Ask The Low-Carb Experts
Jimmy Moore Presents his latest podcast, Ask The Low-Carb Experts. Listeners like YOU can call in LIVE every thursday evening at 7PM US Eastern time. Just call (712) 432-0900 and use the access code 848908 or you can Skype the show for FREE by calling the username freeconferencing.7124320900.


Weight Loss Obstacles




February 2012
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AIR DATE: February 23, 2012 at 7PM ET
FEATURED EXPERT: Dr. Cate Shanahan
FEATURED TOPIC: "The Long-Term Effects Of The High-Carb SAD Diet"

Nutrition-minded physician Dr. Cate Shanahan, MD is the author of two truly fantastic books entitled Deep Nutrition and Food Rules and looks at treating patients with quite a different perspective than most traditionally-trained medical doctors. She is a board certified Family Physician who trained in biochemistry and genetics at Cornell University before attending Robert Wood Johnson Medical School. She practiced in Hawaii for ten years where she studied ethnobotany and her healthiest patient’s culinary habits. She's a big believer in hormone regulation and the impact diet plays on it and did a fantastic job answering YOUR questions related to the long-term effects of eating a SAD diet on your hormones.

Can't make it to PaleoFX or AHS12? Check out the "Paleo Summit":


Here are some of the questions we addressed in this podcast:

I have low testosterone for years. I tried androgel with little increase in my testosterone. The next step would have been weekly injections which I would like to avoid. How does diet effect testosterone levels and all of the insidious problems that go along with low testosterone like low energy and abdominal fat?

What creates a greater health risk: sustained high blood sugars or sustained high (total) cholesterol?

I have found that if I eat before 5pm, I will become very tired for the next 2 hours and have low energy for the rest of the day. If I don't eat until after 5, the food gives me energy and I feel fine for the balance of the day. I have a chronic fatigue problem - some form of hypersomnia - and the after-5 trick has helped me cope for the last half year. I switched to a Paleo diet like you recommend about 2 months ago, but with more grains - mostly fermented whole grains. That has helped, but I still have to stick to the after-5 rule. Why does it help?

I have eaten low carb for around 3 years and lost 80 pounds. For the past 8 months about every 6 weeks I take a weekend where I eat way off program including a lot of junk food. I don't really plan it every six weeks but the way holidays and things have fallen it has seemed to work out in that time frame. I usually gain about 8-10 pounds and it takes about 4 weeks to get rid of it. Will this kind of routine keep low-carb from eventually working for me? Could it do any kind of damage to my metabolism and if so what? I really do plan on stopping this off and on again stuff someday. I hope I have not ruined my metabolism.

I was wondering if Dr. Cate's way of eating is better for everyone no matter what their problems. I know it is better than the SAD diet but is vegetarian or vegan better for hemochromatosis?

I was diagnosed with Type 1 Diabetes at age 15 and was taking insulin injections for 6 years (3 times a day) and eating a high-carbohydrate diet and really did nothing to try to control blood glucose levels with nutrition or exercise. I was able to eventually get off the insulin, drop a lot of weight and as of now, I am very lean and have no signs or symptoms of diabetes.

My question is this: Did the diet I ate, and more specifically the excess insulin I pumped into my system, which I now know is a system that is not artificial insulin-dependent, do permanent metabolic damage that I may never reverse? I am now 28 and have been in great shape for 3 years. What possible long-term effects could I still have from the previous 25 years of abuse?

Why do my hormone levels come back “normal” if I show symptoms of hormonal dysregulation? I have PCOS with abdominal fat, hirsuitism, and a touch of hair loss.

In your book Deep Nutrition you say, paraphrasing,

"Trans fat consumption interferes with hormone expression and daily infusions of sugar interferes with hormone receptivity."

In considering this, could it be plausible that in the absence of trans fat our bodies would be better able to deal with a higher-carb diet? Could this perhaps help explain the French ‘paradox’?

I am most personally interested in hormonal issues during pregnancy and post-partum. What do you advise for a person who had pre-pregnancy hormonal issues, PMS, etc. that, (despite several years of a nutrient-dense, low-carb diet) did not lead to infertility, but rather to pregnancy/post-partum depression, adrenal/thyroid malfunctioning, etc.? Is it too late for many interventions at this point (especially during pregnancy)? When has a person reached the point at which you might advise hormonal supplementation or medications of any sort?

Do semi elite athletes have the same outcomes when on the SAD as those in the general population? And is there a data set to support that? Typically we don’t look at those outcome markers in the athletes because there is little to no effect from the control group. Is there any data published that these athletes have impaired hormonal function with the continued exercise and the SAD?

In pregnant women, how can an abnormal hormonal environment from consuming the SAD diet impact the fetus? This concerns me because the SAD diet not only wreaks hormone havoc, but leads doctors to prescribe hormone drugs in pregnancy and before.

Of all the hormones in the body, which do you think are the most important and why? Are there any governing hormones?

Direct download: atlcx-7-dr-cate-shanahan.mp3
Category:general -- posted at: 1:00am EDT

AIR DATE: February 16, 2012 at 7PM ET
FEATURED EXPERT: Chris Masterjohn
FEATURED TOPIC: “All Things Lipids (Cholesterol 101)”

Episode 6 of “Ask The Low-Carb Experts” features the topic “All Things Lipids (Cholesterol 101)” with blogger and doctoral candidate in Nutritional Sciences at the University of Connecticut Chris Masterjohn where he will be graduating this Spring. He is the creator and maintainer of Cholesterol-and-Health.Com and is the author of two blogs, The Daily Lipid at Cholesterol-and-Health.Com and Mother Nature Obeyed at He is also a frequent contributor to Wise Traditions, the quarterly journal of the Weston A. Price Foundation. Chris is the author of five publications in peer-reviewed journals, including a letter to the editor of the Journal of the American College of Cardiology criticizing the conclusions of a widely publicized study about the effect of saturated fat on blood vessel function, and letter to the editor of the American Heart Journal arguing that the effect of cholesterol ester transfer protein inhibitors on vitamin E metabolism should be studied before these drugs are deemed safe for preventing heart disease, a hypothesis published in Medical Hypotheses about the molecular mechanism of vitamin D toxicity and the involvement of vitamins A and K in this mechanism, a pilot study in humans suggesting that vitamin E protects against some of the negative effects of sugar consumption published in the Journal of Nutritional Biochemistry, and a review published in Nutrition Reviews about the potential for green tea to prevent or treat nonalcoholic fatty liver diseases. Chris Masterjohn has thoroughly studied the impact of cholesterol on your health and the answers he has discovered might just surprise you. If you have questions about cholesterol, HDL, LDL, triglycerides and more then this is the podcast for you.

Here are some of the questions Chris addressed in this podcast:

My cholesterol has been high for quite a while. I was previously on Lipitor which made me feel pretty bad (old and feeble even though I’m neither) so I quit. This week my doctor got back my blood work and noticed my number was high (295) and insisted I go back on Lipitor. He said I was a ‘heart attack brewing’. I don’t want to and need some ammunition. Point me in the right direction.

I have a senior lady that her doctor has recommended her to take statins for a while. She doesn’t want to go on them, and her doctor just ran an Lp(a) test and hers was at 80. I seem to recall that statins don’t really affect Lp(a) and it’s mostly genetic. I’m not sure of her triglyceride/HDL ratio at this time, but should she be worried? Seems that Lp(a) is only an issue if you have heart disease or a lot of inflammation.


Question: Is MGmin LDL the silver bullet of atherosclerosis?

I’ve read suggestions that small, dense LDL is the killer, but I see studies suggesting that large, fluffy LDL can also be atherogenic.

In some countries (like Australia) you cannot get your cholesterol measured down to “small dense” and “large fluffy”. They only measure the basics, Triglycerides, HDL, LDL and Total cholesterol. From these numbers, is there a good ratio to indicate good health versus poor health?

My husband has high cholesterol which is made worse by another necessary medication he takes. Triglycerides were over 700; he is taking very high doses of statins, bring it to 600; We started Paleo (no sugars; no grains; full-fat dairy and meats) and blood results after two weeks showed them at 199. Is this possible to have such a dramatic change so quickly from this diet? If followup blood work shows continued improvement, what is the number that would get his doctor to take him off of the statins?

I’m a 42-year-old male with little to no family history of heart disease. My latest VAP results include:

Tot LDL-Chol Direct 167 H mg/dL
Tot. HDL-Cholesterol Dir. 52 mg/dL
Tot. VLDL-Cholesterol Dir. 23 mg/dL
Sum Total Cholesterol 241 H mg/dL
Triglycerides-Direct 75 mg/dL
Tot. NonHDL Chol(LDL+VLDL) 189 H mg/dL
Total apoB100 – calc. 118 H mg/dL
LP(a) Cholesterol 4.0 mg/dL
IDL Cholesterol 23 H mg/dL
Real LDL-Cholesterol 140 H mg/dL
Sum Total LDL-C 167 H mg/dL
REAL-LDL Size Pattern A A
Remnant Lipoprot(IDL+VLDL3) 37 H mg/dL

My doctor insists I take a statin such as Lipitor. I say I may not need it. Which one of us is right? Also, is it possible that statins inhibit the formation of arterial plaque over time?

What are your thoughts on all the alarmism surrounding glycation and fructation?

I’m about to have blood work done to be underwritten for term life insurance. I’m concerned that my cholesterol levels may have elevated because I’ve only been LC’ing for about 9 months. If it comes back bad, do you have any advice for how to explain what’s going on to help mitigate the consequences?

It’s been almost 2 years since going low carb. Before that time I was taking fenofibrate for almost 8 years because of very high trig (700 -380) and low HDL (37) because of eating SAD. Now my trig is 100 – 75, HDL is 57 and still improving without taking meds. I read that eating saturated fat and red wine will help increase HDL. At my last doctor visit he suggested in begin statins because my total cholesterol was 250 and my LDL was 148 and to see a cardiologist. I asked that he do the test for determining large and small LDL particles to which he replayed he was not qualified to request that test! I also mentioned to him that the LDL level is really a fictitious number gathered by the Friedewald equation. Would you suggest I see a cardiologist and check further? Would it be a good idea to request a CAC score, Lp(a) and test for density particles of LDL?

How are you? My question is what is Lp(a)’s role in heart disease and should we really even track it. As I recall Dr. Kurt Harris from the panu blog has what is considered a high level yet has a very low calcium score. While some on Dr. Davis heart scan blog have levels lower than his and suffer from high calcium scores or other cardiovascular issues. If we should be concerned with this lipid what is the best way to lower it? Niacin? Saturated Fats? Low Carb? I wonder if Lp(a) is just the new kid on the block for Big Pharma trying to keep the lipid hypothesis alive.

Chris, In your most recent interview with Chris Kresser you indicate that a TC:HDL ratio of 4 might be cause for concern and should be evaluated. My husband and I just got our results back, our ratios are 4.3 and 4.6. We can rule out recovering from obesity and fatty liver disease. What do you advise we do if anything? Get retested to establish our averages? Without going into too much detail, we have been following a WAPF/Paleo diet for 4 years, we are healthy and fit, I am 47, my husband is 40. Next, I have in my notes a TC range of 180-250 as found in traditional cultures. Can you also provide a range for HDL and LDL? And last, what foods, herbs, supplements, and food preparation techniques would you advise to support a healthy LDL receptor uptake process?

There seems to be a growing interest in the blogosphere with the work of Dr. Ray Peat. A major tenet of Peat’s philosophy revolves around the toxicity of virtually any dose of polyunsaturated fats (PUFA)–both n3 and n6. Given your past work on EFAs and PUFAs in general, I’d love to hear your thoughts on Dr. Peat’s stance.

What is the relation of lipid volume in the blood and speed of blood flow in the arteries and the body in general? (e.g, the documentary “Supersize Me” made a big deal about animal fat causing slower measured blood flow)

I believe higher cholesterol levels are healthier and protective against many illnesses. If my normal total cholesterol is around 205, and I make a diet change that has the effect of dropping my total cholesterol to 165, am I compromising the protective aspect of cholesterol? LDL is also lower at 92 and HDL has stayed about the same (55). Trigs are at 92. CRP is .75 and HbA1c is 5.5.

Patient just came back with very high cholesterol, but sub markers were phenomenal.

HDL 99
Triglycerides 66

Positive for celiac, although eats very little wheat. Total cholesterol 450. What could cause this?

Regarding lab measurements…lipid panels: Cholesterol measurement – what is actually being measured in standard lipid profiles, and what is being estimated? Is LDL calculated based on your TG measurement?

My stepdad has high cholesterol (mostly high Triglycerides) and has for many years—I have attached his lab report from last May—his numbers were better.

Total cholesterol 252
Triglycerides 534
HDL 33
Testosterone 235
Free testosterone 8.9

He takes: 160mg Fenofibrate, Benicar, Lovaza, DHEA, Niacin, and just started taking Red Yeast Rice. My mother thought he was on a statin—but Fenofibrate and Lovaza aren’t statins are they? Are they just as bad? Haven’t heard much discussion on these meds.

Direct download: atlcx-6-chris-masterjohn.mp3
Category:general -- posted at: 1:00am EDT

AIR DATE: February 9, 2012 at 7PM ET
FEATURED TOPIC: “Ketosis: Devil or Angel?”

Episode 5 of “Jimmy Moore Presents: Ask The Low-Carb Experts” featuresMark Sisson who is the man behind the wildly popular “Mark’s Daily Apple” blog and the author of several health books focused on primal/Paleo/low-carb living, including his bestselling 2009 release The Primal Blueprint: Reprogram Your Genes for Effortless Weight Loss, Vibrant Health, and Boundless Energy as well as several cookbooks. He has been critically acclaimed for challenging many flawed elements of conventional wisdom about diet and exercise. Sisson’s “Primal” theme encourages us to reconnect with our hunter-gatherer ancestral roots by eating natural plant and animal foods, getting plenty of low-level daily activity interspersed with occasional brief, intense exercise, and engaging in lifestyle behaviors that balance the stress of hectic modern life. Sisson was one of the world’s most versatile and accomplished endurance athletes, with a 2:18 marathon to his credit and a fourth place finish in the Hawaii Ironman World Triathlon Championships. He also served as the first anti-doping leader of the International Triathlon Union and consulted internationally for the International Olympic Committee on endurance training, nutritional supplementation, and the effects of performance enhancing drugs on athletes. He is the founder and president of Primal Nutrition, Inc. a Malibu, CA-based supplement company. Sisson lives in Malibu with his gorgeous wife and two teenage children.

Mark has studied nutrition very closely over the years and is pretty astute at articulating information from the scientific research on diet and health. One specific area of expertise he possesses is on the controversial subject of ketone bodies. He does a fabulous job addressing the nonsense that ketosis is merely “smelly breath” and goes much deeper into what the purpose of ketone bodies in the body. This is a BIG TOPIC in the low-carb community and Mark Sisson does an excellent job addressing YOUR questions.

Here are the questions about ketosis Mark addresses:

Is it better, when testing for ketones, if the stick is very dark vs. lighter. In other words, is better to have more ketones? Or is any level of ketosis adequate?

How do you explain to someone in the medical field that ketosis is not a bad thing? I was talking to my sister who is in the medical field and it seems that she along with a lot of other medical professionals who should know the difference between ketosis and ketoacidosis don’t. They automatically assume that ketosis and ketoacidosis are both bad. How do you explain the difference to them when they should already know the difference?

When I am in Ketosis – how do I know if the ketosis is from stored body fat or from excess fat that I may be eating?  Is there a certain level of fat per day (in grams or a %) that I should aim for at to ensure my ketosis is from stored body fat (and not eating too much fat).

I’ve always been taught that ketones could only be produced if you eat around 50g of carb or less.  But I’ve seen on your site that you think eating less than 50g could lead to unnecessary deprivation of plant foods.  Could you elaborate on this? 

How long does it normally take a body to get adapted to using ketones for energy? I keep starting over (VLC – around 30-40/day) because I feel like a slug for a month and just can’t take it. Now I read it can take longer than that to actually get your body adapted to using ketones for energy well? I need to lose about 75 pounds and have ZERO energy for exercise.

Is ketosis really necessary for most people to lose weight?

Are there any negative health consequences (kidneys, brain function, hypoglycemia, bone and eye health or constipation) to being in ketosis for an extended period of weeks, months or years?

Can excess protein at any one meal bring you out of ketosis? If so how much is too much?

Is a ketogenic diet inflammatory or anti-inflammatory?

Just wanted to ask you guys what to do about the dreaded keto breath. My girlfriend really hates it and refuses to even kiss my when I have it. I’ve heard all kinds of remedies, carrots, parsley and other herbs. Any suggestions?

Where does ketosis fit into my weight loss and muscle gain routine? I’m currently 5’6″ and weigh about 185 pounds.

After about 5 or 6 months of low carbing, my scalp started burning and my hair started falling out. Could this be linked with ketosis?

The brain requires a steady inflow of glucose for proper functioning. Gary Taubes mentions in Why We Get Fat that it isn’t known for sure if the brain can run as effectively on ketones as it can glucose. What are your thoughts?

I am 52 years have returned Atkins low carb eating about 4 week ago after being on the diet roller coast all my life. I am also on several medication (blood pressure, thyroid, quit the statin, supplements etc) that I know do hinder weight loss, can they be preventing me from burning more ketones? Any suggestion how I can bump up my ketosis if need to?

Does approaching diet and health from the Primal point of view consider manipulating ketones/ketosis to lose a lot of weight as the OPTIMUM way to do it? The question is assuming that hunter gatherers would not usually make it to the level of hormone damage and obesity we find common in today’s population, so evolution may not have provided a robust way to get us out of such a huge hormonal mess.

I’m wondering how the absence of a gallbladder can affect someone attempting ketosis or a Primal lifestyle in general. I have heard that others require slightly higher carbs to keep away from IBS type symptoms. Have you found this to be true?

Dr. Steve Phinney, in a video interview with Andreas Eenfeldt, says that someone who takes a one or two day “holiday” from a ketogenic diet generally takes “at least two weeks and more like 4-6 weeks” before they re-enter full nutritional ketosis. Do you have any thoughts on this? It was my assumption that it wouldn’t take that long before someone would recondition their bodies to preferentially burn fat. Do we reset the clock every time we eat enough carbohydrates to come out of ketosis?

Is lowering carbohydrates the only thing that determines whether or not someone will get into ketosis? Specifically, is there any effect food sensitivities have on being in a ketogenic state? When I eat nightshades (which I am sensitive to) my ketone bodies (as measured with ketone urine strips) go down. I generally eat a very low carbohydrate diet (less than 20 grams/day) and am wondering if this effect on my measured ketone bodies is due to food sensitivities, the increase in carbs from the nightshade foods, or some other reason?

I’d like to get Mark’s perspective on ketosis and gout risk. Also what about people who have gout going on ketosis?

Direct download: atlcx-5-mark-sisson.mp3
Category:Ketosis -- posted at: 11:59am EDT

AIR DATE: February 2, 2012 at 7PM ET
FEATURED EXPERT: Dr. Fred Pescatore
FEATURED TOPIC: “How To Improve Cardio-Metabolic Health”

Episode 4 of “Jimmy Moore Presents: Ask The Low-Carb Experts” features Dr. Fred Pescatore, M.D. who is the author of several nutritional health books, including the New York Times bestselling book The Hampton’s Diet among many others. He is a traditionally trained physician who practices nutritional medicine and is internationally recognized as a health, nutrition and weight loss expert. You may have seen him as an expert nutrition contributor on The Rachael Ray Show and he is currently on the editorial board of US weekly magazine as well as a regular contributor to In Touch, First for Women and Women’s World magazines.

Dr. Pescatore also has a masters degree in public health and is deeply involved in the philanthropic community devoting his time working in hospitals in Tanzania, while also helping to support organizations in the United States. Prior to opening his own medical practice, he was the Associate Medical Director of The Atkins Center for Complementary Medicine working closely with the late great Dr. Robert C. Atkins for five years. His extensive knowledge of the role nutrition play in improving both metabolic and cardiovascular health make him an excellent expert to call upon to address this week’s issue.


Here are some of the questions Dr. Pescatore addressed in Episode 4:

We know that chia and flax seeds are okay for low-carbers because they do not raise blood sugar. But are there any other metabolic disadvantages to consuming them? I eat 2 Tbs chia seed gel a day with stevia, cocoa powder and blueberries and I wonder if I am harming myself metabolically.

Why do you think congestive heart failure is such a common admitting diagnosis these days? Is it the increased use of statins and perhaps CoQ10 deficiency? Or is it related in some way to the increases in chronic respiratory disease like COPD? Are there different reasons in different countries?

I am 34 years old and I have been eating processed foods and junk foods my whole life. I am sure I have a fair amount of insulin resistance going on, as well as some significant muscle atrophy. I am wondering, one, if my heart could have atrophied as well? Also, now that I am 100% Paleo, how can I work on reversing the atrophies and two, what steps should I take to start rebuilding my body now that I am keeping my carb intake minimal? I am concerned about how slow I should start with exercise until I can be certain my heart is strong enough and my insulin sensitivity is adequate to start building muscle.

I would appreciate it if you could have Dr. Pescatore talk about atrial fibrillation. It is something I have occasionally but I never hear it discussed. Can low-carb or Paleo eating help it?

Dr. Pescatore, your books span weight loss for adults as well as asthma and weight loss for kids. Regarding the relationship between what we eat, our metabolism and inflammation, is there an eating style that is less inflammatory for most people, less likely to create heart problems for adults and possible reduce asthma suffering for children?

What does Dr. Pescatore think that about someone with hypertension watching their dietary salt intake and how can people tweak their diet to help get their blood pressure numbers down?

I’ve had premature ventricular contractions for many years. They seem to be more frequent now that I am 40 years old. Is this a cause for concern and can PVCs be treated through diet and lifestyle changes?

It seems that discussions of heart issues are actually only about cardiovascular factors and rhythm disturbance is ignored. The same advice to take statins and eat low-fat is given in both cases. A few weeks ago while we were attending a church service my husband collapsed then went into fibrillation, no pulse and was turning blue. Fortunately by this time an ER nurses in the congregation was with us and successfully performed CPR and restarted his heart immediately. I have to think that if he had followed the constant advice of his cardiologists to take statins and eat low fat his survival would have been questionable. He has no blockages just rhythm dysfunction which we have known about for years and which has claimed most of the males in his family. We are feeling very fortunate that we were where we were when this struck and with his pacemaker/defibrillator hope to spend many more years together. Why do they give the same wrong advice for such different etiologies?

How do you lower CRP levels with the use of food, supplements and exercise?

I was just on Dr. William Davis’ blog and noticed he is recommending the use of therapeutic niacin (1-2,000). It made me re-think stopping the niacin. Does Dr. Pescatore agree with this for people on low-carb?

Will you please comment on the factors you look at to assess whether someone is at risk for coronary artery disease. It seems the physicians on the front lines of health, with their prescription pads close at hand, are still focused solely on “the numbers” – total cholesterol, HDL, LDL and Trig. A few clicks of my mouse and a dose of Jimmy Moore has told me there might be a bit more to the story.

My doctor would like me to come in for a “discussion” on my alarming numbers.

I am a short/small person – 102 pounds. I exercise daily and have been low carb now for several months. I was not trying to lose weight (but did shave a few pounds anyway) but rather I wish to prevent the diabetes, obesity and heart disease that is a reality for many on both sides of my family.

fasting glucose is 85
Total Cholesterol is 269
LDL 182 – calculated
HDL 76
Trig. 53

The doctor is not in the habit of testing for LDL particle size and only agreed after my insistence and after seeing my shocking LDL number. The doctor did not seem to appreciate the value of performing that test. I have read otherwise — that the particle size is enormously critical.

What do you look at when determining heart health/risk and what can you suggest a person say to their doctor?

Direct download: atlcx-4-dr-fred-pescatore.mp3
Category:general -- posted at: 1:00am EDT