The further a society drifts from the truth, the more it will hate those who speak it. ... In a time of deceit, telling the truth is a revolutionary act. George Orwell

Saturday, July 31, 2010

Atkins revisited

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The reason I decided to post this note today is the following discussion
thread: Atkins Meat and Millet Diet . Start reading with Dolores' posts.


My Cholesterol Bomba


I started experimenting with the high animal fat low carb nutrition in July 1999. It worked so well for me that it became my lifestyle ever since. Since it never caused me any trouble, I could never understand why were some people, especially diabetics, opting out after just a few months with lots of complains. Yet those were exactly the people for whom a high fat low carb diet was best suited (*) and could have been the most benefitial had they been able to persist. Why couldn't they?

I think I can probably answer this question now:

The most likely reason behind diabeitc's failures to follow Atkins lies in the induction stage being too short and Dr. Atkins unfortunate recommendation to increase carbohydrates beyond the ketogenic limit (about 20g) following the short induction stage, as well as the lack of restriction on the amount of protein! Diabetics need probably about 2 years to adapt, before they can add more carbohydrates and protein back to their HIGH FAT diet.   I needed 1.5 years before I could tolerate the average beyond 20g carbs a day!

Quote:

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Fat does not cause permanent insulin resistance. Under normal circumstance, it only does it while you eat it, not a few hors afterwards. Even if I eat lots of fat, I can have 100g of carbs on the next day (though I rarely do).

My body WAS insulin resistant intitially on the high fat diet, but I was able to increase my occasional consumption of carbs way above my initial 50g level [NOTE: this is an error, should be 25], gradually over time.

In the first year I could not exceed 25g of carbs (1 beer) without suffering a massive headache. Gradually after a couple of years my body recovered its usual flexibility and I am able to eat occasionally up to about 100g of carbs as vegetable, fruit and my two favored "truly essential macronutrients" - ice cream and chocolate.

For me a high fat low carb diet wasn't a road from bad to worse, it was from bad to normal!

I suspect that the reason behind Atkins diet #1 delayed (not immediate) blood glucose deterioration among some patient was his allowance to up the carbs after his initial induction stage. Some patients probably took it too liberaly and coupled with the then much stronger fatophobia than nowadays, may have resulted in overconsumtion of lean protein and carbs.

In my experience on the high fat, which is probably representative to many middle-aged adults ( 43 at that time) , my hormonal imbalance involving insulin resistance, with hypoglycemia and poor glucose regulation persisted throughout the first 1.5 year! Atkins induction period (6m ?) was probably not long enough for people with metabolic syndrome and with diabetes! It certainly was not long enough for me. In the first 1.5 years I could only tolerate 25g of carbs! Which was not a huge problem but I just had to remember to be strict. Whenever I ate more, even 50g would cause me a headache especially if I simultaneously exceeded protein as well! For example, I remember a massive headache I got from a plate full of salmon with potatoes!

Technically my capacity to consume carbs became in that initial period much reduced than before on the high carb diet, therefore technically you could argue that I had "deteriorated" from being insulin resistant to being virtually a diabetic! However, that is purely of academic interest (i.e of useless value) because I RARELY exceeded those 25g of carbs/day, and when I did stuck to those 25g I had absolutely no problem and my health continued improving. That 25g limit didn't bother or worry me at all! For example my intestinal sensitivities and dry eyes syndrome went away with weeks. My mild angina begun gradually abate and I was feeling stronger and more energetic with every passing months. That was the story of the first 1.5 years. Most Atkins patients I guess - would probably bail out during that stage, not understanding why they suddenly feel much worse the moment they add "little" bit more carbs after Atkins unfortunate recommendation!

The second stage of my adaptation to my high fat nutrition occured after 1.5 years. My mild angina completely disappeared, and I discovered that I am no longer carbohydrate intolerant!

I remember how surprized I was when after eating two full bowls of strawberries I did not get any sensations! I no longer would get a headache after drinking wine and especially beer.
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I recommend also to look back at this post Can ketogenic diet cure cancer?, please notice the two papers referenced:


Ketosis leads to increased methylglyoxal production on the Atkins diet.

A brief critical overview of the biological effects of methylglyoxal and further evaluation of a methylglyoxal-based anticancer formulation in treating cancer patients.

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References:

*) For example, see the following comments and papers:

1.  Beware of the carbs!


However, at least 22 experiments have documented the benefits of reducing the dietary intake of carbohydrates in type 2 diabetics.2-23 Most of them were controlled studies where a low- carbohydrate diet was compared with a low-fat diet, and almost all of them found that the former was better than the latter as regards weight reduction and glycemic control. In several of the low- carbohydrate groups patients were even able to reduce or stop their antidiabetic treatment.
Most of these studies were ignored by the Cochrane authors because their length was shorter than six months. However, to-day four studies with a length of six months or longer have been published and with similar benefits as in the short-term experiments.14, 15, 19, 23


2.  Control of blood glucose in type 2 diabetes without weight loss by modification of diet composition

... A 30:20:50 [P:C:F] ratio diet resulted in a 38% decrease in 24-hour glucose area, a reduction in fasting glucose to near normal and a decrease in %tGHb from 9.8% to 7.6%. The response to a 30:30:40 ratio diet was similar.

Conclusion

Altering the diet composition could be a patient-empowering method of improving the hyperglycemia of type 2 diabetes without weight loss or pharmacologic intervention.


3. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal

Current nutritional approaches to metabolic syndrome and type 2 diabetes generally rely on reductions in dietary fat. The success of such approaches has been limited and therapy more generally relies on pharmacology. The argument is made that a re-evaluation of the role of carbohydrate restriction, the historical and intuitive approach to the problem, may provide an alternative and possibly superior dietary strategy. The rationale is that carbohydrate restriction improves glycemic control and reduces insulin fluctuations which are primary targets. Experiments are summarized showing that carbohydrate-restricted diets are at least as effective for weight loss as low-fat diets and that substitution of fat for carbohydrate is generally beneficial for risk of cardiovascular disease. These beneficial effects of carbohydrate restriction do not require weight loss. Finally, the point is reiterated that carbohydrate restriction improves all of the features of metabolic syndrome.


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4 comments :

H. said...

Stan, thank you very much for your blog, I enjoy visiting and reading.

Your experience of recovering from having been very sensitive to CHO, during those 1 1/2 years, has been a light of hope for me.

Can you say what might have been occurring during those 1 1/2 years? I would like to know what adaptive or restorative process is taking place.

I am at six months, and find, as you did, that 25g CHO is my maximum limit. I tend to stay at 16-20 grams.

Also, I notice that if I go below circa 16g, that I feel unwell and it seems as though my body is working too hard.

Thanks very much for your blog. I also have enjoyed reading your comments at Hyperlipid

Best wishes to you.

Stan (Heretic) said...

I missed this post so I am answering now, for the record.

The first 1.5 years generally trouble free except occasional headache (probably once a couple of weeks) whenever I exceeded about 25g of carbohydrates or drunk more than a half a glass ow wine. My tolerance for alcohol was as much reduced as for carbohydrates during that time. I never have had it since, and I can tolerate more carbs (up to a 100g) and alcohol, although I rarely do that.

- My taste begun shifting in the first year or so, such that stopped craving carbs, especially sweets, and begun liking the high fat cuisine.

- I also found during that period, that eating too little, for example zero carbohydrates for a few days used to bring some strange symptoms. Headache and sometime faster heart beat although not nearly as fast and as bad as on the high carb diet before (tachycardia and panic attack every month or so).

My guess is that if you do not eat any carbs then neo-glucogenesis might not work ass effectively and fast enough to maintain very stable glucose levels. It may lead to hypoglycemia and this in turn triggers the adrenal response to stumulate neo-glucogenesis in the liver, which then triggers release of thyroid hormones which may bring a panic attack etc.

Other effects of the low carbs were immensely positive, for example:

- Lifting of the mental fog, within the first week of the low carb diet. I became calmer and mentally more focused. Much less prone to fear or panic.

- Ability to work for a day or two non-stop, without sleep, if I need to.

- Not feeling nearly as much tired after work.

- Resistance against cold weather and cold water (swimming).

- Ability to hold breath for longer, and reduction of breathing rate.

- Not needing to dring water as often, rarely feeling thirsty.

- Blood clotting factor initially diminished, but later on normalized.

- I lost a few kg (which was worrying because I have always been of normal weight or underweight). My weight has normalized after 2 years.

- My total caloric consumption has diminished by itself, without trying, by about 30%.

- Never ever got a flu or any other infection. I did have a common cold 2 or 3 times in the last 13 years. Never get a fever. Before I had a flu with high fever, regularly twice a year

- Never got a sunburn ever since. My skin is more resistant to burns and heals faster after cuts.

- Twice as fast bones healing, and teeth healing. When I broke my rib8 years ago, it healed after 2 weeks. Before (15 years ago) on a high carb diet it took 4 weeks. Two of my molar teeth broke in half, one 7 years ago, another 5 years ago. I didn't go to a dentist. Both tooth sealed themselves with some new enamel and are fine to this day. This is BTW similar case to what Weston A. Price wrote in his monography! He describes teeth cavities disapearing/healing after his "Activator X" (vit K2) treatment!

Anonymous said...

Stan, thanks so much for your answer. I am the one who asked the question, and then I didn't mark which blog post it was.

Your writing about your experiences on Optimal LCHF have helped me very much.

I thank you.

Anonymous said...

Oops, that should say, "Your writings". Sorry for they typing error.