LCHF…why isn’t it working for me? (Part 2)

Last week I posted three reasons why many people undertaking a LCHF diet stall with their success or never get it off the ground to begin with. The following delve a little deeper into the less obvious reasons why people struggle with their diet, and offer some options to help troubleshoot.

4. Fat doesn’t fill you up. For some people, they don’t feel satisfied when swapping out their carbohydrate for more fat. If it takes a few handfuls of nuts or half a block of cheese to feel satisfied, then there can be some serious increase in calories that isn’t compensated for by an appropriate increase in satiety from the meal. Yes, cheese and nuts contain protein, but to be honest I treat them more as sources of fat than I do protein. If this is you, then.
   1. Increase the portion of protein you are consuming with your meals. I know many people are scared to consume more protein because protein can be broken down into glucose in the absence of carbohydrate, therefore pushing up their blood sugar levels. For people on a ketogenic diet (where 80% of their calories should come from fat), or those metabolically damaged (whereby there is a dramatic change in blood glucose response from a protein-rich meal), this may be a problem. For most people though? upping protein by 1/3 of a serve is no biggie. Still hungry? Up the protein some more.
   2. Drop out some fat –make room for the added protein by dropping out some of the fat – you could start with ½ – 1 serve and see how satisfied you feel when you do that. A serve of fat is typically 1 tablespoon of oil or butter, or ¼ avocado.
5. You’re eating too much in one meal. A lot of people move from three meals a day, to two a day, to a ‘minimal food during the day’ approach, to sit down to a large meal at night, especially if they’ve been in the LCHF way of eating for a while and are further tweaking it. This may be awesome for some people, but not all. Eating most of your calories in one meal can, though, wreak havoc on your metabolic blood markers (such as blood glucose levels and insulin), increase fat gain, inflammation and reduce your day-to-day energy if this eating pattern doesn’t suit you. You’ll know if this is you, and if it is then:
   1. Spread your food intake out across 2-3 meals to lighten the caloric load and see if this makes a difference to your energy or other more objective markers mentioned above.
   2. Remember you’re still a rockstar even if you have to eat more often.
6. You’ve got a high intake of dairy or nuts. Some, especially women, are not suited to high amounts of dairy or nuts, and when the begin to include more of these foods – ones they’ve avoided for years due to their fat content – they have a weight loss stall they can’t move past or, worse, they begin to store fat around their middle. While some suggest cheese is a food akin to crack, research investigating the addictive properties of the protein in cheese have not found this to be the case. Of course, if you personally can’t stop at one slice and find you’re eating the block, then perhaps it is for you. Nuts can also be trigger foods for some people, and they find it difficult to stop once they’ve started eating them. Ditto with a jar of peanut butter. What to do?
   1. Omit dairy for 30 days – sometimes it’s not the dairy per se, it’s the amounts that you’re eating it in that need to change. Removing it entirely will allow you to change your habits and then reintroduce it.
   2. Omit nuts and/or nut butter as per above in #6a.
   3. Swap snacks to those that are predominantly protein-based rather than fat based – despite the satiating effects of fat, for some, it’s just not like having protein. A hardboiled egg or some leftover chicken wrapped in lettuce or nori sheets (my current obsession) may satisfy you more.
7. Genetically this isn’t the diet for you. If metabolic markers such as cholesterol, blood sugar or inflammatory factors go skewiff then it could be the LCHF approach doesn’t suit you. Genetic variation in the ApoE gene (ApoE4) is associated with LDL cholesterol not being recycled very well, and therefore it’s more likely to hang around the bloodstream and increase the chances of it becoming either oxidised or being transformed into smaller LDL particles, both highly atherogenic. Variants in the gene FTO can increase risk of obesity in the context of a high saturated fat and low polyunsaturated fat intake and may increase risk of high blood sugar and diabetes in individuals already overfat. The PPAR genes plays a role in ketogenesis (the oxidation of fat for energy) and storage of fat by activating genes associated with fatty acid transport and metabolism. Variants of this gene (particularly PPARa and PPARg ) are associated with increased risk of high triglycerides, total small dense LDL cholesterol and type 2 diabetes in the context of high saturated fat to polyunsaturated fat intake. Further, individual glycemic (blood sugar responses) vary considerably for the same amount of carbohydrate in food, suggesting there are a lot of factors to consider when determining the best diet for you (such as genetics, gut microbiome, activity level, stress etc), not just its macronutrient content. How to figure out if LCHF is not the diet for you? A few things to consider:
   1. Are you losing weight? If so, then wait until your weight stabilises and then retest your numbers – your body recycles triglycerides that are released from adipose (fat) tissue, therefore your triglyceride levels can appear high, but it is transient.
   2. Don’t get your cholesterol levels measured if injured, if you haven’t slept properly or you’ve been under significant stress. Cholesterol levels can change easily based on environmental triggers.
   3. Some people notice their cholesterol increases specifically in response to dairy fat, others to coconut fat – experiment for 6-12 weeks by dropping these out of your diet and get your cholesterol levels retested to see if this brings a drop in your numbers. Replace it with foods that have a more balanced fatty acid profile (such as lard or beef tallow) and foods high in monounsaturated fat or omega 3 fats, such as avocadoes, olive oil, nuts, seeds, salmon, mackerel, sardines.
   4. Here’s one I prepared earlier (and by ‘one’, I mean, ‘post on reducing your cholesterol naturally’. And by ‘naturally’ I mean ‘without Flora Pro Activ’).
   5. Get more in-depth testing of your cardiovascular disease risk profile – cholesterol is one measure and possibly not the most important one. CRP, fibrinogen, LDL particle size, number, oxidation and patterning can all give you more information than the run-of-the-mill lab test can. Contact me as I can help you arrange this testing which, for the most part, your doc might not even be aware of.
   6. Consider getting tested to find out your genetic predisposition (either through your doctor, or I can assist via Fitgenes gene testing).
   7. Consider dropping your fat intake, upping your protein intake and perhaps your carbohydrate intake too – ala the Zone diet approach. Despite its gimmicky name, it’s proven itself to be very effective for blood sugar stabilisation and blood cholesterol management. Some people just aren’t meant to eat a higher fat diet.
8. You’ve got an intolerance you didn’t realise you had. Going LCHF means, for many, significantly increasing fat content in the diet from the obvious choices: cheese, nuts, seeds, avocados and coconut products. However, while these are awesome in terms of the nutrients they deliver, they can cause digestive issues in a number of people. Avocado, coconut, nuts and seeds are moderate-high in FODMAPs – a type of carbohydrate that can cause bloating, abdominal pain and other irritable bowel symptoms in many people. Further, the inclusion of larger amounts of cream, cheese or full fat yoghurt can be problematic due to an intolerance to the dairy protein or fat which can result in similar IBS in susceptible people. If you’ve been following a low-fat diet for many years, enzymes that help digest the fat and protein may be downregulated, so your body might not cope with the additional amounts. Sometimes it is a matter of backing down and building up, and sometimes it is that these foods just don’t agree with you. What to do? One of these tips may help:
   1. Follow a lower FODMAP approach to see if removing these foods settles down your discomfort. Doing this for at least 21 days and reintroducing a different food one at a time can pinpoint which one in particular might not agree with you.
   2. Introduce fermented foods as per #3e above to re-establish healthy bacteria in your gut.
   3. Replace dairy fat for alternative fat choices: nuts, seeds, avocado, coconut oil, beef tallow, lard.
   4. Ensure you chew your food properly at each meal to break it down, include lemon juice in water in the morning, and apple cider vinegar with meals to stimulate your digestive system, and consider ox bile supplement or a digestive enzyme that has lipase and/or pepsin enzymes to help you break down the fats and proteins.
9. You’ve upped your alcohol intake because red wine and white spirits are “allowed” on LCHF. This might not even be intentional, but dropping your carbohydrate intake can lead to increased alcohol cravings, especially if your fat intake is too low, or your food intake is too low, or your stress levels are chronically too high. Or perhaps, you enjoy a moderate amount of alcohol but are continuing to gain weight on the LCHF diet.
   1. Be honest about how much you are drinking. Regularly consuming a ‘large’ as opposed to a ‘standard’ pour at the pub? Cracking open a bottle one night and then drinking to finish it off? Your plan to be alcohol free during the week has reduced to being alcohol free Monday – Wednesday? Evaluate if this is a problem for you … or not!
   2. Go alcohol free 5 nights a week, and enjoy a glass of whatever you fancy on the other nights. Ideally not those lolly water vodka mixes, but if you don’t like red wine, then choose something else. It’s not a deal breaker.
   3. Eat enough during the day so you’re not craving alcohol in the evening. This may mean including some additional starchy carbohydrate in your lunch meal – it doesn’t mean you’re not ‘low carb’ – as that in itself is a spectrum. This can really offset your cravings. Try it for 14 days to see if there is an effect.
   4. Lighten the load by choosing to have a low-fat meal if you drink. Old Skool 90s ‘dieting’ approach – those fat calories will only be missed by your adipose tissue, which is where they will be directed to when consumed with alcohol (which is processed first and foremost).
   5. Drink to ensure you are hydrated before you have your first alcoholic drink. This is like 101 really – we always drink more when we are thirsty, and then when we drink more, we become uninhibited and then all hell can break loose, right?
10. Food timing: If you’re beginning your day with breakfast at 7am and winding down with a cup of tea and some dark chocolate at 10pm, you may be doing yourself a disservice. Eating over a time period of more than 12 hours can be deleterious to health. Recent research has found that restricting the eating period to 12 hours or less can improve insulin resistance and glucose tolerance, and reduce breast cancer risk even when the calories remain the same. Anything you consume that requires processing of any sort by the liver – including black coffee or herbal teas – will begin the metabolic process. When we eat is also important as our appetite hormones are on a circadian rhythm (food being an important signalling molecule for hormones), and eating late at night – even if overall eating window is short – can be problematic for your liver. The benefits derived from intermittent fasting (such as these) can still be realised if your version of fasting includes coffee in the morning, however it appears actual fasting (nothing but water) for at least 12 hours is most beneficial for metabolic health.
    7. Try to keep within a 12 hour window for consuming anything other than water. If you struggle with remembering to do this, there are apps that can help. It’s not as hard as it might seem – if you have breakfast at 7.30am and are done eating by 7.30pm then you’ve nailed it.
11. You’ve focused entirely on diet without giving pause to consider other aspects of your lifestyle that contribute to your wellbeing. Lack of sleep, chronically elevated stress levels, over or under activity can all contribute to some of the common complaints people attribute to diet which have nothing to do with the food.
    1. Evaluate your sleep – are you getting to bed at a reasonable hour? Able to sleep through the night with ease? Feel refreshed waking up?
    2. Evaluate your physical activity – are you doing enough? Are you doing too much?
    3. Evaluate your stress levels – are you trying to do too much? Feeling overwhelmed? Or conversely is there not enough stress to keep you stimulated and motivated?

Of course these factors contribute to how your body responds to the food, but it isn’t the food per se. As I said last week, this isn’t a definitive list, however if any of these resonate with you then try some of the ideas I’ve listed, or enlist the help of someone like me to guide you to the best approach for you.

PS: I have organised a few talks over the next couple of months to talk about making a real food (aka LCHF) approach work for you. At the moment I have:

• Takapuna 23 March @ Streetwise Organics, Byron Ave
• Hawkes Bay 6 April – location TBC
• Queenstown 25 May – location TBC

…with others to come, so watch this space 🙂

Yes, I created this pic myself 🙂