Potassium deficiency in low carbohydrate dieting: High protein and fat alternatives that do not involve supplementation

It is often pointed out, at least anecdotally, that potassium deficiency is common among low carbohydrate dieters. Potassium deficiency can lead to a number of unpleasant symptoms and health problems. This micronutrient is present in small quantities in meat and seafood; main sources are plant foods.

A while ago this has gotten me thinking and asking myself: what about isolated hunter-gatherers that seem to have thrived consuming mostly carnivorous diets with little potassium, such as various Native American tribes?

Another thought came to mind, which is that animal protein seems to be associated with increased bone mineralization, even when calcium intake is low. That seems to be due to animal protein being associated with increased absorption of calcium and other minerals that make up bone tissue.

Maybe animal protein intake is also associated with increased potassium absorption. If this is true, what could be the possible mechanism?

As it turns out, there is one possible and somewhat surprising connection, insulin seems to promote cell uptake of potassium. This is an argument made many years ago by Clausen and Kohn, and further discussed more recently by Benziane and Chibalin. See also this recent commentary by Clausen.

Protein is the only macronutrient that normally causes transient insulin elevation without any glucose response. And the insulin response to protein is nowhere near that associated with refined carbohydrate-rich foods. It is much lower, analogous to the response to natural carbohydrate-rich foods.

A very low carbohydrate diet with more animal protein, and less fat, would induce insulin responses after meals, possibly helping with the absorption of potassium, even if potassium intake were rather limited. Primarily carnivorous diets, like those of some traditional Native American groups, would fit the bill.

Also, a low carbohydrate diet with emphasis on fat, but that was not so low in carbohydrates from certain sources, would probably achieve the same effect. This latter sounds like Kwaśniewski’s Optimal Diet, where people are encouraged to eat a lot more fat than protein, but also a small amount of carbohydrates (e.g., 50-100 g/d) from things like potatoes.

Kwaśniewski’s suggestions may sound counterintuitive sometimes. But, as it turns out, potatoes are good sources of potassium. One potato may not be a lot, but that potato will also increase insulin levels, bringing potassium intake up at the cell level.

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Sorting rubbish. Things take a new turn with a comedy litter pick

Volunteers gather at the start of the litter pick and councillors Pat & Frank Warby, regular litter pickers themselves, stop by to show their support. Other people joined in throughout the day.  Unfortunately, Claire the event's organiser was unable to make it due to illness.

Ever since the launch of the 1000 Bins Challenge, Shedwyn the campaign's mascot has been a busy bee, not least travelling around the country to find out all she can about recycling on the go.

However, yesterday, she took a break from proceedings and got involved with Bury St Edmunds' first ever Comedy Litter Pick in a manner that was more like recycling on the go-go.

Organised by Claire Lowe of the Bury Fringe Festival team, the litter pick was created under the theme of Soaper Heroes, encouraging people from across all generations to take an interest in keeping the community clean and tidy.  Today was the first event of its kind, with many more planned, the aim of which is to inject a huge dose of fun and comedy into an activity that many find uninteresting, by providing on-tap entertainment and encouraging folk to wear their fancy dress garb and join in..

So equipped with litter picking grabbers and Big Tidy Up bags for sorting rubbish and recycling, Shedwyn and I took it in turns to pick our way through the Abbey Gardens, having a go at the odd hula-hooping and chatting to onlookers while we went about our litter-picking business.  And what an interesting day it was too.  Just check out those hula-hooping skills for starters.

Shedwyn, getting a mini-lesson from Circus Freaks very own Lucia

I was privileged to have the company of Chris Holmes for the day, the local community manager at Bury St Edmunds' Asda store.

It was interesting to hear how Asda stores are working closely with local communities, and having recently been approached by Claire from the Bury Fringe, Chris is particularly keen on exploring ways in which his store can help the local community to reduce litter and recycle more.

The litter pick gave us a great chance to talk through ideas and opportunities and chat to a whole range of visitors, including the older generations and teenagers.   The teenagers were a very interesting group indeed, not least because they have gained a reputation for littering the areas where they regularly hang out, in particular around the Abbey ruins.

Teenagers clearing up their litter following a visit from the park ranger.

Some admitted that they have left litter and the key reason that they gave was that there aren't enough bins and that the bins in the local vicinity were often full.  While some offered self-acknowledgement that they were too lazy to go further afield and hunt out an empty bin, they also understood why adults took a tough stance and why it was their responsibility.  Some people also quoted that they were often told off for leaving litter when it wasn't actually their fault and felt aggrieved at having to clear up other people's mess, wondering why they should then bother themselves. 

This was a particular theme and it was very clear in our discussions that in their experience, many adults and those in authority appear to class all teenagers as the same and assume that they are going to be irresponsible, before even giving them a chance.  They quoted a number of incidents where they were targeted and told off where young families and similar-sized groups of adults would be left alone.

The feelings that were coming over seemed to be a mixture of defeat, ambivalence and a dose of rebellion, all of which I still remember from my own teenage years. There seemed to be no sense of hope amongst the majority of teenagers we spoke with, nor the immediate desire to change attitudes about litter.  However when I posed the question about whether they would welcome the opportunity to banish misconceptions and get involved with the comedy litter picks in some way, whether it be through providing entertainment, taking photographs or recording You Tube videos, there seemed to be a slight glimmer of interest. 

One thing's for sure.  I have learned a lot from today and if there are ways to engage young people in the Comedy Litter Picks in a way that benefits them and opens new opportunities for those involved, I will give it a real chance.  As well as wider concerns I admit to some self-interest.  In just three years time, my eldest son will be come a teenager and all too soon, he will be one of the many kids who'll be chilling out with his friends in the local park.  Having witnessed first-hand how the disparate groups of our community engage in conflict of responsibilities as well as misconceptions, (my opinions included), I think I need to be better prepared.   

The Soaper Heroes day was most certainly a taster event and a case of dipping our toes in the water, raising awareness of what's to come in the near future. The plan is to roll-out regular events throughout the year featuring comedy performances dotted around town and all sorts of entertainment to engage the public and participants.

Thanks to volunteers from the community, Chris Holmes from Asda, entertainers Circus Freaks and some positive role models from the younger generation, we did well on the litter count.  There were only a few of us, but we collected 5 bags of recycling as well as 6 bags of rubbish, with much credit going to Mr & Mrs Mills who targeted the Station Hill area.  Pictured below are some of the participants who joined in the fun in the Abbey Gardens. 

Entertainers & Volunteers, including Chris Holmes from Asda and members of the Circus Freaks performers.

More information about Soaper Heroes can be found at www.soaperheroes.co.uk.  If you would like further details or find out how to get involved in future events, please contact organiser Claire Lowe on 07545 286574.  In the meantime, check out Lucia's amazing circus skills where she shows off how she can pick up litter and hula hoop at the same time.   It will be a long time before I can do that for sure.

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There is no doubt that abnormally elevated insulin is associated with body fat accumulation

For as long as diets existed there have been influential proponents, or believers, who at some point had what they thought were epiphanies. From that point forward, they disavowed the diets that they formally endorsed. Low carbohydrate dieting seems to be in this situation now. Among other things, it has been recently “discovered” that the idea that insulin drives fat into body fat cells is “wrong”.

Based on some of the comments I have been receiving lately, apparently a few readers think that I am one of those “enlightened”. If you are interested in what I have been eating, for quite some time now, just click on the link at the top of this blog that refers to my transformation. It is essentially high in all macronutrients on days that I exercise, and low in carbohydrates and calories on days that I don’t. It is a cyclic approach that works for me; calorie surpluses on some days and calorie deficits on other days.

But let me set the record straight regarding what I think: there is no doubt that insulin is associated with body fat accumulation. I was told that an influential health blogger (whom I respect a lot) denied this recently, going to the extreme of saying that no professional metabolism or endocrinology researcher believes in it, but I couldn’t find any evidence of that statement. It is not hard at all to find professional metabolism and endocrinology researchers who have asserted that insulin is associated with body fat accumulation, based on very reliable evidence. Actually, this is Biochemistry 101.

What I think is truly unclear is whether insulin spikes associated with carbohydrate-rich foods in general are the cause of obesity. This idea is, indeed, probably wrong given the evidence we have from various human populations whose members consume plenty of non-industrialized carbohydrate-rich foods. On a related note, I particularly disagree with the notion that the pancreas gets tired over time due to having to secrete insulin in bursts, which seems to also be one of the foundations on which many low carbohydrate diet varieties rest.

As with almost everything related to health, the role of insulin in body fat gain is complex, and part of that complexity is due to the nonlinear relationship between body fat gain and postprandial insulin release. Industrial carbohydrate-rich foods have a much higher glycemic load than natural carbohydrate-rich foods, even though their glycemic index may be the same in some cases. In other words, the quantity of easily digestible carbohydrates per gram is much higher in industrial carbohydrate-rich foods.

In normoglycemic folks, this leads to an abnormally elevated insulin response, among other hormonal responses. For example, circulating growth hormone, which promotes body fat loss, is inversely correlated with circulating insulin. Insulin drives fat, typically from dietary sources of fat, into adipocytes. That fat may also come from excess carbohydrates, packaged into VLDL particles.

Under normal circumstances, that would be fine, since our body is designed to store fat and release it as needed. But the abnormal insulin response elicited by industrial carbohydrate-rich foods, together with other hormonal responses, leads to a little more body fat accumulation, and for longer, than it should. And I’m talking here about people without any metabolic damage. Saturated and monounsaturated fats are healthy when eaten, but when they are stored as excess body fat, they become pro-inflammatory.

Body fat is like an organ, secreting many hormones into the bloodstream, several of which are pro-inflammatory. One of those pro-inflammatory hormones, which I believe is closely linked with many diseases of civilization, is tumor necrosis factor. (The acronym is now TNF. Apparently the “-alpha” after its name and acronym has been dropped recently.) Dietary fat, particularly saturated fat, seems to be anti-inflammatory. In other words, body fat accumulation is the problem. You only need 30 g/d of excess body fat accumulation to gain around 24 lbs of fat per year. Over three years, that will add up to over 70 lbs of body fat.

In my view, ultimately it is excess inflammation (which is, in essence, a vascular response) that is at the source of most of the diseases of civilization.

That is where the nonlinearity comes in. Insulin is healthy up to a point. Beyond that, it starts causing health problems, over time. And one of the main mechanisms by which it does so is via excessive body fat accumulation, with different damage threshold levels for different people. Insulin may decrease appetite as it goes up, but it increases it if goes down too much. If it goes up abnormally, typically it will go down too much. As it reaches a trough it induces hypoglycemia, even if mildly.

Take a look at the graph below, from this post showing the glucose variations in normoglycemic individuals. There is a lot of variation among different individuals, but it is clear that the magnitude of the hypoglycemic dips is inversely correlated with the magnitude of the glucose spikes. That inverse correlation is due primarily to the effect of insulin. Under normal circumstances, a decrease in circulating insulin would promote an increase in free fatty acids in circulation, which would normally have a suppressing effect on hunger in the hours after a meal. But industrial carbohydrate-rich foods lead to increases and decreases in glucose and insulin that are too steep, causing the opposite effect.

You may ask: why do you keep talking about industrial carbohydrate-rich foods? Why not talk about industrial protein- or fat-rich foods as well? The reason is that the food industry has not been very successful at producing industrial protein- or fat-rich foods that are palatable without adding a lot of carbohydrate to them.

More often than not they need enough carbohydrate added in the form of sugar to become truly addictive.

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Laser surgery for myopia early in life may create reading problems after 40

Shortsightedness, or myopia, seems to be endemic in urban populations. The National Institutes of Health suggests that myopia cannot be prevented, and that neither reading nor watching television causes myopia. I find that doubtful, as reading is a rather unnatural activity, and there is evidence that myopia is significantly associated with amount of reading at early ages.

(Source: WebMD.com)

Trying to avoid reading early in life would not be a highly recommended Paleolithic-mimicking choice, except for those who later decide to live among hunter-gatherers. (In spite of our romantic views of hunter-gatherer life, it is very rare to see an urbanite do this outside the context of anthropological studies.) Education requires a lot of reading, and without education in urban environments one is likely to end up suffering from other diseases of civilization. Diabetes, for example, is strongly and inversely associated with education level in urban environments.

Also, keeping up with friends on Facebook, without which life as we know it now could go on, requires a lot of reading and writing.

A different theory, often associated with Cordain, is that myopia is due to consumption of industrial carbohydrate-rich foods. Interestingly, according to Cordain and colleagues, myopia is typically accompanied by higher stature, a finding that is supported by empirical evidence. The idea here is that industrial carbohydrate-rich foods promote abnormal growth patterns during developmental stages, which arguably include abnormal growth of the human eye and its various structures.

Avoiding industrial carbohydrate-rich foods during developmental stages is feasible, but currently very difficult given public health policies that strongly promote the consumption of some of those foods, during development stages, as healthy choices (e.g., cereals). In part as a result of those policies, and also due to budget constraints (those foods tend to be generally cheap), industrial carbohydrate-rich foods are frequently served as meals in schools.

Okay, now to the main topic of this post. Let us say a person has myopia, should he or she fix it surgically?

As one ages, the ability to read at a short-distance (as in reading from books, or from a computer screen) goes down, because the ability to focus on short-distance objects becomes impaired. This phenomenon is called presbyopia, and is also associated with excessive reading. Therefore it could be called a disease of civilization as well. Most college professors at the level of Associate Professor and higher I know (that is, older folks, like me) have developed it, sometimes as early as in their late 30s.

In the general population, normally presbyopia sets in between 40 and 50 years of age, requiring the use of "reading glasses" afterwards … except for those with myopia. This is sometimes called the “myopia payoff of presbyopia”. People with myopia are often able to read well, without the help of glasses, after presbyopia sets in. The reason is that myopia essentially opposes presbyopia at short distances.

Someone with myopia will still have it after presbyopia sets in, and thus will have difficulty seeing at long distances, but will frequently be able to read well at short distances.

So, if you undergo eye laser surgery (the most common type) to correct myopia early in life, you may create reading problems after 40.

P.S.: A friend of mine who has been studying this tells me that eye problems in general are caused by avoidance of indirect sunlight. I am planning on looking into this more deeply in the future.

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Dietary protein does not become body fat if you are on a low carbohydrate diet

By definition LC is about dietary carbohydrate restriction. If you are reducing carbohydrates, your proportional intake of protein or fat, or both, will go up. While I don’t think there is anything wrong with a high fat diet, it seems to me that the true advantage of LC may be in how protein is allocated, which seems to contribute to a better body composition.

LC with more animal protein and less fat makes particularly good sense to me. Eating a variety of unprocessed animal foods, as opposed to only muscle meat from grain-fed cattle, will get you that. In simple terms, LC with more protein, achieved in a natural way with unprocessed foods, means more of the following in one's diet: lean meats, seafood and vegetables. Possibly with lean meats and seafood making up more than half of one’s protein intake. Generally speaking, large predatory fish species (e.g., various shark species, including dogfish) are better avoided to reduce exposure to toxic metals.

Organ meats such as beef liver are also high in protein and low in fat, but should be consumed in moderation due to the risk of hypervitaminosis; particularly hypervitaminosis A. Our ancestors ate the animal whole, and organ mass makes up about 10-20 percent of total mass in ruminants. Eating organ meats once a week places you approximately within that range.

In LC liver glycogen is regularly depleted, so the amino acids resulting from the digestion of protein will be primarily used to replenish liver glycogen, to replenish the albumin pool, for oxidation, and various other processes (e.g., tissue repair, hormone production). If you do some moderate weight training, some of those amino acids will be used for muscle growth.

In this sense, the true “metabolic advantage” of LC, so to speak, comes from protein and not fat. “Calories in” still counts, but you get better allocation of nutrients. Moreover, in LC, the calorie value of protein goes down a bit, because your body is using it as a “jack of all trades”, and thus in a less efficient way. This renders protein the least calorie-dense macronutrient, yielding fewer calories per gram than carbohydrates; and significantly fewer calories per gram when compared with dietary fat and alcohol.

Dietary fat is easily stored as body fat after digestion. In LC, it is difficult for the body to store amino acids as body fat. The only path would be conversion to glucose and uptake by body fat cells, but in LC the liver will typically be starving and want all the extra glucose for itself, so that it can feed its ultimate master – the brain. The liver glycogen depletion induced by LC creates a hormonal mix that places the body in fat release mode, making it difficult for fat cells to take up glucose via the GLUT4 transporter protein.

Excess amino acids are oxidized for energy. This may be why many people feel a slight surge of energy after a high-protein meal. (A related effect is associated with alcohol consumption, which is often masked by the relaxing effect also associated with alcohol consumption.) Amino acid oxidation is not associated with cancer. Neither is fat oxidation. But glucose oxidation is; this is known as the Warburg effect.

A high-protein LC approach will not work very well for athletes who deplete major amounts of muscle glycogen as part of their daily training regimens. These folks will invariably need more carbohydrates to keep their performance levels up. Ultimately this is a numbers game. The protein-to-glucose conversion rate is about 2-to-1. If an athlete depletes 300 g of muscle glycogen per day, he or she will need about 600 g of protein to replenish that based only on protein. This is too high an intake of protein by any standard.

A recreational exerciser who depletes 60 g of glycogen 3 times per week can easily replenish that muscle glycogen with dietary protein. Someone who exercises with weights for 40 minutes 3 times per week will deplete about that much glycogen each time. Contrary to popular belief, muscle glycogen is only minimally replenished postprandially (i.e., after meals) based on dietary sources. Liver glycogen replenishment is prioritized postprandially. Muscle glycogen is replenished over several days, primarily based on liver glycogen. It is one fast-filling tank replenishing another slow-filling one.

Recreational exercisers who are normoglycemic and who do LC intermittently tend to increase the size of their liver glycogen tank over time, via compensatory adaptation, and also use more fat (and ketones, which are byproducts of fat metabolism) as sources of energy. Somewhat paradoxically, these folks benefit from regular high carbohydrate intake days (e.g., once a week, or on exercise days), since their liver glycogen tanks will typically store more glycogen. If they keep their liver and muscle glycogen tanks half empty all the time, compensatory adaptation suggests that both their liver and muscle glycogen tanks will over time become smaller, and that their muscles will store more fat.

One way or another, with the exception of those with major liver insulin resistance, dietary protein does not become body fat if you are on a LC diet.

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Fasting for 24 hours and ending up with a bigger waist!? This may be a sign that you are losing abdominal fat

This is such a common phenomenon that you’d expect to see it discussed more often – people fasting for a non-negligible number of hours and ending up with a bigger waist. However, it is very difficult to find anything published on it. (Lyle McDonald discussed a related phenomenon on this post on whooshes and squishy fat.) I am not talking about only a perceived bigger waist; I am talking about measurably bigger. This frequently happens with folks who were obese, lost a lot of body fat, and are trying to get rid of the stubborn lower abdominal fat.

(Source [ironically]: Gograins.com.au)

Fasting and ending up with a bigger waist; how is that possible?

Contrary to popular belief, this is very unlikely to be due to the body turning muscle protein into glucose, and then converting that glucose into fat for storage in fat cells around the waist. When you are fasting, one factor strongly opposes that transformation. The body is in net body fat release mode, due in part to low circulating insulin, and thus body fat cells are essentially rejecting glucose. Blood glucose levels are maintained, to feed the brain, but uptake by adipocytes via GLUT4 isn’t happening.

So where does the bigger waist come from?

When people fast they typically drink water, quite often lots of it. A reasonable explanation for the bigger waist is that body fat cells store water in place of fat, as fat becomes energy. Since water is denser than fat, the stronger gravitational pull will lead to a larger bulge around the lower abdominal area, increasing waist circumference at the point it is widest. The amount of fat mass, however, is going down due to fasting.

In the obese, body fat cells generally become insulin resistant, even though many people believe the opposite to be true. This leads to the creation of new body fat cells (hyperplasia) to store the extra fat. If body fat loss is maintained over time, I’d expect the body to get rid of those fat cells that were created through hyperplasia during the obese period. The literature, however, seems to suggest that the number of body fat cells is set before adulthood, and does not change afterwards. I am skeptical, as the body seems to be very good at  getting rid of cells and tissues that are not used.

The loss of those extra body fat cells may bring the number of adipocytes to pre-obesity levels, but for many people quite some time is needed for that to happen. Often in the order of months; maintaining reasonably low body fat levels.

So don’t despair if you end up with a bigger waist around noon after skipping breakfast, or before dinner after fasting the whole day. That may be a good sign; a sign that you are actually losing abdominal fat.

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Liver and meatballs separated by a wall of sweet potatoes

A commenter wrote here some time ago that she liked to eat rice because rice can be easily used to separate food items on a plate. One can just as easily use sweet potatoes to do that; preparing the sweet potatoes in much less time than the rice. This post explains how, with a simple recipe.

- Cut up half of a sweet potato as shown on the first photo below, adding coconut oil or butter to prevent the pieces from sticking to a microwave-safe saucepan.
- Microwave the sweet potato pieces in high heat for about 5 minutes.
- Use the sweet potatoes to separate food items as in the second photo below, showing beef liver and meatballs with their respective sauces.
- Cover the dish with a wet paper towel to prevent spilling, and microwave it for as long as needed to heat up the meats. In this case, 2 minutes in high heat was enough. That will further cook the sweet potato, but not to the point of burning it.

The above assumes that the beef liver and meatballs are leftovers that had been cooked before. In this example, we have about ½ lb of meat and ½ of a sweet potato. As far as plant foods are concerned, sweet potatoes are at the very high end of the nutrition density scale. This is a very nutritious and satiating meal (for me) with over 55 g of protein, as well as a great mix of macro- and micro-nutrients.

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