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Eades Answers Page 1:

Eades Answers Page 2:


Low-Carb : Eades Questions, Page 1

 

This question and answer session was posted in 1999, but still has relevance today.

   
Q: Exercise?
 
      I have recently read and begun the Protein Power program. I feel much better, although have not yet lost any weight. In reading the low-carb mailing list, someone recommended reading the articles on Ketogenic diet on the PowerStore Web page. I have some questions based on the article, which is presumeably based on the research of a Jeffrey Krabbe. Anyway, although the diet is more like Atkins induction, than Level I of your diet, they state that if you exercise, you have to carbo-load two days per week in order to replace necessary glycogen in your muscles. I guess this is pretty much the Anabolic diet I have heard about. They also state that this diet (low-carb) is okay for up to 12 weeks, but at that point you should go back to eating 100-300 gms carb. per day. I did not get the impression that it was only body-building type exercise that they meant. I got the impression that in order to stay on a very low-carb program, one must be sedentary or else do the carbo loading. They also say that you have to stay at 8-10 calories per pound bodyweight or below in order to lose or you will gain. It has been my impression otherwise that calories were not all that important. What is your take on this? Thanks
   
A:     Actually, work done by Charles Gray, M.D., at the U.S. Naval Hospital in San Diego demonstrated that performance and endurance increase on a low-carbohydrate diet -- but only after a period of low carbohydrate adaptation has taken place. In other words, you can't carbo load one day, then go low carb and expect performance to be good. It takes a little time (usually a week or so) on a fairly strict low-carb diet for the body to generate the necessary enzymes to be able to efficiently access body fat as the fuel of choice. Once that happens, both performance and endurance actually increase. These same types of studies have been performed at many other research facilities with the same results. You've got to be careful in evaluating studies on low-carb dieting because so many of them are done on subjects that aren't low-carb adapted. Before this low carb adaptation takes place, perfomance and endurance may be reduced--and many studies that bash low-carb dieting have been undertaken during this pre-adapatation phase, when performance is impaired. In other words, subjects who have been carb loading, perform much better on a higher carb diet than they do--initially--on a lower carb diet. But after the same subjects have spent a week or two adapting to a low carb diet, their performance exceeds their performance when they were carb loading. In answer to the question about calories: In order to lose, you really do have to eat fewer calories that you burn. If all your energey needs are met by the calories in your diet, there is no reason to turn to your own fat stores for energy. However, on a diet higher in protein, your metabolic rate is higher and you burn more calories than on a low-fat, high-carb diet. In addition, people on low-carb diets tend to naturally consume fewer calories, even though they eat to satisfaction, because of the appetite sating effect of protein and fat. Thanks for your question.
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Q: Swollen Ankles
   
 

    I have recently been diagnosed as hypoglycemic and it was suggested that I go on a high protein/low carb diet. I have read the diets suggested by the Hypoglycemia Association, Inc. and Protein Power and have become quite informed. I was on a strict (to my preference) high carbohydrate/barely no protein diet. Currently, I have been dieting for almost 2 weeks eating 80 g prot/20 g carbs that includes mostly cruciferous vegetables, tofu, cheese, fish, and poultry while drinking at least 1 gallon of water per day (and sometimes 2 caffeine free diet sodas). My question/problem is that ever since last wednesday, my ankles and calves have been swollen. Most notably in my ankles and a couple of times a certain food (e.g., cooked spinach), caused the swelling to get worst such that it was difficult to walk. I sometimes have numbness (with no pains) and sometimes the swelling decreases, but constantly my feet look like they belong to an 8 foot gorilla (I am 5'2" and 87 lbs). I was taking two 90 mg potassium pills per day as suggested by PP but discontinued its immediately. Although I should probably be "raising" my feet, I constantly sit for my job and I constantly move about for my exercising. After a week, the swelling went away. Then a few days later, I ate some cooked spinach and I swelled up a little bit again! Plus this time, my lymph nodes (or the glands inside my jawbone) are very swollen (noticeable by others) making me feel that I have to throw up sometimes. I have never had problems with food allergies in the past and remember eating at the very beginning of my diet spinach dip w/cheese. I have heard about the oxalates in spinach but could I all of a sudden be supersensitive to it?

    Can anyone explain this or help me remedy the problem? My doctor has been no help at all. She is too concerned with me being underweight---another problem I am battling. Thank you in advance for your guidance.Take care.

 
A:     With a very specific medical problem, such as the one you describe, it's difficult if not impossible (not to mention potentially dangerous) to attempt a diagnosis without taking a thorough history and doing a hands-on physical exam with lab work. While your problem, could indeed be a specific allergy to spinach or something in it, it could be fifty other things. I would avoid spinach entirely for three weeks and then try it again in a small controlled way to recheck your suspicion. Another possibility is that the foot swelling might be of a viral or autoimmune disorder and I would want to make certain these possibilities were checked thoroughly with blood work and exam. It would be a good idea to check blood levels of sodium and potassium them. Thanks for your letter.
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Q: Low Glycemic Index
   
      What is your feeling on 'low glycemic index' programs (ie; Montignac, Sugarbusters) vs. your type of program? Also what are your thoughts on low carb eating during pregnancy? I am NOT asking your advice, I am asking more hypothetically-speaking :). Common sense would tell me that our ancestors managed to have children without eating alot of refined carbs, but I am interested in what might be considered the best level (number of grams-wise). I am at this poing heavier (not pregnant) than I was on the day I delivered my last child. I was on Phen/Fen two years ago, lost alot of weight, it stopped working, I rebounded 50 pounds more than original baseline, and cannot seem to lose weight anymore. I was on CAD, but although it worked from a standpoint of losing the hunger, I lost no weight. I am just beginning your program and have high hopes, but a friend is trying to push me in the direction of the Sugarbusters, I think it may be too high carb to do me any good. Needless to say, I am finding the whole thing rather confusing. I do apologize for the rambling nature of this post. Thank You
   
A:     Low glycemic foods are not always those that don't increase insulin, although there is considerable overlap. (Please see the detailed explanation in Protein Power, page 191 in the hardback edition.) And some foods that have a very low glycemic index can cause other problems; for example, fructose, a low glycemic sugar, given to diabetics for years because it doesn't raise blood sugar levels, actually raises triglyceride levels. Fructose, instead of converting to glucose and running blood sugar up, converts to triglycerides in the liver. Don't be afraid to eat a controlled amount of the right carbohydrates (as recommended in PP). Your point about early human mothers not eating a ton of carbs is a valid and astute one. Traditional Eskimo mothers also eat very few carbs and have healthy babies. And although humans probably could survive and reproduce with none, we like to keep our pregnant patients on a maintenance level of carbohydrate. A pregnant woman should NEVER be in a reduced calorie state, in fact she needs increased calories, especially in the form of protein and good quality fats. We have them select high quality protein from varied sources: fish (especially sardines, which are a great source of essential fatty acids), beef, poultry, and if possibly brands that are free-range and raised without antibiotics or hormones. We have them eat fresh veggies (low starch varieties), low carb fruits, organic dairy products, nuts, seeds, avocados, olives, and their oils. As to the CAD, a large number of research papers have shown that the best way to lower insulin levels is to eat smaller meals spread throughout the day-- a la PP. An equally large number have shown that a huge meal (such as the reward meal specified in CAD) tends to cause an hyper release of insulin--especially when the meal is in the evening. We can't think of a single study showing that a large meal--especially one containing all the carbohydrates you can stuff in in an hour--reduces insulin levels. Now given this information, how can we reconcile it with the fact that some people DO lose weight on CAD? Here's how we think it works: Many people eat everything they want all day long. When they begin CAD, they can only eat everything they want for one hour during the day, so it makes sense that they would lose some weight. Given the biochemical realitites of the situation, we suspect that most people who lose significant amounts of weight on CAD probably eat a sensible low-carb reward meal most of the time. Thanks for your letter.
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Q: Losing Pounds Quick
   
      I know, I KNOW this is for the long haul and we shouldn't diet harder for a special event and yadda, yadda, yadda......but if one is trying to zip a particular zipper ASAP...what's the fastest way to get off 5 or 6 pounds...ie: cluster carbs at breakfast? Again, delighted to have found the book and the web site.
   
A:    Keep protein at the minimum (as calculated in PP) and proportioned throughout the day in 3 meals and 1 snack. Stick to the lower fat, leaner cuts of meat to keep calorie intake to a minimum while still getting adequate protein to keep your metabolic rate up. Try protein shakes a time or two a day instead of a full meal. If you must cluster carbs, do so a little in the am, but don't go overboard (say no more than 12 grams). Keep carbs the rest of the day at 7 grams per meal or snack. Also don't go too heavy on fruits while you're in "training" to zip this particular zipper. Nuts, nut butters, and cheese are the biggest culprits in stalling weight loss in people (especially women) who otherwise follow the diet to the letter with respect to protein intake and carbs, because these foods are so calorie dense. You can stand a lot of them in maintenance, but to lose (especially the few pounds you're talking about) avoid them or limit them to 1 ounce a day. Thanks for the question.
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Q: Adrenalin/Thyroid
   
 

    Do you know anything about the theory that insulin release is blunted when adrenalin is flowing? Your book covers a lot of topics, but does not address in particular how to sustain peak or endurance athletic performance when starting out with reduced glycogen stores. This is of critical interest to people who need a low-carb diet for medical reasons but who also want to remain active. I've learned that (apparently, based on blood test results) I can consume straightglucose/maltose/maltodextrin candy (SweetTarts or equivalent) in moderation during exercise, without causing hyperlipidemia. Do you have anything more to say about this subject?

    I've read that low-carb diets reduce thyroid activity, and one blood test seems to confirm that this has occurred in my case (after one year low-carb). I'm more prone to feeling chilly at times, and am generally more sluggish. Should I reduce my carb intake further (groan), per Atkins' "critical carb level" model, or do you have any other suggestions?

    What do you think of the Hellers' model, which is very low-carb except for one reward meal a day? They argue that insulin release is partly dependent on recent diet history. I haven't experimented with it myself.

    Do you have any new/revised information about eicosanoids, in particular, changes in your controversial recommendations about ALA? I've come to believe flax seed/oil is more good than evil. Any comments? Thank you

   
A:

    Dr. Chales Gray at the U.S. Naval Hospital in San Diego has done extensive research on endurance and the low carbohydrate diet, using both lab animals (primarily swine) and naval recruits. He has found that performance and endurance on a low carbohdyrate diet are impaired until a period of low carb adaptation has taken place (usually about a week). Once adapted, the subjects' performance and endurance actually increase and surpass that recorded prior to the low carb diet (i.e. on a high carb one). He has also found that the enzymatic activity involved in the synthesis of glycogen increases with adaptation to a low carb diet--in other words, people who are low carb adapted make and store glycogen more easily even in the absence of much dietary carbohydrate. (Carbohdyrate can also be made from protein, and a small amount from the glycerol backbone of triglycerides, so even in the absence of dietary carbohydrate, glycogen sythesis goes on.) Dr. Gray did find that in subjects involved in intense activity (anaerobic exercise) performance was enhanced with the addition of small amounts of dietary glucose (i.e., SweetTarts). The only reason that dietary glucose would cause hyperlipidemia is if it stimulated an excessive and prolonged insulin rise, which is difficult to do during intense exercise because the insulin receptors become much more sensitive at this time (i.e., it takes much less insulin to deal with the dietary sugar when the receptors are sensitive). One caveat, however: a number of studies have shown that even small amounts of dietary carbohydrate during or immediately preceeding exercise (i.e., SweetTarts) blunts the release of growth hormone.

     As to your question about thyroid activity: reduced carbohydrate diets (and reduced calorie diets) sometimes decrease the activity of the enzyme that converts T4 (the inactive form of thyroid hormone that is released from your thyroid gland) to T3, the active form. We sometimes give our own patients small amounts of T3 during the weight loss phase of the program. Micronutrients also play a role in this conversion, especially iron and magnesium, so you might want to make sure that you have adequate levels of both. (You need to check your ferritin level (the storage form of iron) before you take extra iron, because elevated ferritin levels are a consequence of excess insulin and a major risk factor for heart disease. Don't take iron if your ferritin level is up.)

    As to the CAD, a large number of research papers have shown that the best way to lower insulin levels is to eat smaller meals spread throughout the day-- a la PP. An equally large number have shown that a huge meal (such as the reward meal specified in CAD) tends to cause an hyper release of insulin--especially when the meal is in the evening. We can't think of a single study showing that a large meal--especially one containing all the carbohydrates you can stuff in in an hour--reduces insulin levels. Now given this information, how can we reconcile it with the fact that some people DO lose weight on CAD? Here's how we think it works: Many people eat everything they want all day long. When they begin CAD, they can only eat everything they want for one hour during the day, so it makes sense that they would lose some weight. Given the biochemical realitites of the situation, we suspect that most people who lose significant amounts of weight on CAD probably eat a sensible low-carb reward meal most of the time.

    Since we wrote the section on eicosanoids, we have had brain transplants. (Unfortunately when Mike wrote that section he had fallen under the evil influence of our good friend, Barry Sears.) We, too, now believe that flax seed oil can be valuable and we take it ourselves and use it on many of our patients. However, in some people (those who are very ill, the elderly, diabetics, and certain others) the enzyme that converts LA to GLA may function poorly, in which case, the inhibitory effect of flax oil on delta-6-desaturase may be enough to cause problems. Thanks for your questions.

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