Thursday, October 2, 2014

Dr. Atkins Advice on Exhaustion and Leg Cramps

This morning I was taking a stroll through some of the threads over at Low Carb Friends, and I ran into something that really disturbed me. A patient of Dr. Westman was there asking for help. She has been on the high-fat low-carb diet known as Nutritional Ketosis for 4 months now. She is eating 20 carbs or less, is losing about 1 to 2 pounds a week, but she feels horrible.

For some reason, she is not adapting to the state of Ketosis.

Despite a high salt intake, she's having excruciating foot and leg cramps, gets dizzy, and comes near to passing out during her gym activities. She says she has zero energy, so her gym routine has dropped from 5 days a week and 1 trainer session, to just the training. She is taking magnesium and potassium supplements, along with chicken broth every day, but nothing is helping. She's exhausted and feels horrible, and yet, they want her to continue with the regimen she's been on, even though it's not working for her.

That doesn't make any sense to me.

Typical Nutritional Ketosis Diet

I've talked about my experience with a standard Nutritional Ketosis Diet before. My own results were not good. I gained a lot of weight when I tried it. It's low in protein, super high in fat, and keeps you at an Atkins Induction level of carbs throughout the diet phase. Since my hunger never corrects itself when I go into the state of Ketosis, and I don't get that energy upsurge that those who have Insulin Resistance claim to get, I can really relate to just how badly this woman feels eating at very low-carb levels. That level would make me feel horrible too.

Plate of scrambled eggs, bacon, and cheese sticks
Typical Low-Carb Breakfast: Bacon, Eggs, and Cheese

She is eating an adequate breakfast of 2 eggs, 3 slices of bacon, and some coffee with heavy cream and stevia -- but she's eating no lunch. Just a snack 3 times a week of 2 ounces of nuts. Dinner varies, depending on what she is feeding her family, but an example she gave was a chicken breast breaded with pork rinds, broccoli with butter sauce, diet soda, and a Carb Smart ice cream bar.

That particular menu only gave her about 15 grams of carbohydrates per day.

That's more than a very-low carb diet, but less than one would eat on Atkins Induction. Plus, Atkins Induction is only for 2 weeks. After that initial 2-week period, you return carbohydrates to the diet in 5-gram implements per day, per week, until you find the "highest" level of carbohydrate you can eat and still lose a pound a week.

If You Don't Feel Good You Won't Stick With Low Carb

The sad thing is that there is no way this woman is going to stick to this long term if her energy level and the way she feels doesn't improve. She might be able to withstand the program long enough to lose the weight (she didn't say how much she needed to lose), but that isn't going to do her any good if she goes back to the way she was eating before, once she reaches goal.

Replies to her plea for help mostly focused on the type of magnesium she is taking, but a couple of folks did ask her about the small amount of food she was eating. Apparently, Dr. Westman encourages his patients to only eat twice a day, and stresses the need to eat fewer calories in order to drop the weight, so that's what she's doing. She is following her doctor's advice. Plus, she says that she is eating to her personal hunger level. It's just the way she feels and the leg cramps that are the problem.

What to Do About Leg Cramps and Exhaustion

Leg cramps comes from unbalanced electrolytes. Since a low-carb diet keeps your glycogen storage less than half full, the diet is very dehydrating, so leg cramps are common. Shedding the water the body stores to process glycogen eliminates necessary minerals, which have to be replaced. Drinking a lot of water, which she is doing, will do exactly the same thing. It sweeps calcium, potassium, and magnesium out of the body.

If you're having cramps, the most important mineral to replace is calcium, but adequate magnesium and potassium are also important:

"When there are leg cramps, extra calcium is in order, and there is often a kind of fatigue for which potassium supplements are the specific." (Dr. Atkins Diet Revolution, page 126.)

Dr. Atkins was really into vitamin and mineral supplements. He believed in optimum dosages, and not minimum requirements. Minimum daily requirements are only what will keep you alive, not what will produce optimal health and well-being. However, exhaustion isn't always about potassium. Sometimes, it's about losing more weight than the body can adapt to:

"A weight loss that is too rapid is more than the body can comfortably adapt to. And it isn't necessary to lose rapidly. It is more important to lose easily; and losing easily means feeling well all of the time. I can't emphasize this too much: Quick weight loss is not the primary thing we're after -- what we both want for you is an easy and lasting weight loss." (Dr. Atkins Diet Revolution, page 142.)

His advice for those who feel tired and ill on a low-carb diet is to raise your carb intake to the next level and see if that corrects the problem. Eating too few carbohydrates is just as stressful on the body as eating too many. This isn't a race, so the same could be said for calories. The goal of a low-carb diet is permanent weight loss, which means finding an eating style you can live with for the rest of your life. The goal isn't to get the weight off in any way you can. That usually backfires.

The Atkins Diet is Not Atkins Induction

A lot of people call what they are doing the Atkins Diet, when clearly it is not. The Atkins Diet is not Atkins Induction. Atkins Induction is a 2 to 4 week introductory period where you eat from a specific list of foods and try to keep your carbohydrate level to 20 net carbs per day, or less. This introductory period has the goal of getting you into the state of ketosis. Once you are comfortably in ketosis, you then return carbohydrates to your diet at a slow enough pace that the body continues to burn your body fat for fuel.

Pot of low-carb ham and green bean soup
Low-Carb Ham and Green Bean Soup

If you don't return carbohydrates to your diet to discover your personal carbohydrate sensitivity, then you are not doing Atkins. You are doing something else. Doing something else is fine, but calling it Atkins can be confusing to newbies who don't understand what the Atkins Diet actually is. The Atkins Diet is a progressive diet. It is not 20 net carbs per day or less -- unless --- that is the only level that will allow you to lose weight. However, you won't know that until you try to add additional carbs back in.

Very low carbs will depress your metabolism and interfere with the way the body converts T4 thyroid hormone into T3, the usable form. For that reason, many people find that adding carbs back into their diet increases their weight loss! That is why the Atkins Diet is an individual diet fine-tuned to fit your likes, food tastes, weight-loss, and metabolic issues. It's not a cookie cutter diet where everyone eats from a specific list of foods and keeps to 20 net carbs per day or less. That isn't Atkins.

"OWL allows you much more choice. That means you can now craft a weight loss regimen that is uniquely yours." (Dr. Atkins' New Diet Revolution, page 147)

Dr. Atkins always left the rate at which you lose weight up to you, but he also cautioned patients and readers to be realistic. As long as you are free of cravings, you're satisfied with the food, and you feel good, the rate at which you lose the weight doesn't matter. What does matter is that you make lifelong, permanent changes in the way you eat and that you feel well while you're creating good food habits. Dizziness and problems exercising indicates you're having a problem converting fat into energy. If that's true for you, then upping your carbohydrate level and lowering your fat intake a bit might be a better option.

Tuesday, September 9, 2014

Power of Forgiveness Brings Low-Carb Success

Smoked Pork Butt on cutting board
Going Low-Carb is a Major Event
Going on a low-carb diet is a major event in your life. It is not a whim, and it is not a gimmick. It's a drastic lifestyle change that requires a whole new revolutionary way of looking at food, diet, and health. Most diets are weight-loss games that take a standard American diet and tweak it just enough to trick you into eating fewer calories and fat. Sometimes that works, and sometimes it doesn't, because standard dieting doesn't address the problems that accompany metabolic defects.

That's the reason why a low-carb diet works. It corrects insulin issues, stabilizes blood sugar levels, primes the body to burn fat for energy, and drastically reduces your hunger. All of that makes low carbing much easier to stick to than a traditional low-fat, low-calorie diet. However, expecting yourself to never fall prey to a chocolate chip cookie isn't realistic. While some people do have the strength to never go off plan, others find dieting a struggle.

Deprivation is no picnic, and while it's exciting to initially be able to chow down on a thick juicy steak, use real butter on your veggies, and spike your morning coffee with heavy cream and sugar-free flavored syrup, at some point, most dieters find themselves unconsciously reaching for potato chips rather than cheese. Habits are extremely difficult to break, and no matter how committed you are to your low-carb lifestyle, you could honestly find yourself waking up the morning after a carb binge, and wondering -- what happened?

For Low-Carb Success Forgiving Yourself is Essential

When you fall off the wagon, forgiving yourself is essential. It doesn't do you any good to sit around trying to find something to blame. It's better to just realize that you did what you thought was right and justified at the time. While the rationalization you used the night before might not make sense now, listening to the internal dialog that's blaming you or the carbs only hurts your chances for ultimate success. You are not a victim and you are not helpless. You are just human, so both guilt and blame are equally destructive activities.

Indulging in that kind of thing only keeps you a slave to the dieting mindset. It paralyzes you, especially if you believe the lies that your inner critic is telling. Guilt weighs quite a bit, and being angry with yourself and beating yourself up for eating something you wanted to eat at the time isn't going to help you accomplish your goals. Resistance to what you want to do is normal. It's not something specific to you. While you might be weak where avoiding carbs is concerned, it happens to lots of low-carb dieters. You are not alone.

Getting Inside Your Head

Lemon-Herb Chicken Barbecued on Paper Plate
Weight-Loss Success Takes More than Low-Carb Food
Successful dieting involves more than following a print out of established rules and regulations. It's more than being told what to eat and which foods to avoid. While the science behind low-carb diets is important in order to make an informed choice about which diet is best for you, once the choice has been made, it becomes a mental game to stay on plan.

Most of us have been feeding the subconscious mind for years. It's set in its ways and doesn't want to change. It loves being in charge. It loves seeking after comfort and avoiding all forms of disturbance and pain. Low-carb diets disrupt the way the subconscious mind has been programmed, so it's common to experience resistance. A lot of resistance. The trick is to observe what's going on without resorting to self-judgment and criticism.

You can't make essential changes in your current lifestyle or thought patterns if you're blind to what's happening. That's why a binge or going off plan is not a bad thing. It's actually something to celebrate, because you now have an opportunity to take a closer look at how your mind currently functions. Only then can you take the appropriate steps that will lead to permanent change.

The Power of Forgiveness

Forgiveness doesn't mean that we make excuses for our behavior. If you have serious issues with carbohydrates, such as metabolic syndrome, PCOS, pre-diabetes, or high cholesterol levels, then it's essential to stick to your low-carb diet. You owe it to yourself to lessen the stress on your body and give it the proper nutrition it needs to function appropriately.

But neither is forgiveness an excuse to go off of your diet every single time there's a chocolate cupcake in your environment calling your name. It's impossible to take advantage of the benefits of a low-carb lifestyle if you're not really living that lifestyle.

Cheating can cause your cravings to skyrocket, your hunger to spiral out of control, and it can even make your feel ill if you have hidden food sensitivities you don't know about. For example, many people who turn to a low-carb diet are sensitive or allergic to wheat, so when they cheat on the diet with bread or grain-based desserts, they feel bloated, crampy, sick to their stomach, and quickly pack on the pounds.

The power of forgiveness lies in the understanding that a low-carb diet plan isn't just a diet; it's a lifestyle change. True change takes time and whole lot of work. It requires you to get on top of your emotional eating style, to observe and consider your eating patterns and tendencies, to look at your activity level, and above all -- to teach yourself and habituate yourself to a whole new way of living.

That takes a lot of self-observation, self-considering, and perhaps a little self-talk along the way. It's takes confidence in your self that you can do this, but even more than that, it takes the strength and courage to get to know yourself. Your real self. Not the image you've created in your mind to hide behind, but the bare-naked self that is sabotaging your dieting efforts and goals.

However, the key to making a low-carb diet work isn't demanding perfection. The key to making a low-carb diet work is experiencing the power of forgiveness.

Weight-Loss Success Requires Inner Transformation

Think of it as transforming your inner couch potato and the carb monster who's currently sitting in the driver's seat into someone who's fit and trim. While they have both served you well up until now, and deserve your thankfulness and full forgiveness, the truth is that if you want to be thin and healthy, you can't do what you've always done.

You have to stand up do something different.

Wednesday, August 20, 2014

The True Role of Ketosis in a Low-Carb Diet

Once you have the purpose for a low-carb diet fixed firmly in your mind -- that the aim is to lower your basal insulin levels and thereby make your fat stores more readily available for energy -- it's easier to understand the true role of ketosis in a low-carb diet. Ketosis isn't magic. It isn't a state that automatically makes you well again. Nor does it mean you will always lose body fat. Ketosis is a "sign" or a byproduct of the fat burning process.

When you are in ketosis, it means you are burning fat for energy.

A brick of Amish butter and a jar of Grapeseed Oil
Some of the Daily Fat We Need Must Come From Our Diet

That fat can come from the fatty acids in your diet, or it can come from your fat stores. Obviously, we want it come from our bodies, but it isn't practical for all of your fat needs to come from the fat stored in your body. It takes time to break down adipose tissue and convert it into a form that the body can use, so some of the fat you need every day must come from your diet. How much dietary fat you need depends on how well your body can convert fat into energy efficiently. Everyone is not efficient at burning fat.

Ketosis Myth: More Dietary Fat = Deep Ketosis

Before we delve into the true role of ketosis in a low-carb diet, I want to take a minute and debunk a myth that keeps circulating through low-carb groups and forums. This myth says that the more dietary fat you eat, the deeper the state of ketosis you will be in. That is not true. The reason why a lot of people believe that -- and I mean a lot -- is because dietary fat can turn the Ketostix that you use to measure the amount of beta-hydroxybutyric ketones in the urine a deeper shade of purple. The darker the color of the sticks after testing, the deeper the state of ketosis -- they think.

That's a false assumption.

Ketostix measure the amount of B-hydroxybutyric ketones you are dumping into the urine. They do NOT measure the state of Ketosis! The dark color on the sticks does mean you are dumping more B-hydroxybutyric ketones, but if you are eating a high-fat diet, then those ketones can come from the breakdown of dietary fat into energy, and not necessarily from your fat stores. There is some correlation between the color on the sticks and ketosis, but that depends on your caloric needs for the day.

Although one doesn't initially count calories on a low-carb diet, since hunger reduction from being in ketosis is often enough to make the diet work, calories count. Even Dr. Atkins said that!

Getting Into the State of Ketosis

To get into the state of ketosis, we cut back on the carbohydrates in our diet. If you're on Atkins Induction or the Protein Power Life Plan, that means you are only eating about 20 to 30 net carbs per day. 

Paper Plate with scrambled eggs, bacon, and cheese sticks
Low-Carb Diet Starts Out at 20 to 30 Net Grams

A drastic reduction in carbohydrates will initially cause the body to use its carbohydrate stores known as glycogen. Those glycogen stores can be found in the liver and muscles. We use up our muscle glycogen by moving our body. We use up our liver glycogen (and the water stored to process that glycogen) when the amount of carbohydrates we eat falls below our energy needs.

If carbohydrate restriction continues for more than a day or two, the glycogen level in the liver will get to the point where the body begins to panic. That happens within 2 to 4 days, once liver glycogen drops to about half full. Since liver glycogen is used to maintain a stable blood glucose level, it's essential for the body to have a ready fuel source it can use to maintain blood sugar. Otherwise, blood sugar would drop too low, and we'd pass out.

So the liver sends out a distress signal. It tells the brain that we are low on glycogen. We're in a famine situation. In response to that distress signal, the body secretes cortisol and other stress hormones to save us from starvation.

Initially, cortisol clears the bloodstream. It stores blood fats in the form of triglycerides in the fat cells, locks down our fat stores, and gets working on finding alternative glucose sources. It doesn't automatically turn to predominantly burning fats. This is generally the point in your Atkins Induction diet where you become ravenous and begin craving sugar, starches, and other carbohydrates.

It is cortisol that is making you do that. Not carbohydrate addiction. Cravings are a normal physical response to a lack of available glucose. Cortisol is trying to tell you that you are low on glycogen and need carbohydrates, so the liver can refill its glycogen stores.

On a low-carb diet, you don't want your liver glycogen stores to be full because the idea is to trick the body into believing that we are going through a famine. If you ignore the hunger and cravings and continue feeding the body non-carbohydrate foods and vegetables instead, within a day or two more, cortisol will give up trying to convince you to eat sugar and the body will switch metabolic pathways. The alternative pathway predominantly uses fats for energy, rather than glucose. In that alternative state, the body doesn't expect a large amount of carbohydrates to come in for fuel, so it keeps the body primed to burn fats instead.

That is the state of ketosis.

The True Role of Ketosis

Now, the purpose of a low-carb diet is to fix metabolic imbalances. It does that by lowering your basal insulin levels -- the amount of insulin the body squirts into the bloodstream every few seconds; not the amount of insulin it produces, stores, and dumps into the blood as a response to what you eat. Lowering your basal insulin level consistently is done by putting you in a state of dietary ketosis, what some people are now referring to as Nutritional Ketosis.

The state of ketosis is a method that helps to lower basal insulin levels, so the body can access and use body fat for fuel. It's not the purpose of a low-carb diet, but it is a good TOOL, especially if your higher-than-normal insulin levels are a result of overeating carbohydrates -- very typical in a standard American diet. The amount of glycogen storage the average person has is about 300 grams of carbohydrates. If you eat more than what you body can use and store in a 24-hour period, it ends up stored as body fat. For most people, it's the overeating that causes the problem, not carbohydrates themselves, but going into the state of ketosis can help us reverse the tendency to overeat.

The true role of ketosis is to keep the body primed to burn fatty acids for energy, rather than glucose.

Frying Pan of Fatty Bacon Ends
Calories Still Count: You can GAIN Weight Eating High Fat

However, that state of being doesn't mean you will always burn body fat. If you eat a low-carb high-fat diet, and your calories are at your current maintenance level or more, the body won't need to withdraw any stored body fat, as you are supplying all of the calories the body needs. In fact, you can even gain weight on a low-carb high-fat diet if you are eating more calories than the body can use in day.

Being in ketosis isn't a guarantee that you will lose weight. It's simply an alternative metabolic pathway that encourages the body to burn fats for energy. Nothing more.