Remembering Kevin Moore

ATLCX (Episode 23): Long-Term Stalls & Weight Gain Even On A Well-Formulated Low-Carb Diet | Dr. Stephen Phinney


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In Episode 23 of “Jimmy Moore Presents: Ask The Low-Carb Experts,” we hit on a topic that is arguably the most important issue for people embarking on a low-carb lifestyle change. And even for those of us who have been eating this way for many years, weโ€™ve all run into those times when the weight loss just doesnโ€™t want to cooperate with us despite doing everything the same with our low-carb diets as we always have when weight loss has happened before. But now we’re stuck with no weight loss or, worse yet, even weight gain! When this begins happening, you might be asking yourself what the heck is going on and what am I doing wrong? Has anybody ever felt that way before? Are you even living this in your own life RIGHT NOW?

This week’s “Ask The Low-Carb Experts” guest will help you circumnavigate through what might be happening to help you get on the right track again. He is legendary low-carb diet researcher and nutrition maven Dr. Stephen Phinney (listen to him in Episode 479 of “The Livin’ La Vida Low-Carb Show” podcast), the co-author of the 2010 New York Times bestselling book The New Atkins For A New You as well his two follow-up books with Dr. Jeff Volek called The Art and Science of Low Carbohydrate Living in 2011 and The Art and Science of Low Carbohydrate Performance in 2012. Dr. Phinney has been studying low-carb diets longer than just about anyone else in modern times and so he has the pedigree to dig deeply into this issue to provide REAL answers for those who are struggling even while on a low-carb diet. It was a true honor having such a prestigious low-carb diet expert like Dr. Stephen Phinney joining us on ATLCX to take on your questions about long-term stalls and weight gain even on a low-carb diet in EPISODE 23 on August 23, 2012. This nearly two-hour podcast is worth every second to listen to and will surely be an INSTANT CLASSIC! Don’t you miss this one!

Listen to Dr. Stephen Phinney help get you through stalls on low-carb:

  • What a “well-formulated low-carb diet” really is?
  • There are so many concepts of low-carb diets put out there
  • 10 concepts define what a real low-carb diet
  • They counter the idea that low-carb is high-protein
  • If you eat too much overall fat on low-carb, you’ll gain
  • You need “a modest amount of salt” on your low-carb diet
  • Consuming salt will ward off the effects of “Atkins flu”
  • Defining what a genuine weight loss stall really is
  • The study he did with athletes on high-fat, low-carb
  • Given adequate calories, weight can be stable on low-carb
  • Being on a ketogenic diet doesn’t equal weight loss
  • People can tend to not pay as much attention to their diet
  • Low-carbers who limit fat and increase protein usually stall
  • The “dietary drift” opens up greater appetite temptations
  • A scale is a very imperfect measure of your metabolism
  • Weight can fluctuate in a 4-pound range at any given time
  • Scale doesn’t report well on how you’re actually doing
  • Many thyroid issues tend to be “self-diagnosed”
  • Thyroid problems don’t cause weight stalls or gains
  • Excessive exercise is not necessarily good for you
  • His study that looked at exercise and weight loss effects
  • Resting metabolic rates DECREASED by doing exercise
  • Everybody “wants to believe exercise speeds your metabolism”
  • Studies show 1-2 hours exercise daily reduces resting metabolism
  • It’s not the low-carb diet if you’re exercising too much
  • Sometimes you may need to “take some rest days” for recovery
  • What about the idea of a “set point” theory about weight?
  • “Set point” determined by carb intake and insulin resistance
  • If you eat low-carb, control insulin, the “set point” drops
  • Sustainability is a big factor in doing a low-carb diet
  • People do a “casual low-carb” approach just watching carbs
  • Many eat too much protein because they fear eating fat
  • Or they are eating the wrong kinds of dietary fat
  • His cycling research that found mayo fat was not preferred
  • They participants refused to eat the vegetable oil fats
  • Soybean oil is in almost all mayonnaise products out there
  • They recommend consuming animal fats and monounsaturated fat
  • Abdominal visceral fat mobilizes faster on ketogenic diet
  • Pregnancy is a major metabolic stress that changes women
  • Does the macronutrient ratio really matter or not?
  • Humans are diverse, there’s no set percentage for everyone
  • Percent protein is not as important as the absolute amount
  • Protein should be grams per day determined by your height
  • The more you reduce fat calories to a degree, the better
  • If your body gives you signals to eat more, follow them
  • Hold protein constant, get adequate protein and enough fat
  • We should look at goals and ask if it or the diet is wrong
  • Doctors are astounded if people lose 30 pounds and keep off
  • Going below 30g carbs is “draconian” for a lot of people
  • Celebrate where you weigh now and attempt to hold the weight
  • Rest your body for 6-12 months after significant weight loss
  • Sometimes taking “a holiday” from dieting see success later
  • Make your own dressings and sauces from scratch at home
  • Don’t get ones from famous people–SORRY PAUL NEWMAN!
  • If adding sweet potatoes and milk make you gain, stop it
  • 16 ounces of milk contains 25g sugar from the lactose
  • Try aged cheese instead to get the protein without the carbs
  • Most Paleo regimens are higher in protein up to 35% calories
  • This can prevent people desiring weight loss from success
  • Raw milk is not any better because of the lactose sugar
  • Zero fat is NEVER good for a human to be doing
  • You need 1-2 teaspoons of omega-6 and omega-3 fats daily
  • If anyone tells you to eat zero fat, run for the hills!
  • It can take weeks or months to restore, but not permanent
  • Pay attention to the amount of protein (1.5-2g protein/kg)
  • Excess protein will turn into glucose and drive down ketones
  • The body can’t store excess protein, burned for energy
  • It repairs tissues or it is used for energy as glucose
  • This excessive glucose can then be stored as body fat
  • Glucose will drive up insulin and inhibit body fat burned
  • Too much protein drives ketones down and you get hungry
  • That urge to eat is what actually makes you fatter
  • Nutritional ketosis will zap your desire to eat whenever
  • His patient who no longer has “intrusive thoughts of food”
  • Type 1 diabetes requires insulin, but amount varies
  • You need just enough insulin to keep ketones moderate
  • Type 1 diabetics can get “ten times the amount of ketones”
  • If you get just a bit too much insulin, you store body fat
  • Controlling diabetes is first priority, fat loss next
  • Getting thyroid hormone replacement right is critical
  • Hashimoto’s is an inflammatory disease causing problems
  • Restoring your body to normal lean tissue can add weight
  • Perhaps some people have unreasonable expectations in place
  • Her HgA1c very likely came way down to “normal” levels
  • This is “almost unheard of” with conventional methods
  • There are many factors besides insulin resistance in stalls
  • Don’t leave your doctor completely out of the issue to help
  • He’d like to study more, but spreading out protein better
  • Humans instinctively like to eat a few meals over the day
  • An ounce of nuts has 5-7g digestible carbohydrates
  • A handful of nuts can give you upwards 40-50g carbohydrate
  • Most people need under 50g daily to make fat loss happen
  • Generally, I’m not a fan of counting calories
  • Let your sense of satiety control how much you eat
  • If you stop gaining while on low-carb, then that’s success!
  • When you follow Weight Watchers, some weight loss is muscle
  • Getting enough fat and protein repairs the lean tissue loss
  • This muscle gain can last for upwards of a couple of months
  • Stay the course and continue on with the low-carb diet
  • We need more public access to DEXA body composition testing
  • He’s done a lot of research on very low-calorie diets
  • Never go down to 800 calories or less daily in your diet
  • Never seen a resting metabolism below 1200 calories/day
  • There is a role for a knowledgeable medical doctor
  • The study he did on determining weight gain while on PMS
  • Inflammatory biomarkers go up just before menstrual cycle
  • A well-formulated low-carb diet is anti-inflammatory
  • This is why PMS symptoms are generally improved on low-carb
  • Omega-3 fish oil fats can provide benefits for this as well
  • Getting cold water ocean fish at least 2-3 times weekly
  • Otherwise, get a gram of fish oil supplementation daily
  • Reader says he’s hungry on a high-fat, low-carb diet
  • The numbers he provided of what he eats “don’t add up”
  • His body is telling him to eat 2500-3000 calories daily
  • Keep protein constant but eat more fat in your diet
  • There’s no need to lower calories to “draconian” levels
  • If you’re “impatient,” then you should take your time
  • When you eat enough fat in your diet, hunger/cravings vanish
  • Being in ketosis merely facilitates fuel flow
  • His experience gaining 5 pounds and losing 5 pounds annually
  • I don’t count calories and eating basically the same thing
  • I consume more fat when doing more bicycle riding
  • My blood ketone levels run .8-2.5 mm most of the time
  • I don’t worry about the weight changes I experience
  • No specific blood ketone level means weight loss
  • Doing just a bit more exercise can make fat loss happen
  • They’re working on a blood ketone individualization plan
  • Lose 55 pounds and keep off for 2 years, that’s success
  • Fasting is NOT a good tool for humans and not necessary
  • The first day you don’t eat food, you lose lean tissue
  • Our body fat does not protect us from losing muscle
  • If you don’t consume adequate protein, you will lose muscle
  • You can lose .25-1.0 pound of muscle daily during fasting
  • Low-carb can slow the muscle loss but you still lose muscle
  • What about going 12-16 hours between meals from satiety?
  • Skipping lunch is probably not a big deal
  • Eating breakfast and then a good dinner is probably ideal
  • Key is getting enough protein in your meals during the day
  • The notion you need carbs for good thyroid function is false
  • The amount of inactive thyroid to active “inconsequential”
  • If you feed people enough calories, thyroid is normal
  • Eating under 1000 calories diminishes thyroid function
  • Depressed thyroid function on a low-carb diet is “a myth”
  • There is absolutely “no need” for the use of “safe starches”
  • Our bodies get all the carbs we need through gluconeogenesis
  • 6% of the energy stored in glycerol can be used as glucose
  • Gluconeogenesis makes 50g carbohydrates in the body daily
  • I just don’t get the argument that we need to eat more carbs
  • Paleo overemphasizes protein, needs to be moderated
  • Measuring blood ketones a great way to know tweaks to make
  • There aren’t too many “overt symptoms” of low protein
  • The signs of protein deficiency are very “subtle”

    Recommended daily protein intake chart according to height

    Source: The New Atkins For A New You

  • Yes, you can overeat dietary fat, but it’s difficult to do
  • You get a “taste extinction” effect where you have to stop
  • People are surprised by how satisfied they can feel on fat
  • If some are gaining weight, maybe “dial back a bit” on fat
  • Hidden carbs in nuts can be a big issue for many people
  • Menopause is inflammatory process, enemy of keto-adaptation
  • Being keto-adapted makes fat fuel more accessible
  • The lean tissue in the fat cell is the key to accessing fat
  • Keep that lean tissue healthy and you’ll see the benefits
  • Low-carb diets may decrease menopausal symptoms
  • This should have been studied long ago, but no funding
  • They used a breath ketone meter for precise ketone measuring
  • They could tell if the patient had a “cheat meal” or not
  • Eating 100g of carbs is “a major break” and will impact you
  • Once you start sliding down, it’s hard to get back on it
  • Keto-adaptation needs to be stuck with as much as possible
  • It’s “extremely frustrating” to go in and out of ketosis
  • Why he once went in and out of ketosis regularly by design
  • They found blood levels of saturated fat go down eating fat
  • When he tried going off, he gained weight and “felt lousy”
  • In 2004 he went back to hardcore low-carb and loves it
  • Low-carb should be nicknamed the “no worries diet”
  • I look at starches like they’re Styrofoam now
  • The breath ketone meter he used was around in the 1970s
  • It measured acetone in the breath to get “accurate” readings
  • The market has never been there for a device like this
  • Companies are looking for a smaller, easier-to-use device
  • People can become comfortable at a lower weight on low-carb
  • Common thread amongst many who struggle is thyroid issues
  • Tweaking the thyroid medication by a physician may be needed
  • Potassium, magnesium, omega fats hard to get on low-calorie
  • Human body would rather have a consistent calorie intake
  • Finding a “sympathetic” doctor to help is essential
  • Whether low iron levels have anything to do with weight
  • There might be a deficiency in zinc and copper with low-iron
  • What about morning intake 50-75g protein (“The Leptin Reset”)
  • I’ve never seen a randomized trial of “Leptin Reset” plan
  • We measure leptin and sensitivity increases on low-carb
  • People with Type 2 diabetes on low-carb control blood sugar
  • Blood triglycerides and HgA1c both go way down as well
  • Whether you can become resistant to weight loss over time
  • You need a common goal of what you want and your body wants
  • Reel in carbs and moderate protein in absolute values
  • Percentage of calories for macronutrients is unreliable
  • Taking a modest amount of fish oil to lower inflammation
  • A well-formulated low-carb diet is potent anti-inflammatory
  • Getting into nutritional ketosis takes careful diet control
  • The problem with work of Gary Taubes is no info on protein
  • Some people need “somewhat finer tuning” on low-carb
  • His goal is to find what will work for them
  • “Intriguing” developments with ketogenic sports performance
  • Learn about Dr. Phinney’s work: ArtAndScienceOfLowCarb.com

    There are five ways you can listen to Episode 23:

    1. LISTEN LIVE ON THURSDAY NIGHTS AT 7PM ET by calling (712) 432-0900 or on Skype at “freeconferencing.7124320900”–whether you call or Skype, be sure to use the access code “848908.” You can listen and even participate on the topic discussion by asking your questions directly to the featured expert.

    2. Listen at the iTunes page for the podcast:

    3. Listen and comment about the show at the official web site for the podcast:

    4. Download the MP3 file of Episode 23 [112:38m]:

    5. Listen on the Stitcher app–NO DOWNLOADING!

    If you cannot join us LIVE on the podcast on Thursday nights at 7PM ET, then you can still ask your questions of the expert guests in two ways. First, you can visit AskTheLowCarbExperts.com and fill out the form along the right-hand side of the page under “Submit Your Question” to input your name, e-mail address, the name of the expert you want to ask, and your question for them. These questions will be asked LIVE on the show airing on Thursdays. Or, for your convenience we have set up a way for you to e-mail us your questions directly to AskTheLowCarbExperts@gmail.com. Be sure to include your name, the name of the expert you want to ask your question to in the subject line, and your question on the specific topic of discussion. This is a golden opportunity for you to tap directly into the wealth of knowledge and experience on all things related to healthy low-carb living featuring the best and brightest experts in the realm of health!

    How did you like what you heard from Dr. Stephen Phinney about “Long-Term Stalls & Weight Gain Even On A Well-Formulated Low-Carb Diet?” Give us your reaction to what you heard in the show notes section of Episode 23. Come back next week in EPISODE 24 on August 30, 2012 when we shift gears with nutrition professor Dr. Donald Layman who is one of the foremost experts in the world on the subject of protein. He’s been studying the effects of proteins and amino acids to determine their impact on exercise performance as well as the role they play in overall health. Needless to say, the topic of discussion Dr. Layman will be addressing is “All Things Protein (Protein 101).” Do you struggle with how much protein is right for you? More? Less? Here’s your chance to ask THE protein aficionado himself. E-mail me your questions for Dr. Layman to AskTheLowCarbExperts@gmail.com no later than 3PM ET on the date the podcast airs. I look forward to expanding upon this issue and encourage you to read my October 2006 interview with Dr. Donald Layman on the “Livin’ La Vida Low-Carb” blog to learn more about where he stands with protein within the context of a low-carb diet.

    Here are the upcoming experts and topics we’ll be covering on #ATLCX:

    EPISODE 25: September 6, 2012 | Fred Hahn | “All Things Slow Lifting (Slow Burn 101)”
    EPISODE 26: September 13, 2012 | Dr. Jonny Bowden | “All Things Vitamins (Supplements 101)”
    EPISODE 27: September 20, 2012 | Jenny Ruhl | “Overcoming The Problems With A Low-Carb Diet”
    EPISODE 28: September 27, 2012 | Jonathan Bailor | “The Truth About Low-Carb Research”
    EPISODE 29: October 4, 2012 | Dr. Thomas Dayspring |“Cholesterol Testing: What Matters Most?”

    Spread the word about this podcast: PLEASE REVIEW THE SHOW ON ITUNES!

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    • Daytona

      I had been really looking forward to this episode, as after losing 50 lbs (with lots more to go) I have been stalled for over a year now. Unfortunately, instead of taking heart in what I heard, it was devastating to me…

      What I heard was Calories In, Calories Out. Ketosis doesn’t cause weight loss; it allows for fat mobilization and theoretically allows you to cut calories without hunger.

      I have been applying the principles from his books. I have been restricting carbs and protein as low as possible. I have been at a calorie deficit. I am measuring body fat and inches, not total pounds. I am exercising but not over-training. I am not losing body fat. I am hungry.

      So the only answer I got to my questions was the one I didn’t want to hear. His advice to be grateful for maintaining my weight loss is what I chose embrace. I am done with dieting. If the game really is won by cutting calories, I refuse to play.

      • Martin

        So how about you do not cut calories? Just eat the constant amounts of carbs with literally as much fat as necessary to not be hungry. Don’t count it – it can only lead to neurosis. Reducing caloriy intake is a technical term here: yes, you must reduce it to lose weight, but it is not something you should consciously control.

        • Daytona

          If I eat to satiety, I do not lose body fat/weight. That is my frustration. The answer for what to do if you have adequate ketones, are following the carb/protein amounts and are not losing weight appeared to me to be restrict calories. I don’t know what else to say to convey my problem and why I was unhappy with his answer…

          • LLVLCBlog

            Actually he said to cut back slightly on fat which cuts calories some. What I’d you hope for him to say?

          • melancholyaeon

            Daytona, first try reducing fat, as Martin suggests. If that doesn’t work, then switch your exercise to weight lifting. If that doesn’t work, then get your hormones checked – you may have a thyroid issue. If that still doesn’t work, try very low-dose metformin. Talk to your doctor. There is hope.

            • I have been doing HIT, slow burn, whatever you want to call it, weight lifting for 9 months. LOVE IT. ๐Ÿ™‚ I’m a strong chick now… chunky but strong!

              I’ve already tried cutting fat (while keeping carbs and protein the same) but couldn’t stick with it because of hunger. I think hitting up a doctor for some tests is the next step. I have had my thyroid tested multiple times without any abnormal results but they never tested rT3 or sex hormones.

              I’m not sure what I was hoping to hear, maybe something that wasn’t “reduce calories” when I am already restricting and hungry… It’s not really a problem with his message (I like being ketogenic), it just wasn’t what I wanted to hear! ๐Ÿ™‚

              • LLVLCBlog

                I think you missed the point if what you took away from this interview with Phinney was to cut calories. Eat ample amounts of fat, moderate your protein intake and limit carbohydrates and you’ll see results.

                • Yeah, based on everyone’s positive responses, I am feeling like I missed the point too! ๐Ÿ™‚ *runs off to listen again*

                  Since I wasn’t losing weight doing calorie restricted ketogenic, I have gone back to just ketogenic. Will report back if my body finally gets the message. Otherwise maybe some additional lab work will reveal why I am stuck.

                  Sorry for the drama! ๐Ÿ™‚

                • LLVLCBlog

                  No problem. It seems he’s saying that it is possible to gain weight on a low-carb diet if you overconsume protein and fat. That’s why paying attention to satiety is important. If after reducing carbohydrates first, then protein doesn’t give you the results you need with adequate calories, then perhaps try cutting some of the fat down. I don’t think Dr. Phinney is saying slash you fat right away (as Dr. Rosedale does).

    • Franziska Spritzler

      I think this may have been my favorite interview you’ve ever done, Jimmy! Steve Phinney is not only extremely knowledgeable and well spoken, he’s very honest as well. Calories and carbs both count, but there are so many other variables. I’m sure I’ll listen to this one again. Thank you so much!

      • LLVLCBlog

        It was my fave!

    • Erik

      Great program. Very informative. Thank you Jimmy and Steve Phinney for your time.

    • Nina

      Jimmy thank you for your comprehensive notes, they’re really useful. Once again this reminds me of Dr Steven Gundry’s Diet Evolution. He emphasised high fats and, once weight loss has started, reducing protein. Nina

      • Hitssquad

        “comprehensive notes”

        Indeed. I counted 204 bullet points. That might be a new record for Jimmy.

        • LLVLCBlog

          That was two hours of a power-packed podcast!

    • I relate to just about everything Dr. Phinney says (with the exception of blood sugar control for “diabetics” on low carb – my sister has upped her fat and is eating what appears to be a ketogenic diet and her fasting BG has been regularly 180 to 300 and her last A1C was 10 – and her trigylcerides were 200; still can’t figure out what is going on with her; very frustrating). But….as for myself, most everyone who follows this blog knows my story and may have read that I did a century (100 mile) bike ride Friday on my ketogenic diet – I had eaten virtually no carbs the previous day and had no breakfast, rode 75 miles, then had hamburger steak and eggs before finishing the 100 miles. I did want to add that I think Steve is “spot on” with his ideas about menopause. I started low-carbing in 1999, and went through menopause sometime during that time. I don’t know when! I recently went to a new doctor and we were discussing my history form and it seemed so weird telling her that I honestly had no idea when I went through menopause and can’t even make a guess – I never had a single symptom. I’m convinced that my low-carb diet had a major impact on my lack of problems with menopause. I also have no problem building muscle – you should see my calf and thigh muscles after a summer of intense cycling!

    • Diane

      I hope this is not asking the obvious, but are the protein recommendations for cooked or raw portions?

      • LLVLCBlog

        No distinction was made, but I’d presume cooked.

    • smgj

      Regarding the thyroid issues tha several people in this program have I’d reccomend swithching to dessicated thyroid as a trial. It would add the active hormone in a protein-bound form (and t2, which some studies imply has a role in weigth control). This may help for loosing the last few lbs.

    • Plainswalker

      Looking at that chart, I was totally undereating my protein during my experiment back in Russia!

      I’m still listening to this podcast ever so steadily (I listen when there’s down-time at work) and I’m not sure if Dr. Phinney talks about this later on, but if I have a recommended range of, say, 95-199g of protein a day, how would I eat that so as not to convert “excess” protein into sugar if I only have the chance to eat two or three meals a day? I keep hearing the cutoff point is 20g before the protein is considered “excess,” but that would translate to having anywhere from 4 to almost 10 meals a day just for protein!
      Am I misunderstanding things, though? I don’t have my own glucometer nor a ketone meter, so as a shot in the dark, would still eating the middle of that range (~150g) divided up in two or three meals still keep me ketogenic?

      • LLVLCBlog

        I do think you’re misunderstanding what was said. The point is to split the protein up amongst the meals in your day, however many there are. The only way you can know for sure if what you’re eating is still ketogenic is to test blood ketones.

    • D. Lane

      Very interesting. Note that hemoglobin A1c is abbreviated HbA1c not HgA1c.

      • LLVLCBlog

        Actually, both are acceptable ways to express it. Thanks so much!