32> The Art and Science of Low Carbohydrate Living by Drs. Jeff Volek and Stephen Phinney
I finished reading The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable by Jeff Volek, PhD, RD and Stephen Phinney, MD, PhD, which was not the easiest of tasks, but worth the effort. It delves into the health benefits of eating Low Carb in a way that the TNT Diet and even The New Atkins For a New You don’t. It is not so much the “how” to eat Low Carb as the “why” you should eat Low Carb. It defines the parameters of eating Low Carb and the health reasons for doing so. It reviews the science behind this way of living.
What follows – in no special order – are some of the things I gleaned from this work and what they mean to me as I follow the TNT Diet.
A Low Carb diet, including TNT, be it weight loss or maintenance should be a Ketogenic Diet. No two ways about it. Anything else is just a “controlled” carb plan.
A Ketogenic Diet is one in which your body is Keto-adapted
Nutritional Ketosis is a metabolic adaptation which allows your body to derive most of your daily energy needs from fat either directly as fatty acids or indirectly by ketone bodies made from fat. Your brain uses ketone bodies and not exclusively glycogen.
Nutritional Ketosis is a benign metabolic state and is not diabetic ketoacidosis, seen in type -1 diabetes or in the late stage of type-2 diabetes with advanced pancreatic burn out.
Liver ketone production does not kick in until daily carbohydrate intake is consistently at or under 50 grams per day for a number of days.
Keto-adaptation takes a solid 2+ weeks with full metabolic adaptation happening in 6+ weeks. The same interval is required if one goes off of carb restriction be it a week or a month and then resumes the low carb diet.
Therefore any study of less than 14 days is invalid since it is not enough time for keto-adaptation.
Low Carb diets have a Natriuretic effect. High carbohydrate diets make the kidneys retain salt, whereas a low carbohydrate intake increases sodium excretion by the kidney (called ‘the natriuresis of fasting’). Failure to replace the salt will result in headaches, fatigue, weakness and constipation. To avoid this add 1-2 grams of sodium to your diet daily and especially within one hour before a heavy workout.
The body will excrete potassium in order to conserve sodium resulting in significant negative effects including cardiac dysrhythmia and muscle cramps.
When you cut back on carbohydrates to the point that fats get burned first, saturated fats go to the front of the line. They become the preferred fuel and their levels in blood and tissue triglyceride pools actually drop. Since you burn them up for energy before they can accumulate, they are not going to harm you – so relax and enjoy.
Another name for Insulin Resistance is Carbohydrate Intolerance.
1 in 4 adults in the US are Insulin Resistant (Carbohydrate Intolerant).
Metabolic Syndrome results from developing insulin resistance and is a pre-diabetic state.
Protein: 1.5 and 2.0 grams per kilogram of body weight (0.7 to 0.9 grams per pound of body weight) is the recommended amount of Protein – on any diet. No one has ever shown that more than 1.5 gram/kg improves human protein synthesis.
When you first take away dietary carbohydrate and replace it with fat, your body’s efficiency in using protein is reduced. You therefore need more protein to maintain muscle and other protein-containing tissues. But once you have become adapted to a low carb diet, most of this initial inefficiency in protein use goes away. Once Keto-adapted your body’s need for protein is not much higher than on a high carb diet.
Your muscles and liver can store somewhere between 1000 and 2000 Calories of glycogen in an adult, depending on how big your muscles are and your training status. Exercise training can increase the amount of stored glycogen.
Your body stores 3-4 grams of water along with each gram of glycogen.
I am not going to re-state all of Chapter 8, “Lipoprotein Effects.” but one concept is important: Once you are fully Keto-adapted your triglycerides go down and your HDL goes up – BUT – it takes a longer time for the HDL to respond.
The increase in HDL-C may not occur as quickly as the decrease in triglyceride, but based on empirical evidence and the results of a recent 2 year diet study, this slowly developing HDL-C boost appears to be very resilient. A notable feature of this study was the gradual increase in carbohydrates over the 2 year intervention which in this case resulted in a concomitant loss of the triglyceride-lowering benefit but a persistent benefit in HDL-C.
High Fat is equal to or greater than 60% of your energy needs and may go up to 80% of an individual’s energy needs. Less than 60% is not a high fat diet.
Exercise is not a robust stimulus for weight loss. Exercise is a wellness tool. It is not a weight loss tool. Making very heavy people exercise is punitive. Enabling heavy people to lose weight and then become more fit is smart.
The combination of dietary energy restriction with resistance training resulted in better maintenance of lean tissue during weight loss.
The combination of a low carb diet and resistance training appears to be additive – it maximizes fat loss while preserving/increasing lean body mass.
The dependence of endurance performance on muscle glycogen has been substantially overemphasized.
Low carb eating is the normal metabolic state associated with health.
If a low-carb adapted (diabetic) patient breaks the diet by eating even transient and/or modest amounts of refined carbohydrates, all those hard-won benefits can promptly disappear within a matter of hours and don’t reappear for 3-7 days.
A Ketogenic Diet is used for treatment of Epilepsy and other Seizure disorders.
The authors think highly of Taubes and his books.
What does this mean for me – and my understanding of and “faith” in the TNT Diet?
I now understand the need for people to be on Plan A for 4 weeks.
A review of all the foods allowed on Plan A, holds your carb intake to below 50 grams, the threshold for Nutritional Ketosis. You do this without having to count carbs.
I understand the reason for unlimited protein during the initial or induction phase of a low carb diet.
I may - to a certain extent – be Carb Intolerant but thanks to the TNT Diet, I no longer meet the test for Metabolic Syndrome.
My Carb Intolerance or as I have phrased it – sensitivity – has kept me on Plan A or B with only occasional re-load meals.
The Carb Cycling plans allowed on the TNT Diet are aimed at those individuals who are NOT significantly Carb Intolerant or diabetic.
I have ceased being afraid of dietary fats – actually I never was – but I really felt guilty for eating and enjoying them.
I see the value of increasing my salt intake and now have to learn to eat more salt after a lifetime of eating low salt.
I am very happy and grateful that I found the TNT Diet.
NOTA BENE: Once you’ve read the book – post your comments and let me know what you belive should be added to this list.
On June 5, 2012, Florian Sperling one of this Blog’s readers from Germany stated: I sent an email to Dr. Volek asking him to clarify his stance on the differences between TNT and the new book. On June 10, 2012, he reported back with Volek’s reply,
“People vary widely in their ability to metabolize carbohydrate in a healthy way, and even within a person that ability can change with age and other lifestyle factors. So it is difficult to make generalizations. Some athletes can tolerate and benefit from the intermittent use of carbohydrates as was presented in TNT, whereas I have come to appreciate that others may not be able to without disrupting their metabolism. At the end of the day, it comes down to personalization and finding out what works for you.“
I would posit that if this statement is true for athletes it is also true for the rest of us and that we need not be concerned about the TNT Plans.