Your comments and questions are welcome.

Please feel free to ask questions or post comments about the documentary film, “My Big Fat Diet”, or anything you see on this site or its links. I will endeavour to reply to all posts.

173 thoughts on “Your comments and questions are welcome.

  1. Dr. Jay,
    The institutional diet in federal penitentiaries across Canada relys almost exclusively on refined carbs and sugar. This is having a huge impact on the health of federal prisoners in medium and maximum institutions. Someone inside Saskatchewan Penitentiary informed me that the incidents of Type 2 diabetes and heart disease is very high, diagnoses that have developed since the prisoners were incarcerated. A study of the institutional diet would be interesting from a nutritional/health point of view. The Aboriginal population is over-represented inside all Federal Prisons, so the results experienced in the Alert Bay project may be duplicated inside an institutional setting.
    I have been following your Big Fat Diet story with great interest, as it parallels my own story. I followed the South Beach, lost 60 lbs, and got off Type 2 meds completely, and follow a carb restricted diet and have maintained my weight/no meds status for over 3 years now.

    Dr Jay’s Reply:

    Thanks for your comment. I agree that there is much work to do in the corrections system. There have been some interesting studies done on omega-3 supplements and mental health in prison populations. They showed that inmates behaviour improved with increased omega-3. I imagine that the standard prison diet would be low in omega-3 and high in omega-6 on top of the high sugar and refined carb content that you point out. I would love to do a diet study in a prison population sometime. Nutrition is so important to mental health and this would be a big part of the problem for prison populations.

    So much to do and so little time!

  2. Dr. Wortman. I watched the documentary that was re-aired about the high fat diet you proposed in Alert Bay. I can see what you were trying to do and thought I should tell you little about myself and my quest for bettering my health. A few years ago I was diagnosed with type 2 diabetes while I was working on a rather stress evoking project. I like anyone listened to my doctor and took the pills that was prescribed to me and all seemed to be better. however the weight continued to slowly incline as the years went by. I met my wife while in Japan working their during a three month exposition on future technologies and lost approximately 20 kilograms due to the amount of work I was doing and the high temperatures I was working in. upon returning to Canada I yet again ballooned to a high weight of 145 kilograms. I pursued helped and found a fantastic doctor who thought he could assist me in the right direction. I proceeded to follow his directions and immediately stopped taking the pills that was prescribed by my family doctor, now don’t get me wrong, I understand my doctor was not a specialist in diabetes so she knew no better than to follow what the medical book tells her to do. I quickly learned that the pills I was taking was actually part of the problem. Metformin causes you to have to eat every four hours in order to maintain your sugar levels. The two pills I was taking to handle a possible degradation of my kidney function was also something that I was not informed about. One pill helps with the assistance of normal kidney function while the other was actually designed by the Pharmaceutical company to fool the tees to give me a false sense of hope. After removing these pills from my daily intake I started to feel much better. drinking four liters of water per day along with a high intake of LOW FAT proteins, NO FAT cooking and high intake of green vegetables with absolutely no carbs, no fats and no sugars. I lost over 31 kilograms in 3 months. I actually lost 3.6 kilograms in one night and found out about KETOSIS and the loss of harmful body fat through urination. The understanding of current TREATMENT and not CURING of PATIENTS not PEOPLE has caused me to be an advocate of helping people find a cure for diabetes and to stop the treatment for financial gain by medical practitioners and Pharmaceutical companies. I hope your program is successful and I noticed one doctor mentioning on the documentary that this diet is harmful to aboriginal people. However through my education and self practice, aboriginal people can handle a high protein diet without repercussions and these doctors with their concerns are misinformed and focus on the current food guide is only about Caucasian people and is biased on it’s opinions of what we should eat. Native people from North America can eat a high protein diet without major health concerns. The damage we do before the diet is why we should have a doctor monitor us during the diet, not the diet itself. Family Doctors need to stop worrying about purchasing their houses and expensive cars with seeing 50 patients per day and focus on curing the people they are supposed to be helping and stop treating patients with expensive pills and outdated ideas that we are all the same. It takes several generations for a genetic makeup to change and my people are only on our first generations because my parents generation was still eating our traditional diets. it is the next generation with fast foods and high carbs and sugars that are going to have more problems with health and with our people having health benefits covered by the Canadian government, it will tax the system to the point of every Pharmaceutical company become a juggernaut that cannot be stopped by our future generations no matter what we do.

    Dr Jay’s Reply:

    Thank you for sharing your story and congratulations on your success.

    I think you are on the right track in cutting out sugars and starches but one thing I would suggest is that you may find it hard to sustain this without adding fat to your diet, especially after you stop shedding weight. It is possible to eat a low-carb diet relatively devoid of fat while you are burning off your internally stored fat. Once the weight loss stops, however, you will need to start getting those calories from your diet again. The best way to do that is to increase your intake of fat. The fats that come from meat and dairy are good as is olive oil and to some extent canola oil. You also need to get certain “essential” fatty acids (like omega-3 and omega-6) from dietary sources as they are not something we can manufacture internally. They should be in balance, however, hence the advice to avoid the high omega-6 oils as much as possible.

  3. Congratulations on your new baby. I wish I had been a “low-carber” when I was pregnant – I had pretty severe nausea and very complicated deliveries.
    I would love to correspond with you if you the time when you are on parental leave. My family story is quite interesting, I believe, and perhaps may prove a testimony to the efficacy of low-carb diets for families with the genetic condition that appears to plague all of us (My sister and I call it our “evil gene.”)
    I posted a bit on one of the other threads. My name is Peggy and I live in Nebraska and have been ultra-low-carb for 10 years. My brother, sister, daughter , and son have all had health improvements from varying degrees of carb restriction, and I have become somewhat of a militant proponent of the low-carb approach. I hope to correspond with you soon. And I’m devastated I missed the broadcast, but perhaps will buy the DVD. I will definitely buy your book. For now, “Good Calories, Bad Calories” is my “bible.” (My son used the cover as the opening slide in the power point of a persuasive speech he gave in a college class – to persuade people that low-fat diets were not necessarily healthful!)

  4. Dear Dr. Jay,

    Can this work for a Type 1 diabetic on an insulin pump? My insulin is strictly manual.

    How do I deal with hypoglycemia when carbs are used to elevate glucose levels?

    Can you provide me with the recipe for the cauliflower fried rice?

    Thank you, Rebekkah

    Dr Jay’s Reply:

    Reducing carbs can be beneficial for type 1 diabetes. The expert in this area is Dr Richard K Bernstein (click on his name in the links section to go to his website). Type 1 diabetics are always going to need some insulin but by reducing carbs the amount required will go down. Yes, if you do experience hypoglycemia as a type 1 you will need to consume glucose to recover. It appears, however, according to Bernstein that the risk of hypoglycemia drops significantly with the amount of insulin you need to take. I would recommend you study Dr Bernstein’s material if you are thinking of trying this.

    Eva, who you met in the documentary, developed the cauliflower fried rice recipe. I believe she just used crumbled pre-cooked cauliflower instead of rice. If you want to try this I would recommend using your favourite fried rice recipe and substituting cauliflower for the rice.

  5. Hello Dr. Jay and producers of My Big Fat Diet:

    I thoroughly enjoyed the documentary that was re-broadcast. Thank you for a job well done. I learned something about current First Nations culture on Vancouver Island, as well as how an Atkins-like eating plan could work at a community health level.

    The question I have for Dr. Jay is whether you will be experimenting with the gradual phase-in of more carbohydrates in the diet…as this is what is supposed to happen with an authentic Atkins plan. Every individual body can come to an equilibrium controlled weight with differing amounts of carbohydrate.
    It would make for a fascinating follow-up documentary to see if the phase-in of carbs can bring stability to peoples’ weight loss.


    Dr Jay’s Reply:

    Thank you for your comment.

    You are correct in that the Atkins diet has phases where carbohydrates are gradually increased until weight gain recurs, at which point one has found their limit in terms of carbohydrate tolerance. In the study, the diet we tested resembled the “induction” phase of Atkins in that it was very low in carbohydrates throughout. In fact, many people did start introducing carbs, often in the form of fruit. We suggested that berries would be okay if they are inclined to do that. We didn’t formally study the reintroduction of carbs along the lines of what Atkins recommends. We did discuss with people the fact that everyone has a genetically predetermined threshold of tolerance, above which they would experience weight regain and a recurrence of other problems related to cholesterol, blood pressure and blood sugar control.

    It is my personal opinion that, once a person has developed metabolic syndrome and/or type 2 diabetes, they are, in effect, intolerant of carbohydrates and that the best diet for the long haul is very low in carbs. I think a major reason that people regain weight after successful weight loss on the Atkins diet is because of the re-introduction of carbs. Although, in theory, it makes sense to gradually introduce them to find your limit of tolerance, in practice I think for a lot of people it gets away on them and they resume eating carbs and pay the price in terms of weight regain.

    Lately I have been intrigued by the key role that fructose plays in all this. I wonder whether, with strict avoidance of fructose, one could possibly reintroduce carbs without weight regain. This is just speculation at this point. Hopefully we will have some research to answer this question soon.

  6. Failure…

    Hello Dr. Jay, I watched the doc last year, and it inspired me to resume eating low carb, or as I prefer to call it, paleo. I’m male, turned 60 last week, and in the 1970’s, did Atkins, with great success – people didn’t recognize me after 6 months, and I’d never felt better. Unfortunately, family life precluded eating “weird”, and I eventually weighed close to 400 lbs. I managed to lose some weight, and have stabilized at 330-340 for the past 15 years. All along I’ve had hypertension, high cholesterol (esp trigs), and high glucose.

    In May ’08, I eliminated all grains, sugars, and PUFAs (from veg oils). My only cheat was beer on weekends. I started taking fish oil and vit D3. I saw my doctor in Oct ’08. His words were very simple: “I don’t know or care what you’re doing, just keep doing it.” My AiC was 5.4, my trigs were low, and I’d lost 30 lbs. I felt great. (Unfortunately, my BP was still very high.) This continued ’til April of this year, by which time I’d lost 50+ lbs. Then the weight loss stopped, and I suspected something was wrong.

    Last month I saw the doctor (a new one, the old one had retired), and shocker…my fasting glucose was 12.5. I’m not doing anything different than when I started this last year. I’ve been testing at home for the past month, and the range is 12 – 16. The doc says my cholesterol is high, but I disagree with her, my trigs are still very low. She wants to put me on Metformin. She’ll probably also suggest a statin, which I’ll absolutely refuse.

    So now I’m exploring other options – chromium, alpha lipoic acid, vanadyl sulfate, high intensity resistance exercise, posting this comment – in an attempt to avoid the Metformin. I still eat paleo, and I attempt intermittent fasting, frequently not feeling hungry till late afternoon, and I’ve cut out the beer. I’m still at 280 lbs, so I’m not losing or gaining any weight. However, I feel that I’ve failed, and contemplating diabetes for the rest of my (probably shortened) life is very depressing.

    Any suggestions?

    Dr Jay’s Reply:

    Thanks for sharing your story. It sounds like you are doing everything right (with the possible exception of the beer).

    Some general observations:

    Cholesterol – you want to have low triglycerides and high HDL (good cholesterol). If you do, and your LDL and/or total cholesterol are a little bit high, it is not something to be overly concerned about. We know that LDL particle size is more important than overall LDL and if you have a good HDL/TAG ratio, it is an indication that LDL particle size will be healthy, too (have a look at the Lustig link for a good explanation of this). Unfortunately, very few practicing docs understand this, especially in the context of a low-carb diet. If you have a favourable HDL/TAG ratio (ie HDL on the high side and triglycerides on the low side) and you are eating very low-carb you should be able to safely avoid taking a statin.

    Blood Pressure – this usually comes down with a low-carb diet and some exercise. If it doesn’t, it is important to get it under control and an ACE inhibitor type of antihypertensive is probably your best option. ACE inhibitors have the added benefit of protecting kidney function, too. Having said that, most antihypertensives can cause weight gain in a small percentage of people which means they can muddy the water when trying to trouble-shoot a stalled diet. It is important to keep BP under control so, if your antihypertensive is suspected, you might consider switching to a different one. Use google to find the adverse effects profile of the drug you are taking and look for hyperglycemia and weight gain to figure out if this might be the cause of your problem.

    Hyperglycemia – it is perplexing to have high fasting sugars when you are not eating carbs. Three possibilities come to mind. One is that carbs are sneaking into your diet in quantities large enough to have an effect. One needs to carefully consider which foods might be avenue for excess carbs. In my case, I found that my tolerance was so low that I needed to eliminate nuts from my diet. The beer you mentioned is also a potential source of carbs in the form of maltose. A second consideration, somewhat linked to the first, is that your capacity for producing insulin has diminished to the point where you will experience blood sugar problems even on a very low carb diet. Some people are going to need to take metformin for this reason. A third possibility is that you have hepatic insulin resistance which causes your liver to produce glucose in excessive amounts. This is related to non-alcoholic fatty liver disease which is remarkably common in people who have metabolic syndrome and/or type 2 diabetes. From your history, I would expect you have had NAFLD to some extent over the years. This should resolve on a very low-carb diet. Another cause of fatty liver, however, is alcohol which means if you are resolving your fatty liver through carb restriction, you may need to also reduce your alcohol intake to get the insulin resistance in the liver under control. The other thing about alcohol is that it can make your blood pressure go up, too.

    All this to say that you might want to look at cutting out the alcohol, or at least significantly restricting it, for awhile to see if that is the reason the diet isn’t delivering the benefits you expect. If this doesn’t get your fasting sugars under control you should seriously consider metformin.

    Good luck and let us know how it goes.

  7. Hi Dr. Jay,
    I was curious whether at the time you were diagnosed with type 2 diabetes, you were overweight or had a high body fat %. My general question is whether even leaner people with no central obesity can develop metabolic syndrome from eating too much carbs in the long run.
    Appreciating your help in advance,

  8. Hi Dr. Jay,
    Thank you for taking this way of eating out of the closet. Here’s hoping you can make a noise bigger than the grain and drug companies!
    I have adopted this way of eating to control my weight as well as my lipids and general way of feeling. My questions is, do the foods eaten on a low carb regime cause or exacerbate gout? I have a son and brother-in-law who both suffer greatly from gout and so will not try to limit carbs because of this affliction.
    I thank you for this opportunity for all the information on this site.

    Dr Jay’s Reply:

    Thanks for your note and sorry for the delay. Having a newborn (whose birthday coincided with your post) has kept me busy and is my current excuse for neglecting this blog.

    Your brother may find his gout improves on low-carb. The reason for this is that fructose leads to increased uric acid output. Uric acid crystals are what causes gout. Fructose is found in anything that is naturally sweet as well in any form of caloric sweetener including sugar, honey, high-fructose corn syrup, molasses, maple syrup, corn syrup, etc etc etc. Since you avoid all these foods on a low-carb diet, it is also a low-fructose diet. I would suggest that someone with gout would have to be careful not to increase protein consumption too much, at least at the beginning, but I would expect overall there should be relief from gout, not the opposite.

  9. Dr. Jay:
    My community is a test market for a new KFC “sandwich,” and a local reporter did a story in which he had his blood lipids tested, ate the sandwich, then was retested. His numbers were: HDL 50 down to 39; LDL 145 up to 155; triglycerides 135 up to 215. He used this data as “proof” that the fat (no transfat,mostly saturated) had caused these horrible changes.
    The product was two breaded. fried chicken patties as the outer “holder,” (no bun) sandwiching cheese and the “Colonel’s special sauce. 590 calories, 280 from fat. No mention of carb count or what was in the sauce, or whether the chicken was processed or what kind of cheese.
    I am wondering about the accuracy of blood tests immediately following a meal. I am wondering why his blood lipids appear to have reacted in a manner that is the opposite of what has been seen in longer term studies of low-fat vs low-carb. Of course, without knowing the carb count (and I expect that it was high due to the breading and suspect the sauce is full of HFCS), this is not a low-carb food and it is possible the ill-effects were due to the carbs.
    I have emailed my questions to the reporter and will report back if I get the answer concerning the sauce, carbs, etc.
    In the meantime, I interested in your reaction to this.
    The newspaper story cited this statistic: Every point your HDL drops, your heart disease risk goes up 10%. And implied fully that dietary fat is the culprit.
    Peggy in Omaha

  10. In response to Helen:
    I have no trunkal obesity – I carry my weight in my hips and thighs. (I have never actually been overweight, to tell the truth – just a bit “chubby”). However, my sister is a classic apple shape. She is official “Type II” while my very slim brother and I have never hit the “magic number” to be diagnosed, but have severe reactive hypoglycemia and other severe reactions to eating carbohydrates. My son is very thin, but has “ADHD” responses to carbs. My daughter weighed 320 at age 16, lost half the weight, but is still a bit heavy in her thighs. (She had to have massive amounts of skin removed from her abdomen and under-arms – which may have also removed some fat cells? would like someone’s take on that.) So, in my family, we are all insulin-resistant. In my generation and the next, the men tend to be quite thin but subject to emotional swings from carbs, and most of the women have trunkal obesity, except for me. I have a very tiny slim waist and no fat on my ribcage. If I get into “carb creep” I know immediately by small “love handles” just above my waist towards the back. So I guess I’m the odd one.

  11. Another comment:
    As I read more of this blog, I am more and more interested in the postings here and feel compelled to respond. I just read the question about bariatric surgery, and, as always, really appreciate Dr. Jay’s reply. My daughter, who weighed 320 pounds at her “peak’ at age 16, lost about 150 over several years with diet (modified low-carb – she prefers to be vegetarian but eventually became resigned to the fact that her heredity would make that difficult) and intense exercise. What a marvelous accomplishment for a young woman! However, by the time she graduated from college, she had massive amounts of loose skin everywhere. That is a side-effect of major weight gain/loss that few people mention. I have an acquaintance that suffered the same fate after bariatric surgery. My daughter commented once that “I worked so hard to lose weight and I’m still a freak.” It was so tragic, especially since she is a talented actress in a society that demands physical beauty for performers of her age group. She visited a plastic surgeon and arranged for surgery, only to discover that her insurance would pay for it. My acquaintance, on the other hand, had the same procedures and her insurance covered it because it was the result of the bariatric procedure. (Dr. Jay, being from Canada, might be interested in that little detail, especially as we debate public health care in the US) Fortunately, between my mother and me, we came up with the $15,000 plus for the operations and my brave daughter endured the pain and rehabilitation of two stints of operations (abdomen and under-arms performed in two separate “bouts”). She is much more comfortable now and has a slim midriff and torso, but is left literally and emotionally “scarred for life.” She is convinced that she will never have the career she wants because of the visible scars. She still has some extra skin on her thighs that leaves them looking heavy, but really can’t afford the cost and trauma of more surgery.
    As her mother, I am laden with guilt that her life was so severely impacted by my mistaken belief in feeding my family a low-fat, high-carb diet. I have no doubt she suffered malnutrition and near starvation that lead her to have disordered eating as a child. She still is prone to bulimia when under stress. I write this so that anyone considering massive weight loss be warned that there are some side effects – especially if the weight is gained or lost quickly. Also, for parents with metabolic syndrome and insulin-resistance in the family, to feed your children a low-grain, low-sugar, low-processed food diet from the beginning and not to listen to the medical establishment. The saddest part of this is that her father is an MD in internal medicine and sports medicine and still believes in low-fat, low calorie diets. His health is a disaster!

  12. Oops – I said her insurance WOULD pay – when it should read that the insurance WOULD NOT pay.

  13. Hi PHolloway:

    Thank you for your response to my previous post. I am now posting in the other string as I think Dr. Jay wanted to divert comments there.
    From I read, yes extra fat cells are created as we become obese. Those who lose the weight retain the original fat cells, which sits there like empty sacs and thus the excess skin and subcutaneous tissue. After my childhood as a obese person, then two babies, I am fairly lean but retain those belly rolls of extra skin.
    It sounds like your husband has perfect insulin sensitivity, and does not produce so much of it when exposed to carbs, so that eating carbs does not get away on him. For people like that, it seems a low-fat, high-carb eating style works fine.

  14. Thanks for your input, Helen. However, my daughter’s father (not my husband anymore, for reasons that may become clear in this diatribe) has diabetes in his family and his health is a nightmare. My kids report that for him, breakfast is a handful of m&ms. He has always believed in low-fat, low-carb in spite of the terrible consequences on his family and, himself. He has always had memory and concentration issues very much like my son, and borders on paranoia, obsessive/compulsive disorder, etc. He has had major health problems that I won’t go into here, but they almost defy belief. His weight yo-yo’.s When I first started dating him, he weighed 230 pounds and he gained even more when he was in medical school and stopped competing in college sports. When he feels like he is overweight, he goes on a starvation diet. He has horrible emotional mood swings and some real cognitive impairment. (I am amazied that he continues to practice medicine, although he mostly works as medical expert on worker’s comp cases rather than seeing patients) So, no, I don’t think low-fat, high-carb is appropriate for him!

  15. Dr Jay I just wanted to thank you for the referral to atkins. I read about your big fat diet and tried to find as much info as possible, your science made sense to me. When I couldn’t find enough info to follow the diet I read your advice to others to try atkins. Lost 9lbs in 4 days! Gotta say thank you so much for the advice!

    Dr Jay’s Reply:

    Thanks for sharing your story. I hope you have continued success.

  16. I am a grocer and the only book I sell/give away is the Taubes book. I also send as many as I can to your site. Enough praise. I also push Vit D – a given. Vit C – if glucose supplants vit C and vit C is needed for healthy connective tissue, then, there would be a less trouble with VLDL and LDL. Iodine, ( a suprise ) our food comes from the same old fields, the dairy no longer uses it for cleaning and the Dr. tells us not to use salt (iodized). The solution for a sluggish thyroid is to supercharge the gland even when there is no iodine to work with. Magnesium, selenium, chromium. And last, Q10/ALA , if q10 declines with age and the heavy demand gets all the q10, then what happens (no one says ) to the less muscular demanding parts of our system? colin, skin, eyes…

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  19. Dr. Jay , I just have a question regarding your recipes. I see you recommend using Splenda, should we not be using Maple syrup as it is real food and it is also native to our diet? Just a thought.

    Dr Jay’s Reply:

    I loved maple syrup. My wife is from northern Quebec and we used to have boxes of it sent to us. No more, I’m afraid. It is actually not that different from plain old sugar in terms of its carbohydrate content and its effect on your metabolism. Sorry to break it to you but it is not compatible with the low-carb diet especially for people who have insulin resistance.

  20. Hello Jay: Yes, diet time again. I would appreciate your comments on
    a couple of low carb diets. Last year my husband and I did the cleanse
    on the Hormone Diet. A friend going through menopause, recommended
    it and we found it surprisingly easy to implement. We dropped our caffeine
    consumption, replaced white flour and sugar from our very busy kitchen,
    and eliminated alcohol, which crept back in with a vengeance, particularly
    over the Holiday season. And that is the purpose of this post. For decades
    I have routinely eliminated alcohol for the month of January after the plethora
    of dinner parties in December. Thus, it is the perfect time to launch into
    another diet that incorporates further good lifestyle changes. And brings the
    weight down. As a First Nations woman, of a certain age, I worry about
    diabetes, having helped my dad deal (poorly) with the disease, I believe I need
    to do this now. Also, as a serious amateur cook, who loves food, I have a
    vested interest in committing to a diet so I can continue to enjoy food. The
    other diet my husband came across is the GI diet. I have browsed through your
    posts but haven’t noticed any mention of either of these diets. I tried Atkins
    back in university days, but found it challenging to maintain in a dorm life.
    I am also intrigued with your comments on exercise, as I was bracing myself
    to venture out for a walk in the snow. I am about to go to campus for a three weeks, where there is a gym and thought that I could us this as a springboard to a moderate exercise regime with the goal of participating in the Sun Run this spring.

    We have tons of canned salmon, smoked salmon, frozen sockeye fillets, (after the
    big run this year), plus free range chickens, and lots of venison, so I feel well equipped
    for the protein portion of a diet. I struggle with winter veggies, especially as we
    live on a small island where produce isn’t always top notch.

    I would appreciate your thoughts on the diets, the exercise, and the veggies.
    With thanks and cheers, A

    Dr Jay’s Reply:

    Nice to hear from you!

    One of the things I found with shifting to low-carb is that I had to figure out a bunch of new recipes. I am like you in that I like to cook. Some people need a lot of structure and for them I recommend the new Atkins book (see comments below) which provides lots of detailed advice and meal plans, etc. For others (people like me), who don’t need that structure and who look at recipes, not as something to be rigidly followed, but as guidelines which can be altered, my advice is to simply learn what are the foods that contain starch and sugar and avoid them. I started using Atkins cookbooks to get some ideas and went from there. I found that one had to be careful in selecting low-carb cookbooks as a lot of them still used too much carb. The Atkins books tended to be reliable so I have no problem recommending them. You will find that there are a lot of wonderful dishes that have minimal carbs already and by eliminating them you still end up with tasty meals. If you are in a place where it is hard to get fresh vegetables out of season, it may be tempting to eat root vegetables as they store well. The problem is that they tend to be fairly starchy. Frozen vegetables are an option. I use frozen spinach, for instance. The big issue, however, is not so much the vegetables but the fat. Where are you going to get your fat? The meats and seafoods you describe will have some fat but probably not enough (unless you have access to oolichan grease). My recommendation is to eat lots of dairy fats in the form of cheese, cream and butter. Olive oil is good to stock up on, too.

    I am not familiar with the Hormone diet. I have heard stories, however, of women who found their menopausal symptoms improved greatly on low-carb so I suspect that our hormonal systems function better with a carb restricted diet.

    I am familiar with the GI diet. I have mixed feelings about it. On the one hand, reducing the glycemic index of the carbohydrate foods in your diet is a good thing when it means eating less refined foods, fewer sugars, etc. There is research that shows people can benefit from the GI diet when compared to the standard American diet. There is also research, however, that shows that greater benefits are achieved on low-carb vs low-GI. The other concern I have about GI is that fructose flies under the radar of the glycemic index. Foods can be high in fructose and still register a relatively low GI score. Fructose is something we should all avoid. I am sure, for many people, moving to a GI diet would be a big improvement. For people who are manifesting signs of insulin resistance, I still think that low-carb is the best way to go.

    When it comes to alcohol, it is not counted as a carb when it is distilled and as long as it is not combined with a sugary mixer. Things like wine and beer bring carbs along with the alcohol so their consumption can be a problem. I avoid beer now but will drink a glass of wine with dinner. I find my desire to drink more than that has gone away. If I drink anything other than wine it is usually a fine Antiguan rum mixed with diet Coke with a squeeze of lime. One drink a day won’t derail your dieting efforts. Too much will be a problem even if it is not accompanied by some carbs.

    I have expounded on exercise in other recent comments so have a look there for more. Bottom line: exercise is good but not necessarily for weight loss. If you do low-carb you can lose significant weight without exercising. You will get an energy boost from low-carb which will make you feel more like exercising and then my advice is to go for it!

    I hope these observations are helpful. Good luck!

  21. I agree wholeheartedly with your thoughts about carbs. I was diagnosed as gluten intolerant 3 years ago and immediately took any gluten out of my diet as well as milk and lost 30 lbs without any effort, have increased energy, and am so much healthier. No more migraines, arthritis pain,or reflux symptoms. It also seems to have affected my self discipline. I developed a daily yoga practise 2 1/2 years ago which is something I’d wanted to do but never been able to stick with.
    Recently I read the Wheat belly diet and decided to take out other starches as well for the most part. If I bake now it’s with coconut or almond flour.
    It feels like a gift to me and I sure never thought that when on a diet.
    So glad to read about your work in Alert Bay in the Reader’s Digest!

    Dr Jay’s Reply:

    I am glad you have discovered the benefits of a low-carb diet. Doesn’t it make you angry that you had to figure that out on your own, though? I hear so many stories like yours where people benefit from huge improvements in their health and well-being by eliminating carbs, yet the mainstream advice is still a very carb-centric model of “healthy” grains, refined sugars and high omega-6 vegetable oils.

    That Reader’s Digest article is a few years old by now. You must have been at the dentist.

  22. Hi Dr Jay,
    You have helped me so much in controlling my blood sugar. I am type 2 and have managed to lose weight and control my blood sugar on your low carb eating plan. My big problem is fasting blood sugar in the morning. I can’t seem to get it down. I wake up early each morning at around 5 AM. My blood sugar this morning was 153. After breakfast it goes right down to anywhere from 85-108 and stays there all day. I stay at or below 20 carbs per day. What am I doing wrong. I started low carbing three ans a half months ago.
    Thanks so much for all of your help.

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