Low carb and calories, part 2
Since I started the previous post on this subject with a letter, I’ll do the same for part 2. God knows we have enough like these to fill a book. In fact, this one was in a book. We published the portion below in The Protein Power LifePlan.
A lady from New England wrote to us complaining that she had diligently followed our low-carb diet to the letter yet, had lost only four pounds over the first few weeks of the program. She included her food diary to show that she was indeed doing a low-carb diet. Here it is:
BREAKFAST: a four-egg omelet with cream cheese, five or six pieces of bacon or sausage, and coffee.
MID-MORNING SNACK: 4 ounces of nuts and 2 to 4 ounces of cheese.
LUNCH: a large bowl of tune or ham or chicken salad make with real mayonnaise, a bag of pork rinds, and a diet drink.
MID-AFTERNOON SNACK: nuts and cheese again.
DINNER: a 16 ounce piece of prime rib, a green vegetable, and a small salad.
DESSERT: sugar-free gelatin and whipped cream and coffee.
When we received this letter MD and I wanted to shake this woman and say: Does it not surprise you that you’re not gaining weight on your diet? I’m sure the only reason she lost the 4 pounds was that she dumped a bunch of excess fluid as a result of her insulin falling. If you run the calculations you will find that this woman was eating somewhere around 5,000 calories per day. She was definitely not creating a deficit. And she wasn’t losing…but she wasn’t gaining either.
The difficult part of any diet – including a low-carb diet – is the bucking up and staying with it during the weight loss phase. It’s pretty easy for most people right at the start because the weight comes off quickly at first, and most people feel so much better just getting off the carbs. As the early days turn into weeks and (in some cases) months, the diet becomes monotonous for many. Weight loss slows down, the great feelings of renewed health and more energy are still there, but have become the norm instead of something new and exciting, and the urge to expand the palate becomes intense.
First, it’s a little nibbling here and there of the forbidden foods, leading a carb creep. And, as I pointed out in the earlier post, many start snacking on calorically dense, low-carb foods, with cheese and nuts being the greatest offenders. Ultimately the weight loss goes from a crawl to stopping altogether. Frustration sets in, and many people bolt from the program saying: Hey, if this isn’t working for me, why am I torturing myself with it? From this mindset it’s a short hop to being face down in the donuts.
I can tell you from both personal experience and the experiences of thousands of patients that this middle time of low-carb dieting (the time between the heady early days and maintenance) can be a drag. And can be fraught with weight-gain peril if you get sloppy with your carb and/or calorie counting. But if you hang in there, you will be rewarded with great dividends.
Once you’ve reached maintenance you can pretty much eat all you want without gaining as long as you watch your carb intake. Like the lady who wrote the letter above, you can feast on all kinds of cheese, nuts, meats, etc. while remaining at your new lowered weight. The calories that come from these sources will sabotage your weight loss if you eat too many of them, but won’t make you gain weight as long as you keep your insulin low.
As you may recall from the earlier post, a lowered insulin levels opens the door to the fat cells, allowing fat to come out to be burned. If your dietary intake meets all your body’s energy needs, however, your body will simply use these dietary calories and leave the calories in your fat cells alone. And you won’t lose. But lowered insulin levels pretty much prevents fat from going into the fat cells, so even if your caloric intake goes up – as long as your insulin stays low – you won’t store more fat in the fat cells. And your weight will stay the same.
How can this be?
The phenomenon is pretty vividly demonstrated in people with type I diabetes, the type of diabetes in which no (or very little) insulin is produced. Most of the time these people get their diagnosis of diabetes when they come to the doctor because they are losing weight like crazy while eating everything in sight. It’s not all that unusual for a person with new onset type I diabetes (who isn’t aware of having the disorder) to lose 40 pounds in a month. These people have no insulin and a lot of glucagon. Without the insulin they can’t store fat, so they dump fat from their fat cells. Much of this fat is converted to ketones since there is no insulin to shut off the process. The glucagon makes them convert muscle protein to sugar even though their blood sugar levels are already sky high. The end result is that these people have elevated levels of sugar in their blood and elevated levels of ketones. They dump both sugar and ketones in their urine, but not enough to account for the amount of weight they lose. The combination of calories lost to ketones and urine can add up to a few pounds per month, but not 40. Other factors are at work. The body has the ability to waste calories, but doesn’t usually do so unless it has to. In the case of type I diabetes it has to. And people with uncontrolled type I diabetes eat and eat and eat and lose and lose and lose.
The same phenomenon holds true in low-carb dieting. Insulin is low and glucagon is high, making it difficult to gain weight. That’s not to say it can’t be done, but it is difficult. Which means that once you lose your weight and get to maintenance, if you keeps your carbs (and thus your insulin) low you can pretty much go back to snacking on cheese, nuts and other high-fat, high-caloric density foods without the fear of gaining. You won’t lose, but you don’t want to lose on maintenance. You simply want to maintain.
You will ditch these extra calories by a number of means. Your caloric-wasting systems will be going full blast. You will be futile cycling, increasing the mitochondrial proton leak, increasing the number of uncoupling proteins, and spending extra energy converting protein to glucose. You will also increase your NEAT. What’s NEAT? It’s Non-Exercise Activity Thermogenesis. Your total energy expenditure is composed of four things: resting metabolic rate, the thermogenic effect from food (the energy required to metabolize what you eat), thermogenesis from exercise and activity, and NEAT. NEAT is from all the little things you do without conscious effort – fidgeting, moving more, moving more briskly, stretching, standing more, etc. These are activities that you don’t really think about but that you perform to dissipate extra energy. It’s why you feel more like exercising after you get going on a low-carb diet; it’s why you perceive your energy levels to be higher. And it’s why you’re less hungry. Your body has access to its stored fat and is using it and even wasting it. As Key’s showed in his semi-starvation studies, subjects on low-fat, reduced-calorie diets pretty much got rid of most of their NEAT in an effort to conserve energy. The opposite happens on a higher-calorie low-carb diet.
Blowing off this excess energy is what allows you (and the woman who wrote the letter at the start of this post) to eat a lot yet still maintain. But it comes at a price. There is a caveat.
If you crank up your intake of fat calories and at the same time increase your carb intake you are going to gain like crazy. Why? Because you will increase your insulin levels and drive this fat into the fat cells. And it will happen quickly.
Most people reading this will probably say, that would never happen to me. But it can and does. Especially when people start guestimating how many carbs they’re eating. A couple of years ago I posted about a survey done at the peak of the low-carb diet mania showing that people who thought they were on low-carb diets really weren’t. They were cutting the carbs, but not enough to bring about insulin lowering to the point required to enjoy the benefits of low-carb dieting. Men who claimed to be on low-carb diets were consuming on average about 145 grams (3/4 cup sugar equivalent) of carbs per day while women were eating on average 109 grams of carb per day. For most people this is way too much.
So, if you keep carbs low and keep calories in check you will lose weight. If you keep carbs low and don’t worry about the calories you will maintain. A commenter on the earlier post put it brilliantly and succinctly:
Eat low carb = you CAN’T GAIN fat.
Eat low carb ≠ you WILL LOSE fat. [unless, of course, you create a caloric deficit]
I noticed that in a number of comments about this post people had come to the same conclusion empirically. They wrote that whenever they jacked up their consumption of cheese, nuts and other calorically-dense low-carb foods their weight loss stalled. But as long as they kept the carbs low, they didn’t gain. As always, I welcome comments on this issue. I’m keen to hear the experiences of all.
Dr. Eades,
Ravnskov once said after a meeting with Colpo, that this is an “angry young man”. After having read his latest postings I think Colpo nowadays even is a mentally very very ill person, obviously struggling with extremely severe aggressions and an extremely low selfesteem. He should seriously look for professional help quite soon, because otherwise he will decompensate sooner or later.
Please do NOT address this pitiable person or his tirades of hate any longer. Please do simply ignore him! He wants to sell his e-book and you should not promote this indirectly. On the other hand it would be quite interesting to read a brief summary or review of his recommendations so that nobody should feel urged to buy his e-book any longer…
Greetings from (old) Germany
(and once again excuses for my mediocre English)
guzolany
I pretty much try to ignore him, but he has struck again with a cheap shot. I’ll do another quick post to set the record straight, but not a lot more.
Ditto on the wine for me. It’s not that much either, but a glass or two several nights a week equals several pounds and some increase around the middle.
hi dr. eades,
this is exactly the experience i just had! i’ve been enjoying steady weight loss while doing a combination of natural low carb whole foods (i don’t eat low carb products, just real food) and intermittent fasting. i just got home from a 3 week business trip where i continued low carb/if but ate all the unsalted nuts in my mini bar every single night! and sure enough..i didn’t lose an ounce during this trip, but what do you know…i also didn’t gain an ounce.
interesting stuff…
best,
ida
I’m glad the wine subject came up. As I mentioned on another post, I’ve lost 132 lbs on low carb (almost 2 years now) and using Fred’s “Slow Burn” which all worked out great. Still trying to tweak out another 3 lbs.
But all that time I included wine or light beer in my diet. If I understand correctly, as long as the alcoholic drink is low carb, the alcohol itself is similar to fat in it’s effect on the metabolism and insulin.
For me, it would always come down to a choice between a couple glass of wine, or a couple low carb beers, or 1.5 ounces of peanuts. Same calories and carbs. The wine usually won that contest. And in the long run it seemed to work out just fine.
But the alcohol does seem to temporarily cause water retention probably in response to dehydration. So that can move the scales. But when you take that into account over time it balances out.
Just my experience, I vote wine!!
Someone was mentioning the dairy – my experience has been that my favourite low-carb food (any and all dairy) wasn’t my friend. In fact, I couldn’t lose any weight, because I was intolerant to dairy foods and didn’t realize it for the longest time. I kept on lowering my carbs further, and to no avail. It was the dairy. Then I got rid of dairy, and some issues magically resolved themselves. But, I was still stuck on this practically no carb diet with all kinds of fat – this didn’t work either. I’d have eggs and meat for breakfast, then not be hungry for lunch – end up snacking on mac nuts at 3pm – then not hungry for dinner, and end up eating a bunch of grilled chicken or whatever topped with tons of dressing and/or dip for ‘dinner’ at 8pm. Um – this really didn’t work out for me. I didn’t gain any weight at all, but I didn’t lose either. Saying that I ‘maintained’ sounds a bit better than saying I was ‘stalled out’ somehow.
Back to the dairy idea…
Even if not intolerant to dairy – I think it’s still worth going a week without it, just to ‘see’ if it makes any difference. The carbs relative to portion size (and the calories) mean that a splash of cream here, a slice of cheese there, some blue cheese dressing here…and you’re at your carb limit for the day, and you’ve added lots of calories. I don’t think this is all about the calories, but they do seem to count, especially as you get into that ‘middle phase’ or are heading towards a point where you can sort of imagine reaching goal. Furthermore, even without considering the cals – there is this ‘carbs relative to portion’ size thing. I’m very happy not to be trying to get all chintzy with the cream in my coffee or worrying about just how much cheese is on that burger…(who am I kidding? I sloshed all kindsa cream into my coffee…)
Just an idea.
Pam: “I see by this post, you are still not dealing with the issue of overconsumption of fat and resultant weight gain. Indeed you reiterate that you will not gain weight if you overeat fat while keeping carbs down.”
Have you considered that the type of fat might be your problem? Maybe fats from vegetable sources that are high in PUFAs (common in mayonnaise, salad dressings, and cooking oils)? Or perhaps you have a problem with cooked/pasteurized fat. Have you tried limiting THOSE fats, but eating all the natural unprocessed fat you want? I think overconsumption of protein is a bigger problem with low-carb diets. Most eat too little fat to become fat-adapted. Read the high-fat blog (HyperLipid), where people focus on eating mainly fats (75-85%).
http://high-fat-nutrition.blogspot.com/
MRE: “Gary feels that any exercise will be compensated for by an increased food intake.”
My experience says otherwise. Years ago, I lost from 235 to 185 doing hard exercise based on Clarence Bass’s interval training articles, and Art De Vany’s Evolutionary Fitness. I did all of my exercise at the highest intensity, like 85-90% of max heart rate (180-190+ bpm). I didn’t notice a big increase in appetite. I lost weight fast. And in fact the studies on interval training show that it blunts appetite and results in 9-fold greater fat loss for every calorie burned. See the articles on Bass’s website that cited above, as well as others.
http://www.cbass.com/
guzolany: “After having read his latest postings I think Colpo nowadays even is a mentally very very ill person, obviously struggling with extremely severe aggressions and an extremely low self esteem. He should seriously look for professional help quite soon, because otherwise he will decompensate sooner or later.
BTW, did you know that “Colpo” is a prefix meaning Vagina? Ex: colposcopy, colpospasm, etc. I’m not drawing any conclusions, but that may explain some things. Give the guy a break. His last name is Vagina. I can see how that might give him issues. And I agree that Anthony needs to seek professional help soon, before he self-destructs.
Can the good Dr or any of you smart arses tell me why elevating ones legs is deeply relaxaing for the bod ?
Pleasum and thankum.
Dr. Mike, you wrote:
“[e]ven if your caloric intake goes up – as long as your insulin stays low – you won’t store more fat in the fat cells. And your weight will stay the same….
“The phenomenon is pretty vividly demonstrated in people with type I diabetes, the type of diabetes in which no (or very little) insulin is produced. …[t]hey are losing weight like crazy while eating everything in sight. [They can] lose 40 pounds in a month. These people have no insulin and a lot of glucagon. Without the insulin they can’t store fat, so they dump fat from their fat cells….The combination of calories lost to ketones and urine can add up to a few pounds per month, but not 40….And people with uncontrolled type I diabetes eat and eat and eat and lose and lose and lose.
“The same phenomenon holds true in low-carb dieting. Insulin is low and glucagon is high, making it difficult to gain weight…. You won’t lose[.]”
This is not the same phenomenon. The LC dieter doesn’t lose weight, but the Type I diabetic does.
In both cases insulin is low and glucagon is high. In both cases calories are elevated. Let’s say the caloric elevation is comparable, even though the diabetic is most likely eating as much as s/he can while the dieter is eating as much as s/he wants.
Why the difference in weight loss?
What is the difference in what is happening?
P.S. I followed your suggestion to eat only meat and noncaloric beverages for two weeks. I’ll report on that in a separate comment. Thanks.
I seem to have missed out on the energy boost that many seem to get from low carbing. I seem to be as tired now as before starting (4 years ago). My maintenance level is about 100g and I do slow burn strength exercises.
Any ideas why this might be?
Has anybody else found this?
Hi Mike.
I can’t save your precious articles on my Pc as .mht files anymore.
Any suggestions?
Marco
Hey Marco–
Good to hear from you. I don’t have a clue as to why you can’t save the articles as .mht files. Moreover, I don’t even know what an .mht file is. Sorry.
Cheers–
MRE
My personal experience is that exercise is sometimes suppressive but very occasionally will make me want to eat a lot. Most of the time, I train 3-5 times a week in a strenuous, competitive “sport” and will go into the training hungry rather than eat anything and get nauseous. After a bit in the workout and right after I am not hungry at all, and when I do get hungry I don’t have a feeling of extreme hunger, I just want my dinner.
Sometimes, though, if I have been shorting my calories (not intentionally), or for no discernible reason I will just want a huge dinner instead of the usual small meal we eat at home. I cannot explain it, I don’t understand it, but most of the time exercise has a suppressive effect on my appetite, but not always.
I read Colpo comment after hearing about this guy for a while. I have a simple philosophy when it comes to menhood and it comes from sports; any man that resorts to degrading, nasty, name-calling tactics ought to examine himself! There is absolutely no need for that. In arguments truth is born, but it has to be civil and respectful. Dr Mike I dont know you personally but being here and seing you on tv makes me your follower and a believer! I just intuitively trust you! I was too paralized by analysis of many different diets but eventually decided to go back to low carb and it is working so far. I know that there is no one size fits all when it comes to human, in any regard. Dr Mike I trust you, respect you and am sure many thousands of others do as well. For every Calpo out there there are thousands and thousands of Vadims. And once again thanks for your patience, free advices and world of information!
It seems that my comment/question has gone into the ether. Trying again.
Say I’m at maintenance, and that I acquire the habit of snacking on coconut oil right off the spoon. If I ate 10 tablespoons a day of this stuff, I would be ingesting an extra 1260 calories of fat. My question is, what happens to the extra fat? Does my body become a mini-furnace and burn it off? Do I excrete it in my urine and/or feces? Or does something else happen to the fat that I’m not thinking of? Does somebody hit the “Delete” button and it all disappears?
Similarly, what happens to the extra protein that I eat–the amount that I consume in excess of what is needed for maintenance and repair of my tissues? You say that if blood sugar is not low, the protein does not get converted to glucose. I wonder if that’s true, because my blood sugar does rise after I’ve eaten a meal that consists only of fat and protein. Am I simply seeing a release of stored sugar in response to glucagon? If the extra protein doesn’t become glucose, does it get converted to ketone bodies and get burned or excreted that way? Or does it get broken down into amino acids and leave the body in that form?
Dr. Eades, or any physiologist who happens to read this, I would appreciate any input you could provide. Thanks in advance.
Hey Stargazey–
A pretty complex question for a comment.
Assuming you could eat 10 TBS of coconut oil without puking what would happen? A number of things.
You would probably decrease your caloric intake for the rest of the day or even the next day. The extra fat calories would be burned off in a number of ways: increased futile cycling, an increased proton leak across the inner mitochondrial membrane and an increased production of uncoupling proteins leading to an uncoupling of oxidation and phosphorylation. You would no doubt move and fidget more, your body wouldn’t do anything to conserve energy. I could go on. There are a host of ways that excess calories can be dissipated under the right metabolic (read: low insulin) conditions.
Protein acts pretty much the same. It’s simply another fuel.
Cheers–
MRE
Thanks for answering my question, Dr. Eades. Sorry for the complexity, but what I was getting at (and I think what Vesna was getting at earlier) was the need to understand the mechanism of how low carb plus mass quantities of fat and/or protein leads to weight maintenance and not weight gain.
We’re not clinicians, and we can only observe an “n” of 1 in most cases. So when we read your two posts on low carb and calories, we know you’re telling us the truth, but we don’t understand how it works, exactly. It’s helpful for us to get an explanation on a biochemical and physiological level. Just to brown-nose a bit, you do a good job of explaining biochemistry and physiology for the masses.
In any case,thanks for your patience!
Thanks. I should probably do a post on calorie wasting because it’s extremely interesting (at least to me), and I think a lot of readers would find it interesting. Problem is that it’s pretty technical, and I don’t know how simple I can make it while still keeping it accurate. If I keep it accurate, then it can become textbook like and dull as dishwater.
Cheers–
MRE
I read a very interesting post on Peter’s Hyperlipid blog (which I only found from a comment in another of your blog posts). It pretty clearly explains the mechanisms of excess fat storage even on LC diets. His most interesting statement is about an often overlooked fact: even with LC diets and low insulin levels, fat consumed at each meal must still be stored for use until the next meal, accomplished by the Acylation Stimulating Protein (ASP) enzyme NOT insulin. Also, he states that excess protein is converted to glucose, requiring a hefty dose of insulin. His post makes sense to me in an evolutionary aspect: if our ancestors were LC, they still had to store fat! It’s just that their mechanism for releasing the stored fat for energy needs was humming along nicely, and not compromised by grains, medications, and the many other bombs of modern life that affect insulin sensitivity. It’s worth a careful read.
http://high-fat-nutrition.blogspot.com/search/label/Weight%20loss%3B%20when%20it%27s%20hard
To Leslie: very interesting link, thanks! One must be careful, however, in the interpretation of the ASP information, which applies to rats or mice and ‘mice are not humans’. Mike has discuss these differences elsewhere on this blog and that is something very important to keep in mind. I should know… we use to make mice very obese by giving them a ‘high-fat’ diet (which in the end has a hefty 25% of their energy intake as one or another type of carbohydrate, plus a nice amount of transfats as part of the ‘fatty’ portion of their diets). That, as we all have experienced or read, doesn’t necessarily translate into what happens to humans on a true low carbohydrate diet. I was usually laughed at when I made the remark that ‘mice aren’t humans’… something really not very popular when you do research in a group where the dogma is that it is the fat what is making their animals fat…
I just wanted to add a few comments that I think may be of help when reading the information in Peter’s Hyperlipid blog. The ‘breadcrumbs’ in Peter’s Hyperlipid blog lead to another blog (Conditioning Research: http://conditioningresearch.blogspot.com) with a link to an article published in 1998 about a study of changes in ASP in humans (with a very small sample size) after different intake of meals containing high doses of lipids. In that study, at least, there was no difference in the levels of ASP regardless of how much fat was in their diets. The study, in my opinion, had a couple of weaknesses; very small sample size, it was done using liquid and semi-liquid meals. I also think that any nutritional study comparing diets cannot be done in short periods of time as adaptation plays an important role in the effect of the macronutrients (and their composition) in any diet. The reason I bring that article up is to reiterate that if it happens in rats or mice, it doesn’t necessarily happen in humans. The information on Peter’s Hyperlipid blog refers to studies in mice.
In Peter’s Hyperlipid blog also there is continuous mention of protein necessarily being converted to glucose. While that is true for some amino acids, that responds to the need for glucose, not an automatic response. Furthermore, the glucose made from amino acids (gluconeogenesis) is not ‘meant’ to be use to supply energy demands but for stabilization of blood glucose when this is necessary. For energy supply, utilization of ketone bodies is a process far more efficient that yields more energy, thus sparing muscle protein to be use for energy, unless one is in an extended fasting period, which is ‘true’ starvation, as opposed to an overnight fast.
I found this very interesting:
“Excess weight is the result of a failure of adipocytes to release energy, hunger is needed to supply any shortfall needed for metabolism.”
Under a low carbohydrate diet, that may not be what needs to happen. There are other reasons for weight gain. Whether that weight is in excess or not depend on individual parameters. In other words, the question would be whether on a low carbohydrate diet one gains weight to the same levels of pre-LC, which would be a complete failure of the diet. I don’t think that is the case with low carbohydrate diets.
The studies conducted by Margriet Westerterp-Plantega, have shown that while once the weight loss phase is over after following a higher intake of protein in the diet, the weight gained is not from fat but from ‘fat-free’ mass. On average and according to her, the amount of weight gain was 1-2 kg. The importance of those and other studies is not only that the weight is from fat-free mass, but also that the weight gain came during the maintenance phase, when individuals were still consuming a protein-rich diet. So, at least from that perspective, weight gain is not a bad thing as long is from fat-free mass. Unfortunately in Peter’s Hyperlipid blood is difficult to read if the weight gain he writes about is from fat-free mass or not. One easy way to find that out at any time during the maintenance phase (or any other phase for that matter), is to estimate our lean body mass and track that parameter instead of just total weight.
Thanks again for the link, which I agree is worth reading.
The fact that somebody doesn’t become obese on a high-carb diet does not mean that diet is not damaging their health. Obesity is one symptom of a failure in the many mechanisms which regulate energy intake and utilization. The regulation is accomplished via a fairly complicated (and as yet incompletely understood) system of hormones and the central nervous system. Hormones activate genes, so of course genetic differences may account for differences in the manifestation of symptoms like obesity. That a particular individual does not respond with obesity to the major excursions in insulin brought about by a high-carb diet does NOT mean that those excursions are not screwing up their health. And there are basic biochemical reasons like glycation to believe large carbohydrate intake is detrimental to health.
Similarly, it can be misleading to draw conclusions from a particular aspect of metabolism, such as how insulin or ASP influences energy storage in fat cells. Those particular actions must be considered in the larger context of regulatory network, which (I think at least) was clearly designed by evolution to avoid obesity (and other metabolic problems). The regulation of appetite, digestion, and energy utilization (e.g. increased thermogenesis) should all play together with fat storage to maintain the body’s state in a healthy range. If you’re storing too much fat, something is broken. There is plenty of evidence to suggest that a high-carb diet perturbs this system through its effect on insulin, not only promoting excess fat storage, but also screwing up appetite regulation. Though ASP can hypothetically store fat without insulin, I can’t come up with a reason why a high-fat diet would perturb the rest of the rest of the system. I believe you’d need some other dysfunction, e.g. a genetic problem that causes fat cells to secrete little or no leptin.
I don’t have any articles to cite–just reasoning and all its attendant faults.
Peter said, “In to the gap steps ASP, which allows us to store the fat from our current meal as adipose tissue for use in the time before our next meal.” This may come from studies in mice, but it seems logical that ASP or something similar would operate in this way in humans. Otherwise we could not sleep all night without needing to eat. Glycogen stores and gluconeogenesis from muscle probably wouldn’t cover energy needs for that many hours.
It also seems logical that if more fat is stored by ASP than is subsequently utilized, in the long run there would be a net increase in the size of fat stores. To avoid large accumulations of fat, one would expect that thermogenesis and activity level would increase. Leptin would also tend to decrease appetite. If excess fat continued to be consumed, it is possible that the person would not become obese, but might become overweight.
Finally, there has to be some mechanism by which people are able to deposit fat from an exclusively protein and fat diet. Historically the Inuit lived on such a diet for 6-9 months a year and carried sufficient body fat that they were able to reproduce with no particular problems.