To maintain proper glucose homeostasis, the body does a couple of things:
• The liver can release some glycogen which is converted to glucose
• Some muscle can be catabolized and glucose can be produced via gluconeogenesis
• Fat cells can release some of their contents (triglycerides) and these can be metabolized in the liver to ketonic bodies (a high energy fuel source) and glucose.
We simply, through the protocol, keep the dieter in the state where the body is using its stored energy (fat) for the primary fuel source. We offer the MINIMUM adequate amount of high quality protein only to spare the muscle (remember the body can break down muscle to get glucose and this is what happens in many other diets and is the main reason why deters typically yo-yo.) When you lose muscle, your metabolism slows and you are more likely to regain your weight.
The kidneys are extensively involved in acid / base balance and gluconeogenesis, two processes which play a major part in the Ideal Protein Diet. For this reason, severe kidney dysfunction is a contraindication for the program. Many patients with “Syndrome X” will present with impaired renal function (GFR < 60 ml/min). Patients with impaired function (between 38 and 60 ml/min) may be placed on the program, but GFR must be re-checked within 6 to 8 weeks. Most patients will show an improvement or at least will remain the same. If the GFR decreases, the program should be discontinued! If a candidate’s GFR is not normal, written consent must be obtained from the primary care physician or specialist as is the case. Elevated uric acid levels are a common abnormality with “Syndrome Xer’s”. These levels will improve as insulin sensitivity and acid / base balance improves, as a result of our protocol. If a patient has a history of gout and/or kidney stones we should have them monitor the pH of their urine, particularly during the first 3 weeks of the program. Maintaining a urinary pH of about 6.5 to 7.0 is very important. You can check this with NITRAZINE (NitraTest) paper. Should their urine be lower than that, prescribers may order PolyCitra-K (1 packet 2 to 3 times a day). Nonprescribers may recommend 1/2 tsp. of baking soda in 4-5 oz. of water 2 to 3 times a day. These folks should also be told to drink an additional liter of water per day (3 liters/ day). See paper on Gout, Kidney Stones and the Ideal Protein Weight Loss Method.
Patients with a history of acid reflux (GERD) will normally see their symptoms completely resolve within two weeks. If this is the case, advise the physician to discontinue PPI therapy (stop Nexium, Aciphex, Prilosc, etc) as these drugs have a negative impact on acid / base balance. If a patient’s symptoms abate, but some GERD is still present occasionally, recommend an H2 antagonist such as Zantac, Pepcid or Tagamet, or even a liquid antacid such as Mylanta Supreme, instead of a PPI (these drugs do not inhibit the proton-pump system and acid / base regulation will not be as negatively compromised). WATCH SUGAR CONTENT OF LIQUID ANTACIDS! (particularly generic brands, Mylanta Supreme is fine).