The Treatment of Metabolism B – part 2

Do you seem to put on a kilo if you so much as look at a piece of cake? This is now recognised as being due to a particular type of metabolism, termed metabolism B. Fortunately, treatment and reversal of metabolism B is possible without needing to resort to medications. Ultimately, the ability to maintain perfect health rests in your hands (and in your mouth!).

My previous article (issue 111, page 66) described metabolism B (Met B) and how to test for it. I will now briefly describe how to manage it, with particular attention to lifestyle changes.


According to Diane Kress,1 the management of Met B takes place in three steps: step 1: the rehabilitation and detox phase; step 2: the reprogramming phase; and step 3: the maintenance phase – a new lifestyle.

Step 1: Rehab & detox

During this phase, which lasts a minimum of eight weeks, you will rest the over-worked pancreas and liver, eliminate excess sugar in the blood, convert the metabolism to burn fats instead of carbs, and slow down insulin release.

This first step is very important to calm the overworked pancreas and decrease the release of the fat-gain hormone, insulin. This enables the body to convert to a fat-burning mode while normalising blood sugar levels. During the first four days the liver will be releasing glycogen stores every five hours, which can make you feel tired, hungry, irritable and craving carbs. From day four on you should experience improvement in all these symptoms (if your glucose levels were high at the start, it may take a little longer). After four days the liver will have released most of its glycogen stores, so fat burning can now occur both in the blood (decreasing low-density lipoprotein (LDL) and triglycerides) and in the body, reducing midline fat.

High carbs must be avoided. A 5-gram low carb can optionally be included with each meal, and at bedtime and during the night if you are awake. If, by mistake, you eat a high carb in any one five- hour period, you will set your progress back by three days (carbs spread across two or three five-hour periods incur ‘penalties’ of six or nine days). You must add three days onto the eight weeks, and you will experience a return of all the cranky feelings you had in the beginning. This is because any high carb flares up the pancreas like adding fuel to a fire.

You may snack in between meals on any neutral food – don’t use low carbs for snacks, except at bedtime or during the night. Use common sense about portion sizes of neutral foods. Sucralose, stevia or xylitol may be used as sweeteners, as they will not affect sugar levels. Alcohol may be taken in moderation (as long as it is not fortified or sweetened). Although it has no direct effect on sugar levels, it does affect the liver, which has to detoxify the alcohol. The net result may be that the blood sugar rises the next morning as the liver tries to compensate.

By the end of step 1 you should have a much improved blood sugar level, lowered lipids (LDL and triglycerides), reduced insulin resistance and improved energy, and will have lost weight.

Step 2: Reprogramming

Now that the pancreas and liver are rested, low-impact carbs are introduced in the right amounts and at the right intervals to accustom these organs to accept and process carbs in a normal way. The three important factors are the amount of net carbs, the type of carbs, and the timing of carb consumption through the day. This step also lasts a minimum of eight weeks or until the desired weight is reached. Blood sugar levels should normalise by the end of this phase.

People who have been struggling with their weight for years often develop a fear of carbs. They are scared to reintroduce them because they are afraid they will develop cravings and lose control over their weight. It is important to remember that the carbs are not the ‘bad guys’, but rather the excessive reaction of the pancreas. By introducing carbs in a measured fashion, one can continue to lose weight while experiencing more energy.

Step 2 is identical to step 1, except that carb intake is increased. Now you must add 11 to 20g of net carb to every meal, and at bedtime and in the middle of the night if you are awake. If your next meal is scheduled more than five hours from your previous one, you must have a carb snack before five hours has elapsed, as well as with the following meal. If there is less than five hours between meals, snack on neutral foods.

If you exercise before breakfast, eat an additional 11 to 20g carb snack before exercise as well as with your breakfast.

The type of carbs you eat should be low glycaemic index and low glycaemic load. The more fibre there is in a food, the lower the glycaemic index is likely to be. If you choose a 15-gram glass of juice (high glycaemic index), the pancreas would respond rapidly to such a rapid influx of sugar, potentially undoing many of the benefits you gained in step 1.

Slip ups may occur in step 2 if you eat more than 20g of carb at once, eat less than 11g of carb at a meal, or skip the carb altogether. If you slip up for a single meal, just get back on track immediately the next day. If you have two or more slip-ups in a week, return to step 1 for 10 days to calm things down again. Going through a stressful period, getting sick or experiencing ongoing pain will also upset your sugar control, and it will be best to return to step 1 for a while.

Step 3: Maintenance

During this phase you are adjusting to a new lifestyle, maintaining good health by establishing your personal carbohydrate range to suit your needs. All the rules of steps 1 and 2 still apply, but you may increase the amount and variety of carbs that you consume. This amount will depend on your level of physical activity and your build. Although it is still important to spread the carbs throughout the day, you may have up to 4 X 15g of net carbs at one meal.

Much of the adjustment will be by trial and error, as you find out what makes you feel good and what sets you back.



Exercise is very important, as it ensures that your muscle cells are depleted of sugars. This means that when the insulin is replenishing with glucose after exercise, the muscle cells get restocked first. Only what’s left over goes into the fat cells. If you are sedentary, your glucose levels will be higher, as will your insulin levels. You will constantly be opening and filling more fat cells.

You need to exercise for 30 minutes a day over and above your usual daily activities. It is better to exercise frequently than it is to exercise for longer periods at infrequent intervals – for example, 15 minutes twice a day is better than 90 minutes every three days. The most beneficial time to exercise is within one to two hours after a meal, when your glucose blood level is highest. Never exercise on an empty stomach; always have a small snack first.


Try to manage your life to minimise your stresses. Exposure to negative stressors causes release of stress hormones, which raises blood sugar levels. Exercise also combats the release of stress hormones.


During the fat-burning stages of steps 1 and 2 (described above), ketones are formed from the breakdown of fats and must be flushed out of the body. If dehydration causes them to build up, the blood will become more acidic and the brain will slow down the fat-burning process in an attempt to neutralise the blood. Dehydration also puts extra strain on the kidneys. Ensure that you drink at least eight glasses of water a day.

The 5-hour rule

Never go longer than five hours without eating. This five-hour rule was explained in the previous article, and is vitally important to your success. If you do not observe this rule, your liver will regularly be pumping 40 to 60g of sugar into your blood every 5th hour, which will trigger insulin release and the glucose roller coaster. Observing this rule will allow the liver and pancreas to calm down. Always eat breakfast or a snack within an hour of waking. Always eat something within an hour before you go to sleep. If you wake during the night, have a snack. If your daytime meals are spaced too far apart, have a snack to prevent the liver from converting glycogen stores to sugar. Snacks should consist of a neutral food in step 1 or a starchy food containing less than 5g of net carb in step 2.

So, together with a little regular exercise, the combination of what you eat and when you eat it is your metabolic secret weapon. Remember that ultimately the ability to maintain perfect health (and perfect sugar balance) rests in your hands (and in your mouth!).


Most foods labelled with nutrition facts will display amounts for total carbohydrates and dietary fibre. Subtract the dietary fibre grams from the total carbohydrate grams to calculate net carb grams.


Useful supplements include:

  • A good multivitamin and mineral combination
  • Omega 3 fish oil 1 000 to 2 000 mg daily
  • Vitamin B complex
  • Calcium 600 mg twice daily to prevent bone thinning, which is common in Met B and diabetes
  • Vitamin D3, if the blood level is less than 40 ng/ml
  • Green tea has been shown to be useful in reducing midline fat and increasing HDL while lowering LDL. Minimum two tea bags daily.


  1. Kress D. The Diabetes Miracle. Da Capo Press, 2012


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The Treatment of Metabolism B – part 2

Dr David Nye
About The Author
- MB CHB (UCT), MFHOM (UK), DIP HOM (CEDH). He practises integrative medicine together with his wife, Dr Sandi Nye, in Pinelands Cape Town. As a registered medical doctor, homeopath and acupuncturist, he has a special interest in chronic illness, especially when conventional medicine fails to help. He uses a variety of modalities, tests and treatments in his quest to find the best solutions for each patient.