Banting for Beginners

Why do people get fat?

A: There are two theories. The first says that you get fat with age because you overeat and don't exercise enough. The implication is that you're lazy, greedy and don't have as much willpower as a slimmer person; if you'd just stop eating so much and exercise more, you'd return to a normal weight. But it's completely bogus. Especially winces this model isn't concerned with what happens to your brain - the key organ that directs how much you eat and how much you exercise is left out of this model.

The second is that carbohydrates play a special role, especially in those who are insulin resistant. My take on it is that in the obese, carbohydrates disrupt the appestat - the part of the brain that controls the appetite - so the feeling of satiety that food is supposed to give becomes ever more elusive, so you eat more. That's the key. This model doesn't view fat people as lazy or greedy; they're just carbohydrate intolerant and eating too many carbohydrates.

Some are also addicted to sugar, definitely those who are morbidly obese. Their addition drives their chronic overeating.

What is 'insulin resistance'?

A: When you eat carbs, your body converts them into glucose and releases the hormone insulin to help your cells absorb and use this glucose as energy.

But, if cells in your body become insulin resistant, they can't use the glucose for energy or store it (as glycogen). The liver then converts excess carbohydrate into fat, which is stored in the fat cells. Insulin also prevents the fat from being released and used as an energy fuel.

When ingested carbohydrate energy suddenly disappears into the fat cells, the brain wonders where it has gone and immediately stimulates more hunger and reduced activity (energy), even though there is an over-abundance of energy in the fat cells waiting to be used a fuel. To counter this, you eat more carbs. But this simply causes even more carbs to be turned into fat, and you're hungry again soon ager. This process then repeats itselfs every few hours.

Over time, though, your pancreas struggles to produce enough insulin to keep your blood glucose levels stead. When that happens, your blood glucose levels will rise and you'll be vulnerable to a number of serious health disorders, such as Type 2 diabetes mellitus.

How can I tell if I'm insulin resistant?

A: Do a glycated haemoglobin (HbA1c) test. As soon as you blood HbA1c value exceeds 5.5%, you're eating to much carbohydrate and need to cut down.

You can be very healthy at a rate of 5.5%, but it if rises progressively over time - from 5% to 5.2% to 5.4% - you're going in one direction. And, once you get to 6%, you're in potential trouble! 6.5% is a diabetes diagnosis. You can prevent diabetes just by checking your HbA1c levels, always ensuring your value is below 5.5%. It's much more important than checking your blood cholesterol concentration, which does not tell you much about your health.

Doesn't your body need carbohydrates in order to function?

A: Not at all. Your live can produce all the carbohydrate, in the form of glucose, that your body needs.

What is ketosis?

A: It is the process your body goes into when deprived of carbohydrates. When your body is deprived of glucose (ie. carbs & sugar) it has no choose but to burn fat as energy - which is why the Banting/LCHF plan is so effective for weight loss. The live starts to product ketone bodies (from fat) which can be used by all body tissues instead of glucose. As a result, the body's glucose requirements fall, and are replaced by ketone use.

Ketosis is a normal physiological response to starvation in persons able to secrete insulin. It is one of the most important human adaptations - without it we cannot survive starvation, so humans would not exist without it.

This diet is loaded with saturated fat. Won't it give me heart disease?

A: The idea that saturated fat is the sole cause of heart disease is nonsense. It's never been proven, In fact, it's impossible to prove, because there is no food that is purely saturated fat - every food that has saturated fat also has monounsaturated and polyunsaturated fats, so pinpointing saturated fat as any kind of culprit is scientifically impossible. Increasingly, the evidence points to polyunsaturated fats in vegetable oils, not the saturated fats of animal origin, as the key drivers of both heart disease and cancer risk. But, all this research only proves certain associations, not causation. Some countries that have the highest saturated fat intake have the lowest incidents of heart die seas; France, Switzerland... the so-called nutritional European paradox. The Swiss also have the highest blood cholesterol concentrations in Europe and the second-lowest rate of heart disease. All this proves nothing, but it conflicts totally with the global fear that if we eat saturated fat, we can expect to drop dead in a few weeks from fatal heart attack. In my view, the clear evidence is that heart disease is a disease of inflammations in which a high-carb diet plays an important role, especially in those with insulin resistance.

Thie diet doesn't restrict calories - is there a danger of overconsumption?

A: Fat and protein act differently from carbs in the brain. Both fat and protein curb hunger, so you'll ultimately eat less naturally, because you won't be hungry - not because you're counting calories or watching portion sizes. Such restrictions never work since we all to the point of satiation. The way that Banting/LCHF works is by changing the brain's relationship to food so that it signals hunger when you really need to ingest food, and so you escape the addictive eating behaviour produced by a high carb and sugar diet.

Can I go back to eating carbs once I've lost weight?

A: No, this is not a diet. It is an eating plan for life. It is works for you it does because you are insulin resistant. Sadly, this resistance is a lifelong disease. If you go back to eating carbs, you'll merely reverse the positive results of Banting/LCHF. If you're carbohydrate resistance, that's for life - it'll never change.

Are calories from carbs different from those from fat?

A: If you look at the literature, there's enough evidence to show that they are different, in that your body responds differently to calories from carbohydrates on the one hand, and calories from fats and proteins on the other. I think that you burn far more calories to metabolise fat than you do to metabolise carbohydrates. Carbohydrate does straight to energy. And, if that energy is not used immediately, your body will store it as fat. A major study on how calories from different sources are used by the body is underway in the United States - the first of its kind. It's always been assumed that a calorie is a calorie is a calorie, So we don't yet have the final answer, but I'm backing the theory that calories from carbs are used differently from those from protein or fat.

Is there a downside to Banting/LCHF?

A: The downside is that everyone is going to tell you that you're mad! Medically, the only issue for most people is constipation, which is a temporary problem because your gut flora need a little time to adjust. You can take a fibre supplement called psyllium husks during the transition which may help ease the symptoms. Probiotics are an even better option.

Should you consult your doctor before switching to the Banting/LCHF plan?

A: Probably not a good idea; most doctors are likely to tell you not to do it. Which is ludicrous, because this diet holds such promise for the treatment of cancer, diabetes, IBS and gastric reflux. I think it will be proven to be the treatment of all autoimmune diseases, including rheumatoid arthritis. But that is still in the future.

How does a diet low in cabs affect your brain?

A: The evidence is showing that low carb diets can protect against dementia. There's a reason Alzheimer's has been dubbed 'Type 3 diabetes' and that is because it is linked to insulin resistance and a high carbohydrate diet.

Can the Banting/LCHF eating plan benefit those who aren't overweight or at risk of diabetes?

A: I think so, because your insulin resistance gets worse with age. People may be fine up until the age of 40; 50 or 60, but eventually most people, I suspect, become mildly to severely insulin resistant. It's estimated that 75% of Americans over 65 are insulin resistant. And the medical profession, at least in this country (South Africa), doesn't properly recognise insulin resistance as a real issue. There are many diabetologists who don't even acknowledge it as important.