Aragorn said:
Thanks Megan, you've got a point there, but I'm not sure where you're getting this "relatively low fat" not being dangerous. What would be the benefit of eating relatively small amounts of healthy fat unless you're a "carboholic"(in which case you're already destroying your heath)? Of course, I don't know what amount of fat you're having in mind when you're saying this.
Probably not the best choice of words, but it
is "relative." During weight loss (induction, OWL) you usually determine fat restriction empirically -- eat enough to satisfy while still losing weight. This is still "high fat" relative to a "low fat diet" and it includes saturated fat and cholesterol, but it is limited fat intake relative to "maintenance."
The New Atkins for a New You (p. 107) said:
...Are you eating too many calories? Although you don’t have to count calories on Atkins, if you’re overdoing the protein and fat, you may be taking in too many calories. We know, we said that you don’t have to count calories on Atkins, and the vast majority of people don’t, but you may need a reality check...
We have seen some evidence here that this group does not typify "the vast majority." According to the book, the vast majority can readily drop directly to 20 g/day of carbs without problems, but a fair number of us were not able to. It took me several months to get down there (I am down to about 15 g/d except when traveling). Weight loss has been equally challenging and it has taken me a couple of months to find a level of fat intake that will allow me to reach my target weight (high 170's) within my lifetime -- and I am not entirely exaggerating about that.
My housemate, on the other hand, was able to start an ordinary Atkins diet a couple of months or so ago and lose weight quickly. She skipped induction and went straight to OWL. I don't think there is any danger in limiting fat intake so as to lose weight, as long as the fat you do eat is of high quality (NO vegetable oil!).
It is my understanding that when you cut the carbs you must increase the fat intake, because the body and especially the brain has to get it's energy from somewhere. That is when the body switches from utilizing fat instead of carbs, and one of the results is weight loss - in a natural way, until you reach your "equilibrium". How much we loose weight seems to vary between individuals. In a case with a healthy and "robust" individual who has eaten at least some saturated fats, decreasing both carbs and fat intake for a while would not be lethal, but certainly it would have negative psychological and psychological effects. The amount of carbs and fat depend also on if you're aiming for ketosis so that the body can produce ketones for your benefit, but I'm sure you know this.
If you had already been severely restricting fat, especially saturated fat, then you would need to increase fat to provide energy that had previously been coming from carbs. If you are overweight then it is not such an issue, because you would be carrying a fair amount of fat in reserve. You need enough calorie intake, however, to keep your body from going into "energy conservation mode" so that you can lose weight. That energy needs to come from fat rather than protein, because excess protein can convert to carbs.
The picture is different with anorexia, and I have not read a book yet that covers the topic. A low-carb diet should be beneficial but there is the problem that people are literally afraid of dying from eating saturated fat and cholesterol. When you don't have a normal or excessive store of body fat, you need to be eating LOTS of fat just to maintain body weight. Eating protein instead will prevent starvation, but without sufficient accompanying fat intake there may be a danger of protein poisoning which, now that I think of it, may be what you were referring to. This is rare, but anorexics push the limits of what the body can handle.
The only thing I can suggest is to offer an example. I have been eating lots of saturated fat and cholesterol and I am feeling better than I have in years, while losing weight without going hungry. My lipid panel numbers are not "ideal" but they are pretty normal for someone on a low-carb diet and my TG/LDL-C ratio is excellent (an estimate of "fluffy" LDL) even if my doctor doesn't know what it means. I tell other people I know about that, and I get shocked looks from them. Isn't that dangerous? And I explain -- a little. Not much; they can't take it in. It is reality-shattering.
In the case of Joan however, there's the fact that she has not eaten any healthy fats for most of her life. The whole family is hysterically scared of animal fat. It is really, really sad to see that even the three youngest girls (there are 5 of them) who are between 4-10 years, are scared to death of fat. If someone would put a slice of bacon on their plate, they would probably faint or throw up. All the girls are very skinny and the youngest one, being 4, is already showing signs of not wanting to eat anything.
I wonder if the low-fat, avoid-saturated-fat-and-cholesterol mass programming isn't a primary cause of anorexia? I haven't read anything to that effect so far (and I am taking a break from "food" books at the moment) but it seems like the negative impact of low saturated fat intake -- as well as insufficient or damaged omega-3 fat -- on brain function could lead to such symptoms. Even just a fish oil supplement could make a difference.
I can't say for sure what Joan is eating at the moment, but from what I could tell she isn't eating much of anything at all. Being already very slim, this has to be very dangerous. I've seen individuals with a background of bad anorexia, and they have completely destroyed their body - walking with crutches etc. I've sent an email to my sister with a link to a discussion program where they brilliantly expose the "fat being dangerous" myth (it's in Swedish) and also talking about the Low Carb High Fat diet. I'm leaving it at that, staying tuned to if there's any response. Sigh, they have to learn their lessons, but observing the process is sometimes so very hard. :(
The anorexia itself is a very real concern, apart from any consideration of carbs, fat, and protein. There
are times when you can make a difference (and I was able to do that with my housemate before her doctor did her in), but it is vital that you match your response to your sister's needs. Sending an email about fat not being dangerous, for example, may make perfect sense to you but if she doesn't respond positively to it then you should think about some other approach.
I can't even begin to guess what might work, and if it weren't someone close to you then it might well not even be a good idea. All I can suggest is that you need to be totally responsive to her, not pressing your own ideas if they aren't received well. It can't be about you, or esoteric matters or anything of that sort. I don't know but it may be your lesson as well.