on this, but it seems pretty clear from people’s experiences that you can be in at least a mild state of ketosis and gain body fat stores.  I really don’t see a reason why not.

Using Nutritional Ketosis as a Tool in Weight Control

  1. Context is everything – best health requires an individualized holistic approach.
  2. What does it look like when this is going well?
  3. What is going on when things are not going well?
  4. Concerns? – There are always concerns.

(1) Using Nutritional Ketosis within a Satiety-Oriented Approach to Weight Health

(I digress  – I can’t brush this close to my bug-bear topic without touching it – if this is not of interest to you, please skip ahead ’till you see #### .)

There are two types of harm associated with high amounts of body fat stores:

  • what we usually think of – the harms from high body fat itself, from visceral fat, from associated conditions both as causes and consequences of obesity/visceral fat, from emotional impacts, from prejudice and discrimination, and so on.
  • the harms caused by what people do in their efforts to avoid weight gain and reduce body fat stores

I think this second type of harm has been underestimated as a major driver of the current obesity epidemic – and I mean this separately from the topic of diet composition in terms of carbs, fat, etc. I am particularly concerned about the potential for harm when the public has the impression that the medical community and policy bodies view putting up with sustained hunger as benign, as effective and as an advisable strategy for weight control.

I consider that calorie-restricted dieting, which intrinsically includes the instruction to not eat when hungry if the calorie limit has been reached, should generally be reserved for situations where a satiety-focused approach is, for some reason, inappropriate or not effective or not effective enough.

What does a “Satiety-Focused Approachmean? (see also Overview)

  • General health, individual circumstance, over-all quality of life and individual goals take precedence over total body fat when considering body composition targets, as is true in all situations where there is consideration of body fat stores.
  • If reduction or stabilization of body fat stores is desirable and this is not occurring, interventions are chosen that don’t require restriction of food intake in the face of sustained hunger (no imposition of a calorie cap). 
  • The interventions are designed to facilitate achieving satisfactory satiety with no excess hunger (i.e. hunger other than in the pre-meal period) while undergoing weight loss. 
  • Failure to meet the chosen goal (whether weight stabilization, reduction of body fat stores, more food “peace”, etc.) over time is a valuable feedback from the body that more needs to be done to reduce appetite drive and facilitate satiety. 
  • Any attempt to impose a calorie cap will ruin this essential feedback and risks sabotaging progress towards a successful long-term strategy (which will actually be composed of a combination of strategies).

The most ideal outcome is to have the appetite/satiety control system performing its proper function of maintaining a healthy body weight and, if the body weight is too low or too high, nudging the body towards reaching that person’s best body weight.

Things that favour improved functioning of the appetite/satiety control system are intrinsically things that favour health in general and the over-all best functioning of the body. There are countless things that can disrupt appetite/satiety control.

Just to give a few examples, for some people, simply resolving one of the disrupters below might be enough allow recovery of appetite/satiety balance:

  • getting enough sleep
  • dealing with stress
  • re-establishing regular eating patterns, including breakfast (avoiding restrict/rebound patterns)
  • becoming able to safely reduce, change or stop certain medications that may be interfering
  • avoiding high-sugar liquids.

One of the most important and effective things that can be done to favour proper functioning of the appetite/satiety control system is to consider whether the person is under any form of harm or strain from the amount and/or type of carbohydrates in their diet.  At the present time, in Canada and in all the “developed” nations of the world, the biggest cause of ill-health in the area of nutrition or metabolism is carbohydrate intake in amount/type that is beyond the individual’s current ability to handle without adverse impact (what I think of as “glucose load strain“) – causing metabolic ill-health and its consequences. I think this is having more ill-health impact than obesity itself.

An individually tailored change in type of carbohydrate, with or without a reduction in total amount of carbohydrate, will help many (not all) people who struggle with their weight or who are normal weight but have excess visceral fat. This strategy can help the appetite/satiety function by:

  • lessening swings in insulin and demand for insulin, thus lessening exposure to high blood levels of insulin
  • lessening swings in blood glucose
  • making control of blood glucose much easier in diabetes or pre-diabetes
  • thus helping to preserve health (which helps preserve future ability to control weight) and reducing requirements for medications – with their potential for side effects
  • avoidance of trigger foods in those with sugar craving/addiction or food craving/addiction that involve sweet taste, starchy foods and/or foods that mix sweetness, sugars or starches with fats.

It’s not all about the carbs. However, your carb intake is something that you have control over, whereas you might not be able to do as much as you would like about your sleep, your stress, the medications you require, your level of chronic pain, and so on.  Still, long term results are best served by the broadest possible effort to maintain your health. (Remembering that carbs are not just about weight and, in fact, the impact of carbs on metabolism is much more important.)

With a satiety-focused approach, improving weight control rests on improving general health, including burdens on body function and regulation. Doing the most possible to promote appetite/satiety function equals doing the most possible to promote health and un-burden the person and the body.

This will not always be enough. There may be disruptors that, at the present time at least, cannot be resolved.  There may be essential medications that can’t be safely stopped, there may be unresolvable sleep problems, there may be long-term consequences on body regulation that have been brought about by high body weight or by losing substantial amounts of weight, and so on.

If it can’t be “fixed”, find a “patch” or “work-around”.  ####

When a person’s appetite/satiety control system needs a little extra help, from my point of view the first choice “work-around” to give consideration to is taking advantage of the appetite-suppressing effects of nutritional ketosis. (Recognizing that there are other weight control or “obesity management” interventions that derive all or a major part of their effectiveness through their impact on appetite/satiety balance including obesity management medications and surgeries.)

A very high exercise level could be considered to function as a “work-around” in those individuals for whom it results in reaching a balance point of calorie expenditure versus appetite.

Calorie restriction remains an option in considered situations and for some people this can be very useful and become their favoured, successful and long-term intervention. It should certainly be tried before obesity management surgery and should be at least considered and offered before obesity management medications.

(2) What Does it Look Like When Things are Going Well?

I refer you back to two of the stories I link to on the previous Part 4, near the bottom of the page.

  • Jimmy Moore’s story is the best that I have seen in terms of demonstrating the difference between his experiences with a very low carb eating pattern and his experiences with nutritional ketosis. Not everyone will feel the difference between the two as profoundly as he has and certainly most people will not have such a dramatic weight loss. (links below)
  • Tommy mentions in one of his blog posts that he was starting to have a little weight regain after holding stable for years. He took advantage of blood ketone testing.  He tightened his diet, succeeded in increasing his blood ketone levels and this helped with his weight.

(3) What is Going on When Someone Who has Plenty of Fat Stores is Keto-adapted and Not Losing Weight?

We don’t know. The short answer is that they are not having enough suppression of appetite to allow their food intake to drop down enough to allow weight loss.

I know that’s not much of an answer, but it is the state of the art at the moment.

As I see it, there would be at least these four things to consider:

(1) The body may be defending the fat stores that are present because of some signalling that is giving the message that the body fat stores are getting low or for some other reason need to be defended:

  • this might be considered “appropriate” – for example, a woman of 5′ 2″ who is finding that her weight loss is stalled at 120 lb. when she wants to get to 115 lb. I sympathise, but her body “has a mind of its own”
  • or “inappropriate” – for example, someone who’s weight loss stalls when they are still 50 pounds above the “normal” weight category – perhaps the body is getting erroneous signals that fat stores are low or for some other reason need to be defended

(2) There may be something (or many things) interfering with mobilising fat from the fat stores. In this situation, the person can still be in ketosis as long as they satisfy their hunger by mostly eating fats, and keep their carb and protein intake low enough.  This can still be very valuable in helping prevent weight regain, helping prevent cravings and “unintended” eating, and other potential benefits.

(3) The level of ketosis may not be enough for that person to have enough appetite suppressing effect in order to allow food intake to fall enough to achieve weight loss.

  • there may be something interfering with the ability to burn enough fats (whatever the source of the fat) to meet the majority of body energy needs – whether due to a disease, toxic influence, medication or a rare genetic metabolic problem.
  • the intake of carbohydrates and/or protein may be too high to allow ketosis for that person at that time.
  • the internal supply of carbs may be too much – continued next paragraph.
  • if the internal supply of carbs can be too much, I wonder if the internal supply of protein can occasionally briefly be too much – such as when tissue is being broken down after an injury or after very intensive exercise or when there is bed rest, particularly in someone who has developed and maintained large muscle mass through regular exercise. I haven’t heard anyone comment on this and this is just speculation on my part.
  • if the person is not very active and has a relatively slow metabolism (generally people’s metabolism slow a bit with the passing decades and people who have lost weight can have a slowed metabolic rate long term) they really may not need to eat very much. They still need their protein for their body lean mass. Once they have that protein and a bit of carbs in their veges and possibly a few nuts or cream or cheese, they may not actually be burning a very high amount of fat to counter-balance that.

The internal supply of carbs being too high is what is happening in the first couple of days when transitioning into ketosis, as the liver’s supply of glycogen is depleted.  The liver produces glucose from glycogen, certain of the amino acids (components of protein), as well as a bit from fat molecules. The glucose is sent into the blood stream to prevent the blood glucose level from falling below normal range. The liver does this mostly under the direction of glucagon and the stress hormones — that is really a rough account, I can’t say I’m really up on the details.

If the blood glucose level is falling and the liver is not keeping up with need, a sudden surge in hormones can bring a surge in glucose output.  This most often happens with exercise and during the night, especially in the early morning and pre-dawn hours. When a sudden surge in hormones is triggered, this is not a finely calibrated response.  The resulting glucose output is generally more than what is needed. In someone with diabetes or glucose intolerance, this may show as a rise in blood glucose above normal, and insulin secretion will go up if their body has the ability to do so. In someone with normal insulin function, the rise in glucose will not be above the normal range, because insulin will go up to handle the glucose. Any rise in insulin inhibits ketone production.

Besides sudden surges of stress hormones, many people have raised stress hormone levels at various times of the day and night.  Many people have chronic elevations of stress hormones, particularly as they get older, and particularly at night.

I wonder if this has a bit of a role to play in why it is so famously difficult for post-menopausal women to lose weight.  This is a very large topic and this suggestion is not meant to over-simplify the picture, but, as a general group, post-menopausal women are famous for having poor quality sleep – and even more so if they have hot flashes or night sweats.  Some women in this situation may be producing enough glucose at night to trigger enough insulin to suppress ketone production.  This would not be detected by blood glucose testing if insulin function was normal.

Also, insulin resistance of the liver is common.  In this situation, the liver may produce substantially more glucose than is needed to maintain the needed blood glucose level.

(4) due to insulin resistance, when starting the diet insulin levels may be quite high and may take a while to come down to lower levels. Besides this, if the person has been habitually having a large amount of quickly-absorbed carbs at their meals, there body is adapted to this pattern. When they first adopt a low carbohydrate eating plan, this may take a few days to settle down, and in that time the person will be hungrier  and hungrier more often.

And … there is always the unexpected unknown.  As mentioned in Part 4, Jenny Ruhl has had some difficulties with very low carb diets, despite being unusually well informed and experienced.  We do know that Jenny has an unusual metabolism in that (1) she has an uncommon form of diabetes and (2) she had a very unusual (though very pleasing) profound response to Co-enzyme Q10).  The thing is, unusual metabolisms happen, and you might not know about it until later life.

Addendum Oct 18/12 – I knew I was forgetting some things in this list:

  • nutritional ketosis is just one influence on your appetite/satiety system.  If you have enough pro-appetite forces in your life, the effect of these may be stronger than the appetite-lessening effect of the keto-adaptation. The Rest of Reality always applies.
  • when you start into nutritional ketosis, you may be still in a restrict/rebound cycle.  The restrict/rebound cycle can take place within a day (low food first part of day, over-eating in later day), within a week (skimping food in week and rebound on weekend) or over months (“dieting”, then rebound after the diet) or over any other time period.  If you have just spent time deliberately eating less than your body is telling you to, even though you might then switch to a healthier approach that would be successful long-term, you still might have to go through the rebound phase set in motion by your previous restriction. This doesn’t mean you have to re-gain the weight, but you might re-gain some (e.g. rebuild muscle) or stall for a while until your body figures it has repaired and recovered from the forced weight loss.  To help this process, be kind to yourself in other ways, to promote recovery from the previous dieting stress – especially, don’t heap on more stress.
  • if you have lost weight recently, you may be in a ‘stall” or “plateau” that you just have to wait out. Stalls happen to every-one.
  • sights, smells, thoughts –  your appetite/satiety system is integrated with your entire functioning.  Seeing and smelling food already sets the digestive system in motion.  You may need to be careful how much you are exposed to foods that are of a type you are not intending to eat.  Thoughts matter – find other things to enjoy and be cautious about negative self-talk.  If you are exposed to food that is in keeping with your intended eating plans and you feel hunger – eat it (or, if that’s illegal, find food you own and eat that).

(4) Concerns About Nutritional Ketosis for Weight Control?

There are always concerns …..I have mentioned some of these near the bottom of Part 1 and in Part 2 and I’ll get back to this topic in a later post. (likely 3 more in this series)

……………………………………………………..

The field is starting to move quickly. As I have been preparing this, an important post has appeared on Dr. Richard D. Feinman’s blog (the biochemist, listed in my blogroll). The post is by Dr. Eugene Fine and he explains a research paper just published. The purpose of the research was to examine insulin lowering as a strategy in cancer treatment.  I expect research interest in this topic to expand rapidly.  Now it is in its very earliest stage and there are only baby steps towards a good working knowledge.

The point of interest in Dr. Fine’s post that relates to the topic of this post is the graph of insulin levels versus blood beta-hydroxybutyrate levels (the type of ketone measured when using blood ketone testing – also noted as beta-OHbutyrate) and how variable the ketone (beta-hydroxybutyrate) levels were between the participants when on a ketogenic diet even when strict care was taken to use diet compositions as identical as possible. Also, they clearly noted appetite suppression.

“(We tried to over-feed the patients in order to maintain weight and calorie intake, but it didn’t work: very low CHO diets do indeed cause spontaneous calorie restriction and weight loss, even when you try to prevent that.)”

To hear more about Dr. Eugene Fine’s work, look for Jimmy Moore’s upcoming podcast with him on Monday, October 22, 2012

To hear more about ketogenic diets and cancer, look for Jimmy Moore’s Ask the Low Carb Experts podcast tomorrow, Oct 18/12 with Dr. Colin Champ.

Related articles

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Some Research:

Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum.

Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE.

Am J Clin Nutr. 2008 Jan;87(1):44-55.   PMID: 18175736   FULL TEXT

“In conclusion, the low-carbohydrate component of the high-protein regimen affects subjective motivation to eat, and volunteers feel less hungry and consume less energy, at least in the short term. Whether LC (ketogenic) diets are a suitable tool for weight loss will remain an important issue for some time, as more complex interactions between phenotype and diet composition are identified (23). This regimen appears to reduce calorie intake without increased hunger, and, therefore, it promotes compliance.”

………………………………………………..

The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms.

McClernon FJ, Yancy WS Jr, Eberstein JA, Atkins RC, Westman EC.

Obesity (Silver Spring). 2007 Jan;15(1):182-7.  PMID: 17228046   FULL TEXT

“Hunger was significantly lessened in the LCKD group for as long as 3 months.”

“Furthermore, the present findings represent a replication and extension of previous studies demonstrating significant appetite suppression during an LCKD.”

Ketosis in a Nutshell – Part 4, Happy Campers More

shrimp (boiled), lemon juice, fresh cream, may...

shrimp (boiled), lemon juice, fresh cream, mayonnaise, salt, chervil (Photo credit: Wikipedia)

Nutritional Ketosis and Weight Loss

The other significant intentional use of nutritional ketosis has been for weight loss and weight control.

To be clear, nutritional ketosis is just one tool that can be used to assist with weight control. It is not suitable for everyone. Even for the people who do find it useful, the benefits will not be limitless. Many factors are involved in weight control, such as sleep and stress – it does not all come down to diet.

OK, Now for the Stories of Happy Campers –

Uhm, wait….

Yes, I do have some stories for you – two in particular make for very interesting reading. The most fascinating is the personal story of Dr. Atkins himself.  I will get into these stories, but first it is important to discuss some areas of confusion.

It is not such a simple matter to find stories for the topic of weight loss as it was for the previous topic of epilepsy control. Why? In the situation of ketogenic diets for epilepsy control, nutritional ketosis has been the agreed-upon target from the beginning (although this is changing with some of the less strict dietary regimes of the past decade).  The people were following strict diets that would clearly induce ketosis and these were consistently maintained over time (in those who had success with their seizures). They were all under the guidance of professional expert teams and meaningful research data was collected and published. When considering nutritional ketosis in the context of weight loss, the situation is much less clear.

Isn’t following a low carb diet about the same as being in ketosis?

Don’t we know all about this from the wide use of low carb diets over the past decades?

When people follow a very low carbohydrate eating plan, such as what is commonly thought of as “the Atkins Diet”, most of them will be in nutritional ketosis. (I put “the Atkins Diet” in parentheses as often people are following some concept of their own of what the Atkins Diet is, rather than truly following Dr. Atkins’ actual recommendations.) Some people will not be in ketosis – for various reasons their metabolisms are resistant to going into ketosis and/or they may be consuming an amount of protein that is too much for them.  Some people may be testing to monitor over time whether they are in ketosis or not.  Some are not.  As people start to eat more carbohydrates or more protein, individual people will move out of being in ketosis at different amounts of carbohydrate or protein intake.

Therefore, everyone who is in dietary ketosis is eating a low carbohydrate diet (unless they are taking a ketone-producing medical product or eating high amounts of medium chain triglycerides). However, not everyone eating a very low carbohydrate diet is in dietary ketosis.  It is now very clear that you can be carefully following a very low carbohydrate diet – for example, staying below 20 grams of carbohydrates a day – and yet not be in nutritional ketosis to any meaningful degree.

Unfortunately, the two things seem to have gotten somewhat mixed up together in many people’s minds.  I think somehow being in ketosis – turning the urine test strip purple – has come to be commonly viewed as just the far end of the low carb spectrum. In reality, being in ketosis is a metabolic state of its own with effects and implications that go beyond just leveling out the blood sugar levels, or lessening swings in insulin or other benefits of lessening the strain on the body from carb intake above an individual’s tolerance level..

What’s the big deal? Why does this matter?

  • being keto-adapted can help weight loss and weight control
  • the changes that happen with ketosis, if not understood, can interfere with weight control by causing confusion and discouragement

How can being keto-adapted help with weight control beyond a low carb lifestyle?

(1) Being in sustained ketosis provides some degree of lessening of appetite (more below).  This knowledge has faded from awareness or not been appreciated for the invaluable tool that it is.

(2) Some people might have a benefit to their brain function that results from their keto-adaptation. (See previous post in this series.) We don’t know enough about this yet, but many people report improvements in mental energy, focus and mood – these effects could be expected to improve a person’s ability to control their weight.  Scientifically, these effects are quite plausible and I hope the current interest in research on ketosis and brain function will expand quickly.  This is just speculation, but it is even plausible that being in ketosis may favour improved function of the appetite/satiety control centres of the brain if these centres might be (hypothetically) metabolically compromised in their function??  This topic is particularly interesting in view of the current concept of “Type 3 diabetes” (see the second post in this series).

(3) There may be other aspects of being keto-adapted that might be helpful in weight control – for example, some people feel that their muscles function better when in ketosis and then find it easier to be active. Some athletes are now using keto-adaptation as a high performance strategy. See HERE and HERE and HERE.

How can ketosis cause confusion during weight loss?

If you are transitioning into ketosis and you are not well informed about what that means or how that can be expected to affect your body and your energy metabolism, you could be very confused or even distressed by changes you experience.  Without proper information, you might not even know you are going into ketosis.  You might not even understand that the way you are eating has made ketosis a possibility.

The same is true in reverse if you are in ketosis (intentionally, knowingly or not) and you unknowingly move into a slight degree of ketosis (where you are not really running substantially on ketones) or fully out of ketosis.

(1) rapid weight changes not related to changes in fat stores

When transitioning into ketosis, there is a rapid drop in body stores of glycogen, which causes a rapid drop in body weight from the weight of the glycogen and the water that had been associated with the glycogen. There is also a increase in sodium excretion, with some drop in body water from that, as well.  None of this weight is actually loss of body fat stores.  This can lead to false expectations of continued rapid weight loss.

Over time, the body adapts to the state of ketosis and there is some re-balancing in the body.  In terms of any regain of that body water, I don’t think there is much definitive to say at this point and it is bound to be highly variable between individuals.  However, to the extent that there were a slow regain of some of that water over the first 2-3 months, this would show up on the scales and falsely appear to be lack of progress in reduction of body fat.  The more dramatic the initial drop in body weight as water, the more chance that some return of that body water could, soon thereafter, give an impression of lack of progress in fat loss.

It can be very easy to move out of the ketotic state. One substantial serving of carbs can mean that the next day your body weight shoots up just as rapidly as it initially fell.  Only a very little bit of this would be actually fat – almost all of it would be water and glycogen.  This causes people great unhappiness and confusion and can precipitate a dark mood that then brings even further “off-plan” eating.

(2) changes in energy and sense of well-being

When you are transitioning into nutritional ketosis, you can feel quite “low” and tired for a few days or even a week or two as your body adapts to the new fuel mix.  Some people even call this “the Atkins flu”.  It will pass and there are ways to lessen these effects (such as increasing sodium intake – see Resources below).  The real problem comes if this is happening to you and you don’t understand why.  Once the transition period is well underway, people often feel better than they have in some time.  Imagine how confusing it is if these changes come and go unpredictably and with the real cause unknown and thus uncontrollable.  If the person moves out of ketosis for a few days, they may suddenly feel a real change in their sense of well-being.  If they then shift back into ketosis, it will take some days or a week or two again for them to get back to a keto-adapted state.

Without knowing the real cause for there mysterious changes in how they feel, they may incorrectly blame the problem on something else and start making other changes in their diet or lifestyle or health practices that can then lead to other confusions.  None of this bodes well for finding their best personal happy healthy stable eating pattern

(3) changes in appetite and cravings for starches and sweets

  • loss of the appetite-suppressing effect of being in ketosis
  • suddenly the brain is not getting the ketones it is adapted to, so it quickly starts using much more glucose than the liver has been used to supplying, potentially drawing down the blood sugar level.  When the brain gets hungry, it sends out signals to supply it with its emergency fuel – glucose.
  • when coming out of ketosis, for a few days the body is not fully adapted to glucose intake again and the blood sugar will go higher than it normally would, risking an exaggerated eventual insulin response which would compound the problem by causing an unusually sharp drop in blood sugar.  Remember that starch is pure glucose, so it isn’t just sugar that causes a flood of glucose into the body. The rapid drop in blood sugar would bring more hunger and a craving for carbs to bring the blood sugar back up. Repeat. Repeat again. By the time this roller-coaster settles down, several days have passed and the person has regained glycogen (and therefore a number of pounds) and can be very discouraged and also not understand what just happened to them.

Imagine a person who had become adapted to being in a sustained state of ketosis who then shifted their diet so slightly that they did not notice or did not think it was a significant.change. Imagine that person thinking that they were still following the diet, but they were no longer in ketosis.  They would not understand why suddenly they were both more hungry and having craving for carbohydrate foods.  They would just feel that “the diet stopped working” or “I don’t have the will power to stick to the diet”. A bit of extra hunger or craving, if due to being close to moving out of ketosis, can bring “a little nibble”, which would then be sure to bring a bit more hunger or craving.  As the ketone level then fell further, a few “nibbles” more would again cause more hunger, not relief of hunger. This hunger leading to more hunger is often the path that leads a person fully out of ketosis – and into a sharp spike and drop in blood sugar, as well, depending on the foods and amounts chosen.

There are many happy stories of sustained weight loss while eating low carb.

But very few that include (adequate) details about the topic of ketosis – although this can be expected to change dramatically over the next months.

Over the decades and until very recently, relatively few of the people who have reported their experience with low carbohydrate diets have included in those reports enough (or any) detail on their experiences with ketosis itself in order to be able to understand the impacts of nutritional ketosis on their experiences – both good and bad.

Thus, the stories of those people who actually experienced a sustained period of nutritional ketosis are, for the most part, not clearly separable from the stories of people who undertook low or very low carbohydrate diets without a period of being adapted to nutritional ketosis.  Generally, the stories of people who had problems with weight loss on low carb diets – or who found staying on the diet too difficult – do not contain information on whether they had attained keto-adaptation and what was going on with their ketosis situation during the time when they were having difficulties.

Stories of experiences with nutritional ketosis can be suspected within stories of people who have followed low carbohydrate eating plans.

When you hear or read stories of people’s experiences – good or bad – with following a low carbohydrate eating plan, keep in mind how their encounters with ketosis may have been a factor in their experiences with low carb.

Stories That are Clearly About Nutritional Ketosis for Weight Loss

(1) Patient Number 1 – The original Happy Camper using nutritional ketosis as an aid in his own weight loss – Dr. Robert C. Atkins.  Unfortunately, this post is getting too long already, so I will have to leave as this teaser – from how I read it, Dr. Atkins’ original focus was just as strongly on the vital role of nutritional ketosis as it was on the problems of carbohydrate intolerance.

(2) The story that is creating Major Buzz is Jimmy Moore’s recent experience, which he has been documenting in detail since the spring.  It should be pointed out that each person’s needs and medical situation is different, so his story is not intended to imply that his approach is for everyone or is the most healthful way for you to proceed.

I include it here because it highlights the difference between a very low carb diet and a targeted ketogenic diet.

I expect that few people would have an outcome as dramatic as Jimmy’s.  He obviously is able to go into a strong level of ketosis and feel very well while doing so.  People are very different in how readily they go into ketosis and how they respond to it. As I’ve said before, ketosis is not right for everyone. Jimmy’s response is in keeping with his earlier experiences of dramatic weight loss when he first went on a very low carb eating plan in 2004.  His results then were similarly “not typical mileage” – with a much more dramatic weight loss than many people achieve with the same diet changes.

(3) Jenny Ruhl’s recent experience – You have to scroll down to the comments section below her post to see where she reports that she did test positive for urine ketones throughout the trial 2 weeks, after the first couple of days. I include it here for some balance.  Also, it reflects some other people’s experiences that I have read about in the past months where the person has done blood testing for ketones and not had substantial weight loss when eating to satiety.  Note – in Jenny’s trial she did lose weight, but she remained hungry as she kept to a calorie cap.

What you eat is only part of the whole picture when it comes to what is determining your body weight (unless being in semi-starvation or putting up with chronic hunger, neither of which are tenable long-term).

Jenny is an extremely happy camper when it comes to a “to the meter” individually targeted lowering of carbohydrate intake as an essential aspect of controlling diabetes and glucose intolerance (see her other web site, facebook and books).

(4) Tommy Runesson in Sweden – very impressive weight loss, now stable at healthy weight.  Recently doing blood ketone testing and reporting this in detail on his blog.  Great blog for seeing the very tastey-looking food he photographs daily.

(5) More stories with testing of blood ketone levels are bound to be appearing in increasing numbers over the next months.  We really know only tidbits of info so far about this whole topic.

Places I would suggest to keep an eye out for more stories over the next months:

To be continued … this post has gotten too long.

Next: more on the topic of appetite reduction in nutritional ketosis and a look back almost 5 decades ago to the insights that started it all for Dr. Atkins.

Resources – Link to my page Resources – Low Carb and Ketosis

Related articles

Are you dealing with a saboteur?

I’ve just come across a great new blog, Keep Weight Off for Life!

This is written, articulately and with passion, by Linda Armistead RN

Check out her story.

One of her posts is What to do About Weight Loss Saboteurs?

Sunday Stories of Low Carb – June 17

(travelling to see papa tomorrow, so posted a bit early.)

Sunday Stories:

Today’s stories come from Tom Naughton’s web site (of Fat Head Movie fame).

The June 11th post contains letters Tom has received, including a couple of detailed inspiring stories.  LINK

Sunday Music:

I’m hampered this week. Installing the latest 11.3 version of Flash several days ago has knocked out my online audio.  Adobe knows of the bug and I’m waiting it out to see if they get that fixed, rather than trying to back-track to a previous version. So, from the description, I think this should be good and I’d love to be able to hear it!

 

Testing Blood Ketones Update

At the bottom is an addendum to this article (originally published May 28th).

Also, Jimmy Moore, of Livin’ La Vida Low Carb, has posted his very interesting report of the first 30 days of his trial of using blood ketone testing and I’m sure interest is going to rise quickly.

Testing Blood Ketones to Monitor Nutritional Ketosis

A number of people who follow a low-carb lifestyle have become interested in testing blood ketone levels.  The reason for this is that the amount of ketones that show up on urine testing tends to drop over time as your body adapts to burning ketones for fuel.  This makes following your urine ketone level (urine dip sticks for ketones) of limited value.

If you are eating low carb, you may be surprised to find that your level of blood ketones is much less that you expect.  The old “people are so different” game.  This matters if being in ketosis would be helpful to you personally for your fat burning and your appetite/satiety balance.  If your health is fine without dropping your carbs (actually total carbs plus some limit on protein) down far enough for ketosis, then going this extra mile isn’t something that you necessarily need to do to thrive.

It also matters if you are wanting to be in ketosis for some of its other known or proposed medical benefits (such as seizure control) or its benefits in athletic performance.

If you ketones are not in the range that you’d like, the first things to think of are (1) are you having more carbs than you thought and (2) should you cut back a bit on protein, though keeping in mind that adequate protein is essential?

If that’s not the answer, perhaps your liver is just pumping out too much glucose.  This happens when the liver becomes “insulin resistant”.  Yes, your liver can become insulin resistant just like your muscles can.  This effect is noticed most in the mornings. If you are not yet diabetic or heading into pre-diabetes, this may be happening without necessarily showing up as a notable rise in blood sugar (glucose) level if you still have enough insulin effect to clear the glucose from the blood.

If you are eating low carb, you also will have more ketones with greater activity or exercise levels.  There are also medications and medical conditions that could be a factor.  This area of science has not received enough research attention to say that we understand it very well, yet.

If you consume a significant amount of medium chain triglycerides (MCT), such as tablespoon amounts of coconut oil, you will have some ketones in your blood that are produced directly from those medium chain triglycerides that you have just eaten, whether you are truly “in a ketogenic state” or not. This is too much to explain properly in this post, so I’ll write on this topic another day.

If you are at all interested in doing this yourself, you will need to put some time and effort into learning about this topic.  You would need to thoroughly understand the safe and effective use of low carb dieting and the ins and outs of nutritional ketosis.

If you are considering low-carb eating for yourself, especially at the level of going into ketosis, you must discuss this first with your doctor as (1) there may be reasons for you that this might be a bad idea or a bad idea at this particular time, (2) you may need some testing before and during and (3) you may be on medications that could have very dangerous and potentially lethal effects if the medications are not or cannot be adjusted or changed before and during the transition.  You may need frequent medical follow-up in the first days and weeks for adjustment of medications and medication dosages.  This is an interesting problem, when you think about it.  Your health may improve so quickly that you could actually be killed by the medications you take because those medications are to help you with problems you no longer have.

The book to read that is most informative about nutritional ketosis is The Art and Science of Low Carbohydrate Performance by Jeff S. Volek, PhD, RD and Stephen D. Phinney, MD, PhD.  The price is more than reasonable ($8.95 on amazon and no I have absolutely no commercial ties or links). (Update: now available in Kindle format for $5.99)

One of the speakers at the Nutrition and Metabolism Society meeting in 2011 was Dr. Adam Hartman, who is an expert in the use of ketogenic for the control of epilepsy in children.  He made an interesting comment on the timing of testing for ketones.  When eating the typical mixture of foods that people normally consume in our society (a mix of proteins, carbohydrates and fats), ketones are highest in the morning.  This makes sense because the least flow of carbohydrates in from the digestive tract is overnight, so the body burns some fat in the night.  When eating a ketogenic diet, on the other hand, the most exposure to carbohydrates is overnight especially towards morning as the liver produces glucose to keep your brain fueled and to prepare you for getting up.  Therefore, if you are eating a very ketogenic diet, the blood ketones go up during the day as you burn more fat for fuel.

Regarding testing blood ketones, the following refers to the blood ketone test strips for the Abbott Precision Xtra (Medisense).  These come in a box of 10 strips.

Please note that the shelf life of these strips is not long (I don’t know the details) so please be aware of this before ordering a large number of testing strips or before buying from a source you don’t have confidence in.  An expiry date will be on each box and a lot number.

For people in Canada, the first place to turn to is your local pharmacy.  I bought mine at London Drugs (a major chain) over the counter for $20.00 per box of 10 strips.  I checked their on-line ordering site, and they do not offer these strips for on-line sale.  I didn’t shop around to compare price, so I am not advocating London Drugs over any other store.

People in the US face prices for these testing strips that can be quite high and also people in smaller towns may have difficulty getting testing strips locally.  I did some looking around on-line.

Also, of course I can’t vouch for any company on-line or not.  You have to look into any company or on-line seller and make a decision for yourself.

I am just reporting what I have found on-line. I have no idea whether these are good companies (or even real companies) or not.  Exercise caution.

A significant factor in cost could be the shipping fees, so you might want to take that into consideration, not just the price per box.

Well.ca offers at this link a box for $24.29 USD ($2.43 per test strip)

CanadaDrugs.com lists, at this link

  • $32.42 USD (May 28/12) for box of 10 ($3.24 per test strip)
  • for 3 boxes or more (30 test strips or more) this drops to $2.49 per test strip

Universal Drug Store offers at this link a box of 10 for $19.99 USD ($2.00 per test strip)

There may be other sites that are as good or better, this is just what I found with about 20 minutes of checking.

I am not advocating that you purchase from any of these sites or that these sites will link you to a reputable business.  Buyer beware.

If you come up with something better, please let me know.

UPDATE June 14, 2012

My Abbott Precision Xtra (Medisense) is my new BFF.  Turns out I really do need the ketosis (at least for now) to have a reasonable time with appetite and I was not reliably achieving that with my low carb eating.  Despite carbs total about 15 g most days (1-2 times a week up to perhaps 25 g) and protein most days about 90 g (some days about 100 g), I was not getting a good level of blood ketones.  My fasting ketones were 0.4 mmol/L to 0.6 mmol/L and late afternoon ketones 0.9 mmol/L to 1.1 mmol/L. I have cut back a bit on protein and added some MCT oil.  It will be a while to find my best balance, but I feel an effect on appetite with my ketones in the range from about 1.5 mmol/L to 3.2 mmol/L.  Above that I feel a bit tired and out of focus.

It will take some time before there is much collective understanding about the hows and the whys of using blood ketone testing for insight into low carb eating and its benefits.  People will have to put their heads and their experiences together.  Also, we have to avoid jumping to conclusions too soon, based on only a few people’s experiences.

Addendum July 18, 2012

When I originally wrote this post on May 28th and when I composed the update on June 14th, the book “The Art and Science of Low Carbohydrate Performance” was not available in Kindle format. It was released in Kindle format on June 15th.  The price is a paltry $5.99 for this excellent book packed with useful insights into low carbohydrate nutrition.

Short link for this post http://wp.me/p2jTRh-87

The Precious – Sleep Denial and What We Throw Under the Bus

This photo shows an owl perched at a tree bran...

This photo shows an owl perched at a tree branch at night. According to Brit, this is Barred Owl (Strix varia). (Photo credit: Wikipedia)

The rock we are battered against.

The public health hill hardest to take.

The “precious”, gripped ever tighter in our hands no matter the consequences.

We wants it, the “precious”.*

OK, what on earth could I be referring to?.  Well, pick your metaphor or I’m sure you could come up with a few of your own.  What I am referring to is:

Denial of the need for adequate sleep.

Denial of the need for circadian rhythm health.

We don’t like being accountable. I sure don’t. It’s so boring and frustrating.  Aren’t we born to be free?  As a society, we’ve had to learn the hard lessons about money.  Now we are having to learn the hard lessons about food choices and weight health (and no, I don’t mean the simple calories-in-calories-out stuff).  Barely visible yet on the public radar are the hard lessons we will face about chronic under-sleeping and chronic circadian rhythm disruption.

When it comes to weight health, think of all the blogs and comments and tweets out there. I have seen countless posts and comments from people willing to turn their whole eating pattern on its head. (I have.) Willing to learn and chase the smallest details. (I have.)  Willing to spend hour upon hour tracking various people’s opinions and the latest commentary, insights and research. (I do.) Many put time and effort into being more active or engaging in a deliberate exercise program.  People talk about which medications might interfere with weight health.  Some pursue unusual techniques that are like grasping at straws. There are countless ways people take measures aimed at improving their ability to have and hold their chosen target weight.  Many times a lot of time, effort and loss of personal freedom is involved.

In all this, how often is a goal of adequate sleep and normalised circadian patterns targeted or achieved?

How much of all the other stuff we are doing is only necessary because of the chronic sleep/circadian issues?

In other words, what are we throwing under the bus in our attachment (sometimes fierce attachment) to keeping short sleeping hours and eating/sleeping/waking in disordered, non-rhythmic patterns?  One type of cost is the health impact from the sleep/circadian issues themselves.  This is a huge field of study and I won’t try to review it here.  A number of studies have linked sleep deprivation and circadian disruption with a tendency to gain weight.  (You can see some of this under the category “Sleep Heals” in the sidebar.)

The second type of cost is what we do to try to cope with the effects of the sleep disruption – instead of sleeping!  Just as an example, what if most of your tendency to gain weight would resolve if you just got well into a program of regular adequate sleep and a regular circadian patterns of sleep and meal timing?  How much less burden might there be from all the total things you do now that are for the purpose of helping you control your weight?  For example, research suggests that you would likely have some improvement in your ability to handle carbohydrates.  Research also suggests you would likely have less of a desire for sweets or reward foods.

If you have been chronically low on sleep, the benefits of getting regular adequate sleep are not going to be clear in the first weeks. In fact, there is a confusing phenomenon whereby people who have really been driving themselves and then get a night or two of unlimited sleep can suddenly feel much worse as the adrenalin levels fall and the body pushes you towards going into a “repair and recovery” mode of increased sleep for a while. This is very often mis-interpreted. People take this phenomenon, which is really an expression of the body’s desperation for sleep, as an excuse justifying their high-adrenalin habits.

The heart of the matter is time. We want more time. I don’t know of any other topic in weight control that can make so many people respond as if they are personally under threat.  In terms of emotional response, this topic is even worse than that terrible and much dreaded horrific topic – breakfast.

Of course, the topic of breakfast and skimped/skipped meals ultimately also involves time and time pressures for many people. (See the page “Restrict/Rebound” under Key Keys above.)

So, what are you “throwing under the bus” instead of turning the computer off and getting to bed?  I’ll be asking myself the same question more often.

*Lord of The Rings

All Diets Equal – is that the valid study conclusion?

The website “Ancestral Weight Loss Registry” has posted a very good analysis of the widely-reported study by Dr. Sacks, Dr. Bray and associates, which has been presented as showing that there is no benefit to one weight loss diet over another.

 “For example, let us assess a popular randomized clinical trial testing the efficacy of different diets, performed by some of the biggest names in diet and obesity research, such as Dr. Frank Sacks and Dr. George Bray.
The conclusion of their study is simple. All diets are created equal. “

LINK to the full text of the study.

LINK to the analysis posted by Ancestral Weight Loss Registry

Taking a good look at the full report of the study, to see what was actually done and what the researchers were actually working with as data, sheds a very different light on what value the research actually contributes.