Why weight loss surgery is not the solution

ProblemStorlek

Weight loss surgery is hot. A lot of people are starting to see it as the only effective treatment we have for obesity. That’s just insane.

Here are some slides from a lecture at the obesity conference last weekend. The slide above shows the magnitude of the obesity problem. Bariatric (weight loss) surgery will hopefully never have to be used on more than a small minority of obese patients.

Why not operate on everyone? Here’s why: 

Removing healthy organs

Procedures

Here’s the three most common surgical procedures today. All of them are about stopping the normal function of the digestive system. The more effective surgeries (like Gastric Bypass) actually disconnect or remove healthy organs.

We live in a sick world when we need to surgically adapt our bodies to our industrial processed food.

Complications

Komplikationer

The bigger the surgery the more effective it is, with a higher percentage of EWL (Excess Weight Loss). But at the same time the risk of compications increase.

What kind of complications? Here’s one list:

Komplikationer2

Vitamin deficiencies are common after weight loss surgery, but here they don’t tell us how common. I love how they instead claim that “Vitamin/Protein malnutrition is a result of non-compliance with vitamin recommendations and food sources”. Really?

Another explanation could be that vitamin / protein malnutrition is a result of removing or disconnecting the organs that absorb vitamins and protein. But of course then doctors couldn’t just blame the fat patient.

Bottom line

Why isn’t weight loss surgery the solution to the obesity epidemic? There’s a simple answer:

Removing healthy organs is not the solution to bad food.

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89 comments

  1. Michelle
    Hi Doc

    I had the Gastric sleeve done 2 years ago. I accept that it is not the answer; however, I can honestly say that it saved my life. What it did for me was to stop the never ending cycle that is binge eating. It also enabled me to loose a huge amount of weight quickly and thus enabled me to overcome the 'I have too much to loose, how can I do this?' mentality. Being obese is a psychological issue just as much as a physical one and although radical and extreme, sometimes weight loss surgery can open the gates to those that have seriously lost their way with food.

    The operation may not have solved my problem completely as I still have huge problems with how I see food and it's function in my life, but it has given me the ability to see beyond the weight and aspire to a better way of being.

    Love your blog, keep up the good work as I have never felt better than when I eat LCHF.

    Michelle

  2. Laura
    Here in Britain it is also becoming an important weight control tool and as much as I accept that it helps people I msut say I feel lucky to be able to exert my own control over food intake (although it is hard work as I have a HUGE appetite even on a LCHF diet! At least starch bloated me for a couple of hours!). The bariatric surgeon in the media is Dr Shaw Summers he is the TV face of this new trend. Of course they ahve been careful here to portray gastric bypass especially as a last resort but seeing often very young morbidly obese people go for the surgery is disturbing especially because the vast majority of people will have indeed tried many diet programs but alas NOT the low carb/paleo system and I wish I could reach them and tell them before they get themselves under the knife.
    Every invasion of our body is sooo irreversible but also the thought of all that can go worng and the fact that some 20% of patients will put quite a lot of their weight back on as the years go by...still not clear why perhaps the smaller stomach pouch learns to expand with time and can accommodate more food who knows.....

    But if there was a way to make me less of a slave to insulin I would try it I am indeed on the look out as I am soooo sensitive to carbs it is not real!

  3. Alexandra M
    Me: Doctor, I'm so frustrated about my weight!

    Doctor: How about a lap band?

    Me: You know that's not the answer! We've been discussing this for years! Could you recommend a bariatric physician who really understands low carb diets?

    Doctor: Sure. You should definitely choose one who specializes in the procedure.

    Me: What procedure?

    Doctor: Lap band surgery.

  4. Alexandra M
    And they're doing this to teenagers! It's so sad.

    http://www.nytimes.com/2012/01/08/health/young-obese-and-getting-weig...

  5. Michelle
    Sometimes it can take these teenagers years, in fact most of their lives to overcome their eating problems and in that time their lives have gone. Poof! Gone. I support those who want this surgery, it may be sad, but by god does it work in the short term. Once the weight has gone, you then can work on what was causing them to be obese in the first place, such as insulin resistance ect.

    I promise you, once you get to a certain weight it is not just hard to rid yourself of the excess weight, for some it is nearly impossible to do so. This is the last resort, but I wish I did it years ago.

  6. Alexandra M
    "...their eating problems..."

    But most of them don't have "eating problems." What they have is bad information and a bad food environment. My husband works at a charter school which is also a working organic farm. The focus is on "real food" and knowing where it comes from, but the emphasis is still on low fat. You can't even get whole milk in the cafeteria. The breakfast they provide to kids who need it is low-fat yogurt with sweetened fruit in it, a banana, and a bottle of orange juice. These kids are HUGE, a few over 300 lbs, and one girl was 400 lbs before she was sent to an obesity treatment program.

    They've heard the "healthy eating" message every single day, but that message is "orange juice, bananas and sweetened low fat yogurt are healthy foods."

    Imagine the surge of insulin they're getting from those foods and the effect that's having on fat storage and hunger and you don't need to look for eating "disorders."

    http://www.dietdoctor.com/the-1-cause-of-obesity-insulin

    I'm not suggesting that there's no such thing as an eating disorder, just that when SO many people are obese it makes more sense to look for something in the environment than to assume that so many individuals have a particular abnormality.

  7. Jen
    Doctors see it as effective because it's obscenely profitable.

    And it's cash money – no discounts.

    Things might be different in Sweden, but over here it's all about cash money.

  8. Maggan A
    I saw a TV program about a young extremely overweight mother who went through gbp. She wept of fear before the surgery, but her doctor told her it was the only solution. She was only 18 years ... and I wept with her :-/
    Because I know it was not the only solution.... fine if people do this surgery - but I doubt that their decisions are well informed...
  9. Michelle
    You've just described an eating disorder. It can be impossible for some to disentangle themselves from this way of eating. Sometimes and I stress sometimes, surgery is the only way for this way of eating to stop and to empower that person to begin again.

    Life is not as cut and dried as education. When things go so badly wrong that someone manages to eat themselves to 30 stone or higher, they lose the will to do anything about it. They stop seeing themselves as human and surgery can give this back to them, quickly and with good after care (which does not always happen) they can get on with their life, which is the most important thing.

    What works for one does not necessarily work for another. LCHF is an amazing way to stay slim and healthy and it works for me. I recommend it to everyone, but I can guarantee that at my heaviest weight I would have tried it, but the enormity of losing 10 stone would have melted away any will power to stick to it. I must be all those things that Dr Lustig says our doctors think we are to have been so fat; lazy and greedy.

  10. Mel
    Alexandra, I know things are bad in the states, what I never realized is that here in Canada is a lot of parents are told to start restricting fat in diets of kids as young as two. (Skim instead of whole milk, reduced fat cheeses, limited red meat etc, instead- lots of starches). We are poisoning people, both physically, and mentally with this terrible advice. And starting them before they're out of diapers. It's no surprise to me now, why I have met a 17 year old with T2 diabetes, and have heard of kids younger then that with this condition. Other then diabetes, It sounds like a recipe for giving some kids anorexia, or binge eating problems down the road.

    I have LONG been wondering if we lived in a world where LCHF was the standard diet. Would ED's become a true rarity? I'm waiting for the day. Stores and restaurants that have healthy LCHF menus, School cafeterias with a selection of LCHF, Hospitals feeding patients LCHF. Kids growing up not fearing butter, or a marbled steak.

  11. Bob Johnston
    I'm not convinced that gastric bypass and Lap Band surgery work because they make the digestive tract shorter, if you look at the diet these people eat after the surgery you may notice another reason why they lose fat.

    http://www.lapband.us/diet-restrictions.html

    "Eating foods that are high in sugar content, high in fat content, and high in calories with little nutritional value will decrease your rate of weight loss. In order in increase your rate of weight loss, there are some foods you should avoid, including:

    - Sugar and sugary foods, including: high-calorie soft drinks, syrups, honey, jelly, jam, cakes, cookies, candy, ice-cream.
    - High-fat foods, including: chocolate, chips, pies, pastries, ice-cream, bacon, sausage, fried foods, cream soups, cream sauces.
    - High-calorie drinks, such as milkshakes, soda, beer, orange juice, apple juice, other fruit juices, whole milk.
    - Starchy and white flour foods, such as pasta, rice, and doughy breads.
    - Fats such as butter or oil should be restricted to 3 to 4 teaspoons per day."

    It appears to me that they cut out pretty much all the foods that we low-carbers cut out. Hmmm...

  12. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Bob,
    Hmmm indeed.
  13. Maggan A
    Michelle

    With all respect I dont belive the knife, and mutilation of a perfectly healthy organ can cure an eating disorder,an eating disorder sits in our heads.

  14. Alexandra M
    I must not be making myself clear.

    "You've just described an eating disorder."

    No, I've described a disordered endocrine system. When insulin levels are high, it is perfectly natural to eat more and more because an energy deficit has been created as calories are shunted to fat storage instead of to energy. What would be an "eating disorder" in that situation would be to ignore the hunger signals and not eat. That's not what we evolved to do. We evolved to seek food when the body signals an energy deficit, and the problem is that the standard "healthy" diet unbalances things so that the hunger signal is being sent out all the time. The signal is there in the hormones, not in the imagination, and we have a powerful biological, not psychological, drive to heed its directives.

    Michelle, you say you would have tried LCHF - but you don't know what would have happened. It's quite possible that the novel freedom from constant hunger would have been enough to keep you on the diet, with weight loss as a secondary benefit.

    And that's the true "miracle" of LCHF: as miserable as people are being overweight, I'm sure the constant hunger of a high carb diet is even worse. LCHF fixes that.

    If the surgery changed your life, Michelle, I'm glad about that. But I'd much rather see people - especially kids - try a LCHF approach and discover that they don't have to be hungry all the time. If that doesn't work (but I'm sure that it would), surgery might be an option.

  15. Michelle
    I guess we all have to agree to disagree. Though I only have myself to offer as an example, I feel that in itself is enough to endorse this radical treatment, for some and not everyone. I am well now and for that I thank my surgeon.
  16. Maggan A
    Alexandra M #14

    Thumb up :-)

  17. Maggan A
    Michelle

    Don´t misunderstand me - Im happy for you if you are feeling well. That is the most important :-)

  18. Alexandra M
    Mel - "Kids growing up not fearing butter, or a marbled steak."

    I've noticed lately that the whole "vegetarian / vegan is better" attitude has become so deeply embedded in the culture, especially in the younger generations, that the problem isn't getting them to believe that eating eggs and meat is okay - the problem is that they don't even like those things anymore. They think they're "gross."

    We'd better figure out a menu for those people or this whole project will be DOA.

    I don't know the Doc's feelings about soy, but I just don't trust the stuff. So imagine how I'd feel recommending this pathetic mess to a friend:

    http://lowcarbdiets.about.com/od/vegetarian/a/veganlowcarb.htm

  19. Maggan A
    Alexandra M

    No we don´t have have to figure out a menue for these people. The only thing we have to do is continue eating our owne menue and getting healtier and and healthier everyday...Let them eat theire birdfood and soyproducts that is disastreous for the environment... we know better....

  20. If the LCHF diet (and its theories on fat) is as effective as we think...the medical, pharm, fitness and grain industry will suffer tremendous losses...it would change our entire society! Very exciting times ahead if people start accepting this. I can only wonder how those industries will react once their profits start dropping.
  21. Alexandra M
    "No we don´t have have to figure out a menue..."

    I should have explained that I'm talking about people who are very interested in switching to LCHF but don't like a lot of the foods we eat. I'm talking about, for instance, an aversion to meat that is more a matter of food preference than one of ideology (though I'm sure it has its origins in ideology if you look closely enough).

    It's like if somebody told me I could be slender and healthy and super-smart by eating a lot of insects. I just couldn't do it, though I'm sure some people could. People have been asking me personally and on the web generally, so I'd like to have some good answers to give them.

  22. Maggan A
    TheFatNurse

    They thretean us whit jailsentenses

    http://www.fathead-movie.com/index.php/2012/04/26/dietitians-go-after...

  23. Maggan A
    Alexandra M

    "I'm talking about people who are very interested in switching to LCHF but don't like a lot of the foods we eat."

    God luck for you Alexandra if you have people listening to you - but I would never allow it to be MY problem though. My edvice - tell them LCHf means less of carbs and more of fat. Take it from there... if they dont like it - it is there lost...

  24. Jay Wortman MD
    I have a friend who is a bariatric surgeon. He told me that the post-surgery diet is very low in carbs. I recently had a conversation with another bariatric surgeon who told me that he routinely puts his patients on a very low carb pre-op diet to shrink their livers so that he can get access with his laparoscopic instruments. Why not put these patients on a low-carb diet and skip the surgery?

    What really annoys me is that this permanently disfiguring procedure is offered before everything else has been tried. Consider the amount of resources that go into supporting a bariatric surgery patient in the form of pre- and post-surgery care, diet counselling and follow-up by a variety of health professionals. What would be the result if the same resources were directed at supporting them on a low-carb diet? That is a study that needs to be done before we start sending everyone off for bariatric surgery. Also, if the purpose is to physically restrict their ability to eat, why don't we just sew their lips together? That would be much cheaper and easier.

  25. @Maggan: yea I saw that...scary

    @Jay Wortman MD: that is very interesting about the preop diet for surgery...please ask your friend why!

  26. Alexandra M
    "...please ask your friend why!"

    "...to shrink their livers so that he can get access with his laparoscopic instruments." :)

  27. Alexandra M
    "I can only wonder how those industries will react once their profits start dropping."

    "New Improved Cheerios! Now with 50% more Healthy Fats!"

  28. @alexandra: (Shakes Fist!) you know what I meant!
  29. Galina L.
    There is little could be done about people who can't eat meat or declare they have to eat cookies or they would go insane. There are dysfunctional people around, saving humanity is an impossible task..Every diabetic I know is sure there is a sacred right to eat bread and sweets. May be there are diabetics who have different priorities, I just never met one. Take care of yourselves and immediate family, guys, Somehow, the more health and weight problems one has, the more defensive he/she feels about his/her diet.
  30. Maggan A
    Alexandra M

    "New Improved Cheerios! Now with 50% more Healthy Fats!"

    hm... "you can fool some people sometimes - but you can´t fool all the people all the time"
    quote Bob Marley

  31. moreporkplease
    Dr Wortman:

    "What really annoys me is that this permanently disfiguring procedure is offered before everything else has been tried"

    As you know, here in the USA, you get the medicine that can be paid for. Surgery is easy to pay for: everyone's insurance will cover part or all of it, esp. since gastric surgery has been declared "the cure" for obesity and T2D.

    Most USA health plans will pay only a very limited amount for "behavioral or lifestyle interventions." For example, my health plan at work will cover 3 such sessions. Ever. Whereas all surgery approved by my primary care physician and properly referred will be covered 90%.

    If I wanted to go to Dr. Westman's community clinic counseling, I couldn't go more than 3 times, unless I wanted to pay the US$20 out of pocket, or US$180 a year. So it's really that simple. A lot of folks really don't have that extra US$180.

    But even if you did, why would you go if your doctor has already told you that surgery is the "real cure?"

    Why would you "waste" your time on a diet everyone says will fail because you're just fat & lazy? Making obesity a moral problem, a character problem, also makes it insoluble on a personal level, right? :) Once you do that, you *need* the surgeon to come save you from your depraved and sinful self because you can't otherwise be "redeemed."

  32. The WRONG way to "beat' diabetes & obesity, gastric bypass surgery will put your life on the line. http://goo.gl/qEBN2
  33. I think surgery like this has got out of hand. Many overweight people treat it like the magic solution.

    Didn't people used to get their jaw wired for weight loss? Whilst I don't think that is a good approach either as it doesn't change habits - it's got to be so much better than surgery!

  34. @Alexandra M, The answer you need to give those people is to quit wearing their ass for a hat, that you're not gonna fall for their drama & brain damage any more, and to step out of the diaper they've been wearing all their lives and put on a pair of grownup pants & stop all their damn whining about the taste of eggs, meat & vegetables.

    You need to wise up yourself, get a clue, read the subtext between the lines of what they say and realize it's not that they or other humans have an inborn aversion to paleo or low carb & natural whole foods, it's just that they like what they've been eating MORE, all the cakes, cookies, candies, pies, pizza, hamburgers, fries, Cokes, etc. because THEY'RE TASTIER. It doesn't matter that it's no good for them, it's what they really want to eat all the time & as much & as often as they can. The bottom line is that no matter how much they SAY they'd like to switch to a LCHF diet, in the end THEY REALLY DON'T WANT TO, or they wouldn't hit you with all their lame ass excuses.

    The REAL foods that keep a human strong, healthy, disease & obesity free and alive don't taste like the crap they've been eating that got them the way they are now, THAT"S the reason they don't like real foods. None of the real foods are as sweet & loaded with all the sugars & engineered chemical tastes they actually prefer, so quit babying & making excuses and trying to find a work around for them. If they want to live a long healthy high energy illness free life they're gonna have to make an adjustment, get used to it & GET OVER IT!!!

    I've worked with knuckleheads that wouldn't eat fish or vegetables & would make fun of the sardines, carrots & celery, boiled eggs & things I'd eat for coffee break & lunch, then an hour later complain that the double cheeseburger, fries & soda they ate while they were making fun of me was making their stomach hurt. I've been on jobs where on coffee break some of the guys would pass a soda around between them, then a week later wonder why they were all sick with colds & sore throats, not real genius material that bunch. I once offered to give a guy twenty bucks to eat a 4 inch celery stick, when he refused I asked him why, and like a three year old he said "cause I don't WIKE vegables!"

    The harsh reality of life is that life always has & always will be about survival of the wisest and most adaptable, and those that can't make the adjustment will die & remove themselves from the gene pool, and the human herd will be stronger for it. And that's just as it should be, but don't blame me, I didn't invent The Immutable Laws of the Universe, I'm just telling you how it is.

  35. Alexandra M
    cancerclasses - I'm not talking about people addicted to junk food. I'm talking about people who are starting to understand the science of LCHF, but who have been brought up to loathe "animal products."

    The point I was trying to make is that the culture of vegetarianism / veganism has taken hold in such a way that there are people who have grown up with it since they were weaned. They haven't decided that meat / eggs / whatever are disgusting - they've been indoctrinated to believe it in their very bones.

    I think I already used the example: If somebody told me that the healthiest thing I could eat was insects, I still wouldn't be able to eat them because I've grown up in a culture that regards eating insects as disgusting. Even though I know in my rational mind that insects contain lots of protein and fat, I doubt that I could choke down even one. I don't know how I'd get over that conditioning.

  36. @Alexandra: Just shove a piece of bacon in their mouths...problem solved.
  37. Alexandra M
    Believe it or not, there are people who think bacon is "disgusting." Maybe if I could get them to try bacon ice cream... ;-)
  38. After reading the diet restrictions at the link in Bob Johnston's comment I had a brainstorm. Instead of calling it LCHF, low carb, paleo, Atkins or whatever, we should eliminate ALL the other names and just call it THE LAP-BANDLESS® DIET!!

    "Your THE LAP-BANDLESS® DIET!! should consist of the healthy foods eaten by virtually every human being that ever lived before the invention of wheat, grains, flour & processed vegetable oils - foods that are naturally low in calories and high in nutritional value. Since you've wisely chosen not to let some ass hat doctor gut you like a fish, it's up to you to control the amount of food you eat, and it is up to you to decide what foods you eat, and it's also up to you to determine how often you eat, just like everybody else in human history, because let's face it, you're NOT a special case, get over yourself. But if you want to lose weight it will be important to follow the diet and THE LAP-BANDLESS® DIET!! nutrition guidelines."

  39. Margaretrc
    The Lap-bandless diet. I kind of like it.
  40. Laura
    Isn't is HUGELY IRONIC!! Bariatric surgery patients go through that abomination of stomach amputation only to be put on a restricted diet that fi they had followed to begin with they would not have needed surgery i the first place!! aaarrgghgghghh we msut be CRAZY!!!!

    We have one life one shot at it and one body to go through it and we msut make the msot of it! Instead we become slaves to grains and sugar and then diseases and metabolic imbalance!

    There must be will power over and above food addiction that can prevent surgical procedures that put our poor bodies under so much stress both in the long and short term.

    I am now even more certain that carbs are bad for us they cloud our better judgment they force us to udnergo amputation of our gut for goodness sake!

    We are the only animal in nature to do all this to ourselves first we domesticate foods that are bad for us then we refine them even more make them our staple and make them so good (apparently) and easy to get to that we have to spend the rest of our lives avoiding them and if we fail...well we go and see a nice guy in white coat with a big knife who will make your stomach smaller!!....what's wrong with us?!?!
    We are WEIRD! I hope the rest of nature is laughing at us!
    adios

  41. Jennifer
    Alexandra M

    Vegetarians CAN eat lchf (vegans are trickier), there are loads fo different dishes you can do with eggs (scrambled, omelette with veggies, poached with beanaise sauce etc etc), quorn (bolognese, sausage, tacos, "chicken" dishes. However this is low-fat so be sure to add a fat sauce), broccoli or cauliflower in the oven with melted cheese and cream, tapas (halloumi cheese, olives, guacamole, veggie sticks) and lowcarb pancakes (almond flour mixed with eggs and cream topped with berries, whipped cream with vanilla powder or cinnamon). If you like my list can go on and on! For vegans its obviously more difficult but even here it would work by adding lots of avocado, olives, coconut and oils to add fat to your veggies.

    Bread can be baked with mixed seeds flour, eggs and cream cheese, then add butter, cheese and vegs.

  42. Laura
    Although I perfectly udnerstand that dairies are endorsed on this blog as part of a sustainable LCHF regime may I comment from the viewpoint of a Paleo that:
    1) Scientifically the jury is still out on dairies..I know they fill a 'fat' gap and they taste good if I remember as i was vegan for 17 years before turning paleo so but I know butter tastes good!
    See also the Ancestral Health Association http://ancestryfoundation.org/
    2) from an ancestral perspective we are not adapted to eat dairy as we only started about 10000 yrs ago as with grains and many populations in the East retain the in my view healthy lactose intolerance in teh adult that keeps them well away from cow juice. A single mutation that stops us throwing up if we injest milk is not tantamount to adaptation to consume this substance
    3) We are the only animal that drinks another animal's baby's milk as adults....jsut weird again!
    4) Ethically organic or not dairy cows have been bred to lead a poor life they are milk factories and have to be kept in a lactating state which means the milk is even richer in growth hormones and oestrogens that could have an effect on us sicne bovine hormones are similar enough to ours to bind to the same receptors..

    Milk is NOT essential for bone health see also cultures where they do not consume any or very little e.g. China. In fact if anything there is evidence that it may be bad and cheeses are very acidifying...

    Fermented milk product may be less harmful but as said the jury is still out

    In general I am worried about the liberality with which dairies are promoted in LCHF. We should be cautious about this substance and derivatives because too many times we go for convenience food at teh detriment of health.

    I fill my fat gap with animal fat of coruse but also with vegetable fat such as coconut and not jsut the oil but also the cremed flesh (addictive stuff I tell you) and other low carb seeds (sesame for example) and brazil/walnuts and of course avocado yum yum.

    just wanted to say that it is possible to do LCHF without dairies!

  43. JAUS
    I was so close to surgery, but fortunaly I looked around for alternatives while I was on the waiting list and found LCHF. I had eaten Atkins some years before and lost some weight for the first time in my life, but I was scared away by "experts" who alarmed about the "dangers" of fat.

    This time with LCHF, I checked all the facts myself instead of relying on so called "experts". I lost a lot of weight especially in the beginning and while I still have much left to loose my blood tests show that I am very healthy and I feel so much better than before.

  44. Alexandra M
    Jennifer, thank you. I think the problem I'm encountering is more about food preferences - sometimes it's beyond me how anyone could be overweight rejecting so many foods! I guess they just eat bread and pasta and such.

    Don't you think Quorn is a processed food though? When I think of the words "microbial biomass," the next thing I think is "do not eat." I once had a long discussion with a vegan friend who wanted me to try Quorn:

    Me: Does it taste good?

    Vegan: I've never cared for meat.

    Me: Yes, but how does Quorn taste?

    Vegan: I've just never liked the taste of meat.

    Which tells me pretty much all I need to know about the taste of Quorn!

    http://en.wikipedia.org/wiki/Quorn

    Laura - There are people for whom the only things that are going to appeal are heavy cream smoothies, so I'm not about to warn them off milk products!

    And tell me more about this creamed coconut - I bought a young coconut (more juice, more gelatinous flesh) and it was so sweet and delicious I figured it must not be a smart choice. Anybody know about this?

  45. Laura
    JAUS Good on you!
    You could be the one that got away...from the knife!
    I apply paleo principles to Atkins and find it really good. I am following the latest New Atkins New You by WEstman, Phinney and Volek and the advice in there is very good. I am in very low carb induction phase and I think I will do induction every few months for a few weeks to prevent carb creep.
    If you are also on less than 50gr carb/day don't forget to drink broth!
    Ciao and well done
  46. Alexandra M
    Close call, JAUS! Glad you escaped the knife.
  47. Laura
    Hi Alexandra
    Re-dairies...it is about choices all food is out there I jsut wanted to say that there are alternatives to dairies for those who wish to do without be it for paleo/ethics whatever reasons..

    Creamed coconut or coconut manna..it is a US product so i would be really surprised if you cannot find it there (I assume you are in the US) in WHole foods for example. It is from the same brand that does the coconut oil Sunvita(?) so it comes in a jar it is a guess equivalent to peanut butter but it is coconut. There is also a type by Biona in a bar. It melts and can be used as coconut milk i used it to make Thai style fish dishes amongst other things! What a wonderful ingredient!

    YES it does have quite a bit of carbs 20g total carbs (prob around 18 net carbs will check...) per 100g so I treat it as a...special treat! As a woman still cycling I get terrible cravings once a month and by Jupiter a bite of this stuff pure bliss(it is also the consistency that pleases from hard and crunchy to melt in teh mouth!! yum yum)....one day when I am off this extremely low carb stage I can envisage preparing a wonderful dessert by metling it with dark chocolate and a bit of honey yum yum.....to die for. There is an amazing recipe for a wonderful coconut milk based healthful drink on MArk Sissons website that includes tumeric, black pepper nad cardammon all in a base of coconut milk and a bit of honey..I have all the ingredients at the ready for when i get out of this extremely low carb stage...a little reward in life I msut say sweet is still in my mind associated with pleasure more than savoury....sigh

  48. Laura
    Alexandra sorry i had to comment on this as a veteran vegan Quorn is NOT vegan as egg white is used to improve texture and bind the fungus protein together...so as a vegan I never had quorn!

    I lived on soya for 16 years and it even had an effect on my monthly cycle scary stuff although fermented as miso is supposed to be good for you...hmmmm might get back to it in menopause when I need to curb the beard growth and other effects....

  49. Alexandra M
    "Quorn is NOT vegan as egg white is used..."

    Ooooh! Can't wait to tell the vegans! *evil grin*

    I think that if the soybeans are fermented, as they are for miso, the phytoestrogens (which are responsible for relief of menopause symptoms) are destroyed. Not sure though. We need experts on everything!

    Thank you for that good information on coconut. I'm going to Whole Paycheck today, so I'll look for manna (but not from heaven).

  50. Zepp
    To the question about dayries on a LCHF diet I say.. its a part of an North Eoropean and North American diet.. not any demand to eat at all, only an old custom.

    And there is altso a lot of old tribes, perticuly herders that thrives on a high dairy diet.. special in eastern europe and in desserts like masai and Ural populations.

    And humans are mamalian.. and this means we are born milk drinkers.. so there is no need to be an evolution for us to drink milk.

    Its seems to mee that the only thing thats nesecery to drink milk on older days is to never stop drinking it.

    If there is a problem of dairys there is this about casein allergy from some cow milk.. its almost breeding thing becuse not all cows dont have this casein, not sebu cows, not islandish cows eighter.

    And there seems to be a rise in consumption of dairy in the world.. its a technichal thing.. about refrgriation and pasturiation for safe distribution.

    But my self, laktos intollerant do not use that much dairys, more butter, chees and cream.

    And I think that milk is for children.. they can probably havé some benefits of it, its a nutritial fluid to make mamalian childs grow and gain weight.. mayby not so good if you need to loose weight!

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