In the medical community we don’t offer “diets” as solutions, we guide people on lifestyle changes — and adopting a healthier diet is a large part of that lifestyle change. But it’s important to understand the different meanings of the word “diet.” Diets that are marketed to people on TV and through books are rarely positioned as actual lifestyle changes based on science and what your body needs. “Diets,” let’s call them “fad diets,” often offer unhealthy short term solutions in the hopes that you see and feel some sort of results — and continue to spend money on the fad diet.
We do not condone short term diets, except in extreme circumstances — and we come to that decision after extensive lab work. Sometimes people have metabolic irregularities, and we need to give them short term corrective diets. Those are very specialized moments. Let’s look at some of the reasons we’d change a person’s dietary lifestyle. And then we’ll close by looking at when and why we use short-term diets with patients.
Someone may eat perfectly, but whenever they get on the scale they see weight-gain no matter what they eat or how much they eat. This situation most likely hinges on blood sugar levels.
Let’s say you go out to lunch. When the average person eats, they bring their blood sugar up to a normal level. Your pancreas should sense that blood sugar increase and then release insulin to match your blood sugar levels. The insulin escorts the sugar to your cells to be used as an energy source. Your blood sugar starts to go down because it’s being taken up by your cells, and your insulin goes down with it as well. This is ideal. This is healthy.
Sometimes we see patients who have type 2 diabetes or are pre-diabetic. Chances are they regularly eat too much, causing their blood sugar to soar too high. These people may be over indulging on a regular basis, resulting in high blood sugar levels. Their pancreas is likely responding with a lot of insulin. They have high insulin and high blood sugar. The insulin will still escort sugar into the cells to be used for energy, and the insulin levels will drop. But this person is setting themselves up to for diabetes, if they aren’t diabetic already.
Now let’s look at someone with type 1 diabetes. They don’t produce insulin, their pancreas doesn’t make it. That person can eat a salad, or an orange, (something small), and their blood sugar will start to go up. But since their pancreas isn’t secreting insulin, the blood sugar is not escorted to the cell to be used for energy. Blood sugar levels continue to soar. These people will have a level of blood sugar that is three to four times higher than normal. You may think this person should be overweight, but they usually aren’t. People like this are usually under weight.
Sometimes we have a patient who has trouble loosing weight no matter how hard they try. We do a hemoglobin a1c test, that shows what their average blood sugar is over the course of three months. Their blood sugar is very low, we know that from lab work. They calorie restrict, but it doesn’t matter — their body is trying to gain weight. So in our labs we also test their insulin, and we find that their insulin is astronomically high.
Basic physiology shows that insulin preferentially takes whatever you eat and does everything it can to store it as fat. it’s like living with a hoarder who takes part of your paycheck every time you get paid. Instead of using that money for the upkeep of the house, they’re hoarding it away. This person’s blood sugar isn’t being used as an energy source, it’s being stored and held onto, as fat. These people are now left with a small amount of energy. They’re fatigued and gaining weight. And perhaps eating a low calorie diet. A lot of times these people are also exercising — they want to lose weight.
A low calorie diet will not help this person. She wouldn’t loose any weight and she’d feel worse. We have to address the insulin issue.
The standard american diet has a bit of fat, a good amount of protein and a lot of carbs. This could be a healthy diet, but most of the time it isn’t. Most of the time we load up on carbs by eating junk food. We just do. But you could do this healthily, carbs can be found in fruits and vegetables. But low calorie diets simply change the volume of fats, proteins and carbs. As soon as this person eats carbs, it stimulates the pancreas to produce insulin. They are over responding to carbs with too much insulin. So what’s our solution for that? There’s a few and we’re going to talk about the ones that work best for us.
Let’s look at the standard American diet. Your protein will be moderate, your carbs will be high and your fats will be low. The problem is high carbs lead to high insulin. This diet will not help, even the lower calorie version of it.
What about a high protein diet, like paleo or Atkins? That type of diet is high in protein, low in carbs and has a little bit of fat. That could work, but the problem is you only need so much protein in your diet. As soon as you exceed a certain point, your body will bioconvert protein into carbs using gluconeogenesis. And that’s when high protein diets no longer work. These people are eating too much protein, the protein gets turned into carbs, and the carbs stimulate the pancreas to create more insulin.
In our experience the diet that works in this case isn’t a diet that’s sustainable — to be honest. This is why it is one of the rare times we implement a short term diet solution. the diet is: you eat as much protein as your body needs, as low a level of carbs as we can get away with, and we level it out with fat. This is a crazy diet, it is not good long term. it isn’t safe. But after a period of time this diet leads to a regression in insulin. At this point we pivot and take the patient off this potentially detrimental diet, now that it’s done its job.
Every decision we make is based on extensive and continual lab work — whether we are offering a short-term diet to mitigate the dangers of metabolic irregularities, or we are changing a patient’s lifestyle long-term. We base all decisions on lab work that pertains to each individual patient of ours. No two people are alike, and no two plans are alike.