What’s the difference in power between fasting and low-carb high-fat (LCHF)? Sometimes, it feels like arguing whether Batman or Superman is more powerful (Superman, of course). But they’re both superheroes, and the point of both these dietary superhero regimens is to lower insulin. This stems from a rational examination of the causes of obesity and Type 2 diabetes. You need to understand the etiology of obesity (the underlying cause) if you are to have any hope of treating it.
For decades, we have labored under the false assumption that excessive calories cause obesity. However, overfeeding and underfeeding studies clearly proved this hypothesis wrong. If calories caused obesity, then overfeeding calories should cause obesity. It does, but only in the short term. In the long term, weight returns to normal. Underfeeding calories, on the other hand, should lead to permanent weight loss. But it does not. The failure rate of calorie reduction as a primary strategy is an abysmal 99 percent.
So if we understand that excessive insulin causes weight gain, then the treatment is quite clear and just really damned obvious. You don’t need to decrease calories, although there is some overlap. You need to decrease insulin to cause weight loss. Both LCHF diets and fasting accomplish this goal. Refined carbohydrates are the biggest stimulus to insulin, so reducing carbs reduces insulin. Protein, especially animal proteins, also raises insulin, so keeping protein moderate and fats high is another way to keep insulin levels down. Fasting, by restricting everything, also keeps insulin down. A “fat fast” (i.e., eating nothing except pure fat) may also accomplish the same thing, but studies are sparse. So “bulletproof coffee” may certainly achieve the same goal of lowering insulin without lowering calories, but the data are simply not there to say for certain.
If you are trying to lower blood glucose, nothing really beats fasting. After all, you can’t go lower than zero. Even then, the carb-free diet does remarkably well, giving you 71 percent of the benefits of fasting without your actually having to fast. The standard diet was 55 percent carbohydrate, 15 percent protein, and 30 percent fat—not far off from what most dieticians and dietary guidelines recommend. You can see how insufficient it is for actual blood glucose control.
The carb-free diet is less than 3 percent carbs (that is ketogenic or ultra-low carb), 15 percent protein (moderate), and 82 percent fat. LCHF pretty much says it all. The calories delivered were 25 kcal/kg (1,750 calories for a 154-pound man) in three meals. This was the same between the standard and carb-free diets. So the benefits of carb restriction on blood glucose were NOT simply due to calorie restriction. This is useful knowledge, considering how many ill-informed doctors and dieticians keep saying, “It’s all about the calories.” Actually, in this study, it had nothing at all to do with the calories.
Anybody who still believes that “It’s all about the calories” despite 50 years of unrelenting failure of the Caloric Reduction as Primary (CRaP) model either has not thought about things very hard or is simply not all that intelligent. Yes. If a strategy such as CRaP fails for 50 years, we should be changing our strategy. It doesn’t take Albert Einstein to tell us that is the very definition of insane.
This graph is pretty sobering. Looking at the standard diet (American Diabetes Association (ADA)-recommended); you can see how high those peaks of glucose really get. You might rightfully ask yourself: If the good folks at the ADA know that their diet sends blood sugars skyrocketing upward, why on Earth would they recommend it? Are they trying to kill us? Unfortunately, the answer is yes. They are trying to kill you. Not intentionally, but with their ignorance. All that money showered upon them from Big Food and Big Pharma has something to do with it, too.
But what if carb-free just isn’t enough? I have lots of patients who limit their carbohydrates but still have elevated blood sugars. How do you get more power? Sorry, Batman, it’s time to call in Superman. (Don’t bother about the Wonder Twins; they were always useless. One of them would turn into a dolphin or something.) In a word, we need fasting.
The study results are even more impressive when you look at insulin levels. This is very important because blood glucose levels are not the main driver of obesity and diabetes. Insulin is the main driver. The entire strategy of weight loss hinges upon lowering insulin.
Looking at the total area under the curve, you can see that a carb-free diet can reduce insulin by roughly 50 percent, but you can go another 50 percent by fasting. That’s power.
And NOTHING beats fasting for bringing down insulin. It is simply the fastest and most efficient method of reducing insulin. Luckily, it’s also not as hard as most people believe it to be.
Let me explain. Insulin causes weight gain, so giving insulin causes weight gain. Does reducing glucagon cause weight gain? Not really. Does increasing glucagon cause weight loss? Not really. Sure, glucagon plays a primary role in rat livers, but I don’t really care. I care about humans.
The bottom line of this study is to reinforce what we already know. Insulin is the primary (but not only) driver of obesity. Therefore, for most people, reducing insulin is the best method for treating obesity. Carb-free diets are a powerful method for reducing insulin. But if that doesn’t work, intermittent fasting offers an even more powerful strategy.
In Type 2 diabetes, you can reduce blood sugars by 50 percent to 70 percent by carb-free diets. You can reduce it by another 30 percent with fasting. So if we already know how to reduce blood sugars in Type 2 diabetes with dietary strategies, why do we need medications at all? Here’s the answer, of course: You don’t. Type 2 diabetes is an entirely reversible disease.
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