I’ve been helping people lose weight and reverse diabetes and other metabolic problems at Duke University now for over 20 years, starting with our initial research and now with the clinical care that we give. It strikes me that the fundamental principle that’s missing in the knowledge of people coming in, and even doctors and medical students, is that fat comes from sugar. In our world, the most common thing occurring is that extra sugar turning into fat.
Fat versus sugar
The sugar that you consume is different from the fat that you consume because of the hormonal response that sugar elicits. You hear, “A calorie is a calorie,” when the way calories actually work in our body is very different depending on the hormonal response to the calorie. If you drink a sugar-sweetened beverage or juice, you have extra energy for the day to be burned off. If you’re relying on your diet to do everything for you and at any stage, you’re unable to or don’t want to exercise, you’re going to be turning that sugar into fat. This is because sugar stimulates insulin secretion. Insulin is the fattening hormone – internally, if it comes from your pancreas, or externally, if you inject it as a person with type 2 diabetes.
The danger of abdominal fat
Excess sugar turns to fat, and the place where the most damage can happen if sugar is turning to fat is in your belly. Abdominal fat is the fat that is associated with all the metabolic problems of being overweight or obese. You might not know it, but obesity is up there on the risk factors for heart disease, stroke, and for atherosclerosis, which is the hardening or narrowing of the arteries throughout the body. It’s belly fat, abdominal obesity, or visceral fat – these are all terms applied to the same situation of accumulating belly fat. This is associated with the serious metabolic problems that go along with being overweight, obese, and many times with type 2 diabetes and pre-diabetes as well.
How do you lose that belly fat?
There are many different methods. You can use one of many different diets, medication, meal replacement programs, or even weight loss surgery, but the one diet that really targets belly fat is the low-carb or keto diet. The reason for that is you’re keeping the sugars and starches so low that you maximize your fat burning from your body. You don’t add in oils and fats and butter and medium chain triglycerides (MCT oil) – don’t do any of those “internet keto” things. You want the fat that your body burns to come from your belly fat. Your body can generate ketones by itself from the fat that comes from your body when you’re burning your belly fat and other stored body fat. You don’t have to drink ketones or take pills. I want to maximize your belly fat-burning by having you burn your belly fat, not the added fats and oils that you’re drinking.
Keeping carbs low is key
To maximize belly fat burning, you want to keep the carbs really low. What happens on a properly formulated keto diet – the kind I’ve been using with patients for over 20 years now – is that the hunger goes away after a day or two. The cravings go away for the high-carb foods you used to consume. It happens pretty fast. Then, you start burning your body fat.
Typically, I’ll see people lose one to two pounds per week with an approach of eating as much meat, poultry, fish and shellfish, and eggs as they like, but keeping the carbs under 20 total grams. This means that your body won’t have much sugar to burn, so it will burn your belly fat instead. This happens automatically, just by keeping the carbs really low. You can become a fat-burning machine, not by adding fats and oils, but by keeping the carbs super low. Drop the sugars. Starches get digested to sugar, so if you want to maximize burning your belly fat, you want to keep the carbs as low as possible.
The 20 grams of total carbs per day is a program that we’ve used now for over 20 years in research and clinical care. In fact, the program that I use was built upon programs that date back to the 1860s. It used to be called the Banting diet and then doctors in the 1900s, like Dr. Atkins, Dr. Eades, Dr. Bernstein, and Dr. Rosedale, all used the same super low-carb diet without adding oils or ketones, without all of the new internet products that you’ll see. It’s just keeping the carbs low and eating real food as much as possible.
Keto comes out on top among weight-loss diets
To maximize your fat burning and your belly fat burning, the keto, low-carb diet is actually superior in several head-to-head trials against a low-calorie, low-fat diet. We think it’s because the insulin is brought down a little bit lower. Insulin is the fattening hormone so if you want to maximize your belly fat burning, choose a keto or low-carb diet over others. Although other diets, medications, meal replacements, and even surgery can work, there’s a lot of hassle with all that. I think using a real food-based program certainly is a place to start. As I look at all of the different ways we have and have worked with doctors all around the country, there are a lot of different kinds of programs, but it seems to me the simplest and most elegant way is to just use food to generate the fat-burning and ketones automatically. You do that by keeping the sugars and starches really low.
Losing excess belly fat improves your health
Targeting belly fat is really important because this is where a lot of the chemicals come out that cause inflammation. It’s all part of the metabolic syndrome in the bigger picture, which includes high triglycerides, low HDL in the blood, high blood glucose and blood pressure, and the increased belly fat. Fatty liver, too, is from the sugar and starch in the food, not from fat in the food. I’ve seen doctors trip up on that so they may not give you the best advice if they’re not specifically trained in this.
I hope this has been helpful to you. Check out the full video here.