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.

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AIR DATE: September 26, 2013 at 7PM ET
FEATURED EXPERT: Dr. William Curtis
FEATURED TOPIC: "Nutrition-Based Diabetic Therapy"

According to the latest statistics from the American Diabetes Association, 26 million Americans currently have diabetes (mostly Type 2) with a whopping 79 million more who are what's known as prediabetic where they are insulin impaired to the degree that if nothing changes they will become a full-blown diabetic in the coming years. The sad reality of these statistics is they are getting worse, not better, with an additional 2 million+ new cases of diabetes being added annually. What's going on here to explain the explosion in the rates of Type 2 diabetes and even the more rare Type 1?

That's precisely what we cover in this podcast featuring a former ER physician and family doctor from Corpus Christi, Texas named Dr. William Curtis from the multi-specialty clinic "Future Focus Family Medicine" who has become passionate about how healthcare must shift the way they treat patients away from disease management and more towards wellness and prevention care. His clinical experience has shown him firsthand that health does not come from the medicine bottle for the vast majority of patients but from the very foods they are putting in their mouths as well as fitness and lifestyle changes.

When it comes to the subject of diabetes, that statement is magnified many times over with the need for the right kind of nutrition and lifestyle treatment modalities as the FIRST line of defense in an overall wellness plan. Dr. Curtis doesn't believe we should be convincing everyone they are sick and in need of a prescription medication to get better again. He contends that a whole foods-based, low-carb lifestyle that he teaches through his NRG Tribe Diet & Lifestyle Compass will provide diabetic patients with REAL encouragement and invaluable information to help them defeat this chronic health issue. That's the topic we'll take on directly in Episode 47 of "Ask The Low-Carb Experts" taking YOUR questions on "Nutrition-Based Diabetic Therapy."

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Here are some of the questions we address in this episode:

ANDREW ASKS: It may just be a semantic argument, but I am wondering why the typical medical establishment position is that Type 2 diabetes is incurable. Conventional wisdom says that once you have a consistently elevated fasting blood glucose level, the “diabetic” label seems to stick for life. My doctor bestowed me with that distinction although he never even once checked my A1c, which I later discovered was low. But now my medical records show me as having Type 2 diabetes although I’ve never taken a single drug to treat it. This is such a scarlet letter on my health history that I’m wondering if I am plagued with this label for the rest of my life. What is the difference between "reversed" and "cured" in the context of diabetes? And is the term "managed" the best label one can hope for in the context of our current medical nomenclature?

DEB ASKS: I am a 48-year old female who has eaten low-ish carb for the last year and a half (~75-130g per day) and my fasting blood glucose was always nice and low (<85). In the last few months I've tightened up the carbs and usually consume 50 or so per day. Now my fasting blood glucose levels are regularly in the 90's and 100's and I've even seen it go as high 124 which totally freaked me out. My post-prandial numbers are fine (90-120) except occasionally if I eat some starch or sugar like a frozen yogurt, when it went to 149—it made me freak out again!

So my questions are: Can you explain why this “physiologic insulin resistance” occurs? Is it dangerous for my blood sugar levels to be lurking so high for so long? I often fast in the mornings, so that means that my fasting blood glucose tends to be high for a long time, albeit not over 140. Please tell me I'm not somehow giving myself diabetes by eating low-carb!

JANE ASKS: My aunt was eating a very low-carb diet for many years and was suddenly put on metformin. I never really thought about it until I realized that she PROBABLY was diagnosed as pre-diabetic or diabetic because she had a high fasting blood glucose level and possibly a high oral glucose tolerance test since a low-carber would show that unless they took 3 days of 150g carbohydrates daily prior to the test. I'm sure she didn't. Even if her A1C is normal (which she reports it is now), I have a feeling that her doctor would have looked at these two “smoking guns” and labeled her diabetic when in reality she was just a good law-abiding low-carber!

Of course she LOVES being on metformin because for the first time in her life, she can eat bread and chocolate cake for dessert when we gather and it's all solved by this newfound magic pill. I don't want to be the stick-in-the-mud to tell her that she should be retested and suddenly give up all that sugary goodness for the rest of her life. My question for you is how dangerous is it for her to be on metformin in this circumstance and should I be that evil niece to break it to her that this sweet-fest should come to an end? She is nearly 70 years old and has had all sorts of medical issues including breast cancer, lymphoma, rapid heart rate and high cholesterol. I love her but I don't want to ruin her twilight years! This scares the daylights out of me that innocent low-carbers might get caught in this trap if they are not informed about these abnormal test results that are actually completely normal.

PEGGY ASKS: I am looking for an answer as to why my sister has very high fasting blood sugar levels even after 14 years of low-carbing. We have a strong family history of insulin-resistance related health problems including Type II Diabetes. My siblings and I all went low-carb in 2000. My brother and I have been very successful, but our older sister who was already diagnosed with Type II diabetes has not been able to get control of her blood sugar. She sees a traditional medical doctor and has been on metformin, Januvia, and other medications. She even took insulin for a brief period because the high fasting blood sugars just didn’t come down. I've suggested she try a very low-carb, high-fat, ketogenic like I do and I think she has trouble with it because she doesn't like fatty meats. I’m not sure how high her fat intake is and if she's getting too much protein in her diet. But it just doesn’t make any sense that she can have a fasting blood glucose level in the morning as high as 300 on a low-carb diet. Food doesn't seem to have an effect on her blood sugar levels that tend to go down throughout the day. But with those high fasting numbers, her A1c has been as high as 12! That is so frightening to me and thankfully she hasn’t experienced any complications in her health yet. She does take a beta blocker and swears that without it she gets migraines. She works very hard in her job and has a lot of stress that may be contributing to this. And, unfortunately, she is still overweight and carries it in her midsection. Got any words of advice about what my sister can do?

JAN ASKS: So what’s the deal with insulin? We obviously need to secrete SOME insulin for our body to perform as it was intended. Would a low-carb or ketogenic diet interfere in any way with the benefits that could come from insulin secretion beyond simple glucose metabolism?

I keep hearing from various sources that low-carb or ketogenic diets doesn’t “cure” the underlying metabolic issue in the diabetes pathway (i.e. insulin resistance, pre-diabetes, or Type II diabetes), they merely control the symptoms. Some people even assert that the low-carb or ketogenic diet itself causes insulin resistance, claiming that we are not “cured” unless our bodies can become insulin sensitive to handle carbohydrates like those who have a “normal” metabolism. In fact, there are those like Perfect Health Diet author Paul Jaminet and even starch-based vegan diet advocate Dr. John McDougall who claim that carbohydrates are absolutely necessary to help us become insulin sensitive. What is your opinion about this?

JEANNE ASKS: I’m 55 years old and have a family history of Type II diabetes and have been interested in eating healthy and anti-aging for over 22 years. So, I have been off sugar for a long time. Lately I’ve been hearing more and more about the ketogenic diet and I read the books by Dr. Jeff Volek and Dr. Steve Phinney. I have been eating low-carb, moderate protein, high-fat since June 1st. It was really easy for me to get into a ketogenic state since I was already grain free and sugar free. My question is this: My blood ketone readings range from .6 - 3.7 millimolar, but my fasting blood sugar levels has gone UP in the recent weeks. Initially, I was seeing blood sugar readings in the upper 80’s/low 90’s when I woke up in the morning but now it’s upper 90’s/low 100’s. I don't see a correlation now between the ketone level and blood sugar level. Do you have any idea what might be going on? I'm almost to the point of just ignoring the blood sugar reading for a while just to see if it normalizes. I feel good and I am not eating any carbs that would raise my blood sugar like that. I do enjoy a glass or two of wine a few times a week but I include those carbs in my total. I’m 5'8" and weigh 136 pounds. I eat an average of 1100 calories/day with 50-60g protein, 40g carbohydrate and the rest dietary fats mostly from avocado, fatty meats, macadamia nuts and coconut oil.

HEIDI ASKS: My husband may as well be considered "genetically diabetic" since his entire paternal line is diabetic, and includes both Type 1 and Type 2 diabetes. I've been trying to help him with his blood sugar problem for over a decade. A couple of years ago, his doctor got worried enough to issue him a blood glucose meter and recommended he take his fasting readings weekly. When his fasting readings crept up to 100, and then toward 110, I hit the panic button and started shoveling supplements at him, including fiber. When that was no longer enough, the carbs came way down to the point of Atkins Induction and then a ketogenic diet. Not much improvement came after that until I heard a podcast about intermittent fasting and tried spacing out my husband’s meals. Clearly his body has trouble clearing out the blood sugar spikes from his previous meals. The IF strategy did bring the fasting and post-prandial numbers down a little bit, but what REALLY seems to be working is the reintroduction of carbs on a weekly basis a la Kiefer’s Carb Nite Solution plan. For example, last Friday night he gorged on melon at a co-worker's farewell party and his fasting blood sugar level the next morning was 102 and then in the 90's all day on Sunday. A few days later he was back in the upper 80’s eating low-carb and implementing intermittent fasting. My question for you is this: WHY IS THIS WORKING? It goes completely against every bit of logic and reasoning I’ve ever heard about managing diabetes.

FRED ASKS: I started eating low-carb to control my Type 2 diabetes I was diagnosed with 15 years ago. I only eat a small amount of oatmeal and berries for breakfast and animal protein and fats with lots of vegetables for lunch and dinner. My nutritionist has suggested that I start eating 150g carbohydrates per day but my blood sugar numbers eating low-carb are in the 90’s consistently. My doctor recently increased my metformin dosage to two 500 mg tablets in the morning and at night. My last A1c level was 7.4. Here are my questions for you: How many carbs should a diabetic be eating in a day? Is it dangerous to consume less than 85g carbohydrates daily (this is what I’m currently doing)?

JEANNIE IN NORWAY ASKS: My father-in-law has been on metformin for years. His A1c has been close to 10 at times. He replaced his bread and potatoes with salad vegetables. He still eats fruit, though. He is incredibly skeptical about consuming dietary fat and refuses to add it in out of fears for his health. He swears that he tested himself after eating salad with and without oil and that his blood sugar was higher with the increased fat. His last A1c was pretty good at 5.6. When should he consider weaning himself off of metformin? I have finally convinced him to try 2-4 Tbs coconut oil daily to help prevent memory loss. Have you noticed any increase in blood sugar levels with your patients when they have added fat to their diet?

ERIK ASKS: Please ask Dr. Curtis about the use of regular insulin vs. long lasting insulin for Type 2 diabetes while following a low-carb, moderate protein, high-fat diet. I am a 5’9”, 210-pound Type 2 diabetic who has been eating a fat/protein/carb ratio of 70/20/10 for the past four months. I would like to use insulin to lower my blood sugar levels but I’m concerned it will slow down or stop my weight loss efforts. Do I need to lower my calories when taking the insulin or is there a better way to control my diabetes and achieve my weight loss goals?

PETER ASKS: I was diagnosed as a Type 1 diabetic in October 2012 and it came as a surprise to me since I considered myself to be far above average in health. I am an endurance athlete and coach and had just completed my third ironman distance event the month before. My training was off a bit and I experience high levels of inflammation, frequent colds, eye infections, and my body wasn't responding to training as it had in the past. I still did surprisingly well all things considered. As a larger than normal athlete at 6'5”, 220 pounds and 10-12% body fat, I would consume about 5000 calories/day. I already was a fan of coconut oil and never feared fat, but I also ate more than my fair share of carbohydrates. I saved money by making my own bread, thinking that would make it healthier. I was under the assumption that I needed carbs for my exercise performance, but post dinner I'd be glued to the couch. I just wasn't quite myself. Since becoming a Type 1 diabetic and being very sensitive to insulin (1U to 40grams initially), common sense taught me the easiest way to balance the carbs and insulin would be to use as little of each as possible. I started using an insulin pump which has allowed me to fine tune even further. For the past 7-8 months I've been on the ketogenic approach carefully researching all along the way and I’ve been very successful with this. I'm now planning to compete in the Ironman Arizona in just a few weeks. So here are my questions: Should I have a variable level of insulin so that my body doesn’t get used to a steady rate? I already reduce my rate while exercising, which is usually a couple of hours per day. What is the natural fluctuation the people see in a healthy body? And is there a good blood sugar range I should be shooting for being in a ketogenic state while exercising?

NICK ASKS: I work in Family Practice and find many patients cannot even consider giving up bread, rice and pasta. Do you have any tips to increase compliance with the diet when you first approach a patient about going on a low-carb plan? What has your “real life” experience been with long-term diabetes on large doses of insulin (>100 units per day) who adopt a low-carb lifestyle? Do you see problems in this type of patient particularly in achieving the blood sugar lowering you’d hope for and do you attribute that to glucagon dysfunction and hepatic insulin resistance? What other factors should be considered when low-carb just isn’t enough on its own?

Direct download: ATLCX-47-curtis.mp3
Category:general -- posted at: 1:00am EDT

AIR DATE: September 19, 2013 at 7PM ET
FEATURED EXPERT: Dr. Jacob Egbert
FEATURED TOPIC: "Functional Fitness Medicine"

One of the major flaws in the way traditional medicine is practiced these days is this over-obsession on treating symptoms and lab panels rather than getting to the heart of what is causing chronic disease in the first place. Rather than seeking out preventative modalities that include nutrition, fitness and lifestyle changes, many doctors are opting for pharmaceutical and surgical answers first without ever giving a second thought to alternative treatment options. Thankfully, there are an ever-growing number of medical professionals who are bucking that system by zeroing in on what just plain works for their patients.

That's exactly what this week's guest expert has done and the lives of his patients are being changed on a daily basis as a result. He is a Utah-based Physical Medicine and Rehabilitation specialist named Dr. Jacob Egbert, DO from "PrimalRx" and the "Primal Mountain Strength and Conditioning" gym. Dr. Egbert has seen firsthand how debilitating physical weakness is for most people and is committed to improving their functional fitness level to coincide with a rock-solid Paleo nutritional plan. That's what we'll address in Episode 46 of "Ask The Low-Carb Experts" taking YOUR questions on the topic "Functional Fitness Medicine."

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Here are a few of the questions we addressed in this podcast:

ANN ASKS: I have been following a high-fat, moderate protein, low-carb diet for the past 5 months. It has been life-changing for me to say the least and I have lost 40 pounds with no exercise. But now I would like to become stronger and more flexible but unfortunately can't afford to join a gym. Do you have some suggestions to help me accomplish this goal in my home?

JAMIE FROM AUSTRALIA ASKS: A medical term we don't hear enough about is “sarcopenia,” that is the loss of skeletal muscle mass and strength. This is typically attributed to aging, but a lack of physical activity, dieting and illness are the primary forces behind why it happens. Of course our skeletal muscles are the body's sink for glucose and are important for metabolic health. So here’s my question: What is the best way for a doctor to monitor muscle mass and strength changes? Why don't they pay any attention to muscle status? Is there a role for a certified personal trainer in the health care system to monitor strength as a simple predictor of muscle health? Is there a process or prescription/referral pad for a doctor to prescribe exercise or refer a patient to a certified trainer?

Direct download: ATLCX-46-egbert.mp3
Category:general -- posted at: 1:00am EDT

AIR DATE: September 12, 2013 at 7PM ET
FEATURED EXPERT: John Kiefer & Dr. Rocky Patel
FEATURED TOPIC: "Cyclical Ketogenic Diets For Health And Performance"

At the recent 2013 Ancestral Health Symposium in Atlanta, Georgia last month, Jimmy Moore was the moderator of a fantastic panel of experts addressing the topic "Ketogenic Diets & Exercise Performance" featuring a star-studded line-up of Paleo fitness studs that included Robb Wolf, Mark Sisson, Ben Greenfield and Jamie Scott. The general consensus by most of these top names regarding the future use of the ketogenic approach for exercise and general health is the idea of regularly cycling in and out of ketosis to experience the maximum benefits. This is something that our expert guests this week know just a thing or two about. They are an exercise scientist, nutrition expert, and the author of The Carb-Nite Solution as well as Carb Back-Loading 1.0 named John Kiefer and a board-certified family physician from Gilbert, Arizona named Dr. Rocky Patel. These two knowledgeable men were here in Episode 45 of "Ask The Low-Carb Experts" addressing the issue "Cyclical Ketogenic Diets For Health And Performance."

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Here are some of the questions we address in this episode:

PEGGY ASKS: I see no reason why I should "cycle" in and out of ketosis. That seems a bit ridiculous to me, actually, when my performance is so fabulous remaining in ketosis virtually all the time. It's been truly miraculous for me. What added benefits will I get from going out of ketosis on occasion rather than simply staying in a constant state of ketosis for my exercise performance?

ALAN ASKS: Dr. Peter Attia on his “Eating Academy” web site (http://eatingacademy.com/nutrition/ketosis-advantaged-or-misunderstood-state-part-i) says that research shows "someone in nutritional ketosis – even if eating zero carbohydrates – still has about 50-70% of a normal glycogen level, as demonstrated by muscle biopsies in such subjects." I have been on a ketogenic diet myself since May 2013. And as a recreational athlete, I like to do long endurance runs of 13+ miles at a time. Sometimes my runs are great, but other times the performance is poor and I bonk near the end. It feels like I have depleted my muscle glycogen stores at this point. What strategies would you recommend that I do to boost the muscle glycogen prior to going on a long run while on a ketogenic diet?

ADAM ASKS: Is there such a thing as bulking up on a ketogenic diet? If you can’t bulk up in the traditional sense, then can you at least build muscle or see body recomp changes using a ketogenic approach?

JERIS ASKS: I do a lot of Bikram Yoga and I've been on a low-carb, high fat ketogenic diet for several months. I noticed at first I was getting that ammonia smell and bonking near the end of the 90 minutes. I tried loading up on different carbs and experimented with this on several occasions. A bunch a fruit right before, sweet potatoes the night before--nothing worked.

Finally, I heard Ben Greenfield talking about MCT oil and I was already putting that in my coffee in the morning. So I tried putting it in my water for the yoga and amazingly I could do the whole class with no carbs and without bonking or getting the ammonia smell. Maybe I just wasn't getting enough calories of any kind or I was eating too much protein.

My question is this: Is it okay to use MCT oil daily in order to stay in ketosis? I guess cycling in and out would mean back-loading with a sweet potato or some other "safe starch" once or twice a week. I'm not doing that right now, I'm just eating a bunch of veggies and a little bit of berries for carbs, so I THINK I'm staying in ketosis. If you stay in ketosis, then won't you become fat adapted more quickly?

DENNIS ASKS: If someone is engaging in a 24-hour intermittent fast a couple of times a week, then should they break the fast with starches?

LINDA ASKS: I am a 50-year old female runner who has been running for nearly three decades. I’ve always eaten carbs and low-fat protein 5-6 meals a day up until a year and a half ago when I started to lower the carbs and up the fat. I am at a healthy weight, but found that adding the fat made me feel so much better. I’ve been eating mostly Paleo with a little bit of dairy. I’ve really enjoyed listening to the ketogenic success stories of athletes like Ben Greenfield, Vinnie Tortorich, and of course Jeff Volek and Dr. Steve Phinney. My question is how is this working for the ladies? Even all the male podcasters have female co-hosts that seem to whisper in the background that they need more carbs, especially when they race or train at high intensity. I will admit, when I posted to Ben about how many carbs to eat when training for a half marathon, he said at least 100g on high volume days and scale back on rest days. I know eating for leanness and eating for performance are two different goals, but I would like to hear more about low-carb performance for women, especially at you get older.

DAMON ASKS: If someone ate a cyclical ketogenic diet but never got blood ketone levels to a significant level, then it seems to me that they would be in no man’s land where they have no ketones for energy but are also carbohydrate depleted. How can someone with this issue of low ketones and depleted carbohydrate stores figure out how to increase ketones to improve their health and performance?

LAWRENCE ASKS: Keifer says that staying on a ketogenic diet for too long can lower your testosterone levels. But low-carb researchers like Dr. Steve Phinney and Dr. Jeff Volek never mention this as a long-term problem for people in a constant state of nutritional ketosis. On what basis does Keifer make this claim?

JASON ASKS: Is a cyclical carb strategy REALLY necessary for everyone or is it more dependent on the specific kind of activity you are engaging in? I stay in a constant state of ketosis and run 20 hour/week as well as hit the gym twice weekly. I never feel low on energy and actually feel great pretty much all the time. In fact I do NOT like the feeling I get when I am kicked out of ketosis. In light of this, is there some unknown performance reason why I should be cycling in carbohydrates into my diet? And if I do decide to add in some carbohydrates, how do you determine the correct quantity so you don’t prevent keto-adaptation from taking place?

MINDY ASKS: I’m a 47-year old female who weighs ~175 pounds and I want to lose body fat. I’ve been on a Paleo/low-carb plan for about 3 years and I swing kettle bells a few times a week for exercise. I am currently attempting to do my own version of Kiefer’s CarbNite plan with a very low-carb, higher fat program for six days followed by a smaller carby snack, carby dinner, and ice cream on day 7. I’ve had blowout CarbNites before and then end up spending the next 6 days just losing what I gained from that event which is why I'm scaling back on them. Also, I initially did your high protein protocol and started gaining weight. I have found that much lower protein and higher fat just works and feels better for me. What, if anything, would you advise I change about the way I’m implementing a cyclical ketogenic diet?

DAMON ASKS: What is the maximum amount of time that you suggest being low-carb before beginning to cycle in and out of ketosis? Other than diabetes, are there any other conditions that may prevent someone from getting into ketogenesis if they are eating low-carb, high-fat?

MARK ASKS: What is the relationship between ketogenic cycling frequency, the amount of workload during exercise, and lowering body fat percentage if your goal is continual fat loss?

GREG ASKS: Does Kiefer or Dr. Patel promote using tools like blood glucometers or blood ketone meters along with the carb back loading protocol? I am particularly interested in the context of someone like myself who is around 15% body fat while doing heavy lifts like back squats, deadlifts, bench presses, and military presses a few times per week. Is there a particularly good way someone could use these meters to optimize and individualize things like carbohydrate intake post workout?

PAUL ASKS: On The CarbNite Solution, is it possible to kick start things by lowering your protein intake down to the bare minimum needs perhaps around 30-40g a day? If so, is this something you’d do for 6 of the seven days or just a few of them?

DEBBY ASKS: I'm currently using the CarbNite Solution protocol and an avid baker using coconut oil and coconut milk predominantly in my baking. I live a primal/Paleo lifestyle and limit my carbs to rice, sweet potatoes, and other real food starchy carb sources. I have heard that combining MCT oil with carbs, like sweet potatoes, raises insulin levels. If this is true, then would using coconut oil with other clean carbs such as the ones I listed above do the same? And if so, is there a limit to how much coconut oil to consume with our carbohydrate on a CarbNite plan?

JULIE ASKS: I am a 34-year old female currently following the CarbNite Solution program. I had gestational diabetes with both of my kids 2 and 3 years ago. At my heaviest weight I was 260 pounds and my fasting blood sugar level was about 104. I gradually reduced carbs and finally discover CarbNite Solution that helped me get down to 185 pounds with an 84 fasting blood sugar in the morning and 5.4 A1c level. However, my blood sugar sometimes goes up to 97-104 on other mornings. Is this something to be concerned with? Should I consume less carbs on my CarbNite until my readings return to normal the next morning? Or am I just overthinking this?

JOS ASKS: I'm a 34-year old female and just started weight training about almost a year ago. I am 5’5” and weigh 110-112 pounds with about 19% body fat. My goal is to increase muscles while minimizing fat gain. My current workout program mainly focuses on basic lifts such as a glute bridge, squats, deadlift, push and pull. I've been on CarbNite Solution for almost a year and have lost a good amount fat and gained a bit more muscle. I used to be that skinny fat Asian girl.

Recently I've just started to increase my training intensity by going a bit heavier in weights. I heard that once you increase the workout intensity that we need to increase our carb re-feeds during the week, as opposed only having it once a week. What do you consider “working out with intensity” and why can't we just increase the amount of carbs in our once a week carb re-feed CarbNite instead of eating more carbs during the week? Or do you think I should start switching to your other protocol, Carb Back Loading?

Direct download: ATLCX-45-kiefer-patel.mp3
Category:general -- posted at: 1:00am EDT

AIR DATE: September 5, 2013 at 7PM ET
FEATURED EXPERT: Dr. Paul Ralston
FEATURED TOPIC: "Low-Carb Diets & Spinal Pain"

Have you ever suffered from back pain in your life? If you're like most people, the answer is an emphatic YES! Spinal pain is the #1 cause of disability worldwide and lower back pain is the #2 cause of missed days at work (behind sunny days!). What's at the root cause of all of this chronic pain that people are dealing with? And what can a low-carb and/or Paleo nutrition and lifestyle plan do to help alleviate the aches associated with our backs? That's what a Milwaukee, WI-based chiropractor named Dr. Paul Ralston will be exploring with us in this week's show. Dr. Ralston presented a lecture entitled "The Effect of Diet on Chronic Spinal Pain Disorders" at the recent 2013 Ancestral Health Symposium in Atlanta, Georgia last month and he is a big fan of CrossFit, Paleo and low-carb diets. In other words, he knows just a thing or two on this subject we've got for you in Episode 43 of "Ask The Low-Carb Experts" addressing the issue "Low-Carb Diets & Spinal Pain."

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Here are some of the questions we address in this episode:

MARGIEANNE FROM NEW ZEALAND ASKS:
I’m a 75-year old woman and have had Bells Palsy since February 2012. I am working hard to stay in a state of nutritional ketosis. Recently I twisted my back while re-learning to ride a bike again. My chiropractor is doing wonders so I have great hope of feeling better than I did before the accident. I think I'm doing okay with my diet except I seem to be stuck about 44 pounds heavier than I’d like. I have about 30g of coconut oil daily and 10-15 mL of cod liver fish oil. Since I'm not losing weight, I've been tweaking things until I find what works again, including setting for myself a goal of getting in 10,000 steps/day several times a week. Is there anything else I can do to optimize my health based on what you’ve heard from my story?

KIM ASKS:
I suffer from a lot of back pain mostly due to spinal fusion, scoliosis, degenerative discs, and fibromyalgia. The pain has gotten a lot better since I started eating low-carb. Why does low-carb help with back pain? I know I would have less back pain if I could lose some belly fat, but low-carb alone is not getting rid of it. I currently take oxycodone for the pain and wondered if taking pain medications interferes with weight loss. Do you have any natural remedies that can help me with my persistent back pain?

J.D. ASKS:
I used to get severe pain in my lower back whenever I ran. Over the years, it began showing up when I walked, too. Among my many pre-low-carb attempts to fix my health, I tried a calisthenics routine for a few months that involved back extensions and that improved things considerably extending the distance I could walk. When I started eating low-carb, it had progressed to the point that I couldn't walk more than half-a-mile without pain. In fact, two weeks after starting low-carb, it was gone, entirely, and has never come back again! I spent the day at the State Fair, last weekend, walking for more than ten hours, carrying a backpack, and I had soreness in my joints, and in my shoulders and back, and was generally worn out--but I never experienced that back pain. And here's the thing: it disappeared over the space of two weeks, during which I did no exercise and lost about five pounds. So what changed?

I have to think that the problem involved fuel partitioning. My hypothesis is that because I was severely insulin resistant, and thus hyperinsulinemic, when I walked the muscles in my back were mostly burning carbs, and that the pain I felt was just ordinary lactic acid build-up. After I went low-carb and got my insulin levels under control, I regained the ability to burn fat. Of course, I may be entirely off-base, but whatever happened, it couldn't have been a response to weight loss or exercise, because it happened before any significant amount of either had occurred. Does Dr. Ralston have any thoughts about my situation?

Direct download: ATLCX-44-ralston.mp3
Category:general -- posted at: 4:00am EDT