Love your blog! Thanks so much for having it on the net.

I was wondering what you thought of CKD. It seems that most athletes who practice this are consuming VLC for 6 days, then for one day they consume TONS of carbs. Many of them have PWO carbs, but usually restrict that to about 20g or so. In relation to this article on carb binging, I was wondering what your take on this regular carb binging was? How much harm are these athletes doing? Or is there some trick to CKD that makes it safe?

Also, if one is on a near zero carb diet, can they still build muscle effectively? And, if so, what is the best way? More protein or what? What would be a good PWO meal, and why?

BTW… I’ve always been curious as to why glycogen stores go up and down depending on carb consumption. If some glycogen is needed, and will be produced via gluconeogenesis, why is excess glycogen shoved into liver and muscle when carb consumption is high? How did this come to be during our evolution, where carb consumption must have been extremely miniscule if not totally absent? What is the physiological advantage (or disadvantage) to putting so much sugar into this type of storage?

Thanks again for such a great blog!

Dean

Hi Dean–

The fact that these folks eat a ton of carb once a week is mitigated by the fact that they are at zero carbs for the rest of the week.  It’s kind of like intermittent fasting.

People can build muscle effectively if they eat plenty of leucine, one of the branched chain amino acids.  It requires about 8-12 gram per day to drive muscle synthesis.

Glycogen is a storage reservoir for carb to basically get it (carb) out of the blood quickly where it can cause real damage and into the storage space in the cells.  Although primitive man didn’t eat a lot of carbs, I’m sure when he figured out about honey be binged from time to time, and ate a fair amount of sweet fruit when he could get it during the short period that it was ripe.  The glycogen storage system is designed for just such occasions.

Cheers–

MRE 

I posted above in #15 and I wanted to give you an update.

This month I was off-plan for a week b/c I had family visiting. I decided to test my fasting blood sugar (diabetic Daddy was visiting) and I was astounded to see that the result was 135!!

It has always, always been 89-90ish when I’m adapted to whatever style I’m eating, whether it be LC or see-food diet (I see food, I eat it!).

You could have knocked me over with a feather. I was incredulous of the increased sugar response on LC b/c of my experience above, but I’m a believer now! I’ve seen it with my own eyes (Thomas that I am)!

Hope that it doesn’t mean I’m IR now? Oh well. I go for another physical in the fall. My weight is good now, so I figure I’m at holding it at bay with being normally weighted.

Thanks for all your great info. I have just recently discovered your blog…don’t think I can ever get caught up…

Elle

Hi Elle–

I doubt that you’re IR now.  Just check again after you’ve been back on the plan for a while.  I’m pretty sure it will be okay.  Keep me posted.

Cheers–

MRE 

I honestly think I’ve been misdiagnosed, and should be retested, but my doctor disagreed and put me on several meds that caused my glucose levels to crash several times per day. I have moved on to a different doctor (and gotten off all meds), and plan to revisit this again. I’ll bring a copy of this article with me when I do. Thank you.

Hi Robin–

Sounds like you’ve made the right call.  Let me know the outcome.

Cheers–

MRE 

I find this really interesting.

I low-carbed through all 3 of my pregnancies. (Advanced maternal age all 3, at 35, 37, 39 y.o., no complications, normal unmedicated vaginal deliveries without complications)

The first PG, the GD screening was required to be fasting, and I got very sick and even nearly fainted when I drank the liquid and my sugar was 114 at one hour.

The second PG, I could eat before (different OB’s) and remembering how sick I had gotten, I had a big protein breakfast of bacon and eggs. I felt a little yucky when I drank the liquid, but nothing terrible. My result at one hour was in the 90’s, I forget the actual number.

The 3rd PG, same as the 2nd, and my result after one hour was 89.

I tell you all this to say that I thought my low-carbing before the test (I refused to eat any differently the week before the test b/c I wanted to the test to reflect results based on the way I usually eat) would somehow show that eating a LC diet would protect one from high blood sugar even after a load of glucose? My hypothesis (eat low carb, have normal screening) held true 3 times, or so I thought.

Now I read that the result was likely HIGHER that it would have been had I just been eating a high-carb diet??? Good Lord, if a HIGHER result was 89, then what would it have been??? 60?? 40??

I’m very confused now.

What, if anything do you make of the fact that my nunmber were great, even though I was low-carbing for months (years even) before the tests? I’m very curious. I thought I was doing the right thing at the time…now, not so sure?

Kids are just fine, BTW, at 6, 4, and 2 years old!

Hi Elle–

I think you are fine.  You obviously did not develop insulin resistance during your pregnancy, which is a good thing.  Had you done so, your blood sugar levels would have been much higher.  I think some people adapt nicely to the low-carb diet (especially those who have followed it for a long time), increase their insulin sensitivity, and have no problem with a glucose tolerance test.  You are one of those people.

Cheers–

MRE 

Hi Jay–

DiabetiSweet contains a sugar substitute called isomalt that is really a sugar, but one that has a pretty low glycemic index.  I’ve not had any direct experience with isomalt, but it supposedly doesn’t break down and absorb as well as does sugar, leading to much lower blood sugars after its consumption.

I would say that your best bet would be to try a couple of teaspoons of it, then check your blood sugar with a glucometer in 20 minutes or so to see what happens.  If your blood sugar goes up significantly, then I would avoid it.

If you do the test, let me know the outcome.

Best–

MRE 

Hi Kent–

I can’t really make a call without a whole lot more information.  And even if I had the information, I couldn’t diagnose and/or treat over the internet.

If your sugar levels are consistently as high as you report and haven’t responded to a low-carb diet and exercise, I would recommend that you find a good physician experienced in the use of low-carb diets and work with him or her to get things under control.

Good luck–

MRE

Hi Margie–

Your results are within the normal range, at least at the lab I use. You can indeed get higher readings if you’ve been on low-carb for a long period before the test. That’s why it’s always recommended that those scheduled for a GTT up their carbs for a few days before.

Carbs do indeed make one sluggish after a long period on low-carb. Makes you want to get back to the proper diet in hurry.

Best–

MRE

Hi Margie–

Follow the standard American diet and you’ll double that carb intake.

What to eat? I would probably eat a potato and some bread and maybe a bunch of rice. You want to eat starch so that you will get glucose. Don’t eat a bunch of stuff with sugar or HFCS because you’ll get a lot of fructose.

You need at least three days of the higher carb fare for the glucose tolerance test to be accurate. I usually have patients follow such a diet for a week just to be sure. But, I don’t usually do a glucose tolerance test, I do an insulin challenge instead, which is much more revealing.

Best–

MRE

I’m about to have a glucose tolerance test (2 hr.). How many carbs should I be eating leading up to the test and for how many days before?

You need to consume 150-200 grams of carbs for at least 4 to 5 days prior to the test. That’s why MD and I almost never did glucose tolerance tests on our patients.

MRE

I don’t know anyone–and I know a bunch of extremely diligent low-carbers, low-carbers who put my diligence to shame–who doesn’t succumb from time to time. I think the point is to control when you succumb and make amends for it ASAP by hopping back on the low-carb wagon.

As a friend of mine is fond of saying, “Pleasure is a nutrient.” I agree with him entirely. A little ‘forbidden’ pleasure once in a while is probably good for us despite the temporary spike in free radicals.