Aging Gracefully with Low Carb and Exercise, Part 2
In all honesty, your genes do play a large role in determining the rate at which you age, the degree to which you tend to gain weight, and the types of chronic diseases you’re at risk to develop as you get older. It’s not fair, but that’s the way it is. However, there are so many things we do have control over that affect how we age, particularly what we eat and how much exercise we get. It’s empowering to realize how much you can do to look and feel your best! My motto is, do the best you can with what you’ve got and don’t compare yourself to others. A second recommendation would be to not compare your current self to your 20-something self. There’s no way to turn back the hands of time, and we shouldn’t spend our energy and efforts trying to do so. Focus on the present and the future.
Advanced glycation end-products (appropriately abbreviated AGEs) occur when glucose reacts with proteins and fats in the body, forming cross-linkages that accelerate the aging process and contribute to chronic disease. This reaction occurs in everyone, although to a much greater extent in people with uncontrolled diabetes. AGEs are considered largely responsible for the damage to the kidneys, eyes, cardiovascular system, and extremities that occurs when blood glucose levels are high. There is evidence indicating that AGEs also contribute to skin wrinkling, loss of collagen and elasticity, and other signs of aging. Although twin studies have demonstrated that the amount of AGEs circulating in our bloodstream is determined in part by genetics, environmental factors such as smoking and the types of food we eat also play a role. Vitamin B6 may help counteract the effects of AGEs in diabetes complications such as neuropathy, but at this time it’s not clear if taking supplements will help prevent skin damage. Research suggests that caloric restriction (CR) can help counteract the effect of AGEs on skin; however, this can cause unwanted effects on the thyroid, including lowering of metabolic rate, in addition to being very hard to sustain without high levels of hunger. Very-low-carbohydrate ketogenic diets (VLCKDs) have been shown to mimic many of the beneficial effect of calorie restriction without the adverse reactions often seen in CR. They also help normalize blood glucose levels, which further reduces AGE levels.
Dietary fat gets such a bad rap among many health authorities, so it’s great to see research demonstrating its benefits, including healthy skin. Despite what many people have been led to believe, consuming fat –including saturated fat — can reduce the signs of aging. Researchers in Japan examining the effect of diet on skin in over 1000 women found that those who consumed the highest amount of fat scored best in terms of wrinkling and skin elasticity, provided they also obtained antioxidants in the form of nonstarchy vegetables.
Now, I know there are people who follow a low-fat diet and have great skin. I ate a low-fat diet for many years, and people still thought I looked younger than my age (or at least that’s what they told me!) But since I started low-carbing and significantly increased the amount of fat and saturated fat in my diet, I’ve definitely noticed that the quality of my skin has improved. My pores appears smaller, my skin is very smooth, and I never break out, which was a problem I periodically struggled with in the past. I truly feel that my skin looks better than it has in years. Maybe it’s a combination of high fat intake and improved blood glucose control from following a VLCKD?
We constantly hear that in order to lose weight, we need to burn more calories than we consume. While it is true that a caloric deficit is necessary for weight loss, there are well-controlled studies indicating resting metabolic rate (RMR) often decreases when endurance exercise is performed daily over several weeks, including one on identical twins that found a large variance in RMR changes between different twin pairs but similarity within each pair. Genetics again. While some people may be able to lose weight by increasing their caloric expenditure by ramping up activity, others may lose far less or even maintain by performing the same amount of exercise.
So relying on the Stairmaster that tells you you’ve burned 500 calories in 45 minutes may give you a false sense of security. If we’re unable to increase our metabolism as much as we’d like by doing aerobic exercise, why should we do it? Well, it is undeniably beneficial for our cardiovascular system, which is important, but doing too much may be counterproductive in terms of weight loss. Is there any kind of physical activity that does help prevent weight gain as we age? Resistance or strength training increases muscle mass, which increases RMR. Exercise also improves insulin sensitivity. I’m still doing the Ellen Barrett workouts I referenced in my previous post on aging, and they all have a strength-training component regardless of whether weights are used.
In terms of how to eat when doing resistance training, the classic approach is to have a high-protein meal immediately after working out in order to maximize muscle growth. However, Bill Lagakos over at the Calories Proper website offers an alternative idea: Fuel up with protein prior to working out so that the body has time to break it down into amino acids that will be available at the precise time the body needs them most. I like this approach myself and have always eaten prior to working out, even before reading Bill’s great rationale for doing so.
Although losing fat rather than muscle becomes more difficult as we get older, following a very-low-carb diet may be the best way to achieve this. There is evidence that restricting carbohydrates to ketogenic levels (less than 50 grams per day) can preserve lean body mass during weight loss. When three 1800-calorie, low-carbohydrate diets (containing 30 grams, 60 grams, and 100 grams) were compared over a nine-week period, subjects following the 30-gram diet experienced the greatest retention of muscle tissue. For anyone already following a low-carb diet but having trouble losing weight, check out my recent Answers.com article to read about potential causes for your stall.
While it’s nice to dream about, there’s unfortunately no way to stop the aging process. However, we can at least try to slow it down somewhat and stay as healthy as possible through the transition. And I firmly believe that carbohydrate restriction coupled with right type of exercise can make a world of difference in this regard.
* Consult your doctor prior to starting a low-carbohydrate diet or engaging in physical activity.
References:
1. Gkogkolou P, et al. Advanced glycation end products: Key players in skin aging? Dermatoendocrinol 2012 Jul 1; 4(3):259-70
2. Nagata C, et al. Association of dietary fat, vegetables, and antioxidant micronutrients with skin aging in Japanese women. Br J Nutr 2010 May;103(10):1493-8
3. Bouchard C, et al. The response to exercise with constant energy intake in identical twins. Obes Res 1994, 2(5):400-410
4. Young CM, et al. Effect of body composition and other parameters in obese young men of carbohydrate level of reduction diet. Am J Clin Nutr 1971, 24(3):290-296
I am 5 years older than you, and I think I can add my testimonials to yours about benefits of LC diets for the slowing of aging. As a person who have many chances to observe people who are heavily engaged into exercises, I can also tell that exercising and following a low-fat diet at the same time seems to have a pro-aging effect on many – they seems to be prone to loosing a sub-cutaneous fat especially on their faces, the effect is much worse on the people who are eating limited meat. Fat is important for keeping skin young longer. I also suspect that it is better to avoid excessive cardio for anty-aging purposes.
Thanks so much for your comments, Galina. It’s always a pleasure to hear from you. LCHF trumps LFHC again!
Agree with Galina’s observation. I’ve also noticed a drawn, haggard appearance in people who work out heavily & eat low fat. Particularly unhealthy when they don’t eat enough protein to repair muscle. Their rears look good, but not their faces. Losing a full faced look is what’s aging.
Thanks for your comments, Gerri! Good observation that protein is also needed to preserve facial fullness. Carbohydrate is the macronutrient that can have a negative effect on skin health.
“My motto is, do the best you can with what you’ve got and don’t compare yourself to others. A second recommendation would be to not compare your current self to your 20-something self.”
I whole-heartily agree with this. We have to accept that time does not stand still.
It is so important to do the best we can … and enjoy our next birthday not fear or dread it.
BTW – Happy Birthday Wishes Franziska
All the best Jan
Thanks so much for your comments and birthday wishes, Jan! Hope all is well with you and Eddie across the pond 🙂
Happy Birthday, Franziska, and you really do look much younger than your age, no kidding.
Aww, thanks so much, Dan!
Hi Franziska
I would firstly like to say thank you for a very intriguing blog – it is an incredibly well written and extremely useful blog that I imagine is helping many people. Despite recently graduating 3 months ago as an RD, low CHO diets are actually quite new to me – my training demonised them and so I have given them little consideration.
However, I admit that during my training 1 thing stuck out – I could never accept why we were telling Diabetics to eat a diet of at least 50% CHO. No matter how many times it was explained to me it simply made no sense & I felt that restricting sugars would offer a better option – if I mentioned this I was soon shouted down.
Anyway – just after I graduated I spoke to a diabetic friend of the family who, hearing I had just become an RD, started ranting at me about the rubbish advice they had received for years from Dietitian’s & after going against their Dietitian’s advice, had started low CHO with extraordinary results. I immediately was intrigued and have begun vigorously researching it since.
Soooo anyway – my question that I really would like to ask regarding low CHO diets comes in two parts is:
Low CHO diets are based largely on the premise that removing CHO from the diets will mean the insulin response is minimised with a view to maintaining a state of lipolysis – hence greater fat burning will ensue.
I struggle with this idea because protein, which will be present in the Low CHO diet, in at least a moderate amount, also instigates a pronounced insulin response – indeed some protein foods will cause as much insulin release as pasta for example.
So, the Low CHO diets appears to me to be built on a false premise because lipolysis is always going to be shut down to some degree regardless of whether CHO is present. I am sure you are aware of the insulin index for reference to the insulinaemic effect of protein.
I also question the idea that even if lipolysis has not been shut down that we will lose more fat anyway. This is because even if we eat a meal of 100% fat, which will not initiate the insulin response, the body will still promote utilisation of that recently ingested meal as its energy source meaning that even if lipolysis is occurring concurrently the freed fatty acids will simply not be oxidised and I assume will simply go back to the adipocytes – so we will have not utilised our fat stores – just as we wouldn’t have if we ate a CHO/protein meal.
Have I got all of this wrong? I am really struggling with this!
Oh – finally – in Obese people we tend to see insulin resistance – this will mean insulin isn’t working as well and so obese people are likely to be in a prolonged state of lipolysis because of this – so why do we not see the fat melting away?
I am sorry for going on a bit there – but I am just so confused because clearly low CHO are working, but the way I am being told they work isn’t squaring with me at all.
Many thanks for any response in advance.
Sean
Hi Sean,
Thanks so much for your very kind remarks and feedback on my blog. Congratulations on becoming an RD! You seem very open-minded and unafraid to question standard recommendations, which I consider a huge asset in our field.
I’m very pleased to hear that your friend with diabetes is doing so well on a carb-restricted diet. I hear from others with diabetes (both Type 1 and Type 2 ) who have experienced similar results several times a week.
Thanks also for your questions. I will attempt to address them to your satisfaction below:
1. It is true that protein also causes an insulin response; however, the amount of insulin released is generally less than for carbohydrates, and more importantly, it is accompanied by a subsequent release of glucagon, which has a lipolytic effect. This makes sense if you think about it, because if only insulin was released, hypoglycemia would result after a meal containing only protein and fat, but this does not occur.
2. Although fat is more easily mobilized when insulin levels are lower (i.e., on a low-carbohydrate diet) the amount of fat that will be oxidized versus stored is still dependent on caloric intake. However, this appears to be extremely variable from person to person. Some people report being able to consume several hundred calories more when carbohydrates are kept very low (less than 30 grams per day), while others notice only a small effect. There is research suggesting a “metabolic advantage” of about 350 additional calories burned per day on very-low-carb diets.
3. During insulin resistance, the body is not in s state of lipolysis; rather, more insulin is needed to get glucose out of the blood and into the cells, and the pancreas continues pumping out insulin in an attempt to achieve this. The muscle cells are resistant, but the high levels of insulin in the blood prevent lipolysis and indeed promote fat storage.
I answered your questions rather quickly as I am about to run off to work, but I hope they helped a bit. If you’d like to speak with me more about this or other nutrition-related issues, please use the “Contact” page to contact me privately.
Thanks again, and have a great week!
Franziska
Hi Franziska
Well – firstly I would like to say how much I appreciate the time you took to respond to my queries – I have certainly found them insightful, helpful and extremely interesting.
I had not considered glucagon and its role in suppressing the insulin response when a meal has been eaten which doesn’t raise blood sugar in order to avoid hypoglycaemia.
This is a very solid hypothesis which does, I think, seem to fill that gap regarding the insulinaemic effect of protein. I am aware that there is dissent as to whether glucagon does have a lipolytic effect but studies here seem to be inconclusive – but as you know more than I – hardly an aspect of nutrition has been established as proven fact. When we consider that protein generally causes a lower secretion of insulin as well as the fact that gram for gram we eat less protein than CHO – as pointed out by Galina – then with the additional effect of glucagon it makes extremely good sense that protein does indeed initiate a less pronounced insulin response.
I suppose, this is all quite revelatory to me, because a mere few months ago I had left Uni after 4 years spent learning the scientifically ‘proven’ dietary approaches to weight loss etc – I felt I knew, within reason, the right and wrong ways. So, I suppose my confidence has taken a slight knock now I realise there is a lot to learn regarding low CHO and its potential for weight management, diabetes and even heart disease (if indeed cholesterol is a factor!) – this simply wasn’t supposed to happen! As I mentioned, Low CHO as option here in the UK is given really short shrift – it is not an approach that is considered at all and is met with scorn. However, I have read enough studies over the past few months as well as anecdotal evidence and respectable blogs such as yourself to be very confident that this is an incredibly powerful tool to have.
I am baffled as to why it isn’t being taken seriously here? But then the idea that saturated fat may not raise cholesterol which itself may not lead to heart disease is still met with smirks as well (this is another revelation I have only become exposed to in the past few months). There is a lot of work to do!
So anyway – I do thank you for the time taken to reply to me and I will not only follow your blog with great interest in the future but will speak to my fellow Dietitians & point them this way also. That may not be as easy as it sounds because I have tested out the notion of low CHO on 1 or 2 former classmates and they are dismissive from the first instant – citing the issues it will cause such as heart disease due to the increased fat, tiredness from lack of energy, lack of fibre and B vitamins not to mention renal and bone issues etc. You can imagine how they respond when I say, but there is no evidence for….
There is a lot of work to do.
Oh – regarding obesity and insulin resistance, I suppose I was looking at it from the point of view that despite there possibly being higher insulin in the blood, because the tissues have an inability to respond to the insulin this would bypass the control of HSL – meaning fat burning still ensued. However, if I have interpreted what you said correctly, then the mere action of insulin secretion and its presence in the blood will shut down lipolysis – thus insulin resistance will not equate to a prolonged lipolytic state in the obese. This actually makes more sense – I am not sure what I was thinking now! I better get back to those dreaded books.
Thanks again
Sean
Sean,
I just want to bring to your attention the book of Dr.Bernstein “The Diabetes Solution”, his story is really extraordinary http://www.diabetes-book.com/readit.shtml- the book is available on-line for free in the link I provided and you can find it in any public library. It is due to his efforts we have portable devices to measure a blood sugar. He was diagnosed with Diabetes 1 at the age of 12 more than 60 years ago, became an engineer, and figured out how to control his own blood sugar later in life.His wife is/was a doctor, so through her he managed to get a very expensive then BS monitor (not available to buy for non-medics) to in order to be able to observe the relationship between consume foods and BS levels, learned on which regiment (no more than 30 grams of carbs a day) he needed minimal amount on injected insulin (small amount led to small mistakes) then at 45 years old finished his medical education in order to be qualified to treat other diabetics. He still works and treats patients.
I think that the recommendation to eat 50% of calories in the form of carbs is based on the assumption that the diet for diabetics should be low in fat (because it is the assumption that it is necessary for the prevention of cardio-vascular deceases diabetics are at increased risk of) – if you recommend to a person to eat 60 – 100 grams of protein a day and limit fats, what else should he/she eat? Fiber?
I also want to add that besides protein causing less of an insulin spike, and it also rises the glucagon, people are normally don’t eat as much of protein during regular meal as they eat carbohydrates. It is much easier to consume 25 grams of carbohydrates (a slice of bread, a big apple) than 25 grams of protein (3.5 oz of stake, 3.5 eggs, 3 oz of chicken breast).
Thanks for your comments, Galina! I second your recommendation to check out Dr. Bernstein’s book. It is an amazing resource for anyone with diabetes, as well as doctors, dietitians, and anyone with an interest in optimal management of DM.
Hi Galina
Thank you so much for having the kindness of bringing that book to my attention and pointing me in the direction of where I find it! I can’t wait to read it which will no doubt benefit my understanding of these concepts a great deal.
I also have to say cheers for the straight forward fact that we eat more CHO than protein gram for gram over the day which will translate to overall insulin secretion – I am embarrassed that I completely missed it. Thank you.
Yes – CHO is recommended to make up about 50% of ones energy intake in the UK and if we drop this percentage then the fear is – what do we replace it with? Fat is seen as a no no especially considering the increased risk of heart disease in diabetes. I know that higher protein diets are also a cause for concern in diabetes due to implications upon the kidney – I do realise however that low CHO does not mean high protein at all.
Thankyou for your wisdom – I am sure we will hear from each other again.
Cheers.
Sean, I’m a T2 who low carbs with good results. I think the reason glucose obtained by converting protein is not a problem is that it hits the bloodstream gradually and many T2’s can produce enough insulin to handle it. Something like sugar or starch hits too fast and can overwhelm the body’s ability to produce sufficient insulin. T1’s who low carb do have to account for protein as it accounts for a significant percentage of the glucose they must dose for.
Thanks again for your kind remarks, Sean! Trust me, I understand all too well the reaction you’re receiving from fellow dietitians. Fortunately, there are some more open-minded RDs out there who question conventional recommendation, and I’m happy to include you in that group. Thanks for reading my blog, and I have a feeling you’ll learn just as much from my very knowledgeable readership.
Tim, thanks as always for your excellent comments. I’m ever grateful for your contributions.
Sean I am also a type two diabetic, a low carb high fat diet has been my salvation. Diagnosed with HbA1c 12 and realising to avoid diabetic complications, I needed to get to non diabetic blood glucose numbers to stay safe. What were my options? Injected insulin? no, I was already awash with plasma insulin brought about by severe insulin resistance. Type two diabetes medications? no. To this day I have not heard of a single type two medication that reduce HbA1c by more than two full points, most are usually less, and many only when used with metformin. Merformin is a long established drug which is considered safe. Metformin can reduce HbA1c by approximately one full point at best. Maybe a type two multi drug regime could help. Using a multi medication regime to ram down blood glucose numbers does not work and was proved with ACCORD trial. So many participants died the trial was abandoned. Drugs used such as Avandia and Actos were banned for killing people.
Many consider type two diabetes is a lifestyle disease, and in part I agree. That being the case it is logical to use lifestyle to return to good health. The correct diet and exercise and two metformin pills per day, returned my blood glucose numbers from highly dangerous to non diabetic within one week. Think about that, from staring grim complications in the face to safe, in one week. Also, within three months HDL raised LDL reduced and trigs drastically reduced from +3 to 0.8 Within three months a 50lb weight loss. Blood pressure reduced and no tiredness or lack of energy and absolutely no down side whatsoever, confirmed by my three monthly 40+ blood tests.
For over five years I have asked medical professionals including Doctors, Diabetes Nurses and Dietitians, how do I hold these numbers on two metformin a day other than a low carb high fat diet, the silence has been deafening. The NHS, DUK, ADA methods of diabetes control have failed totally, as evidenced by the NHS audited statistics published each year, 93% of type one UK diabetics fail to get to a safe HbA1c, the situation for type two diabetics is also lamentable. I can shred every obstacle and myth regarding low carb high fat for diabetics that has ever been thrown at me, it works and keeps on working. I believe it is fair to say no one is more critical of Dietitians than me, most I know of are useless, indeed worse than useless, they ensure the dietary madness for diabetics continues.
Thank God for people like Franziska and other enlightened and forward thinking medical professionals. Only through more of the same, will we begin to tackle the epidemics of obesity and its often linked type two diabetes. As Einstein said it is insanity to keep doing the same thing and expect different results. Franziska is not following the path that has lead to failure and an early death for countless diabetics around the world. If I was a newly qualified Dietitian I would have a big decision to make, do I play it safe and stay with the herd, or do I put my patients well-being first. Good luck and good health Sean and may the force be with you.
Kind regards Eddie
Eddie, thanks as always for another thought-provoking, insightful post. You have made excellent points once again. Thanks also for your very kind words and continued support.
Sean, be sure to check out Eddie’s website and blog at http://www.lowcarbdiabetic.co.uk. It’s a great resource for people with diabetes.
Hi Franziska. I am one ofEeddie’s lowcarb team members. I just wanted to say thanks for all you do for the lowcarb cause.
It is good to see one of our newly qualified dietitians in dialogue with you. We need to see more of that so that many more people may be helped.
Thanks again and Birthday wishes from me too.
Kath
Thanks so much for the nice feedback, words of support, and birthday wishes, Kath! I agree it’s great that a dietitian from the UK is open to learning more about carb restriction. The tide continues to turn, and I’m excited about the momentum!
I enjoyed a low carb, high protein diet several years ago with great results. Since then I have started long distance running and biking. I am quite interested in returning to a low carb lifestyle, but am worried as I know that carbs are important for endurance athletes. What do you recommend for endurance runners?
Hi Kim,
Thanks for your comments and question. Although fat can be used to fuel most exercise, depending how long you are running, you may need a small source of glucose during activity. I recommend reading The Art and Science of Low Carbohydrate Performance by Drs.Steve Phinney and Jeff Volek. You’ll also find great information on endurance training on Dr. Peter Attia’s blog. He’s an endurance athlete who follows a very-low-carb diet and only consumes carbs when training for more than 2-3 hours at a time.