What if you’ve been on a low-carb diet for years and you exercise regularly. Yet you still do not quite get rid of your belly fat? What should you do then?

Well, you could ask me. One reader did, and here’s the answer.

The question

Hi Dr. Andreas,

I have been on an LCHF diet since 2014. Sometimes very strict, sometimes more liberal. I exercise three to four times a week for about 45 minutes and do a combination of high-intensity interval training and strength training (resting heart rate below 60, many times at 52). I am 33 years old. I do not take alcohol regularly (about once every second month a glass of wine). I don’t smoke. I don’t eat sugar, of course, but I use artifical sweetners (sucralose (only for my tea and coffee) and xylitol otherwise. Dairy is limited, mostly 100 g with breakfast (if I don’t have an egg). And then the cheese in your recipies.

Yet, I struggle with visceral fat. I have this belly fat and cannot get rid of it. Last week Tuesday I did a Dexa scan [shown at the top of the post], and you can see that I actually have quite a high percentage of body fat. I know it is still in the normal range, but I have been working for 4 years (prior to LCHF I actually trained for a marathon in Stockholm) to get to a place where I can actually see a “six-pack”, yet no luck.

I thought that I had perhaps very bad insulin resistance, but a blood test revealed I am not (we tested the amount of insulin in my blood). I also had a test for cortisol levels, and those were also in order. Similarly, my testosterone levels are in check. I checked my thyroid, and my metabolism in general seems healthy (I had my resting metabolic rate tested). I discovered a Vitamin D deficiency, and that I treat at the moment (through supplements, sun, and food).

Don’t get me wrong, I am happy with who I am. I am, however, also a scientist (working in the field of machine learning), and I cannot rest until I understand what is going on. Why is it not possible to get rid of the visceral fat? Why do I build muscles slowly (even though I take the recommended 1.5 g/kg protein a day)? Or am I just not eating strict enough? I read about normal weight metabolically obese syndrome, and some of the information seem relevant.

Can you help perhaps?

Many thanks.

The answer

Hi,

Everyone is different genetically etc. and perhaps you tend to reside on the upper side of normal, when it comes to visceral fat. So this could be normal for you. And clearly a lot of people would love to be in your situation.

That said, maybe it’s something in the environment, that can be influenced to lose more visceral fat.

With all you’re already doing I’d recommend cutting out artificial sweeteners completely. It’s really something of a habit and if you avoid it for a few weeks or months you’re probably not going to miss it any more. It is possible that it messes with your system, resulting in increased food cravings, possibly via an effect on insulin. Controversial but possible.

Possibly lifting HEAVIER things when strength training could help – not that I know anything about your current routine.

Also doing a stricter LCHF diet and/or adding intermittent fasting can be very helpful to lose more fat.

Best,

Andreas

Follow up

The reader of course allowed for his email to be published, and is planning to reply with the results in 3-6 months.

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