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Eades Answers Page 2:
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| Low-Carb : Eades Questions, Page 2 |
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| Q: |
Ketosis |
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I'm
sure you've had this question asked of you several times, but
I've never seen a satisfactory answer. There seems to be a split
of opinion among "low carbers" as to whether ketosis is a desireable
state to maintain, either for the short or long term. Some,
like Barry Sears, suggest that it is undesireable and may lead
to muscle loss. Others, like Robert Atkins, consider ketosis
to be highly desireable outside of diabetes, and suggest that
ketone bodies are a favored fuel for the brain. Others (yourselves?)
are more neutral, and I've read that certain organs like the
heart and brain can use ketone bodies, but certain muscle types
require glucose. Do you think ketosis is desireable all of the
time or some of time, or is the jury still out? |
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| A: |
First, it's hard to consider
our very good friend, Barry Sears, a low-carber, since he advocates
a diet of 40% carbohydrate. And, basically a diet that's 40%
carbohydrate and 30% fat is considered by most to be a low fat
moderately high carbohydrate diet. So we could never understand
how Barry gets lumped in with those of us who advocate a low
carb diet. As to the issue of ketosis: It's neither good nor
bad-- it's just a fact of biochemistry. Fat in the bloodstream
(and it doesn't matter whether it's from dietary fat or fat
released from our own fat cells) goes through the liver where
it is partially broken down into substances called ketone bodies
(or ketones). This is a normal part of metabolism--it happens
whether we eat carbohydrates or not. As these ketone bodies
circulate through the blood, many tissues use them as fuel,
and in fact, heart muscle prefers them to any other fuel available
(even glucose). Usually, all the ketones in the blood are used
as fuel, and totally burned, but in the absence of dietary carbohydrate,
ketones have difficulty getting into the biochemical pathway
necessary for their complete oxidation (burning) and so accumulate
in the blood and spill over into the urine. The reason that
ketones have difficulty getting into this pathway during periods
of low-carb consumption is as follows: Although most tissues
can use ketones and fatty acids for fuel, some can't--most notably
red blood cells, some cells in the retina of the eye, some in
the kidney, and some in the brain. All of these need glucose
to function properly. If we take in dietary carbohydrate adequate
to provide the glucose required by these cells, the body doesn't
need to make its own glucose from other substances, namely protein
(in a process called gluconeogenesis). What does this have to
do with ketones? Ketones can only enter their final burning
pathway in combination with another substance called oxaloacetate
(OA). When the diet contains little carbohydrate, the body makes
what glucose it needs using OA as a building block, therefore
making the OA unavailable to combine with the ketone bodies.
Without OA, ketones can't be totally burned, and so accumulate
in the blood and spill into the urine--the state called "ketosis".
In most people (the exception being type I diabetics) as the
ketones rise to a certain level, they stimulate the release
of insulin, which turns off the fat burning process and shuts
down the release of fat from the fat cells, effectively stopping
the production of any more ketones. Type I diabetics have no
insulin to release and cannot halt excessive ketone production;
for them ketosis can become a dangerous condition. For the rest
of us, it's simply not a problem. Now that you've had this dissertation
on the biochemistry of ketosis, what does it all mean? If your
ketone stick turns purple, does that mean you're burning fat?
Yes, but that fat could be dietary fat or body fat. If you keep
carbs low and stuff yourself with thousands of calories of fat--i.e.,
the Atkins Fat Fast--you'll turn the stick as purple as a grape,
but it won't be your own body fat that you're burning, but rather
the dietary fat you're eating. And the name of the game is to
burn body fat. And what if the stick doesn't turn purple, does
that mean you're not burning fat? NO! It just means that you're
burning the fat completely. So all a purple ketone stick means
is that fat (from somewhere) is being burned in a low-carb environment.
That could be good, bad, or indifferent. That's why we don't
pay a lot of attention to ketone levels and instead measure
body fat percentage--if that decreases, you KNOW you're burning
body fat. One last spiel--on the subject of ketosis and muscle
loss. This is a pet peeve of ours. The supposed connection arises
because in a state of starvation (true starvation)the body makes
blood sugar out of protein which it harvests by breaking down
its muscle mass. When sufficient dietary protein is coming in,
the body can make the glucose out of dietary protein, sparing
its muscle mass. Thanks for your question. |
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| Q: |
Short
Temper |
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I love the Low-Carb Cookbook and
I love Protein Power also. I started on Sept. 25th and have
lost over 50 lbs already. My question is that a few weeks
into low carbing I noticed that I seemed to be very short
tempered and very grouchy. I had no patience with anyone.
I was wondering if this is a withdrawal symptom? I have read
that carbohydrates increase serotonin levels. After doing
low carb for awhile, will the serotonin levels balance back
out? Thank you so much !
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| A: |
Your grouchiness could
indeed be related to sertonin levels (and in women, even to
reproductive hormonal levels that cycle). You might try a small
increase in carbs (say 10 grams or so) as a couple of tsp of
honey or a small piece of fruit, such as a Valencia orange a
small peach or 1/2 cup grapes to see if this makes the symptoms
lessen. If so, then stay with the PP plan as prescribed, but
add that extra 10 grams (sort of a Phase I and a half). Also,
make sure you're getting adequate magnesium and chromium, both
important in controlling sugar craving. There's some evidence
that a night time dose of tryptophan (now safely back on the
market) or St. John's Wort might help to ease the symptoms,
and you might look into these options. And yes, in most cases,
after a little adaptation period, the withdrawal symptoms pass.
Thanks for your question. |
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| Q: |
APLA Syndrome |
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Is there anyway she can use the Protien
Power Plan as found in your book, or would her "Anti PhosphoLipid
Antibody Syndrome" preclude it? Also, If you have had any
experience with someone like this in your practice how was
it handled?
Any advice or comments would be truly
welcome. Thanks in advance.
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| A: |
We have not, to our knowledge,
ever had a patient with AntiPhospholipid Antibody Syndrome,
and consequently anything we said about the appropriate nutritional
structure for your wife, without a thorough history, evaluation
of lab data, and probably consultation with her physician, would
be purely speculation--and that's rarely a good idea. That said,
although we've never had a patient with this disorder, we can
see no reason why a short, careful trial of Phase I of the Protein
Power Plan in combination with plenty of essential fatty acids
(sardines would be a good source) would be a problem. Good luck
and keep us posted-- |
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| Q: |
Oxalates |
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I've been on Protein Power
since October and have lost over 25lbs. My triglycerides have
tumbled from 600+ to a low of 130 (last report 159 because I'm
on maintenance and have raised the amount of carbs I'm eating
weight remains the same). I unfortunately form kidney stones
which are made of calcium oxalate. My question is how do I balance
between two sometimes opposing ways of eating - lo carb and
low oxalates? Many of the foods which I enjoyed on Protein Power
are very high in oxalates. Foods which are low in oxalates are
prohibited on a lo carb diet. I don't want the stones, but I
also want to stay on the "diet". What can the doctors suggest
because I might wind up with a rather narrow range of foods
which would do me no "harm" for both "conditions"? Thank you
for your assistance. |
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| A: |
Calcium oxalate stones are the
most common type of kidney stone. Studies have shown that restricting
calcium intake causes and increased excretion of oxalate, which
can form stones in the urine. The best ways to prevent the formation
of these stones is not necessarily by limiting oxalate intake,
but rather by making sure that you get plenty of calcium, along
with at least 50 to 100 mg of vitamin B6, plenty of magnesium
(at least 300 mg of a chelated magnesium supplement, such as
magnesium citrate), and by making sure that you drink copious
amounts of fluid to dilute the urine. With those provisions,
a Protein Power diet should be fine just as it is. Thanks for
your question. |
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| Q: |
Pregnancy |
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I have a questions for Eades: I am
doing very well on the diet and one of my goals is to get
my body into shape for pregnancy. Obviously, weight is a huge
factor in that but I am also worried about the needs of a
fetus vs my need to keep the carbs low. Is regular maintenance
good enough during pregnancy, or will too much protein hurt
the fetus? Are there any other nutritional needs that I should
address for both the fetus and myself?
Thank you, Protein Power and the
Low Carb Cookbook have added more than just weightloss to
my life. I consider these books to be a valuable resource
in improving my health.
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| A: |
Yes, a maintenance level of carbs
(about equal in grams to the minimum protein requirement plus
maybe 20% to 30%) and an increase in calories as lean protein
and good quality fats is an excellent structure for pregnancy
and lactation. No, protein won't hurt the fetus -- it's being
contructed of protein and your needs must increase to accomodate
the new body under construction. Pregnancy also increases
the demand for magnesium, calcium, and the essential fatty
acids (especially DHA) important for brain growth. Sardines
are a good source of all these nutrients. If you like them,
great-- if not, hold your nose and eat them anyway. Thanks
for the question.
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| Q: |
Nutrition Labels |
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On some labels, if you
add up the sugar grams and the fiber grams, the total is more
than the total carbs. How can this be? Is this just inaccuracy
at work? Are the sugars (when they're broken out) the really
crucial part of the equation? And when the sugars and fibers
add up to less than the total carbs, what makes up the rest?
Inaccuracy again? Or starch of some kind? You can't just rely
on the sugar grams alone for carbs, right? |
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| A: |
In answer to your question: inaccuracy is a part
of it. More correctly, rounding up and down often done in order
to achieve some mystical level that enables them to tout a product
as "high fiber" or "low fat" or "low sugar" or whatever. In
some cases, the labels are just plain wrong. When sugar + fiber
is less than carbs, the rest can be assumed to be starch. Don't
just rely on sugar grams, though, since starch may be there
too. The safest route is to calculate Total carb - fiber = ECC.
Or if in doubt, look it up in a reliable food count book --
like Bowes and Church. |
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| The Eades wish to thank everyone
who sent in questions. If your question did not appear here
we apologize. In the future we hope to do other interactive
projects. Thank you again for your participation. |
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