Type 2 Nutrition #1000: Oprah Winfrey or Me?

 In 2010, when I started to write about nutrition – specifically, nutrition for type 2 diabetics – I had no idea that I would write 1,000 columns. After all, my message was really quite simple: 1) take charge of your own type 2 diabetes health, 2) eat very low carb and 3) lose weight without hunger…and your type 2 diabetes will take care of itself. Your diabetes will quickly go into remission, and you will become healthier and happier with all your outcomes. The scale and your lab tests will testify to your success.

And that all proved to be true.

But it was also true that this Very Low Carb thing was a new paradigm. As such, at the time, it was not sanctioned by the medical establishment. In fact, it went against the Standard of Care. Clinicians were taught to treat a somewhat higher than normal blood sugar as a precursor to a metabolic disease condition which they named Pre-diabetes, to get a billing code. Then they established a new standard for defining full-blown type 2 diabetes (a different billing code), and just to be sure they were covered, they established that “obesity” was classified as a disease so it too could get its own billing code.

To treat these conditions, observable on any office scale and by simple laboratory tests, they could prescribe existing and newly developing pharmaceuticals to “treat” these symptoms of disease. And as the conditions worsened (because they had designated type 2 diabetes as a “progressive” disease), they prescribed higher doses and, with the passage of time, new classes of meds to treat the disease.

Of course, these physicians also advised patients to “diet and exercise” (“eat less and move more”), but when that didn’t work and the disease “progressed”, they blamed the patient for not sticking to the prescribed diet. On the patient’s chart it said “patient non-compliant.” It never occurred to the physician that it was the “prescription,” the diet recommended by USDA/HHS, Big Pharma, and the AMA, AHA, ADA, etc. that was the underlying problem…in point of fact, the cause of these chronic diseases.

So, in 2010, my storm-tossed message was lost in this sea of conflicting messages. I had to repeat it over and over, as it turned out, 1,000 times. But I did get some encouragement. Among the first, the 2015 Dietary Guidelines for Americans (DGA) stopped recommending that we eat no more than 300 grams of cholesterol a day. “Dietary cholesterol” was, “no longer considered a nutrient of concern.”

Another, the 2020 DGA declared that dietary fat be no longer limited to 30% of daily input. That was a tacit admission that eating fat didn’t make you fat. And, with protein at 10-15%, and carbs already at 55-60% (and by implication the leading cause of obesity and Insulin Resistance, this delimiting of fat allowed for fewer carbs. Unfortunately, they then doubled down by pushing for more “factory-made” fat (vegetable and seed oils), aka PUFA’s, instead of Saturated Fat naturally present is animal protein

Finally, the ADA, after years of opposing low carbohydrate diets as dangerous fads and hard to stick to, with “not enough long-term randomized controlled trials,” etc., the ADA relented and admitted that low carb diets were now an acceptable eating pattern for blood sugar regulation and weight loss.

But, in this storm-tossed sea, Big Pharma is fighting back. Recently, Oprah Winfrey had a primetime television network special touting the latest craze in weight loss drugs: a new class of injectable drug called a GLP-1. Two brands, Ozempic and Mounjaro, are among a passel in a crowded field that is very expensive ($1,000/mo.) and not covered by medical insurance (yet), and that’s why Oprah is schilling for them. She said, “don’t blame yourself” for being fat. She pointedly added, obesity is a “disease.” The 1-hour show was an infomercial for Big Pharma designed to get the taxpayer to “pay the piper.”

So, the way I see it is this: you have a choice: MY WAY: 1) take charge of your own health now, eat very low carb and lose lots of weight without hunger or 2) OPRAH’S WAY: wait for the lobbyists and politicians to make a deal, and then inject yourself in the belly with chemicals for the rest of your life.

Type 2 Nutrition #999: "Have I got a diet for YOU!"

 It’s been almost four years since I wrote my 997^th and “final” column at type2nutrition.com. My little writing adventure began in 2010 in response to a small, weekly-newspaper publisher’s request that I write (for free) a weekly 750-word column on any subject I chose. He needed content, and he knew (from many Letters to the Editor I had written) that I could write well enough to not require much editing and still not be a discredit to his newspaper.

The subject I chose was nutrition for type 2 diabetics. I had a story to tell, and he agreed. It all began in 2002 when my internist greeted me from his nurses’ station as I walked into the waiting room for a scheduled appointment. My doctor, an internist/cardiologist, said to me, “Have I got a diet for YOU!”

That was August, more than 21 years ago. Sixteen years earlier, in 1986, I had been diagnosed with type 2 diabetes. Over the years I had been prescribed oral anti-diabetic drugs until I was maxed out on one class and then another, and was starting a third. Soon, I would be injecting insulin or, in today’s drug world, a newer class of injectable. Because, that was (and still is) the Standard of Care for type 2s.

But my doctor wanted me to LOSE WEIGHT. He had me covered for diabetes (and hypertension) with drugs. However, a few weeks earlier, on July 7, 2002, he had read a New York Times Sunday Magazine cover story, “What If It’s All Been a Big Fat Lie,” by science writer Gary Taubes. The story attracted him because the cover photo was a ribeye steak with a pat of butter on top, and he was, besides my internist, a cardiologist. And, to a cardiologist, that picture was a prescription for a heart attack!

But my doctor tried the described diet himself, and in 6 weeks’ time, he’d lost 17 pounds. So, since he was starting a 2-week end-of-August vacation, he suggested I read up about it and start the diet the day after Labor Day, which I did. I had weighed in at 375 pounds that day, and I wanted to lose weight too.

The rest, as they say, is history. I lost 60 pounds in the next 9 months (39 weeks; 1½ pounds/week) but then regained 12 pounds over the next 4 years. So, I rededicated myself and lost 100 pounds in the next year, and then another 10 and finally another 30, altogether losing 188 pounds. By August 2017, I had become, quite literally (375/2 = 187.5), “just half the man I used to be,” to quote my wife.

I’m proud of the weight loss, of course, but importantly (and I almost forgot to mention it), from the beginning, my type 2 diabetes has been IN REMISSION (clinically neither “diabetic” nor “prediabetic”). My A1c is now 5.4%. Following the diet strictly, taking my prescribed meds, on the 1^st day, I had a late afternoon “hypo” (a low blood sugar). I felt a little light headed, so I ate a candy bar and called my doctor who took me off one of the meds. The next afternoon I had another hypo, and he cut the other two meds in half, and soon after he cut them in half again. He then took me off the SU (micronase) completely and left me only on metformin, which I still take today. And I haven’t had a hypo since!

Importantly, my blood lipids also greatly improved: over a few months my HDL more than doubled, my triglycerides were cut by 2/3rds and my LDL stayed the same. My doctor saw me monthly for a year (quarterly now) and with all the weight loss, he was also able to cut back on my blood pressure meds.

And for the skeptics out there, here’s the big surprise: Today, MORE THAN 20 YEARS LATER, after making this lifestyle change in my Way of Eating, I am still more than 150 pounds lighter than when I started. At 222 pounds today, I’m at the weight I was when I started high school 70 years ago.

The diet? It goes by different names today, but there is only one governing principle: eat VERY LOW CARB. Just avoid them. All of them. There are NO essential carbs. The body can make all the glucose it needs from amino acids (from protein) and fatty acids (from triglycerides/fat) through gluconeogenesis. If a food is not fat or protein, it’s a carb. Period! If you’re overweight, or prediabetic, or a diagnosed type 2, you’re CARBOHYDRATE INTOLERANT. Avoid them.  To be healthy again, JUST DON’T EAT CARBS.

Type 2 Nutrition #998: "I write about nutrition." Crickets!

When I introduce myself as Dan Brown, people sometimes hesitate and then ask, “Are you…” I reply, “No, but I do write a little.” Then they usually ask, “About what?” and I say, “Nutrition.” Pause. Crickets.

No, I’m not talking about eating bugs. I’m a meat eater. Mostly protein and fat. As few carbs as possible. But the silence (“crickets”) is because… I am, well, still “overweight.” At 5’-10” (shrunken from 6 feet), I currently weigh 222 pounds. I’m not muscular, so all that extra weight is body fat. My BMI is 32 (obese). Overweight is 25 to <30. “Healthy” is 18.5 to <25. And frankly, I would call that BMI “sickly.”

“Crickets” is just being polite in casual conversation. The “silent person” is actually thinking, Would I take nutrition advice from a person who is obese? Especially if that “silent person” is “normal” weight. Out of context, the answer is, “no”! It’s ludicrous. I actually laugh when I see the morbidly obese Health Minister of a certain European country or even our own U. S. Assistant Secretary for Health.

But context is important. (Witness: “bloodbath.”) While my current BMI is 32, my BMI used to be 52. And, at 222 today (2024), I still weigh more than 150 pounds less than I weighed in 2002 (375). Without surgery! Or exercise! Just nutrition. Just learning about the physiology of weight gain and weight loss.

So, after I lost all that weight (and as adjunct put my type 2 diabetes “in remission” in the first days before any weight loss), I had the opportunity to write about nutrition for a local weekly newspaper, and I took it. And then I discovered the internet, and I started posting my columns on line. This is #998.

How did I do it? I already told you. It’s not complicated. I eat mostly protein and fat, and as few carbs as possible. I like all animal protein, and full-fat dairy, but I limit my daily dairy to heavy cream and butter.

For “meat,” I prefer ruminant species, principally beef (steaks or chopped/mince) but lamb is good for a treat. I sometimes eat pork and chicken (skin on), but never breaded or deep fried. All seafood appeals to me, but I’m partial to shrimp, clams, oysters and mussels, and cod or any other white, flaky fish. For lunch, I love a can (tin) of sardines, tuna, mackerel or salmon, so long as it’s packed in olive oil or water.

I skip breakfast, except for coffee, and as you can see, I eat a very light lunch (just a can/tin of fish). And supper is usually just one of the “meats” I’ve described above, with fat. I don’t prepare a vegetable, but I do eat vegetables when served in a restaurant or by a host. I prefer the above ground type or the leafy type. I don’t eat bread or potatoes or other root vegetable (except on Thanksgiving and Christmas day).

Why am I not hungry? Here’s the physiology part: There are only three macronutrients: protein, fat and carbohydrates. Protein has many important bodily functions, building and maintaining a host of essential structures and processes, but it is not a primary fuel. Fat is a dense fuel (9 kcal/g) used as a secondary fuel and stored long term for that purpose as body fat. Carbohydrates act as a less dense (4kcal/g) but easily available primary fuel for immediate use or short term (1-2 day) storage.

Carbs are almost all converted to glucose and enter the blood for circulation and “pick-up” by muscle and other cells. Glucose is accompanied by the transporter hormone INSULIN to “open the door” so it can get picked up. High levels of glucose in the blood are very bad, so insulin has to always do its job. And if we’re always eating carbs, blood insulin levels stay high, and the “cell door” becomes RESISTANT.

So, the “secret” to losing weight when you have INSULIN RESISTANCE is to eat as few carbs as possible. That way, the insulin level in the blood will drop (since the glucose level has dropped), and the body can turn to burning your backup body fat for energy. And if you’re still fat like me, you’re never hungry. ;-)

The body doesn’t need carbs for energy. It can make all the glucose it needs from protein and fat by a process called gluconeogenesis. And when body fat (triglycerides) breaks down for energy, besides making fatty acids for fuel, it also makes ketones for fuel, which both your brain and your heart love! 

Retrospective #500: Many, many thanks, especially to my intrepid editor.

With this column (#500), I will cease publication on Blogger of the Retrospective Series of “The Nutrition Debate,” renamed at some point, “Type 2 Nutrition.” The daily Retrospective Series posts were edited versions of my original posts begun in 2010. The Retrospectives were begun in anticipation of a possible book.

None of this endeavor would have been possible without my intrepid editor, Laurie Weakley. From the very beginning, she has been there for me and my faithful readers. Of the original 500 weekly posts, she never missed a timely, thorough and professional review of even one – and she did it entirely pro bono. Laurie recognized, without my ever mentioning it, that 1) my writing skills left much room for improvement and 2) my motivation was purely educational outreach (not a commercial enterprise). She wanted to help with both.

Laurie was formerly a university librarian. She is smart and highly skilled in computers, very well read in the physical sciences (and otherwise), and extremely well organized with a vast library of saved hyperlinks. She also has the skill to improve a writer’s message without changing it. She’s flexible to adapt to a writer’s style, a very good communicator and has a soft touch when making corrections and suggestions. In case I haven’t made myself clear, I highly recommend Laurie Weakley to anyone looking for a highly qualified editor.

I originally began writing this column at the invitation of the editor/publisher of a local weekly newspaper. He published my columns as “content” to fill space between ads. He published about 20 columns and then lost interest in “all the low-carb stuff.” A few years later, he ceased publication of the weekly newspaper too,

On the other hand, interest in “the low carb stuff,” has increased exponentially. For me it began in 2002 with The New York Times Sunday Magazine cover story, “What If It’s All Been a Big Fat Lie,” by the heralded science writer Gary Taubes. Taubes based his story on research but fundamentally vouchsafed for Robert Atkins, MD. I’m very glad to say, it got my doctor’s attention. He just wanted to lose weight, and he wanted me to as well. So did I. He tried the diet recommended and lost 17 pounds in 6 weeks. My doctor then suggested I try it too.

And the rest, as they say, is history. By the time the local newspaper publisher asked me to write a column for him, I had lost 170 pounds, first on Atkins Induction (20g of carbs a day), 60 pounds over 9 months, and then another 110 on Dr. Richard K. Bernstein’s 6-12-12 program for diabetics. I also learned a lot by lurking on Bernstein’s on-line “Diabetes Forum.” And in the first week on Atkins Induction, I had 3 hypos, and he took me off virtually all 3 of my oral anti-diabetes meds (all except 500 Metformin), putting my diabetes “in remission.”

My doctor knew he was going “off label” by prescribing “very low carb” for weight loss, so he monitored me monthly for a year. In that time, and in the 18 years since, I never had a hypo again. In addition, my HDL more than doubled, my triglycerides dropped by more than 2/3rds and he took me off the statin he had prescribed.

My column’s focus these last 10 years has remained the same: Type 2 Diabetes is a dietary disease. It is best treated with a Very Low Carb diet. Since 2010 I have had about 425k page views on Blogger, plus with the daily Retrospective Series, an unknown number on Facebook and Twitter. But that pales in comparison to the giants, many of whom arose after I began. Dietdoctor.com, I think, now gets about over 400k hits a day!

Andreas Eenfeldt, MD (dietdoctor.com), and Jason Fung, MD (The Jason Fung Fan Club – Fasting Support) are today two of the brightest stars in the nutrition firmament and among my favorite places to visit. They deserve our profound gratitude and thanks for their pioneering work and courage. But for me, personally, I am hugely indebted to my intrepid editor, Laurie Weakley, who stayed with me for almost 10 years in my weekly foray into the blogosphere.

Thank you, Laurie. I don’t know how I can ever repay you for your support and encouragement…and help. 

Retrospective #499: Lose the Fat, Save Your Life

This column, #499, will be my next-to-last post on Blogger. I started to write on Blogger about type 2 diabetes and nutrition in 2010 because a friend, who was following “doctor’s orders,” died of heart disease, a Macrovascular complication of type 2 diabetes. He was a pharmacist, and as his condition worsened through medical mismanagement of his disease, he became an insulin-dependent type 2 diabetic.

Why did this educated man follow “doctor’s orders”? Why would he not? Don’t we all, generally? Aren’t doctors trained to treat disease? Like high blood sugars, a type 2 symptom? The answer to these questions is, of course, “Yes.” So, you might suppose that a pharmacist would too. Pharmacists are trained in pharmacy and pharmaceuticals, and that is how doctors treat type 2 diabetes. With drugs. They treat type 2’s primary indication: a high blood sugar.

So, Dick continued to eat the one-size-fits-all, “balanced,” very high carbohydrate diet to which he, and the rest of us, sadly, have transitioned during our lifetimes, and especially since 1980: The Standard American Diet (SAD). This diet, if you didn’t know, is +/-60% carbohydrates. Check out the Nutrition Facts panel on processed food. And it is not the healthy, whole-food carbs we used to eat. They are highly processed boxed and bagged food products and sugars.

Knowing what I learned on my own, and from online forums, I was motivated to help others treat the cause, not the symptom of type 2 diabetes, and reverse the course of the disease. But it didn’t start out like that. From the time I was diagnosed a type 2 in 1986, I followed my doctor’s advice too. To control my blood sugar, my doctor started me on one oral medication and over the course of 16 years I graduated to where eventually I was maxed out on 2 classes of oral meds and starting a 3^rd. I was, to be sure, on a certain path to becoming an insulin-dependent type 2 too.

Then my doctor turned his attention to my weight. He had read, “What If It’s Been a Big Fat Lie,” the cover story of The New York Times Sunday Magazine on July 7, 2002. He tried the diet himself, to lose weight. When it worked for him, he asked me to try it too, just to lose weight. It occurred to him, though, as we walked down the hall to schedule my next appointment, he said, “It might even help your diabetes. The diet was Very Low Carb (20g of carbs a day). We know now how well that works, but doc didn’t learn it in medical school, and Dick didn’t learn it in pharmacy school.

In the next week, strictly eating just 20 grams of carbs a day, I had 3 hypos (hypoglycemic episodes). Each time I called the doctor and each time he cut my meds. The first day I stopped taking the 3^rd class and by week’s end had cut the other two classes of meds in half twice. I later stopped one of those, a sulphonylurea, and today just take Metformin.

In the course of 9 months, strictly followed the Very Low Carb regimen, I lost 60 pounds. Four years later I slipped a little and regained 12, so I started Very Low Carb again and over a year and a half lost another +/-120 pounds.

Of course, copious health benefits (and cost savings) followed. Besides the diabetes drugs, my doctor too me off statins. Why? My Total Cholesterol and LDL remained about the same, but my HDL more than doubled from borderline (39mg/dl) to 84 average. And my triglycerides (TG) dropped from 135mg/dl to 49 average. On this Very Low Carb diet, my TG/HDL ratio, “the strongest predictor of a heart attack” was always less than 1.0 (“a very low probability”). And so was my chronic inflammation, and my blood pressure dropped to 110/70 on fewer meds.

When I started out to eat Very Low Carb, it was just to lose weight, as both my doctor and I wanted. I had followed his weight loss “prescription,” before, including when he employed a Registered Dietitian in his office. I did it then and in 2002 because, like most of us, I trusted my doctor. I was positively inclined to “follow doctor’s orders.”

But my doctor didn’t learn how to lose weight in medical school. He learned it from a newspaper story. He did it just to lose weight, and he did. And when he suggested that I try it, he thought – almost as an afterthought, channeling something he remembered maybe from a pre-med course in physiology – that it might help with my worsening type 2 diabetes – no matter how many drugs he prescribed for it. By accident you might say, my doctor saved my life. Today, 18 years later, I am in tip top health, still 150 pounds lighter that when I started, and I think I may live forever.

Retrospective #498: Save Money on Food and Meds Too

For almost 500 columns I have been harping on the health benefits of adopting a Low Carb or Very Low Carb Way of Eating. I have been trying to cajole my readers into acting in their own best interests. I’ve been telling you that you will lose a lot of weight, easily and without hunger, you will normalize your blood sugar regulation, and by strictly following a low-carb diet, you will put your Type 2 diabetes in remission…and with it reduce your risk of all the co-morbidities, both Macrovascular and Microvascular. By now, I hope, you have been persuaded…

However, just in case, if you need a little more push, there’s another very good reason to eat a Very Low Carb diet:

YOU WILL SAVE A LOT OF MONEY ON FOOD AND MEDS TOO. AND I’M TALKING SERIOUS MONEY HERE.

Let’s start with medications. If you are overweight (from chronic hyperinsulinemia), you are probably on blood pressure medications. At one time I was on 3 classes of BP meds. As you lose weight and your BMI returns to “normal,” your doctor will be able, in all likelihood, to titrate you off one or two or even all three BP meds.

If you’re a diagnosed Type 2 diabetic, you may be on as many as 3 classes of oral anti-diabetic meds. I was, and within the first week of going “cold turkey” on a Very Low Carb diet (20g of carb a day), my doctor had to take me off one and reduce the other 2 meds in half twice. And a while later, he eliminated a 2^nd med altogether. I still take a very inexpensive Metformin, but many very low-carbers have stopped taking that medication as well.

In addition, the new classes of diabetes meds that are still on patent are very expensive. The 20% Medicare co-pay for the SGLT-2 class, that makes your kidneys excrete glucose, is $300 for a 60-day. That’s a $1,500 prescription!

And it you’ve been following “doctor’s orders” and eating a “balanced” diet of 55% to 60% carbohydrate, the Standard American Diet (SAD for short) of processed carbs and simple sugars (as in fruit), you may already be injecting insulin in your body…so I don’t have to tell you how expensive injected insulin (and other injectables) have become recently.

Then, if you’ve been eating the SAD, you probably have “high cholesterol,” a Total Cholesterol (TC) of ≥200mg/dl and an “elevated LDL-C,” so you’re taking a statin. But it’s low HDL and high triglycerides that are the real risk to your cardiac health. My HDL doubled and my triglycerides dropped by 2/3^rds on VLC, and my doctor took me off statins. Eating a Low-Carb or Very Low Carb diet will fix non-alcoholic fatty liver disease (NAFLD) too. It will burn visceral (abdominal) fat around and within the liver and pancreas too, returning them to “normal” function. All of these medications (7 or 8 so far) cost a passel of money, and you can save virtually all of it…while improving your health!

Saving money on food is also a huge opportunity. People say protein and fat are more expensive than carbs, but have you looked at the price of a box of cereal or a bag of chips recently? And those “foods” are not nutrient dense. In fact, they are empty but addictive calories. And they’re totally non-essential. That right. There are no essential carbs.

Proteins have certain “essential” amino acids (that your body can’t make), and fats contain certain essential fatty acids (Omega 3’s and 6’s). And without fat, there is no way to take up the essential fat-soluble vitamins A, D, E and K.

And fat is satiating and protein digests more slowly, so you will eat less real food when you eat just protein and fat because you’ll be less hungry. In a restaurant, I frequently order just an appetizer. That’s a big way to save money.

And then there’s fasting: the 16:8 type, where you skip one meal a day, and there’s the OMAD way, where you skip two meals every day and eat just one-meal-a-day, again because you’re not hungry. Now, that saves a lot of money.

Finally, there’s extended fasting (EF), where you fast all day, taking just water, coffee or tea. When your body is fat-adapted, it switches back and forth easily between eating VLC and fasting, while maintaining a high energy level because it has access to your body fat for fuel. When you are in this state of nutritional ketosis, you can full-day fast on alternate days, or even 2 or 3 consecutive days, all the while feeling pumped no matter what your activity level.

And you feel great, because you are full of energy, but also because of all the money you saved on food and meds.

Retrospective #497: How to Transition to a Low-Carb, Fat-Adapted Life

A few years ago, Andreas Eenfeldt, MD, founder of dietdoctor.com, the world’s most widely viewed source of information on the health benefits of a low-carb lifestyle, produced a New Year’s video with these 5 guidelines:

1) FOLLOW STRICTLY A LOW CARB DIET, 2) EAT ONLY WHEN HUNGRY, 3) SLEEP 7-8 HOURS A NIGHT, 4) WEIGH YOURSELF DAILY, AND 5) PRACTICE INTERMITTENT FASTING (IF).

This prescription works. I lost altogether 180+ pounds, put my Type 2 diabetes in remission (in the first week!), and dramatically reversed “high cholesterol” (stopped taking a statin) and lowered my “chronic inflammation level.”

How you transition from “here” (where YOU are NOW) to “there” (how you WANT to be) is what this post is about.

To strictly follow a low carb diet, you need to know what a carb is. No joke! Most people don’t know. There is not room here to describe a carb in detail, so suffice it to say: IF IT IS NOT PROTEIN OR FAT, IT IS A CARB. Think about that. Then make the time to learn about carbs, because to be successful in this Way of Eating, you need to know.

Then, when you strictly follow a low-carb diet, you will soon discover that you eat a lot less because you are never hungry. That’s because when you eat low-carb, your blood insulin level is low and your body can access stored fat whenever it needs it for energy balance. Your body is adapted to burn its own fat for energy, so you don’t need to eat.

When I first thought about the Diet Doctor guidelines, I wanted to reverse the order of guidelines 1 and 2 above. Then, I realized it’s nonsensical to follow the “eat only when you’re hungry” guideline if you’re always hungry! And if you eat a “balanced” diet (typically 55% to 60% carbs), you WILL always be hungry, or at least every 2 or 3 hours. So, that’s why you have to “strictly follow a low-carb diet” before you can, “then, eat only when hungry.” Got it?

Then came along Jason Fung, MD, the Toronto nephrologist whose book, “The Obesity Code” was a blockbuster. Fung has a way with words, and his writing style is very “accessible.” You will see that, when you’re not hungry, fasting becomes much easier. So, Fung and Andreas Eenfeldt are kindred spirits and now frequently collaborators in fasting.

The two IF methods Eenfeldt described a few years ago were 5:2 and 16:8. I suggest you use them both to transition to a low-carb, fat-adapted Way of Eating. Once you start strictly eating low-carb, and you start skipping breakfast (except for coffee with heavy cream), because you’re not hungry at breakfast, you’ll already be fasting 16:8.

Then, you might also sometimes transition to skipping lunch, or to eating a very light one (one or two hard boiled eggs). And voilà, you’ll be in a mildly ketotic state – a mild form of nutritional ketosis – for most of the day.

The other form of IF that Eenfeldt describes is 5:2. I have instead adopted, from time to time, as needed for weight loss, intermittent 42-hour fasts 2 or sometimes 3 times a week. Instead of eating 5 days and fasting 2, I eat 4 days (Tue-Thu-Sat-Sun) and fast the 3 alternate days, M-W-F, fasting from supper one night to lunch the second day after.

Guidelines 4, to get a good night’s sleep, they say is important. Just make sure your bladder is empty before retiring, and if you have trouble falling off, take a magnesium pill or even a glass of wine. Guideline 5, weighing yourself daily, is a good idea for motivational reasons. I keep a written record and set a weekly weight loss goal.

The essential thing is, when you eat, eat Very Low Carb. In 2002, I started “cold turkey” on 20 grams of carbs a day. I saw immediate results. Within the 1st week, my doctor took me off virtually all the oral antidiabetic medication I was on to avoid hypos (hypoglycemia or low blood sugar); I had three hypos the 1^st week, but not one since (in 18 years).

The other two macronutrients (protein and fat), besides carbohydrates, are important to understand, but are secondary in importance to weight loss. Protein is important to eat, every day when you’re not fasting, but if you’re fat-adapted (from strictly eating very low carb), and you want to lose body fat, you don’t have to eat extra fat beyond that which comes with the protein. Give your body a chance to burn body fat, not food, to make up the energy deficit, whether you’re fasting, or eating less because you’re not hungry, even of “feasting” days. Your body likes to burn fat.