MTF HRT and Belly Fat?

[richie]

I'm a very small 18 year old that will be starting HRT in a few days. My current weight is 105 and I'm 5'5. My body can be best described as "skinny fat". I look very skinny but my body is just a small layer of fat with skin on top.

I still have a little bit of belly fat remaining from a recent weight loss but it's only noticeable when I sit down. If I maintain my current healthy diet and more active lifestyle (I walk up to 5 miles a day just from running errands/going to classes), will I be able to diminish the belly fat and have it go somewhere else while on HRT?

I know that people say old fat doesn't move upon starting HRT unless it's burned, but if the amount is minuscule like mine, what will happen?

[richie]

My belly is the only place on my body that accumulates fat. My arms, legs, and everything else remains skinny. How long will it take for HRT to change that if I'm only 18 with low T to begin with (193 ng/dL compared to the average of 348 - 1197)

[KayXo]

Cutting carbs will help (insulin will decrease). Estrogen should prevent belly fat while promoting fat in a typical female fashion. Estrogen also increases serotonin, is anxiolytic and anti-depressive, keeping stress to a minimum which also helps to keep away belly fat.

[Harley Quinn]

Cardiovascular exercise alone will not get rid of the stubborn belly fat. As Kay said changing your diet will help, but you should look into a workout regimen that focuses on your core. This will also help with your posture, which is very important as you're looking at transition.

[Steph34]

Old fat does not just move in people (like me) who are too old to still be developing. At your age, the HRT alone should redistribute your fat fairly quickly. Beware of diet or exercise related 'miracle fixes' and just let the hormones do their work. Upper body exercise is worthless because it is impossible to 'spot reduce' an area by exercising it. If anything, abdominal exercise might stimulate muscle or bone growth in the area, impeding development of female body shape. Likewise, restricting carbs would cause fatigue and have no benefits because they only turn into fat when eaten in excess and not burned off through cardiovascular exercise; you clearly do not have that problem or else you would weigh more. Give the HRT a year and you will be impressed.

[OCAnne]

Hello everyone, portion control (still enjoy lots of cocktails) coupled with HRT has pretty much eliminated my belly.  Had to alter skirts multiple times and reduce tops/dress size to keep up with the changes.  My weight is rather bizarre, does not fluctuate more than 3 pounds day to day.  Although butt and breasts are getting larger.  On HRT 18 months.

I do take the supplement Garcinia Cambogia 60% HCA after Dr. Oz reported it was effective at reducing belly fat.  Could be snake oil but appears to work for me.

EOM

[KayXo]

Maturitas. 2012 Mar;71(3):248-56.

"Ovariectomy of rats increases food intake and, concomitantly,
body weight [11] and these effects can be reversed by restoring
physiological levels of estradiol [11]"

"estradiol potentiates the effect of the satiating CCK peptide released from the small
intestine in response to food intake [14,15], while attenuating the
appetite-stimulating potency of the gastric hormone ghrelin [16].
Furthermore, estradiol stimulates anorexigenic POMC/CART activity
and inhibits orexigenic NPY/AgRP neurons in the ARC [17,18]."

"In contrast to estrogen, progesterone itself does not significantly
influence feeding behaviour in ovariectomized rats, except when
administered in non-physiological, pharmacological doses [11].
However, in the presence of estrogen, progesterone does stimulate
appetite and promote weight gain [19]."

"both female rodents and primates eat less
during the estrus phase prior to and following ovulation, when they
are more sexually receptive and active [10]."

"Similarly in the case of women, food intake during the different
phases of the menstrual cycle varies (Fig. 3). Thus, a meta-analysis
revealed that mean food intake is lowest during the periovulatory
phase of the menstrual cycle, when estradiol levels are high [23].
In contrast, a peak in food intake occurs during the premenstrual
period, when progesterone levels are high [23–28]."

"Moreover, binge-eating may be more pronounced during
the premenstrual period [29], a process which may involve low levels
of serotonin in the brain [25]."

"Estradiol stimulates the activity of lipoprotein lipase
(LPL) in femoral adipocytes and lipolysis in abdominal adipocytes
[35], thereby promoting accumulation of gluteo-femoral fat. On
the other hand, estrogen deficiency is associated with enhanced
accumulation of abdominal fat [35]."

"In contrast, most such investigations conclude
that HRT actually lowers weight gain and body fat [76,80,81].
In addition, HRT prevents the shift in fat deposition from the normal
female condition to the more unhealthy central fat depots associated
with the menopausal transition (Fig. 5) [76,82,83]."

"treatment of postmenopausal
women with estrogen enhances LPL activity in the
femoral region and at the same time lipolysis in the abdominal
region, which might promote fat accumulation in the former region
and fat loss from the abdomen [84].

"Interestingly, the route of estrogen
administration may be an important factor in this context, since
one crossover study found less fat gain with transdermal than with
oral administration [85]."

"Progestins are known to stimulate food intake (Fig. 5) [72].
For example, cancer-related cachexia and anorexia and other
forms of malnutrition can be effectively treated with high doses
of megestrol acetate"

"treatment of women with bulimia nervosa with an
antiandrogenic OC containing ethinylestradiol and drospirenone
not only reduces androgen levels, but also attenuates binge eating
and appetite in connection with meals [59]. Furthermore, users of
this particular OC exhibit a small reduction in body weight [75]."

Megestrol acetate, like cyproterone acetate and medroxyprogesterone acetate are progestins of the same class, structurally related to progesterone, called acetylated pregnane derivatives.

Drospirenone is also a progestin, structurally related to testosterone, of a class called ethinylated derivatives. It is anti-androgenic, and antimineralocorticoid like Spironolactone, also structurally related to it.

Endocrine Reviews, April 2013, 34(2):171–208

"To avoid confusion in light of current practices, the North American Menopause Society has recommended that the term progestogen should be used when referring to progesterone and synthetic progestogens collectively, whereas the name progestin is specific only to synthetic progestogens (4)."

Here they consider progesterone, natural and all other progestogens (or progestins) synthetic when really they are all produced in the lab, hence synthetic. Instead, they should say progesterone is BIO-IDENTICAL (identical to what the body produces) while all others aren't.

A quick lesson in endocrinology.

[richie]

Hello everyone, portion control (still enjoy lots of cocktails) coupled with HRT has pretty much eliminated my belly.  Had to alter skirts multiple times and reduce tops/dress size to keep up with the changes.  My weight is rather bizarre, does not fluctuate more than 3 pounds day to day.  Although butt and breasts are getting larger.  On HRT 18 months.

I do take the supplement Garcinia Cambogia 60% HCA after Dr. Oz reported it was effective at reducing belly fat.  Could be snake oil but appears to work for me.

EOM

Garcinia Cambogia actually does a lot! I used to weight 150 lbs at 5'5 (pure fat.. no muscle) and now I'm 105 lbs. I just took Garcinia Cambogia for 6 months with my crappy diet until I got down to 120 lbs. From 120 lbs, I stopped Garcinia CAmbogia, started eating healthy and started walking more, taking the stairs to my 10th floor dorm, etc.
I'm sure your belly fat is just from Garcinia Cambogia's magic

[richie]

Maturitas. 2012 Mar;71(3):248-56.

"Ovariectomy of rats increases food intake and, concomitantly,
body weight [11] and these effects can be reversed by restoring
physiological levels of estradiol [11]"

"estradiol potentiates the effect of the satiating CCK peptide released from the small
intestine in response to food intake [14,15], while attenuating the
appetite-stimulating potency of the gastric hormone ghrelin [16].
Furthermore, estradiol stimulates anorexigenic POMC/CART activity
and inhibits orexigenic NPY/AgRP neurons in the ARC [17,18]."

"In contrast to estrogen, progesterone itself does not significantly
influence feeding behaviour in ovariectomized rats, except when
administered in non-physiological, pharmacological doses [11].
However, in the presence of estrogen, progesterone does stimulate
appetite and promote weight gain [19]."

"both female rodents and primates eat less
during the estrus phase prior to and following ovulation, when they
are more sexually receptive and active [10]."

"Similarly in the case of women, food intake during the different
phases of the menstrual cycle varies (Fig. 3). Thus, a meta-analysis
revealed that mean food intake is lowest during the periovulatory
phase of the menstrual cycle, when estradiol levels are high [23].
In contrast, a peak in food intake occurs during the premenstrual
period, when progesterone levels are high [23–28]."

"Moreover, binge-eating may be more pronounced during
the premenstrual period [29], a process which may involve low levels
of serotonin in the brain [25]."

"Estradiol stimulates the activity of lipoprotein lipase
(LPL) in femoral adipocytes and lipolysis in abdominal adipocytes
[35], thereby promoting accumulation of gluteo-femoral fat. On
the other hand, estrogen deficiency is associated with enhanced
accumulation of abdominal fat [35]."

"In contrast, most such investigations conclude
that HRT actually lowers weight gain and body fat [76,80,81].
In addition, HRT prevents the shift in fat deposition from the normal
female condition to the more unhealthy central fat depots associated
with the menopausal transition (Fig. 5) [76,82,83]."

"treatment of postmenopausal
women with estrogen enhances LPL activity in the
femoral region and at the same time lipolysis in the abdominal
region, which might promote fat accumulation in the former region
and fat loss from the abdomen [84].

"Interestingly, the route of estrogen
administration may be an important factor in this context, since
one crossover study found less fat gain with transdermal than with
oral administration [85]."

"Progestins are known to stimulate food intake (Fig. 5) [72].
For example, cancer-related cachexia and anorexia and other
forms of malnutrition can be effectively treated with high doses
of megestrol acetate"

"treatment of women with bulimia nervosa with an
antiandrogenic OC containing ethinylestradiol and drospirenone
not only reduces androgen levels, but also attenuates binge eating
and appetite in connection with meals [59]. Furthermore, users of
this particular OC exhibit a small reduction in body weight [75]."

Megestrol acetate, like cyproterone acetate and medroxyprogesterone acetate are progestins of the same class, structurally related to progesterone, called acetylated pregnane derivatives.

Drospirenone is also a progestin, structurally related to testosterone, of a class called ethinylated derivatives. It is anti-androgenic, and antimineralocorticoid like Spironolactone, also structurally related to it.

Endocrine Reviews, April 2013, 34(2):171–208

"To avoid confusion in light of current practices, the North American Menopause Society has recommended that the term progestogen should be used when referring to progesterone and synthetic progestogens collectively, whereas the name progestin is specific only to synthetic progestogens (4)."

Here they consider progesterone, natural and all other progestogens (or progestins) synthetic when really they are all produced in the lab, hence synthetic. Instead, they should say progesterone is BIO-IDENTICAL (identical to what the body produces) while all others aren't.

A quick lesson in endocrinology.

Please forgive me if I misread/misinterpret this, but isn't this for cisgender woman who hit menopause?

[KayXo]

Please forgive me if I misread/misinterpret this, but isn't this for cisgender woman who hit menopause?

No, this is about hormones produced in significant amounts in women, the same hormones (estradiol and progesterone) we take. Also, it mentions progestins which sometimes transwomen take. This is about the effect they have on body fat regulation, appetite, etc. This is relevant to us because we take those hormones. Studies have shown that our bodies, even if genetically male, are affected in much the same way as ciswomen, fat increase in gluteofemoral (butt, thighs) region for example after starting estrogen and sometimes a progestogen. Just ask any woman on here and she will agree as well.

[Harley Quinn]

Beware of diet or exercise related 'miracle fixes' and just let the hormones do their work. Upper body exercise is worthless because it is impossible to 'spot reduce' an area by exercising it. If anything, abdominal exercise might stimulate muscle or bone growth in the area, impeding development of female body shape.

I would disagree. You are not going to build "bone" or over develop muscles that would hinder a feminine figure. Exercise is not going to change your skeletal composition. Likewise, bulky muscles won't be an issue without high levels of testosterone and a high calorie diet.

Suggesting that exercise and a healthy diet is not important to a feminine figure doesn't make any sense. Your metabolism will slow down without testosterone, and you will be more prone to gaining additional body fat.

[Nobue]

That's one interesting and worriesome topic for someone like me who is starting HRT. Not being a young person anymore (hitting mid 40) and being pretty much in front of a computer all day at work, I'm wondering if I should do anything else but watch diet and walking.

[Deborah]

The first six months or more of HRT I didn't really notice any metabolism change and losing weight was as easy as ever by just exercising and eating less.  Now after a year that seems to have changed and it's not so easy to lose anymore. 

I'm experimenting with my diet to see how much I can eat to get the same loss rates as before.  I haven't quite got it all figured out yet but it's looking like at least a couple of hundred calories per day, maybe more.  It might be that I have to be more selective about what I eat.  I used to lose on 300+ carbs a day.  Now I've cut it to between 100 and 200 and my weight is stuck.

I'm also finding that my weight is fluctuating more each day than it used to.


Sapere Aude

[Steph34]

I would disagree. You are not going to build "bone" or over develop muscles that would hinder a feminine figure. Exercise is not going to change your skeletal composition. Likewise, bulky muscles won't be an issue without high levels of testosterone and a high calorie diet.

Suggesting that exercise and a healthy diet is not important to a feminine figure doesn't make any sense. Your metabolism will slow down without testosterone, and you will be more prone to gaining additional body fat.

When specific muscles are used, those areas do get larger even without high testosterone. Women who lift weights with their arms have larger arms, for example. I still have bulky leg muscles even though my testosterone has been in the female range for over a year, and it is because I do a great deal of walking. The muscle quickly goes away if I take a break from long walks. I never said I think exercise is bad, just to be selective in what type of exercise to do and to be aware of the fact that it does tend to shift body weight to the area being used and away from other places.

The effect of testosterone on metabolism is relatively small, and is offset by the fact it also increases appetite. If T really helped control weight then all of us who transition would be gaining, which is clearly not the case.

I am very skeptical that diet matters much for body shape. Eating too many calories does cause fat gain but if hormone levels are good, the fat should come on in desirable places. The tendency to store fat in the abdomen is caused by testosterone and can often be overcome with hormones.

[KayXo]

The effect of testosterone on metabolism is relatively small, and is offset by the fact it also increases appetite.

The tendency to store fat in the abdomen is caused by testosterone and can often be overcome with hormones.

Maturitas. 2012 Mar;71(3):248-56.

"Testosterone stimulates appetite and eating in a manner thought to be
mediated centrally [10], selectively increasing the number of meals, but
not the size of each individual meal in rats [20]."

"Whereas testosterone may influence fat distribution in women
adversely, it is noteworthy that the situation appears to be exactly
the opposite in men. Larger depots of abdominal fat in men are
associated with lower testosterone levels because gonadotropin
secretion is reduced [63], while upon weight loss testosterone levels
and insulin sensitivity return to normal. Furthermore, long-term
treatment of obese men with testosterone causes them to burn fat
and enhances lean body mass [63]. This apparent sex difference has
not yet been clarified."

As men age and their T levels decline, abdominal fat increases. Give older men some T and you will most likely see reduction in body fat, including abdominal fat. This is also the case with transgendered men who take T, in whom lean mass increases and body fat decreases. In addition, eating excess carbs, over time, decreases insulin sensitivity, increases insulin levels, leading to increased abdominal and visceral fat depots.

Women with increased testosterone levels have weight issues not because of higher T levels but because they almost always happen to have decreased insulin sensitivity and higher insulin levels AS WELL. It seems insulin interacts with sex hormones.

If T really helped control weight then all of us who transition would be gaining, which is clearly not the case

Most do gain body fat while losing lean mass on female HRT. This is because T drops and E increases. E should keep fat away from waistline while increasing fat in other typical female areas. Body fat distribution will also depend on what you eat (carbs and insulin), stress levels (cortisol), genetics, type of HRT regimen (whether progestogens are taken) and other medications/supplements you may be taking.

I am very skeptical that diet matters much for body shape.

I have read enough studies to be convinced that type of food ingested can make a significant difference in how fat is stored or used by the body. Insulin is greatly affected by diet but effects can take decades to manifest in some due to genetic susceptibility. 

Eating too many calories does cause fat gain

Read Good Calories, Bad Calories by Gary Taubes.

if hormone levels are good, the fat should come on in desirable places.

I agree. If insulin levels remain normal, sex hormones high enough (T or E, depending on gender), then fat should deposit as expected.

[Steph34]

Maturitas. 2012 Mar;71(3):248-56.

"Testosterone stimulates appetite and eating in a manner thought to be
mediated centrally [10], selectively increasing the number of meals, but
not the size of each individual meal in rats [20]."

"Whereas testosterone may influence fat distribution in women
adversely, it is noteworthy that the situation appears to be exactly
the opposite in men. Larger depots of abdominal fat in men are
associated with lower testosterone levels because gonadotropin
secretion is reduced [63], while upon weight loss testosterone levels
and insulin sensitivity return to normal. Furthermore, long-term
treatment of obese men with testosterone causes them to burn fat
and enhances lean body mass [63]. This apparent sex difference has
not yet been clarified."

As men age and their T levels decline, abdominal fat increases. Give older men some T and you will most likely see reduction in body fat, including abdominal fat. This is also the case with transgendered men who take T, in whom lean mass increases and body fat decreases. In addition, eating excess carbs, over time, decreases insulin sensitivity, increases insulin levels, leading to increased abdominal and visceral fat depots.

I did not mean that T increases total abdominal fat, but rather that what fat is present is more likely to be stored in the abdomen if T levels are high. I get the sense you agree this is the case with women, which would include trans women on HRT.

I am aware that T levels are lower in obese men, but it appears to be a case of 'reverse causation.' That is, obesity decreases blood levels of T because the hormone is distributed throughout a larger body.

Women with increased testosterone levels have weight issues not because of higher T levels but because they almost always happen to have decreased insulin sensitivity and higher insulin levels AS WELL. It seems insulin interacts with sex hormones.

If A -> B and B -> C, then A -> C. It is a matter of semantics.

Most do gain body fat while losing lean mass on female HRT. This is because T drops and E increases.

I agree. I was saying that many do not gain any weight; it is well known that fat replaces muscle on female HRT.

E should keep fat away from waistline while increasing fat in other typical female areas.

I still tend to store most of my fat in the abdomen and along the waistline after 17 months of E, and I do not suffer from insulin resistance. Whenever I gain fat, most of it goes there.

Body fat distribution will also depend on what you eat (carbs and insulin), stress levels (cortisol), genetics, type of HRT regimen (whether progestogens are taken) and other medications/supplements you may be taking.

I have high cortisol and my sister also has too much abdominal fat. Is there no hope for me? And what effect does progesterone have on fat distribution?

Insulin is greatly affected by diet but effects can take decades to manifest in some due to genetic susceptibility.

When people restrict carbs, they make less insulin, leading to temporary weight loss. Then there is a 'rebound effect' in which rapid fat gain occurs when a normal diet is resumed. That is the danger of fad diets; most people will not stay on them long-term. It is also important to distinguish between types of carbs. Sweet treats and high-glycemic foods like white bread will obviously have more adverse effects on body fat than fiber-laden whole grains, which are recommended by many nutritionists.

Read Good Calories, Bad Calories by Gary Taubes.

Oh, not again. What do you think happens when people eat too much fat? It doesn't just burn itself or appear in excrement. It has to go somewhere.

[Rachel]

Do not eat simple sugars including soda. Do not eat artificial sweeteners including soda. Do not eat foods with high fructose corn syrup.

Eat foods that are not processed.

Increase protein and fat intake. Fat must be healthy fats like from avocado's. Chia is an excellent source of fats and protein. Algae (food grade) is an excellent source of fats.

No junk food.

Drink water.

Move your body to get into a target heart rate for 20-30 minutes a day 5 days a week. It is ok to have 2 or 3 10 minute exercise experience throughout the day.

[KayXo]

That is, obesity decreases blood levels of T because the hormone is distributed throughout a larger body.

That doesn't make much sense to me. I suspect it has more to with first insulin increasing due to excess carbs, body fat stores increasing as a result, in body fat, increased conversion of T to E (due to aromatization) so less T, more E induces increases in SHBG which binds T more strongly so even less T.

I still tend to store most of my fat in the abdomen and along the waistline after 17 months of E, and I do not suffer from insulin resistance.

It doesn't mean you don't have insulin resistance that you aren't producing too high levels of insulin for too long a period time which keep the body from burning fat and instead promote body fat storage.

I have high cortisol and my sister also has too much abdominal fat. Is there no hope for me? And what effect does progesterone have on fat distribution?

Cortisol can increase with E as CBG which binds cortisol increases on E, especially if taken orally or high doses of E parenterally and as a result, cortisol levels go up. If one is chronically stressed, cortisol can also be chronically be high and increase abdominal fat over time. Progesterone can help relieve stress due to conversion to a neurosteroid called allopregnanolone which has anxiolytic and anti-depressant properties. But, it seems, in some women, it can also increase fat around the abdomen. Some progestins, like cyproterone acetate or medroxyprogesterone acetate, being glucocorticoid agonists (bio-identical progesterone is apparently a weak agonist), can also lead to increased abdominal fat.

When people restrict carbs, they make less insulin, leading to temporary weight loss. Then there is a 'rebound effect' in which rapid fat gain occurs when a normal diet is resumed. That is the danger of fad diets

Eating less carbs is not a FAD diet. LOL. You continue eating this way your whole life. I am one of them and I know plenty of ppl like myself who've lived for years, decades eating like this. This keeps insulin levels normal, improves cardiovascular parameters, like triglycerides, glucose tolerance, blood pressure, HDL, Apo-B, LDL buoyancy, etc. Improves energy too. There may be a period of adaptation (a few weeks). This has been shown in studies and its safety established, as far back as the 1920's...also refer to William Banting, Vilhjalmur Stefansson. I personally ate no carbs for more than a year and my triglycerides were so low and HDL so high, no health complications, test results came back normal but I missed my carbs and was tough socially so went back on some. Weight was not adversely affected.

Sweet treats and high-glycemic foods like white bread will obviously have more adverse effects on body fat than fiber-laden whole grains, which are recommended by many nutritionists.

I agree but some people are especially sensitive (or intolerant) to carbs so even whole grains need to be cut out.

What do you think happens when people eat too much fat? It doesn't just burn itself or appear in excrement. It has to go somewhere.

Goes in the toilet. You become nauseous from eating too much fat and will throw it up...or goes right through you. Fat is not like carbs where you can easily overindulge. Fat, on its own, is VERY satiating and there is only so much you can eat. That is the beauty of it. Hunger drops and you aren't constantly munching away. Plenty of interesting studies in that book from Taubes where participants in a study ate high carb vs high fat and I should also know from years of eating fat...try eating butter with fatty meat in excess, it's impossible and if you do, well, see what happens...LOL!

Increase protein and fat intake. Fat must be healthy fats like from avocado's. Chia is an excellent source of fats and protein. Algae (food grade) is an excellent source of fats.

I think saturated (animal) fats are healthy and there is plenty of evidence in recent years showing its safety, and lack of association with cardiovascular complications. Where I'm less convinced is some vegetable oils like corn or sunflower oil, where there is too much omega-6 or margarine. Please refer to Sally Fallon, Mary Enig, Jeff Volek, Atkins, etc. I can personally attest to all this as I eat bacon, sausage, eggs, full fat yogurt, REAL butter, coconut oil, fatty meats and my HDL has increased, my triglycerides dropped, HDL/Cholesterol ratio perfect and blood pressure around 120/80. Plenty of studies also on this, you just need to know where to look.

It also seems omega-3's in animal fats vs vegetable fats are better used by us.

I agree with all the rest.

[Deborah]

I can vouch for the effect on hunger.  I cut my carbs more than in half and eliminated all processed carbs and I am eating less without a hunger problem.  Whether that is low carb or not is debatable but I have reduced them from around 300 to 400g a day to about 130 per day on average.


Sapere Aude

[WendyA]

I can vouch for the effect on hunger.  I cut my carbs more than in half and eliminated all processed carbs and I am eating less without a hunger problem.  Whether that is low carb or not is debatable but I have reduced them from around 300 to 400g a day to about 130 per day on average.

I agree processed carbs can be problematic and eliminating them is for the best.  My experience is similar but approached via a different path.  Over the last 3 years I switched to a Whole Food Plant Based no oil diet.  This means I eliminated all processed carbs and animal products. In the first two years I dropped 100 lbs (without exercise) and have kept it off for a year now.  On average I take in 400g of whole food carbs a day and about 72g of fiber.  I am never hungry because the typical sugar crash doesn't happen when eating this much fiber.  My way of eating has never included calorie restriction, so it is a long term solution.

The reason I chose this diet is because it has been clinically proven over the last 30 years to halt and reverse heart disease. If my chance of heart disease can change from 40% eating the Standard American Diet to less than .6% eating a whole food plant based no oil diet, I'll choose the latter.

That said, congrats! It sounds like you have a diet that is far healthier than the standard American diet and one that seems to be working well for you.  If you'd like to read an article exploring some of the science behind the diet I chose, Denise Minger a long term Paleo / low carb advocate writes this article covering some of the history of the science behind true low fat plant based diets.  Maybe someday she'll actually release the second part of this article.

Eating less carbs is not a FAD diet. LOL. You continue eating this way your whole life. I am one of them and I know plenty of ppl like myself who've lived for years, decades eating like this. This keeps insulin levels normal, improves cardiovascular parameters, like triglycerides, glucose tolerance, blood pressure, HDL, Apo-B, LDL buoyancy, etc. Improves energy too.

It may or may not be a FAD diet but it is being treated as one by too many people looking for quick weight loss.  Add to that poorly constructed studies comparing low carb with "low" fat diets.  Without exceptions these studies compared low carb to a calorie restricted Standard American Diet (SAD) where the "low" fat goal was usually 24-30% of calories from fat, a level that was rarely actually reached in the studies and a level that while eating SAD will have little if any benefit.  That said, there is much to appreciate in the way you eat.  Any diet that eliminates processed crap is a plus in my book.  Additionally your take on vegetable oils is spot on they have virtually no nutritional value and add to inflammation,  this includes "heart healthy" olive oil.  It is not my job to say other ways of eating are bad.  All I can do is stop generalities that are not true in all circumstances as inferred.

Since my main goal is avoiding heart disease I am aware that having good bio "numbers," like Tim Russert before his heart attack, is different than not having cardiac events.  The science is still out on whether long term low carb high fat diets will provide healthy outcomes.

Peace!