When someone wants to overhaul their diet, be it for reasons of nutritional improvement, managing intolerances or weight loss/gain (body recomp), there is no shortage of advice to be found on the internet. Unfortunately, as a friend of mine put it, there’s also a giant bucket o’crazy.
Why, you may be wondering (and I strongly suspect several people in my life of wondering, which is not a bad thing), did I go for this very low carbohydrate deal instead of just trying to refine a “balanced diet”? It seems like a weird choice to many people, and it’s very hard to say, “I did some research” without sounding like a die-hard graduate of Google University.
The fact that my research includes the primary literature and critiques thereof is, I think, a big deal, but then we enter into a grey area of whether or not it should trump the decades old all-things-in-moderation, calorie-counting advice.
I did try that. I have done Lite’n’Easy. The main reason I did it is because I have a lot of food anxieties, and emotional panic around meal planning: the idea of paying someone else to plan the meals and hand them over was incredibly appealing, and it would force me to confront some of my triggers in a safe way (i.e., at home, where no-one will see my response, which incidentally does occasionally involve vomiting).
It’s not that Lite’n’Easy didn’t “work” for those goals. It did. There are now a few more things I can eat – it took hard work, and it was exhausting, but I had the extra emotional energy because now I wasn’t panicking about the decision making.
However, it’s pretty pricey, and long-term it gets a bit dull, and it wasn’t resolving my other issue.
The other issue is the big, fat, spanking arrow pointing me towards low carb.
The other issue is my insulin response.
For a long time, I didn’t know it was my insulin response. I thought it was fructose (I am, among other things, not able to effectively absorb fructose in my gut). I thought that sucrose (since it’s a disaccharide made up of half-fructose) was setting off that issue, and that’s why it made me feel sick.
The problem was timing. Fructose malabsorption is a gut issue. It takes a little while for food to get to your gut. Meanwhile, sugar also takes about twenty minutes to hit your bloodstream.
Here’s the problem: the sick feeling I get from eating really sweet stuff happens within seconds. Seconds. The sweeter the taste, the stronger the feeling (and the final nail in the coffin is my recent realisation that even stevia – in sufficient quantities – elicits this response, despite containing no sugar. I’ll explain). It’s a nasty feeling: a sort of falling sensation, followed by abruptly feeling so hungry that you feel sick, and then – maybe about twenty minutes to half an hour later – an extended anxiety/panic/fight-flight sensation. This is because of the cephalic phase insulin response which in me appears to be extremely overenthusiastic. Insulin is released before the sugar (or, sadly, replacement non-sugar sweetener) hits your bloodstream, in order to clear available fuels out and make way for the incoming fuels (be they sugar, fatty acids, protein, etc); this is why as you eat, your appetite can increase (“I totally did not think I was hungry but *munch munch* I am ravenous!”).
And, of course, the only way your brain knows that you’ve eaten something sweet before it absorbs any of it is the taste. More is released as you eat, and as your blood sugar goes up – that’s a bit more straightforward – and, of course, if your blood sugar goes down too far (once all the insulin has come out to play and sucked it all up), out comes glucagon (or a variety of other hormones) to release it back into the bloodstream. A rapid sugar crash can also stimulate the release of stress hormones such as cortisol and noradrenaline, which incidentally explains the fact that I get panicky and stressed as well after a sugar crash.
The fact, therefore, that I feel sick almost instantaneously suggests that my body is responding to the taste – it can’t be responding to anything else because I haven’t actually absorbed it yet.
Therefore, it must be insulin.
If high insulin makes me feel sick (and I already knew from talking to a couple of specialists that high fasting insulin is correlated with hidradenitis flares and other inflammatory issues that I have), then obviously the best way to deal with this particular metabolic quirk is to keep insulin low.
There does not appear to be any drawback to keeping insulin levels low (unless you have Type 1 Diabetes, which is a very specific metabolic situation). I haven’t been able to find anything, other than people complaining that adaptation is hard, which it is.
At the same time, there appear to be extraordinary benefits to keeping insulin low. Lower insulin promotes better metabolic health: lower overall cholesterol (although the benefit of this is genuinely debatable now that we have more refined techniques for subdividing serum cholesterol into different categories), lower triglycerides (not really debatable – this is undeniably a good thing, barring a completely groundbreaking study that would show otherwise at this point), lower blood pressure (again, up to a certain point, that’s a good thing – too low is possible). There are other benefits, although they are mostly in the “we have supporting evidence” category rather than “it’s solidly proven” category.
And in my case, it promotes “not feeling sick” which I can totally get behind.
The absolute best, number one, beats-all-comers method for keeping your insulin levels low is to reduce sugar and other carbohydrates. Since this naturally means increasing fats in the diet (you can’t live off protein – google “rabbit starvation” if you don’t believe me), it was necessary to do a bit more research and confirm that fat wasn’t the demonic beast it has been made out to be, and the primary literature has absolutely confirmed this.
(What this all means is that, if you want yoghurt, the absolute worst thing you can do for your metabolic health is pick the low fat, full-of-sugar yoghurt. It’s sold as the healthy option and this drives me bonkers, knowing what I now know)
This is how I selected “keto” (aka very low carb) as my dietary option. This is how I weeded through the big ol’ bucket of crazy when it comes to nutritional advice. I took a symptom that I have – one that is known, one that I can personally detect and feel (although yes, it has been confirmed with a few blood tests. The fact that my fasting insulin went from “crazy crazy high” to “kind of a bit too high” after quitting wheat was informative) – and worked from that. High levels of fasting insulin are correlated to many (not all) of my weird problems.
Now, this all makes a certain amount of logical and narrative sense, but there are still people who will ask why I don’t go for a “balanced” diet, with “all things in moderation”, and my response will be that I don’t eat arsenic in moderation either, and sugary things basically are like poison to me (fast-acting in terms of nausea, slow-acting in terms of overall inflammation problems and knock on health effects).
“Just a tiny bit of arsenic? Live a little!”
No. I don’t wanna feel sick.
Unfortunately, it now also seems like I need to be avoiding a certain dose of alternative sweeteners as well.
I came to this terribly tragic discovery last week. I’ve been experimenting delightedly with low-carb baking, and along with that, I use liberal amounts of stevia as a sweetener. I ate a piece of my glorious low carb raspberry cheesecake and immediately felt sicker than if I’d downed an Allens raspberry (my very favourite lolly). The same thing happened when I ate one of my low carb shortbreads.
Now, initially, when I made these things, I added less than the recommended amount of stevia, because I don’t have much of a sweet tooth. What I love about cheesecake is primarily the texture – the soft creamy filling and the biscuity base. A hint of sweetness (to overcome the sourness of the almond meal in the base and the cream cheese in the filling) honestly should be enough for me to enjoy it. For shortbread, I do need a bit more sweetness (relatively speaking).
But the second time I made these things, I followed the recipe more closely (I’d swapped to liquid stevia, which is much more concentrated, so I felt I should be precise), and that’s when I started to feel so sick. Husband also reported that it was much sweeter this time around.
Since then, I haven’t made the cheesecake again, but I have made the shortbreads – several times – and if I only add a quarter of the recommended sweetener, I’m fine.
It looks like there is a threshold of sweetness to my response, and I need to juggle and stay below that threshold, no matter what sweetener I use, in order to avoid a nauseating insulin spike. Stevia is definitely safer for me than most other sweeteners – I’ve found that my worst insulin response (as sweeteners go) is inspired by sucralose (Splenda). Aspartame and sorbitol are okay. Xylitol is perfectly fine as far as blood sugar is concerned but my gut does not like it and there are some pretty hardcore consequences (I can probably have it in small quantities).
Incidentally, an insulin spike of that size will shut down ketosis for longer than I’d like, which means that I will be getting a bit less energy from the fats that I eat, and I will not be as efficient in my workouts, so I have multiple reasons to avoid it. It also will cause water retention, which will irritate my joints and lead to inflammation, and then of course, if I have a highly inflammatory internal environment, I may get some of my other special symptoms. Much better to avoid the whole mess.
In summary, I targeted my fancy eating plan to my personal symptoms. This is one reason why, although I do recommend dropping carbs for most people, I also add that very low carb, ketogenic diets are not for everyone. Not everyone has my crazy intolerance of sweetness and carbohydrate (although it seems to apply to more people than you might think, based on some anecdotal evidence).
For me, this works.