Low Carb Diet from a Doctor’s perspective

I watched this video and immediately connected with this Doctor for obvious reasons. If only more experts would get it like this guy does.

Low carb from a Doctors Perspective

I feel the need to make a blog post about this just to highlight all the similarities in our philosophies and I want to point out some of the things he shows but doesn’t address.

1. We need to drop the CICO mentality.

He has a patient speak in the beginning. She is listening to the eat less and move more advice and eating low calorie and working out 6 days a week. She is not losing any weight. Now most experts would say she is cheating and lying. I don’t believe that to be the case. I’ve seen it too many times. Not everyone that diets is a liar. Even though the famous starch based Diet proponent Dr. Macdougall would say this is the case. Nasty man.

Here is the problem with that. She is eating less which is causing her body to slow metabolism to save her from starvation. Natural response that has been proven to be the case again and again in studies like The Biggest Loser Follow up done by the NIH. Every contestant showed a dramatic reduction in metabolic rate with prolonged caloric restriction. The big problem here is that as soon as they eat even a little more than the small amount they were eating they quickly gain weight back.

To add insult to injury, the client in the video was exercising like crazy. One thing that exercise is great for is making you efficient. If your body needs to do a given amount of work and it has to do so with a given amount of food energy it will do it and it will get very efficient at doing it with that amount of energy. Unfortunately this comes at a price. Your body will get used to doing this amount of work with a set amount of energy and it will slow caloric expenditure on other body processes to allow the energy to be dedicated to exercise. This is the exact same thing as slowing metabolic rate.

Now you add together the slowed metabolism from caloric restriction and the slowed energy expenditure to account for energy for exercise and you have a recipe for easy weight gain. Eat a little more or exercise a little less and the weight comes barrelling back on. If you had done nothing in the first place but eat 2,000 calories and not exercise at all you would have been immensely better off than eating 1200 cals and working out. After a few months of this you could eat 1500 cals and exercise 5 days a week instead of 6 and gain weight. Who hasn’t been there? I know I have.

2. Protein has a significant insulin response that lasts longer than carbs or fat.

At 5:34 in the video he posts a graph of insulin response to macros. You will see that yes, carbs have the largest spike but protein has a significant one as well. Halfway between that of fat, yes fat has a response, and carbs. What is most important to notice is that the spike from protein trails out way longer than that of carbs. Protein takes longer to process than either of these so the insulin stays elevated longer. This is counter productive to our goal of getting insulin back to baseline as quick as possible. This is the reason I advise keeping protein just to what we need and no more.

I would be very interested to see this graph on fiber as fiber takes even loner to process than protein as it slows gastric emptying. I suspect it would be similar to the protein but slightly higher for longer.

3. He understands how fat storage works and that it is actually easier for glucose to be stored as fat than it is to store fat as fat.

He goes into this at about 9 minutes into the video. In order for fat to be stored as fat it has to first be enzymatically cleaved apart. The Glycerol backbone has to be removed with an enzyme, LPL (Lipoprotein Lypase), then the fatty acids can be packed into the cell then it has to be recombined with the glycerol inside the cell. Glucose, with the help of insulin can be packed into the fat cell directly through the glut 4 transport where it turns to glycerol to be combined with the fatty acids to form trigs again. Which process is more costly?

4. He knows that insulin can create new fat cells when you have reached your limit genetically.

This is why many diabetics gain weight quickly when they start taking insulin. At 11 minutes he starts talking about something I made a post on awhile back on. Lipohypertrophy. This happens to diabetics that inject insulin in the same spots repeatedly. They get masses of fat building up in that area. What more proof do we need that insulin makes us fat? It can literally create masses of fat where you inject it.

5. This one is something I believe him to be incorrect about. Insulin resistance is not caused by over stimulation of insulin, spiking it too many times a day, but rather it is caused by our genetic ability to create new fat cells or to grow our fat cells large.

At 14 minutes he speaks about this. What I and many others are now starting to believe is that insulin resistance starts when the fat cells either reach their limit of fat storage or you reach your genetic threshold for fat cell creation. This causes the cells not to react to insulin as they are now full and no longer want to accept any new storage.

What causes me to believe this is because when the person starts to become insulin resistant they tend to stabilize in weight. They no longer gain but their begin having massive complications from the high blood sugar. They are tehn given drugs to better manage their glucose and this helps for some time. Then they are given insulin and the trouble begins. At this point the person tends to start putting on weight again. This is because the insulin has the ability to grow new fat cells. This is actually how fat cells are made in a lab. Using insulin. This is evident by the aove point on lipohypertrophy.

6. Another item I don’t particularly like. Not everyone can be 100% right I guess. 🙂

He talks about the appetite supression of ketones like it is a way to cut calories despite the fact that he dismissed it above. It is like he felt the need to somehow make ketosis fit the model. The reduction in appetite is not a benefit of keto and is not meant to help you eat less. It is because ketosis is a hack. It tricks our body into thinking we are starving. I wrote these articles addressing this:

Eating to Satiety is misunderstood

Listening to your body is great if you understand it’s language

Not being hungry is not a benefit

7. He believes in experimenting to see the effects foods have on ketones.

He talks about this at 24 minutes.

Experimenting is the best way to learn how your body works. Having someone who knows how to interpret the data is even better. 🙂

8. He understands how bad fructose is and how sweet effects the brain.

25 minutes in he discusses the issues with fructose.

Fructose is far sweeter than glucose thus is more addictive and it only gets processed in the liver which cause the mitochondria in the liver to be over taxed which can result in fatty liver. It also creates far more glycation end products which are highly inflammatory. Berries are not good for you.

9. The most important reason why I think Dr. Paul Mason is likely the best Low carb Doctor out there today!!!


21:45 Dr. Mason starts getting into why we need to stop with the sweeteners. Thank you lord I am not the only one who gets this!! 🙂

This is the post I wrote way back.

Sweeteners are not for weight loss

I highly recommend watching or reading anything else Dr. Mason has out there. He is so far the most together Doctor nutrition wise I have seen. Way to go.

Keto ON!

Coach Jack

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2 Replies to “Low Carb Diet from a Doctor’s perspective”

  1. Have you watched Dr. Berg and how do u feel about his saying we dont count carbs in green leafy veggies and cruciferous veggies because of the fiber content in them. And tjat we should eat 7–10 cups a day of veggies and that we dhould be at 50 net carbs and not 20 total carbs a day ?? Just curious it’s all confusing.

    1. I have watched “Dr.” Bergs videos. He is just another Chiropracter who watched some youtube videos and got enough about keto to make some videos. He is still living in this world that thinks that plants are the best think going. Plants are filler. They are not overtly harmful and if you don’t have much weight to lose and you like veggies then feel free to fill your boots.

      If you need to lose weight and your goal is to control the effects of insulin you cannot in any way shape or form discount fiber as something that affects insulin. The only reason people think you can is because when they look at blood sugar, not a good way to assess insulin response, fiber seems to make it rise less. While this is try it is not because they don’t make blood sugar rise or that they don’t impact insulin. It is only because fiber is near impossible to digest and the stomach tries its damndest to do it. This makes it take longer for food to be released from the stomach and thus less glucose raising substances get released at a time. This results in a lower glucose load and a smaller insulin load but it also results in a longer time exposed to insulin. Instead of having one bolus of insulin and then a return to baseline you will have a shorter overall peak but a longer duration since food will continue to be released from the stomach for hours.

      If the ultimate goal is to have more time at baseline insulin levels, which it is, then delaying the release of food from the stomach is not the appropriate approach.

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