Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
21 Apr

Dear Mark: Why Hyperglycemia Is Bad and Those Stubborn Final Pounds

sugar4Today we’ve got a fairly short one with just two questions and answers. First, I tackle a big topic: the specific effects of hyperglycemia on the body. That hyperglycemia is bad for us is implicit, but it’s important to understand why it’s so dangerous. Today, I give a brief but detailed overview of the negative effects of chronic high blood sugar. Next, Carrie gives a female reader a few thoughts on how to (and whether to) lose the last few stubborn pounds. Her unique advice involves sprinting, reframing, rethinking, and restating.

Hi Mark,

I know it’s too much to ask, but having browsed the internet and your site thoroughly about it, I just cannot get a satisfying answer to how (biochemically) high blood sugar does its damage to the body. How is it toxic? I know about AGEs and how it damages blood vessels, but even in scientific articles there’s no – again satisfying – answer as to HOW? How is coma the body’s response to too much high blood sugar? How it gives you migraines? How it reduces healing abilities? etc, etc, etc.

Maybe I’m not good at searching this or I don’t have access to the proper medical journals, but I was just wondering if you could enlighten us about this topic in a deeper way.

Thanks and regards from Colombia.

Oscar

Great question.

Most cell types, when faced with systemic hyperglycemia, have mechanisms in place to regulate the passage of glucose through their membranes. They can avoid hyperglycemic toxicity by keeping excess sugar out. Other cell types, namely pancreatic beta-cells, neurons, and the cells lining the blood and lymphatic vessels, do not have these mechanisms. In the presence of high blood sugar, they’re unable to keep excess sugar out. It’s to these three types of cells that hyperglycemia is especially dangerous.

Unfortunately, these are all pretty important cells.

What happens when too much glucose makes it into one of these cells?

Reactive oxygen species (ROS) generation is a normal byproduct of glucose metabolism by the cell’s mitochondria. If the stream of glucose into the cell is unregulated, bad things begin to happen: excessive ROS, a mediator of increased oxidative stress; depletion of glutathione, the prime antioxidant in our bodies; advanced glycation endproduct (AGE) formation; and activation of protein kinase C, a family of enzymes involved in many diabetes-related complications. It’s messy stuff.

How does this play out in the specific cell types that are susceptible and what does it mean for you?

Pancreatic beta-cells: These cells are responsible for secreting insulin in response to blood glucose. They essentially are the first line of defense against hyperglycemia. If maintained for too long or too often, hyperglycemia inhibits the ability of pancreatic beta-cells to do their job. For instance, type 2 diabetics have reduced pancreatic beta-cell mass; smaller cells have lower functionality. Mitochondrial ROS (often caused by hyperglycemia) also reduce the insulin secreted by the cells, thereby reducing their ability to deal with the hyperglycemia and compounding the initial problem.

Neurons: The brain’s unique affinity for glucose makes its glucose receptor-laden neuronal cells susceptible to hyperglycemia. It simply soaks up glucose, and if there’s excessive amounts floating around, problems arise. Hyperglycemia is consistently linked to cognitive impairment, causes the shrinking of neurons and the inducement of spatial memory loss, and induces neuronal oxidative stress. It also impairs the production of nitric oxide, which is involved in the hippocampus’ regulation of food intake.

Endothelial cells: Flow mediated dilation (FMD) is the measure of a blood vessels ability to dilate in response to increased flow demands. Under normal conditions, the endothelial cells release nitric oxide, a vasodilator, in response to increased shear stress. Under hyperglycemic conditions, nitric oxide release is inhibited and FMD reduced. A decreased FMD strongly predicts cardiovascular events (PDF) and may cause atherosclerosis (PDF).

Thanks again for the question. While saying “Chronic hyperglycemia is bad for you” is true enough, it’s more helpful to know exactly why it’s bad.

Now, let’s hear from Carrie:

My husband and I have been eating Primal for about 6 months now and he has lost 50 pounds. Although I feel much better and have more energy, I hit a plateau after 3 months and have only lost 20 pounds. My husband has reached his ideal weight and I still would like to lose another 20 pounds. We are living a primal lifestyle and exercising regularly and I am wondering if you can offer any advice around how I can lose the last 20 pounds? Is there anything else I can do?

One of the first things I suggest to women who have hit a plateau is to incorporate sprints into their workouts: 2 times a week, running full speed in intervals or 6-10 sprints for 30 seconds with a minute of rest in between. Cycling sprints work, too. You can also run up hills instead of on flat ground. Doing it on the beach will be harder and you’ll go slower but hit your butt and thighs differently than on flat ground. Women are naturally better at burning fat in response to exercise, so sprints are an ideal, time-efficient way to do that. It wasn’t until I started incorporating sprints that I truly reached my ideal body composition.

If you are over 40 you should have your hormone levels checked to make sure you are not perimenopausal and that your hormones are balanced. Where are you carrying the excess weight? If it is around your belly, this could be a sign that you need hormonal balancing. Visit a medical professional that specializes in women’s health. I myself had the best results with low doses of hormone replacements, but more “natural” methods are also worth a shot and can be exhausted beforehand.

Once you have addressed both of these “physical” issues, ask yourself some important questions.

How can you have a healthy relationship with where your body is now? Figure out what it would take to make peace with your body. Is it holding you back from doing anything, physically, that you’d like to be doing? Does it truly reduce your quality of life in a meaningful, tangible way? Are you healthy, happy (when not thinking about your last few pounds), and generally living life in a vibrant manner? Maybe you are content and just haven’t realized it yet.

What if this is your body’s ideal weight? Remember that women naturally carry more body fat and distribute it differently than men. We make babies with our body fat, and the hips, butt, and thighs are supposed to have a bit more bounce than the rest of the body. It’s totally normal to have it there and a sign that you’re healthy!

Personally, I also like to set intentions around my goals – things and thoughts and abstractions I would like to create and make manifest. They somehow seem more real when I do this. And if they seem real enough that I start acting like they are, aren’t they real? For all intents and purposes, I’d say that they are.

Here’s an example:

“I am making healthy conscious food choices, effortlessly reaching my ideal lean(er) bodyweight, and loving my healthy, limber, strong, fit body.”

I say these things to myself with powerful intention as I’m saying them, almost like a meditation where the focus is on the breath itself. Only here, you’re focusing on the words – how they sound, what they mean, what they mean to you. This isn’t a woo-woo, mystical attempt to “create your own reality.” It’s just a powerful way to establish and ingrain resolve.

Write your intentions down. Say them out loud. Be very specific and clear. It might feel funny saying/writing these usually abstract thoughts that only play out in your head, but it makes them real and attainable. And oftentimes you’ll find that the things you thought you were worried about aren’t even worth it. That you’re happy after all!

Good luck and don’t hesitate to write back with more questions.

That’s it for this week, folks. Thanks for reading and keep the questions coming!

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Yeah sugar is about as bad as bad gets.

    Groktimus Primal wrote on April 21st, 2014
  2. Interesting stuff about the effects of hyperglycemia. I gotta learn more about nitric oxide’s role in the body!

    Sugar…it’s unfortunate how many people are running almost entirely off sugar all the time. The intense energy swings and hunger pangs are thought to be unavoidable when you are in that state. I was there for many years. It blows my mind now when I fast for up to a day and feel great. When I explain it to people, the looks I get are hilarious.

    Easy on the sweet stuff!

    Graham Ballachey wrote on April 21st, 2014
    • Speaking of running on sugar all the time, I’m getting to where AI now loathe to walk into a warehouse store–it seems like everybody else’s carts are all crammed full of junk foods…and the SODA! I even overheard one lady bragging to her kids that she got “all this food” (every manner of carbs you can think of) for $4 less than the eldest daughter in line behind her, whose cart was only half full, but had REAL food in it!

      Yet, walking into a regular grocery store is now like walking into a ghost town–it seems everybody moved over to the warehouse stores. Now, they’re getting their junk foods in village-sized packages over there.

      On the way home, I noticed that our area’s Mickey D’s was closed down for remodeling (and is now torn down). I never cheered so loudly in my life! Too bad it’s coming back…

      Wenchypoo wrote on April 21st, 2014
  3. “One of the first things I suggest to women who have hit a plateau is to incorporate sprints into their workouts: 2 times a week, running full speed in intervals or 6-10 sprints for 30 seconds with a minute of rest in between.”

    It seems like the first sprint would be your only true sprint and the rest of the intervals would get slower and slower. Is that the point of the workout?

    Jake wrote on April 21st, 2014
    • A sprint is a sprint no matter how fast you actually travel from point A to point B. For example running in dry sand is slower than wet sand is slower than grass is slower than tarmac. It’s the applied effort that defines a sprint (not a fact – but probably around 90-100% of perceived effort).

      Tom wrote on April 21st, 2014
      • Also, the point of the minute rest in between is to recover so that you can give full effort for each sprint. The better shape you are in the more sprint sets you can do and/or the short rest you can take.

        Yasmine wrote on April 21st, 2014
      • Surprisingly, I’ve found that it’s often my second or third sprint that’s the fastest. Go figure. This is especially true with row sprints (on a rowing machine).

        Karen C. wrote on April 21st, 2014
        • Same here: I believe that it takes the first couple of sprints before you warm up sufficiently, even if you run a mile or two warmup before starting your first sprint (which warmup I believe to be essential). Even then, I always run my first sprint with caution, say, around 90% perceived effort. After the first sprint, I have a better idea how my body is performing that day. Then I can cut loose on my second sprint and thereafter. ALSO, when my 200 meter times (about 33 to 36 seconds) start to deteriorate by more that a couple seconds, I use that as a my signal that it is time to stop, even if I have not completed all 8 of my planned sprints.

          Warren wrote on April 21st, 2014
      • I think there was some research done that mentioned there are different benefits to higher rest periods though so that you can put forth more work with the same amount of effort. I think the best plan of action might be to perform some of your sprints with full rest between sets and some with minimal rest!

        Zach Rusk wrote on April 21st, 2014
      • No way! You go 70-80 percent and never 90-100 percent unless you want to hurt yourself right off the bat. The only time you want to sprint 100 percent is in a race. Sprinting can be very violent and unforgiving on the body and you need to ease into it.

        victor wrote on April 22nd, 2014
  4. Is there a way to do a sprint-like exercise if you are challenged by injury? At the moment my sciatic nerve is inflamed and I cannot do running sprints. In fact, just walking is a real challenge. I’ve plateaued about 20 lbs from my upper ideal weight. Do you have any suggestions for me?

    DanaG wrote on April 21st, 2014
    • This may be horrible for your injury and not relevant to you (I’m not sure) but sprinting on the rowing machine is a new found method of sprint workouts for me. Sprint 250 meter intervals or do a 2k as fast as you can.

      BFBVince wrote on April 21st, 2014
    • Miracle drug for sciatica: gabapentin (aka neurontin). Talk to your doc about it. I experienced immobilizing sciatica after a pelvic fracture. The strong pain medication (roxiset) for the fracture didn’t touch the sciatica. After 3 days of ibuprofen around the clock (in addition to roxiset), I could at least get out of bed again (to walk with a walker), though not pain free. Then switched to gabapentin and got complete relief from the sciatic pain within 30 minutes of the first dose (300mg, 3 times/day worked for me).

      I continued on the gabapentin for several months to ameliorate chemotherapy-induced neuropathy (yeah, it was a fun year all the way around), but tapered off the gabapentin a couple of months after that and have not had any problems with recurrent sciatica (or cancer!) since. AND I do sprints!

      Miz Pat wrote on April 21st, 2014
  5. Sugar is hard to escape. Like soy it seems to be in everything. I have to read the labels on everything I buy. I mean, sugar is added to roasted almond butter. Why? I ask. Why?

    I didn’t know that certain cells had no glucose regulation mechanism. That’s scary, especially considering the point I made above.

    On the last few pounds front, I have seen first hand how the paleo diet affects women and men differently. The weight seemed to come off me no problem, but it’s been slower for my wife. I’ll mention the sprint idea to her. Thanks.

    C L Deards wrote on April 21st, 2014
    • Hi – MaraNatha makes almond butter without any sugar added. The only place I’ve seen it, ironically, is at Costco.

      KariVery wrote on April 21st, 2014
      • I feel like the consistency of this product leaves something to be desired. Maybe this is why? Either way, it’s a good deal as far as almond butter goes.

        BFBVince wrote on April 21st, 2014
        • My homemade almond butter is much better than anything I can buy in a jar.

          Andrea wrote on April 21st, 2014
      • I agree, I can’t stand the taste and texture of MaraNatha. For the price at Costco, I REALLY wanted to but I just can’t. If you’re OK with palm fruit oil, Justin’s Almond Butter is by far and away the best I’ve ever had. Taste and texture are phenomenal….I prefer its taste to freshly ground almond butter.

        TheSprouse wrote on April 21st, 2014
        • Costco recently got a new brand of almond butter. I don’t remember the name, because cane sugar was the FIRST ingredient on the label. Why indeed?

          I don’t know where you’re located, but I’m in the DC area on the East Coast and I buy Giant store brand – their organic brand, Nature’s Promise – and the only ingredient is almonds. It’s very tasty too.

          Kim Shannon wrote on April 21st, 2014
      • Fred Meyer carries it.

        Danielle Thalman wrote on April 21st, 2014
    • Tree of Life also makes an almond butter without sugar, or added oils. It’s just dry-roasted almonds. I found it at a small natural foods store.

      Ellen wrote on April 22nd, 2014
      • I don’t know if Mothers Markets are a national chain but here in Orange County they have a grinder you can put your almonds in to get fresh almond butter. Almonds do have a poor omega 6/3 ratio and the phytic acid supposedly binds to minerals making them undigested but staying away from vegetable oils will help. I personally prefer macadamia nut butter. It cost more but has a good omega 6/3 ratio and no phytic acid.

        victor wrote on April 22nd, 2014
    • Trader Joe’s brand doesn’t have sugar and is inexpensive. I tried making it at home but my almonds never turn into “butter” but rather into almond meal.

      Farzaneh wrote on April 22nd, 2014
  6. I am very interested in how too much sugar affects hearing abilities, as the person who posed the question of the day to Mark mentioned. We have several people in my family with unexplained hearing loss who eat pretty high sugar diets. I am going to have to check that out.

    KariVery wrote on April 21st, 2014
  7. Mark, what about having a dessert or two on the weekends and sugarless on the week?

    Alan wrote on April 21st, 2014
  8. anyone have suggestions for female trying to lose the last 10 lbs, can’t sprint because of a permanent ankle injury, and no access to a cycle?

    Laura Taylor wrote on April 21st, 2014
    • Sprinting on an eliptical– or any interval type training can work. I personally sprint the hills a couple times a week. but I have also boxed ten 30-40 second rounds intensely with one minute between to recover.

      But better check with the boss (Mark) to see if I have that correct. But if you google Interval Training there are more types that may not affect your ankle problem– Grok ON!

      Pastor dave Deppisch wrote on April 21st, 2014
      • not a member of a gym right now so I’m doing everything at home using bodyweight and a kettlebell. I’m going to start using some suggestions below, thanks!

        Laura Taylor wrote on April 22nd, 2014
        • Intervals with kettlebell swings could also help. I do AMRAP in one minute, rest one, etc., for a total of five minutes…

          defrog wrote on April 23rd, 2014
        • I like swim sprints as it’s easy on the joints and although it doesn’t get some of the benefits of a running sprint, it’s a real all-over workout. I find all-out sprints on a punchbag or even shadow-boxing good too.

          Pretty much anything can be a sprint just do it hard and/or fast for 6-10 rounds of 30 sec with enough rest to do it again.

          WelshGrok wrote on April 29th, 2014
        • Oh dear – I don’t know if my original comment will pass moderation, but “sex” should have read “sec” – But hey I guess that would work too! ;-)

          WelshGrok wrote on April 29th, 2014
    • See how a few bodyweight air-squats treat your ankle. If you can do them without pain, do them as fast as possible for 30 seconds, it will burn and you will challenge yourself similarly to sprinting, but with much less stress on the ankle.

      Brak wrote on April 21st, 2014
      • interesting, I have been doing squats lately but had not thought to do them very fast. I can’t get into a very deep squat because of the injury, but this sounds promising.

        Laura Taylor wrote on April 22nd, 2014
    • Try a battle rope. Lots of gyms have battle ropes now. It will wind you just as fast as sprinting will. I dare say it will wind you faster.

      John wrote on April 21st, 2014
      • I’m not a member at a gym right now, but I’ll keep that in mind for the future

        Laura Taylor wrote on April 22nd, 2014
    • I have osteo arthritis in both knees, so my sprinting days are over. When I said that to my fitness advisor, she said I could get some benefit from energetic upper body moves. I put on some music and do aerobic arm things until I’m breathing hard. Bettter than nothing!

      granny gibson wrote on April 21st, 2014
      • interesting! have you seen any improvement?

        Laura Taylor wrote on April 22nd, 2014
        • Not in weight loss, but I’m also lifting higher weight and have lost fat and probably gained muscle. Certainly changed shape. I’m in for the long term. I only recently started the arm cardio, so we’ll see.

          granny gibson wrote on April 22nd, 2014
    • Swimming works well too, sprint a length, then rest till recovered and sprint back. If one length doesn’t get you to full effort try two one after another.

      Kelda wrote on April 21st, 2014
      • I can’t sprint at all (my ankle is fused and won’t bend, so running is out). Also, no access to a pool right now…but if I get the chance I’ll take up some swimming

        Laura Taylor wrote on April 22nd, 2014
    • I see a lot of people asking for specific sprint exercises. You can “sprint” any exercise as long as doing it quickly and with a lot of effort does not pose any real danger. Not that I recommend it, but you could do high intensity intervals with curls if that was all you could do. The point is to work really really really hard at the exercise for a short period of time, then rest, then repeat the exercise, rest, etc. As far as the exercise you can do almost anything. Just do something that you are comfortable with and can perform at high intensity safely. Good luck :)

      Paul wrote on April 21st, 2014
      • oh ok, I’ve been taking it very literally

        Laura Taylor wrote on April 22nd, 2014
  9. Thanks for the reply Mark. I, and surely everyone else, appreciates it. It’s hard to explain to someone about the dangers of high blood sugar when all you get from some experts is “That it’s bad”.
    Thanks again.

    Oscar wrote on April 21st, 2014
  10. What a wonderful coincidence!

    I’m giving a talk to a group of diabetic patients this week and have been seeking info about WHY all the bad effects of hyperglycemia happen. In spite of all the years I’ve spent in this field, I did not know that some cells can resist excess sugar and others can’t–thus the sequale of diabetes. Then you answered so many of them for me today with your post.

    I haven’t written before but want to say how much I enjoy your posts and podcasts. I follow them daily and have learned so much from you! Thank you!

    Carla ARNP wrote on April 21st, 2014
  11. I tried sprinting last summer. I did it actually for the entire summer all the way through Christmas until my iPod died and took my sprint timer with it. I did not lose any weight and believe me I was stringent with my diet and everything, plus I even was training for backpacking and lifting heavy weights. I have had to resort to the “do you feel content” thing. I backpacked the entire length of Glacier National Park that summer, 120 miles or so, and even our longest days felt like nothing. I can pretty much do anything I want with my body, except maybe pull-ups. I’m never going to be skinny and pretty so I may as well be able to kick some ass. I’m almost to a 200lb deadlift. I’m almost 50 years old, too.

    Diane wrote on April 21st, 2014
    • Sorry about the weight but your workouts…..VERY impressive! I’m a in my mid 50s and very jealous of you right about now.

      victor wrote on April 22nd, 2014
  12. Both of today’s questions were of interest to me but both left important questions unanswered.
    First, as someone who almost certainly was hyperglycemic for most of the first 58 years of his life but has been eating low carb and next to zero processed food for six years, what is the chance that damage caused by hyperglycemia gets repaired or is it simply that one is now staving off further damage?
    Then although Carrie’s answer was clearly addressed to women it looks like a similar problem I seem to have. On January 1, 2008 I weighed precisely 278 lbs at 5’9”. Sometime that year I read Gary Taubes book and fairly quickly cut out all sugar and flour from my diet and cut back all other carb sources so I was eating under 20g of carbs a day. Over the years that has drifted nearer to 50g. And since hitting a weight low of 204 lbs in July 2012 I have drifted between that and 222 lbs, peaking, unsurprisingly, around the new year, and returning to the trough by late summer.
    Having been following a Doug McGuff exercise regime since January 2011 I am now experimenting with interspersing that with an hour of high-intensity work a week (actually 12 mins of high intensity and 48 mins of warming up, cooling down, and recovering for 2 mins between each minute of flat out excursion using a cross-trainer, a bike and a rowing machine). And I walk a lot too.
    I note Carrie’s very sensible advice about a healthy relationship with one’s body but my sense is that my waist measurement which drifts between 41’ and 43’, whilst hugely improved on a one-time 52’ is still less than ideal.
    Any thoughts on either of my questions would be much appreciated.

    Roger Butler

    Roger Butler wrote on April 21st, 2014
    • You could try increasing your fats, and put yourself into a more ketogenic state….

      Shannon in Farmerville wrote on April 21st, 2014
    • Consider reading the Diabetes solution book by Dr. Richard K. Bernstein for answers about reversing hyperglycemia damage. Or check for videos and interviews–podcasts on line. He is a Type 1 diabetic since age 12 who learned how to control his diabetes with low carb diet and glucometer and small doses of insulin as needed. He has managed to reverse all the long term effects of diabetes and is now in his 70’s and practicing as a diabetologist in NY. Very Inspiring!

      Carla ARNP wrote on April 22nd, 2014
  13. Would jumping rope work for sprinting? I love jumping rope, and I hate running.

    meepster wrote on April 21st, 2014
    • Yes. Any exercise that you can do at high intensity safely will work. The more muscles you have to use for the sprint the better, but you can really choose most any exercise.

      Paul wrote on April 21st, 2014
  14. Please explain what you mean by “balanced hormones.” Everyone says this, but I’ve never seen anyone explain exactly what they mean by it.

    I’ve been on bio-identical hormones for 8 years now and even though all my levels are now in the mid-range of “normal,” it has done diddly-squat for me in terms of weight loss. I no longer have night sweats or hot flashes, but I still keep gaining around the middle despite eating what most here would consider a healthful diet.

    There’s more to it than just “balancing hormones” for those of us who are affected so dramatically by menopause. Some women in their 50s can breeze through, cutting a few carbs here or there, and are able to lose weight virtually effortlessly. I suspect, however, that many of these successful ones are coming off SAD rather than having been low-carb whole-food, as I’ve been for the past 15 years.

    I know far more women who, just like me, can’t shed a pound regardless of what we eat or don’t eat once they reach their 40s, and especially after they reach their 50s. We’ve tried it all. Low carb, lower carb, ketogenic, higher carb with “safe” starches, hcg, RS, higher protein, lower protein, higher fat, lower fat, this plan, that plan, you name it. Nothing works. Homeopathic hcg was the only thing that enabled me to lose 35 pounds and keep it off for well over a year, but even that failed for me in the end. I had gone back to a basic low-carb whole-food way of eating after going off the hcg, and slowly but surely it almost all came back.

    I’d love for someone to come up with an approach for those of us plagued by peri-menopause and full menopause that doesn’t include the phrase “balanced hormones” and the advice to accept ourselves as we are. I’m really not dissing you, Mark, it’s just that we’ve heard this time and time again, and it’s simply not that easy.

    I’m 59 years old, 5’7″, and currently weight about 190 (not sure exactly, because the scale is currently under the bed of the guest room in “time out” for the way it’s been treating me lately). That’s not as bad it could be, but I’m still a good 30 or 40 pounds from where I’d like to be. And it’s not vanity, at least not all of it. I do yoga and sprint walking, and the extra fat around my middle makes it hard to do both. I tell my stick-thin yoga instructor to tie pillows around her arms, legs, belly, and chest and see how limber she is then.

    Or maybe I’m just being a cranky old woman! :-)

    Kathy from Maine wrote on April 21st, 2014
    • Cranky or not, I have the same questions…

      drjoyous wrote on April 21st, 2014
    • Kathy, there is definitely a reason why you can’t lose weight (or stop gaining it, whichever is the case). There’s always a reason. It’s just a matter of figuring out what it is. Possibly a weight-loss physician could help.

      Some ideas: Do you really need to be on the bio-identical hormones at this point? Possibly the hot flashes, etc. would have resolved by now without them. Artificial hormone “balance” on paper via a blood test doesn’t necessarily mean the hormones agree with your body, or that the “balance” achieved is the right one for you at this stage of your life, or that you need to keep taking them indefinitely.

      I’m not a doctor and therefore not suggesting anything one way or the other, but I do know that long-term use of prescription drugs, OTC drugs, and even unneeded supplements can throw the body’s natural chemistry out of kilter, creating all sorts of problems.

      Shary wrote on April 21st, 2014
      • Shary, yes, there’s a reason. I just can’t figure it out. A year ago I weaned off the hormones and felt awful. Worse than awful. So, I went back on them. No clue how long I’ll stay on them.

        Also went through NutrEval nutritional testing and found I’m not breaking down and using the amino acids or most of the B vitamins I’m taking in. I’m on high doses of aminos, B vitamins, plus a bunch of other sups. The NP (specialist in women’s health) said 6 months on this regimen. She fully expects me to feel a LOT better and to have lost some weight within that time. I’m exactly halfway through the regimen, and feel no better and have actually gained a couple pounds. Oh, and we cut down the estrogen dose extremely low, and raised the progesterone.

        I do believe the weight gain (inability to lose) is all tied up in hormones, as most of the gain is in the meno-pot (between navel and breasts). How to fix that is anyone’s guess. I’m seeing her again in June. Perhaps we’ll fiddle with the hormones again.

        Kathy from Maine wrote on April 22nd, 2014
      • Shary and Kathy,
        I agree that it’s frustrating and confusing. I find myself in times when my body/weight seems to just go haywire for no apparent reason since nothing has changed. I am wondering if it may be the city water that can be changed (no notice given to consumers) at certain times of the year. On NOLA’s site she mentioned that her city water changed so much that she had to change how she washed her hair for different times of the year. That makes me go Hmmmmm, could it be some of the strange changes my body goes through are due to that type of change that I’m unaware of? Might have to make a few phone calls to check that out. We also have High-Tech companies in our area that release moisture, maybe that is having an effect on me?
        AAAAAAACK! Where is that tin foil hat I made to protect me?

        2Rae wrote on April 22nd, 2014
    • Have you looked into thyroid issues? I’ve had good results keeping my body temp, heart rate, and metabolism at a higher level by taking ThyroGold (150 mg) and taking RS + AOR Probiotics-3 and eating RS foods as my “safe” starches (but not too much in quantity.) I’m almost 55 and not taking any hormones. Also, no wheat or sugar. Good luck?

      Energy! wrote on April 22nd, 2014
      • That was supposed to be one of these: !

        Energy! wrote on April 22nd, 2014
    • Same problems — 5’7″, 175 lbs. On bio-identical hormones (for good reasons — including bone health) plus natural thyroid. I have gained 10 pounds in the last year and am only maintaining that on around 1200 cal per day. I have tried ketogenic, Atkins, Paleo, basic Primal, dairy-free, elimination diets, and pretty much all of the above, as well. Exercise daily, plus sprints. I’m upping my carbs to 75-100 g/day. Been low carb for most of the last 15 years. Been paying attention to Chris Kresser (hence the higher carbs). No added sugar. Still have glucose levels over 105 most mornings — but insulin blood levels are good and I don’t spike with lower carbs. Clearly, my liver LOVES to make glucose. Something is weird. I work with my doctor quarterly. Frustrated? You bet. Little attention and pretty much no research is done on or for the benefit of post-menopausal women.
      So — the Experiment of 1 continues…

      dkd2001 wrote on April 22nd, 2014
      • dkd: Make that the Experiment of 2 continues. :-)

        I’m currently trying to up my carbs, too, ala Kresser and others. For resistant starch I’m eating a small (5 oz) raw potato daily, so am getting around 37 grams of RS each day. Along with the RS I take probiotics (15 strain, 50 million organisms), Prescript-Assist (2 each morning), and digestive enzymes at each meal, though I often forget the enzymes. Doh.

        I avoid wheat and sugar, but do indulge on the rare occasion we go out for dinner (once every month or so).

        As for thyroid issues, yes I’ve always tested out just within the normal range (close to 4), and my NP says she likes to see people closer to 2 on the scale. All other doctors I’ve seen say if the reading is within the normal range, they won’t medicate for it. The NP is totally in agreement that thyroid might need to be tweaked, but wanted me to address the malabsorption issues first, and then said we’d look more into thyroid. Makes sense not to make too many changes at once.

        My fasting BG is usually around 92 or even lower (sometimes as low as 78). Haven’t really tested after eating, so I don’t know how high the spikes are.

        I have been struggling over whether to continue the hormones or not. Some women I know say they’ll never get off them, and a lot of health practitioners out there agree with this approach. On the other hand, there are other health practitioners and women like Shary who believe that hormones should only be taken for a finite amount of time and then stopped. I just don’t know where I stand on this issue. Both sides have merit.

        To respond to 2Rae, we live way out in rural Maine and have well water. We’ve had it tested and it’s very good.

        Kathy from Maine wrote on April 23rd, 2014
        • Well, make that the experiment of 3! I’m 50, been eating PB for 2 years, just went Paleo by cutting out diary and I’m just not budging on the scale. I’m definitely peri-menopausal as my periods are all over the place with no set rhythm anymore. I have lost fat around my stomach and the rest of my body, but my scale is permanently stuck on 90kgs, no matter what I do. I finally decided that it didn’t matter what I weighed, that I should rather focus on getting healthier. I’ve been paying a lot of attention to my stress hormones (I’ve always had anxiety issues) and my sleep and I’m waiting for the “boundless energy” that every one says will finally happen. So far, all I feel is a bit under the weather most of the time.

          I’m hoping that if I keep on with what I’ve been doing, things will finally sort themselves out. I’ve cut out all the supplements I take apart from Olive Leaf (to kill a very persistent gum infection), D3 and probiotics. I’ve decided that, since all my hormones are out of whack (female hormones, insulin, cortisol, leptin, etc, etc, etc) that I’m not going to force my body into anything anymore. Give it a break, eat properly, focus on sleep and stress, slow movement and patience. I’m trying to learn how to listen to my body and work out what it needs and think of “it” as me and try to reconnect with my body. If weight loss happens, then it will happen as the weight is a symptom, not a cause.

          Keen wrote on April 25th, 2014
        • Keen, I feel for you, but I think you’re on the right track. I’m trying to do the same … forget the weight and focus on health. Easier said that done, though, when you know the extra weight is, well, weighing you down.

          I also agree whole-heartedly with your comment that the “weight is a symptom, not a cause.”

          On the Free the Animal site, Richard recommends taking butter oil for the vitamin K4 for dental issues. He says since he’s been taking it his gums and tartar buildup, etc., have improved dramatically. You might want to look into that. Go to the site and do a search on “butter oil.”

          Kathy from Maine wrote on April 25th, 2014
  15. I like Carrie’s response, although it might be hard to hear if the questioner has not yet found peace with her body. It links up with the post last week about placebo and you are what you think.
    Twenty pounds lost is a fantastic feat and should be celebrated! You have achieved a great deal. I believe when I stopped seeing myself as a “fat person”, it became easier and has had tremendous benefits. After years of being the “fat person”, it was hard to make that mental shift.

    healthyservesone wrote on April 21st, 2014
  16. Very timely. After keeping my glucose down to a reasonable range for 5 or 6 years, it is now out of control. Metformin isn’t helping much any more. I had been eating low carb (<75 g/day), now about 25. Hasn't helped much yet.

    Harry Mossman wrote on April 21st, 2014
    • Harry,
      You might also check out the upcoming 2014 Reversing Diabetes Summit scheduled for May 5 thru May 16. Apparently Mark is one of the featured speakers on it ,as well, so he may post something here on MDA about it. It’s presented by Dr.Mowll. URL is the diabetes summit dot com.

      Hope this helps and good luck!

      PrimalGrandma wrote on April 21st, 2014
      • Thanks. I won’t be able to go but maybe they will post papers and/or videos.

        Harry Mossman wrote on April 21st, 2014
  17. I always enjoy reminders of the basics of why things work, why they don’t, the how and the why of the basic pieces; the ins and outs. I have a science background, what do you expect!? :) But it’s great because I often forget those details and I can reinforce or build what I know and share still more with people who ask. Thanks to the writers for their questions and to you, of course, for your answers!

    Kevin Grokman wrote on April 21st, 2014
  18. That’s some of Carrie ‘ s best writing imo. More please!

    Danielle Thalman wrote on April 21st, 2014
  19. Maybe you could liken the full and cheap trolley full of junk food to the 1 quarter full trolley of primal food costing slightly more to that scene out of the movie “300” where Leonidas is explaing that he has “brought more soldiers” even though he only had 300 Spartan soldiers, compared to the greeks who had many more numbers of “soldiers” who’s primary skill was not being a soldier.

    “You see friend, I have bought more food than you have”

    Storm wrote on April 21st, 2014
  20. Has anyone seen Peat’s ideas? He advocates a high sugar diet, and it seems to work for some of the followers on this site, which contradicts a lot of the “sugar is bad, carbs are bad” beliefs on primal. I feel like maybe healthy carbs have been demonized too far.

    Barbara wrote on April 21st, 2014
    • I’m somewhat peat. Kind of a somewhere-between-peat-and-primal with a few ‘cheats’ here and there. Aka chicken wings and beer once a month, occasional toast with eggs when going out for breakfast. I was low carb for a while and it sucked the life out of me. Really high sugar didn’t make me feel that great either. Right now, I try not to stress about food do much. I eat mostly unprocessed food, meat and fruit. Sweet drinks are a treat, but I put sugar in my coffee. Primal taught me a lot about food, and so did peat. In the end, I think the best thing is to just eat sugar from fruits (as much as you want) and otherwise not think about it so much. This is, of course, if you’re relatively healthy and not super overweight.

      Devin wrote on April 22nd, 2014
  21. I just want to say thanks for this article today. I am 16 and have been eating primally for about 4 years! I was always the chubby kid growing up and in seventh grade my dad taught me about this way of eating. I lost about 15 pounds as a twelve year old and learned how to eat. Being in high school, it is always hard with all my teachers and friends drilling into my head that people are overweight because they don’t follow the food pyramid, but I know that primal eating is what works for me and I am sticking to it for the rest of my life. I am now at a healthy weight and couldn’t be happier! Anyways, for the past couple of months I have been really trying to eat “perfect” without any cheats along with exercising more frequently. I have recently plateaued and am now going to try to add sprints to my workouts. I think this is just what I needed. Thank you!

    Erin Griffin wrote on April 21st, 2014
  22. Could skipping /jump rope be considered as an adequate substitute for sprint intervals ?

    Robin wrote on April 22nd, 2014
  23. What do you suggest if you aren’t physically up to a point where you can sprint just yet? My weight loss is slooooow! I’m going in for blood tests on Wed to check my hormones, I am 45 yrs old, but man, I feel older some days. I really should just go 100% primal and stay primal.

    Sharon T wrote on April 22nd, 2014
    • Go to a track any jog around it at a comfortable pace for four laps. It might take a few times at the track to get to that point but don’t push it. Once you’re able to jog a mile three or four times in two weeks your ready to start sprinting. Start out sprinting 30-40 yards at 60 percent effort. Rest a minute and repeat 4 more times. Come back 5 days later and do the same thing at 65-70 percent effort. Gradually increase your distance but never Sprint faster than 85 percent of your full effort or risk injury and going back to the drawing board.

      victor wrote on April 22nd, 2014
    • I recently have had an ankle/foot tendon problem which made even walking difficult at times. After doing a bunch of exercises and taking some supps for the ankle, just walking was a “sprint” (ha!) But seriously, after a couple of weeks of almost no ankle pain, I added intervals of walking fast, then slower. Rinse and repeat. Then walking very fast, in spurts. Finally one day I tried a few steps of jogging with no problems. Walk, jog, walk jog. One day I jogged over 800 yards. Now can walk/jog for 2 miles. Am working up to a real running speed. Sprinting is relative. :)

      Energy! wrote on April 23rd, 2014
  24. Some say carbs from grains (different types of rice for example) can contribute to hyperglycemia, as well as hypoglycemia. And this may be the case for most people.

    However, for the rare ectomorph, this may not be the case. I’m a female, in my forties and am and always have been naturally underweight (BMI somewhere between 16 & 17, depending on what I weigh at the time). I didn’t do too well w/ just green vegetables and berries for my carbs, and I ate plenty calories, protein and fats. Had too add some rice in there. I think the more fat one has, the better one responds to eliminating grains. I think I just had too little fat to live off of, and, being an ectomorph, just naturally require more energy (as we are generally very hyper, bouncy, fidgety, active, fast walking types).

    I do believe in the Paleo tenant, btw, and don’t believe rice is an optimal food, nor most fruits and sweet potatoes. I would love to not have to eat rice, fruit or sweet potatoes…..less to buy, less to cook, haha. But my body just demands more.

    Wonder if there are any other ectomorphs who find they ‘need more carbs’.

    LS wrote on April 22nd, 2014
    • I lost way too much weight going hard core primal and so have to eat more carbs now and then so I don’t become underweight. I tried increasing my fat intake instead but there is only so much fat and protein I can take in my sitting. And I was getting sick of eating fists full of nuts!

      Farzaneh wrote on April 22nd, 2014
      • I went to ER b/c indigestion from nuts, had 30 almonds. Felt like I was having a heart attack.

        I just don’t understand….if we as a race, did not evolve eating grains, many carbs…….why on earth do I feel like I need them??? I would love not to have to buy and cook and eat more food than I have to. I’d love to cut back on my food bill, and would love to cook less food. Any th

        LS wrote on April 22nd, 2014
        • Any thoughts?

          LS wrote on April 22nd, 2014
        • Have you tried more tubers and non-berry fruits? I learned that a 1/3 of a sweet potato added to my dinner, or a small banana instead of berries does the trick. If all you’re eating is leafy greens and blueberries you could be getting too little carbs for your activity level. One of my issues was that after 20 years of brainwashing on low-fat and portion control I was simply eating too little food and fat. I was STARVING and losing too much weight. I knew something was wrong when someone told me if I turn sideways they would have to send a search and rescue team to find me because I was getting too skinny!

          Farzaneh wrote on April 22nd, 2014
        • i would say, keep truckin’. from what I’ve learned, it takes about 60 – 80 days for the human mind and body to accept any change and adapt to it. that goes for sleep, habit, point of view, memorization, food, travel, etc…the longer the total duration you are doing said change, the less difficult the change becomes. so if you are not used to eating less grain, you will get used to it soon. if you fall of the train, enjoy yourself! guilt free! then hop back on.
          there is also a good chance you may be addicted to grain. while the grain itself is not addicting as far as i know, the chemicals produced in digesting it can absolutely be. fermenting/sprouting grain can help this, but technically it’s not paleo.
          That being said. From a personal POV, i found as time passed (5 months to be precise) i no longer craved grains, milks and processed food. it was just stupid, how easy it was to pass up a piece of cake.
          now sweets are so sweet, they actually make me sick if i eat too much.

          once the worst was far gone, i did a bit of retrospect. no one could tell me not to eat sweets, and they make me happy. so i made them an adventure. never again would i buy cheap junk food candy at the store. if i had to have a sweet, i would have it with my tea and it would be a ridiculously expensive $4.00 bite-size lemon curd cupcake from a local baker. i still enjoy a piece of finely crafted dessert here and there. at a very fine restaurant, on a very special occasion. I simply love the art of chocolate too much. but once a month would be frequent for me. 2 years ago ONLY once a month would be unthinkable.

          If this is the change you truly want. then, Keep truckin. you. will. get. there.

          dakotaanddarcy wrote on April 23rd, 2014
      • Read your comment about 1/3 sweet potato & 1 banana….and yes, those small amounts are what it takes to keep me from going crazy w/ hunger for carbs…and this is what I will have to do, just very small amounts. Problem was, I guess I was kind of ‘brainwashed’ by these articles by Dr. Cynthia Kenyon and how she talks about the aging roundworms, how they start to age w/ just a little bit of glucose………and also , the scene in The Perfect Human Diet, where Dr. Jay Wortman works w/ the 1st Nations People…..and they talk about the Native Americans eating just berries and greens for carbs……and how healthy it seems. You know, seems so idealic! Essentially, I have been carb cycling, but eating way to many carbs on the cycling days and too low on the non-cycling days…I would love to eat none, less to cook and buy, but I will have to include some fruit and tubers….despite Kenyon and her worms. I have been lifting since I was 18.

        LS wrote on April 23rd, 2014
  25. I should also note I am a heavy weight lifter as well (meaning I lift heavy, not that I have big muscles). This may contribute to my extra carb requirements.

    Please reply if you too, experience this ‘need for carbs’ (rice, fruit, sweet potatoes), yet wish to eliminate them, in hopes of adopting a ‘healthier’ low carb, low sugar, low gi diet. Would like to discuss this. Everyone I know either just eats the standard American diet and doesn’t exercise. I would like to know what other ectomorphs, particularly weight training ones, are doing.

    LS wrote on April 22nd, 2014
    • Oh ya! I also need carbs but for the most part at high intensity workouts using the large muscles. If not I get light headed. If researched that when in ketosis you don’t retain your sodium so take a couple of bouillon cubes in warm water before a workout. Well that helps to a point but personally carbs are the difference maker in my workouts. If you really want to keeps your carbs in check look into “carb cycling”.

      victor wrote on April 22nd, 2014
      • What are your carb choices? And do you/did you find it challenging to get enough calories/energy on just proteins, fats, vegetables & berries? I struggle…3 protein at @ 200, 3 leafy greens at @ 50, 3 fats at @ 120-160 and berries at @ 25-50….I always fell short (that came to 1,160 calories). When adding fruit and sweet potatoes, would come to a little above above that. That means that if that diet were a lifestyle choice for me, I’d be permanently consuming well below my maintenance calories. I’m already about 15% fat and 106 lbs (I’m 5 ft 7). IDK…maybe the low calories would be good (for life extension, etc.), but I would literally DREAM about food.

        And yes, my old Rachel McLish Perfect Parts book, tells you to eat rice twice a week on her weight loss plan. Even though the diet is outdated b/c it is only 10-15% fat, she recommended carb cycling back then (which can also be used as caloric cycling).

        My opinion is that, while our ancestors may have lived primarily off a low carb/starch/sugar diet…maybe the ectomorphs were hungrier than the others? IDK…

        LS wrote on April 22nd, 2014
  26. I find starch raises my BG very fast. White rice, white potato etc. But the sugar from whole berries and carbs from nuts does not. Does the fructose/glucose combo plus fiber blunt the BG response? Starch/pure glucose /dextrose spike BG faster than the insulin can respond. Give me berries, some fruit and nuts any day. No post meal coma .White rice hits the blood as fast as a glucose tolerance test.

    bea wrote on April 22nd, 2014
    • Yes, me too, white rice, white potatoes, makes me sleepy and crave sugar. Brown rice a lot less, still in the process of observing the effects, just recently added it back in b/c was not sleeping for weeks, due to low carb/calories.
      I struggle…I go back and forth btw, 1,200 calories on just protein, fats, leafy greens and berries….and then add several pieces of fruit and root vegetables & sweet potatoes…and feel like I am consuming too much sugar (which I might be). And the fructose/glucose containing veg/fruit does not satisfy like the pure glucose containing beans or brown rice (glucose shuts down the hunger hormone and encourages the fullness hormone…ghrelin, leptin…that’s why I suppose).

      Then I stop, and feel hungry again. Then I add rice, gluten free crap buns on burgers, fries….it’s a cycle, and I hate it. Want to be satisfied on just protein, fats, greens and berries….but I don’t sleep, dream about food, and feel ravenous all the time. Anyway, chime in if you have an opinion about this. I’d appreciate it, most here seem to have a solid education on the subject. The comment above from me, gives the calories from each macro nutrient I consumed while on that diet.

      LS wrote on April 22nd, 2014
      • Essentially what I am doing is carb cycling….

        LS wrote on April 22nd, 2014
      • @LS
        Just wondering why you are eating only 1,200 calories. I think sometimes people think they are going to low Carb(and they may be) but it’s just too low in calories also. I avoid high gi starch foods but don’t only eat greens and berries. I tolerate veges like peas, carrots, brussel sprouts etc. Greens basically are zero Carb. I tested how much white rice I could eat and not go over BG# of 120. It was 1/4 cup. I think I have a delayed insulin response so I avoid fast acting glucose sources . You will only know if you are consuming more glucose than your body can handle if you test your BG. Maybe you need to spread your Carb sources out and have a little before bed also.

        bea wrote on April 22nd, 2014
        • Wanted to lose body fat, I had gained 5 lbs of fat from eating those sugar free coconut frozen deserts, like 15-20 a month, for like 3-6 months…plus, the low carb thing made me binge a lot on gluten free hamburgers w/ tons of mayo, french fries, potato chips. Don’t laugh, please, but 5 lbs of fat on a small boned, thin person like myself, looked horrible (fat on bum, cellulite). My body fat when overweight was like 16%, I am naturally around 14%. So….I never really stayed on 1,200 for more than a few days at a time……always ate more due to hunger. Am now only like 2-3 lbs over fat…..know it sounds ridiculous, but really, on a lean person, any fat just bloody hangs! I dieted for like 2 weeks on, most days I ate above 1200, way over. Then a break, then 2 more weeks, same mix of low cal and high cal…lost about 2.5 lbs of fat, 2.5 more to go.

          Anyway, I feel best when adding apples, yams, sweet potatoes, broccoli, brown rice in small amounts, like 1/2 c. cooked….not normal to dream about food and to be so bloody hungry all the time….I just am extreme Type A personality, and also really wanted the simplicity of just a protein, a fat and a green vegetable…..was jealous of the Native Americans in The Perfect Human Diet docu…..looks so simple, less to cook, buy, etc.

          LS wrote on April 22nd, 2014
        • Also @ LS, noticing your posts here the main theme seems to be your desire(to the point of craving) of carbs and not particularly liking the results. Obviously 1200 calories is not enough, especially when you lift weights. If you were to add more good oils to your diet (say to 50-55 percent) and resistance starch(look it up) your calories would come up quite a bit, your cravings for carbs will diminish, and that extra weight you don’t care for might not happen. I take three tablespoons of coconut oil a day and cannot gain weight no matter what I eat.

          victor wrote on April 23rd, 2014
      • If you have a chance, read the resistant starch (RS) info on MDA and the posts on the Free the Animal blog about how primitive/traditional people ate many more whole food starches than is generally known. People ate tubers etc. but not necessarily the equivalent of freshly baked white potatoes. Try eating cooked potatoes (fingerling, russet, or another types) that have been in the fridge overnight, which causes much of the starch to change to resistant starch which is not high-glycemic. Or cooked and cooled rice or beans, etc. more info on the RS thread here on MDA. Just a suggestion.

        Energy! wrote on April 23rd, 2014
        • Yeah….I have to add small amounts of whatever starch……resistant starch beans, cooled rice, tubers….I tried eating green bananas for res. starch, but got TERRIBLY constipated, so stopped. Fear of lectins in beans….Dr. Kenyon and her roundworms, how even the tiniest glucose ages the worms (i.e. us…)….in spite of my ‘fear’ of adding some glucose, I will have to. BTW, I have never actually made it more than a day or two, on just berries and greens…….always added starch by default, whether wanted to or not…..felt better. Will try coconut oil, along with my olive oil and avocados.

          LS wrote on April 23rd, 2014
        • Some simple suggestions for Carrie may be she is not eating enough, sleeping enough, or she’s overtraining.

          I would like to know what her exercise routine is.

          Ben wrote on April 24th, 2014
    • Hmm…I think white rice alone raises blood sugar fast…when mixed w/ protein and fat, it slows down the effects remarkably.

      LS wrote on April 26th, 2014
      • White rice alone, cold and reheated, with/without fat, protein always spikes me too fast. I’ve tested it and dextrose same effect. White rice to me is like a junk food. Pure glucose no nutrients and no fiber to slow its surge. All starch makes me tired also. Berries, some fruit ENERGY! No coma. Dr. Kenyon eats No Starch. She does eat berries and dark chocolate. She just avoids high levels of insulin secretion constantly. But everyone has to find what makes them feel their best. I’m a 56 year old woman. Not a 20 something crossfitter.

        bea wrote on April 26th, 2014
        • Yeah, I agree…I think there is more than a casual relationship to the amount of glucose one needs, and one’s age, activity level, body fat, insulin resistance/sensitivity, and even somatotype, as well. All the body builders I know, esp. the ectomorphs (like me), need higher levels of glucose/carbs/starch. Most of the diet conscious people in my age bracket (forties, fifties), require less. Somatotype in part. I think is very important.

          LS wrote on April 26th, 2014
  27. Thank you Carrie. So nice to hear from you. Regarding setting intention and strengthening resolve, I have found that questions work better for me. Affirmations or statements tend to tigger my “little voices” who instantly want to remind me of the many ways the statement is not yet true.

    Here is how I would frame my question, something to write down and read out loud a couple of times per day, without trying to mentally figure out an answer:

    Why is it so easy for me to come to the best possible healthy weight for me? Why do I love my healthy body as it is?

    No need to try to get an answer, just live with the question and eventually your non-conscious mind starts finding answers unique to you which then reinforce real world behavior changes.
    Example: I love my healthy body as it is because it rarely gets sick anymore, because it can take me backpacking int the mountains I love… etc.

    kay wrote on April 22nd, 2014
  28. Carrie, Don’t know if you will read this, but as a doc that has spent 7 years observing research data, don’t get too caught up on carbs alone. No question, excess refined calories are EASY to overeat and create a surpluss. BUT, the fundamental well controlled studies suggest that insulin alone is not the one hit wonder many want it to be. I have seen post menopausal women go from pudgy to super cut (like body competition cut) while in their 50s. The fundamentals still apply. While your hormones aren’t helping at all, keep total calories low and only eat whole foods that absorb slowly. Stay focused on protein and veggies as Mark suggests. but eat tubers and fruit and don’t fret. Read between the lines. Like Mark, we all get leaner on Primal, but he doesn’t look that cut because he is primal alone. He also fasts weekly. This greatly reduces his overall calorie intake. I prefer two 24 hour fasts a week, with 3 meals a day on regular days, and I eat healthy food and don’t stress about it. This greatly lowers insulin, leptin and thus increases insulin SENSITIVITY and leptin SENSITIVITY. The amount of insulin you have is variable genetically person to person. Sensitivity is what correlates to excess weight. Your brain controls the extra weight gain. Without taking long breaks and improving cellular sensitivity, even protein may ruin weight loss. Yes, sacred protein also needs to raise insulin to be utilized. So, don’t stress, fast. Hell, have a cookie once a day, as long as you fast, you really won’t notice set backs. It may take your body longer to reset that hormone balance, but it can happen. Also, lifting weights and exercise in general will improve your muscles SENSITIVITY and they will burn more calories. So, fasting and exercise, two things that will allow your body to remember to burn your fat. Mark does 16 hour fasts every night, LeanGains style I believe. I do prefer the Eat Stop Eat model because I work all day and I can just do my thing and not think about eating until dinner. The first few times might be hard, depending on how hormone resistant you are. And don’t work hard on your long fast days. Just walk, or work, or garden. Best of luck!

    Dr. Jason Bussanich, DC wrote on April 22nd, 2014
    • Oh! and a reasonable goal is 1.5-2 pounds per week while fasting in either style. Either part of every day or long fasts 2-3 times a week. People are sometimes not successful on primal and losing weight and it means they are still eating too much good food. I used to believe insulin alone needed to be low to lose weight, but that’s insane as pretty much everything that allows us to thrive needs to increase insulin to promote growth and usage of calories. I HATE admitting that the old calories in/out is more or less true after all the good data we have, but that’s the honest truth. Being Primal has lots of fat and fiber, two things that make you feel full, but make you lose weight because you don’t over eat CALORIES. Don’t starve on your eating days either. Eat regular meals and don’t confuse fasting time and eating time. Enjoy your food on eating days, you deserve it!

      Dr. Jason Bussanich, DC wrote on April 22nd, 2014
    • Can you please talk about getting carbs from starchy veg and fruit that are fructose and glucose, vs. grains that are pure glucose? I understand that the sugar in starchy fruits and veg are more slowly digested than grains…but is it significantly better for the body to have all that fructose/sugar, than to have none and just have pure glucose from say rice, beans, etc.

      LS wrote on April 26th, 2014
      • I too question the fructose/glucose vs pure glucose sources of food. Fructose has been so demonized probably because of HFCS. My BG stays much more even on natural Carb sources that are fructose/glucose combo. Fructose must cause glucose to be absorbed slower. Also food that has both tends to be higher fiber maybe . You are right nobody addresses this. Maybe fructose should be the new darling instead of PS. At least it doesn’t cause inflammation like tatos.

        bea wrote on April 26th, 2014
        • Well….just tried oatmeal today….white rice mixed w/ my food….brain fog, I wasn’t expecting that, thought that was just for wheat and dairy. My body can’t handle this. My problem is that I just need to eat earlier in the day, eat more frequently and eat more vegetables. It’s been years since I ate oatmeal, and rice in the same day. I do believe humans are not supposed to eat these things. I lift, so I thought rice would be a good carb source…I feel totally ill right now from these foods though. Starchy vegetables and carbs every 4th day for carb and calorie cycling is what I shall have to stick w/, in spite of my ‘fears’ of fructose. I do think I would eat less fruit and starchy veg, if I just woke up earlier and ate more veg more frequently. How about you?

          LS wrote on April 26th, 2014
        • * ate more NON-starchy vegetables…more often.

          LS wrote on April 26th, 2014
      • Sure. Look, I have been on the anti-fructose/anti-glucose diet bandwagon before I toned down the rhetoric. I think we all get on at some point. R. Lustig and his famous video lecture on youtube would have you thinking fructose alone is toxic The thing is, he admits early in the video that small natural doses, such as in fruit, is just fine, which is what studies show. Save for the lectins, gluten (protein) issues caused by grains, the carbs are no different than any other carbs. I personally see no proof or validity that surging your insulin with 100 calories of coke is any worse than slowly raising your insulin over much longer with 100 calories of whole foods. Save for the fact that the surges will make you over eat later because they instigate hunger due to hormone swings. Steel cut oats can raise blood sugar very fast, for example. I believe that we need insulin as a growth factor to be big and strong. But we have plenty at any given time. Body builders become obsessive about surging it with the right timing, and it works. But, all the evidence says that thriving to that degree is counteractive to long life. So, I try to eat some of everything, but if I eat a backed sweet potato that is huge, I won’t eat steak with it. Or if I eat steak, I eat it with non starchy veg. I try to not over eat as a general rule and eating more fat versus carbs has been paramount for me personally in having very little true hunger. I think there are no universal rules. If you eat higher fat low carb for more than a few months, you have reset your hormones enough that your body may tolerate white rice just fine without blowing up your hunger later. The longer you aren’t dependent on huge amounts of sugar, the more effective your metabolism becomes, so you may be able to safely process beans or rice on occasion. Some doctors in the ancestral food movement think any and all carbs are deadly, natural starch or not. I say, it would depend greatly on activity level and how healthy one is. If you are already in a bad place from too many refined sugars, then how well you think your liver will process the better ones? Your liver will be pissed off and not process well. It all comes back to finding strategies for changing to low carb temporarily to find a better liver reset zone, then slowly coming back to whatever balance feels good for you. The cells actually can get lazy about processing carbs the more ketogenic you go. So, it can take time going back on them after a long break, to get some insulin sensitivity back. When they do glucose tolerance tests, they have to tell people who are ketogenic dieters to eat carbs for a week so they can get an accurate test. These changes are just your body doing its best to adapt in the moment to the type of calories you eat. If we mostly eat fat, it will be better at it. If we mostly eat carbs, it will be better at that, as long as we don’t over consume. Proteins raise insulin as well, so anything you eat could affect insulin sensitivity. The only way to guarantee a break is to fast intermittently. Hope that helps.

        Dr. Jason Bussanich, DC wrote on April 29th, 2014
        • Thank you for taking the time to answer my questions so thoroughly. I read your answer several times. Just 2 quick questions please, I will try to be succinct.

          1) I think what you said in your answer was that I will be able to keep lifting weights and doing cardio, and keep my muscle, & make small gains (2.5 to 5 lbs), eating primarily green vegetables, proteins and fats. And you said that the insulin that is generated from just those foods, IS indeed sufficient for muscle growth and maintenance (I don’t desire to be bulky, I am an ectomorph & I like it that way, not wanting to gain more than 2.5-5 lbs of muscle that I have recently lost due to surgery). Is this correct?

          2) And second, will carb & calorie cycling every 4th day (w/ root vegetables, starchy vegetables & fruit, beans, brown rice, etc.), eliminate the reduced insulin sensitivity that can happen on low carb or ketogenic diets? And is there a preference as to where those extra carbs come from (high glucose, no fructose containing foods like beans & rice, that contain lectins, anti-nutrients, etc. – as opposed to foods that contain sugar, fructose, like bananas, root vegetables, sweet potatoes, etc., but no lectins & anti-nutrients)?

          Thank you ahead of time.

          LS wrote on April 29th, 2014
        • LS,

          You get it on both #1 and #2. Carb cycling does help keep your muscles and liver used to processing carbs. Absolutely. Some believe carb cycling increases metabolism, but there isn’t any evidence for that. Metabolism is the same even when fasting. But, your hormones change to conserve fat. So, carb cycling probably serves to remind your body that it is around abundant calories and that it doesn’t need to hang out to anything. Then, the next day, you don’t eat all those extra calories and you end up burning fat. I know that SOUNDS like your metabolism speeds up, but it isn’t the same. Your base metabolic rate is unchanged, it just changes how your body uses your fat… And you know, if they do more good controlled studies, I might say something different. Try to eat without thinking too much. As long as your blood sugars and A1c (ideally 5.2 or less) are good, don’t sweat it too much.

          Dr. Jason Bussanich, DC wrote on April 29th, 2014
  29. Given recept posts on here couldn’t fasting have a potentially negative effect given perimenopause? Just one thing to consider.

    Also really interested in the carb discussion above since I also have issues with feeling satisfied and carb cycling seems to lead to some unhealthy food habits.

    Natalie wrote on April 25th, 2014
  30. @Victor, thanks for your words of encouragement. The truth is, I don’t like or promote eating grains (rice is the only one I dabble w/), but am very lean and active, so need at least 100 carbs a day…but struggle w/ the idea of eating all that fructose that comes w/ starchy veg and fruit (Dr. Cynthia Kenyon and her discoveries really has affected how I feel about eating starchy fruits/veg, etc.). I ate a pint of those sugar free coconut frozen deserts, like 15-20 a month, for about 6-12 months…..as well as fatty meats and fishes….and my cholesterol went up from 120 to 244, HDL and LDL about equal, 125 each, triglycerides are about 40. So, I have hesitations about the coconut oil (trouble w/ acidic, hard to digest foods, took me a while to figure out what was causing me GI trouble, was almonds, peanut butter, almond butter, coconut milk, sugar free coconut frozen deserts, etc.). But, have eaten starchy veg/fruit in the morning for breakfast, and extra higher carb non-starchy veg for lunch and dinner, and has been good. Still, there’s the 4th day of calorie/carb cycling day….I just have to come to terms w/ the fact that I will have to either eat plain rice mixed w/ food that day, or get extra sugar/fructose on those days…..my body really does demand that 4th day. I am very thin and lift quite heavy. Thanks for you comment though!

    LS wrote on April 26th, 2014
    • There is no clear evidence total cholesterol means jack anymore. Your TG are 40? That is exactly what you want. TG should be in the basement low. But, if you want to worry about cholesterol panels, do the right ones. Find a test that shows you particle size. 90% of tests docs use are completely obsolete because they don’t show the factors that actually have been proven to link to heart disease. So insane how many people are given drugs based on completely irrelevant testing. HDL can be bad too, if they are small particles. The point is, the only major marker you need is Apo-B. Excess fructose specifically tends to increase Apo-B. Saturated fats have no effect. Glucose does raise Apo-B, but way way less than fructose. So, you can eat fructose, but in the levels in the western diet, it starts to increase particles that inflame our arteries. No doubt.

      Dr. Jason Bussanich, DC wrote on April 29th, 2014

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