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  4. Do you find that people who have been doing long-term low carb or ketosis develop a carb intolerance, meaning they lost the ability to handle starchy carbs without having high insulin and weight gain?

Do you find that people who have been doing long-term low carb or ketosis develop a carb intolerance, meaning they lost the ability to handle starchy carbs without having high insulin and weight gain?

Kelsey Marksteiner: What happens with low carb or ketosis, things like that, is you actually develop a bit of insulin resistance. This is a temporary thing. It just happens because the body is not used to having carbs around, so it doesn’t really need that response to be happening. If you’re doing ketosis or you’re doing really low carb for a while and then you eat a very, very high-carb meal, typically you’re going to have a higher glycemic response than someone who regularly eats carbs and has normal glucose and insulin tolerance. That happens. Like I said, it’s temporary, so if you are transitioning someone from very-low-carb or a ketogenic diet, you do need to keep that in mind. I always warn my clients, especially if they’re concerned about blood sugar. If they were doing this for blood sugar reasons in the first place, for example, and we decide we need to increase their carbs even just a little bit, I will warn them that they will likely see higher glucose levels as we start to do this, but that they will typically level off, and not to be scared when they see a fairly high—and definitely higher than they’re used to—glucose level at first. Just give it a week or two. Keep doing it. And don’t do it super fast either. If you’re going to increase carbs a lot for whatever reason, I would definitely warn them about that, that it’s most likely going to happen, and just to kind of take it slow. Instead of going right to your goal level of carbohydrate, maybe increase by 20 grams or something every couple of days so that the body sort of has this time to get used to having more carbs coming in so it can create a normal insulin response.

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