The title is terrible, it should read ketosis/ketones may prevent, reverse age-related effects within the brain.
"Low carb" as the title currently reads does not necessarily result in ketosis and your body/brain running on ketones, which appears to be the scope of this study. There is more to dietary ketosis than low carb, just as an example carnivore or paleo diets are low carb, but those will generally not result in ketosis, in protein rich diets your body will convert the protein to glucose which will continue to be the primary fuel for the cells in the brain/body.
If you have never entered ketosis and experienced your brain running on ketones, I would suggest you experiment for yourself. I would say a minimum 2-3 months which should be enough time for your microbiome to change and your body/brain to adapt primarily running on ketones.
> If you have never entered ketosis and experienced your brain running on ketones, I would suggest you experiment for yourself. I would say a minimum 2-3 months which should be enough time for your microbiome to change and your body/brain to adapt primarily running on ketones.
I've been on Keto for about 8 months (before giving up), measuring my blood ketones and being in deep ketosis between meals (over 2 mmol/L). I've also seen values going over 4 mmol/L.
In spite of popular belief, nothing happens, there's no magic at the end of that rainbow for most people. If you felt anything different, there's a high likelihood it was just self suggestion, aka placebo.
Also most people are in ketosis before eating breakfast in the morning, because the liver's glycogen is partially depleted overnight, enough for the liver to produce significant ketones. And nothing will make you enter ketosis faster like skipping a meal or two (aka starvation ketosis). People with a healthy metabolism cycle in and out of ketosis all the time.
Also the idea that your microbiome has to change and your body/brain to adapt for you to feel any better and that it takes months ... is a complete myth. Your body takes only mere days to adjust to any dietary strategy. Also the dreaded keto flu is just dehydration from all the lost glycogen, which pulls a lot of water on its way out.
I actually agree with most all of your posts. The one big difference, though, in my opinion, is that when adapted to a very low carbohydrate diet, it's actually easier for me to not eat. That's it. To me, it's the lone advantage. It's not about the palatability of the low-carb meals. It's that I just seem to be less hungry. I can skip a meal and it's no big deal. When I'm higher carb, missing a meal takes a way bigger toll.
One other thing I'd offer -- for long endurance activities at higher heart rates (e.g., cycling in zone 4 for more than an hour), you absolutely have to supplement with carbs. You can go a long time in Zone 3 on a low carb diet, but as exertion increases, you burn through those sugar stores and bonk. I've tested this repeatedly. In case it's helpful to others, you can consume quite a bit of sugar on a hard ride and be right back in ketosis hours later as your muscles take up the glucose first.
When you state "very low carbohydrate diet" - what do you mean? Do you mean you're actively avoiding fruits and vegetables, oats, nuts, etc? Or are you avoiding processed foods and the carbs that go along with that? The "carbs are the devil" argument is a huge misconception with people.
You mentioned that it's easier for you to not eat on a very low carbohydrate diet. My main eating regimen is two feeding periods that are generally between 12:00P and 8:00P. My diet is mainly plant based, so very high in unprocessed carbohydrates - and I do still eat fish and am also not opposed to eggs from time to time. I have no problem not eating. If I don't eat at all until the early evening I am generally never hungry.
So I'm genuinely interested in what you mean by "high carb". Processed carbs and satiety don't go hand in hand, but a "high carb" intake of whole foods is not remotely the same.
It's a tricky subject because everyone uses different definitions of "low carb". I've seen positions from dietary bodies that define "low carb" as less than 40% of your total caloric intake from carbohydrates, which is still a massive proportion.
That is why "very low carb" was introduced, obviously still not ideal.
For _me_, I'd say I eat very low carb, I aim for max 10-20g of total carbs a day.
Yes people tend to get stuck on "carbs" as a single entity and demonise it, which helps nobody.
My perception is most people on low/very low carb diets avoid as much processed food as possible, then get their remaining carbs primarily from non-starchy vegetables like broccoli, spinach, kale, etc.
By "high carb," I only mean to suggest easily-digestible high-glycemic index carbohydrates. I really do think there's something to the blood glucose spike and crash cycle and its relationship to satiety. I suspect you agree with that. However, whether through plants or other foods, I think it's the fat that most effectively satiates. You can get those fats through nuts and plant oils, but I find it's easier and tastier to get it through butter, eggs, and red meat.
With regard to agreement, not exactly. There's a lot of research around high fiber intake being one of the most prominent indicators of satiety [0]. Keep in mind most all meats are densely loaded with calories compared to whole plants. Fats are less satiating than fiber in many studies [1]. Hence it's far easier to overconsume fats via meats because no meat contains fiber and, again, is more dense per gram with regard to fat.
I don't actually read either of your linked studies to support what you say. But be that as it may, I think fiber is also satiating. It's just difficult to hit my macros when eating all broccoli. Broccoli, butter, and steak, on the other hand, is a nearly perfect meal. I get the sense you're invested in a plant-based diet. Good for you! I'm sure there are way to engineer the outcomes you want with plants.
The postprandial hypoglycemic episodes are very rare in people that don't have diabetes, being most of the time a sign that the first-phase insulin action is impaired.
T2D is a disease of glucose intolerance, but diabetics actually deal with two problems ... insulin resistance, which the keto people focus most on, but they also deal with impaired insulin action, i.e. the ability of the pancreas to respond is impaired. What happens is that the first-phase insulin action is delayed such that later insulin action is exaggerated, causing the subsequent blood sugar crash.
And this is still not T1 diabetes, there are people in which insulin action is impaired before the insulin resistance sets in and it's still classified as T2D.
Keto proponents love to talk about this problem, but it's not a common phenomenon, not even in people that are overweight or pre-diabetic.
---
Speaking of which the Keto diet does lead to impaired insulin action, coupled with physiological insulin resistance — mostly due to the "glucose sparing effect", a natural phenomenon that's reversible — but this is why the ocasional treat can send your blood glucose through the roof.
When people on Keto start measuring their glucose, they are surprise to discover just how much the starchy treats can raise their blood glucose, however this effect is misleading, because you wouldn't get the sugar spike if you weren't on Keto ;-)
This is one of the reasons why endocrinologists recommend diets that are over 100 grams in carbs per day to T2 diabetics. Because a very low carb diet requires total compliance, otherwise those hyperglycemia spikes can wreak havoc.
Keto proponents don't like to admit, but high carb diets made mostly of whole plants can be even more effective in keeping blood sugar in control, in dropping HbA1C and in losing weight.
---
> "I think it's the fat that most effectively satiates"
This is a myth. Fat might be more satiating per gram, but not per calorie.
If you look at the satiety index, the foods that are most satiating tend to be low in fat and many of those items are high in carbs (by keto standards). We are speaking of items like boiled potatoes, legumes or vegetables, or lean meats like chicken breast or cod. Potatoes are what you call a "high-glycemic index" food and yet boiled or baked potatoes stay on top in every satiety test.
You should be able to see for yourself actually — compare chicken breast with chicken thigh. Same animal, same kind of protein, different fat and calories amount per gram. Eat the same amount of calories on different days and see how you feel. We have a brain hardwired to seek foods high in calories and a chicken thigh is less satiating than a chicken breast simply because the former has more calories due to the fat and thus we end up liking it more.
More importantly we've got studies on the subject and high fat diets lead to less satiety and more calories being eaten versus low fat diets:
N.b. foods like boiled eggs are satiating in spite of the fat — unless you're talking about protein and "protein leverage", fat and carbohydrates are energy macros and do not promote satiety in any way, unless you're talking about fiber.
So what promotes satiety is:
1. fiber and volume (found in whole plants)
2. protein (e.g. the "protein leverage" theory, which is still under debate, but at least we've got some evidence for it)
3. blandness
Reasons (2) and (3) are the real reasons Keto works short term. But appetite always comes back, esp in a high fat diet. When I was on Keto I used to binge eat plain full fat butter and used to eat 1 Kg of grilled fatty pork cuts in a single sitting. And I gained weight of course.
I'd say modern grains and "vegetable oil" are probably the biggest issues... heritage grains in moderation are more okay. We take in a lot of refined grains and sugars. And cook everything in oils people wouldn't recognize as food a couple hundred years ago, let alone trans fats.
That combined with a huge uptick in constantly eating all the time, sugary drinks, etc... eating 6-8 times a day. Most people can get away with 1-2 meals a day and a small snack or coffee outside those main meal(s). Longer fasting has historically been involuntary and/or religious, has other benefits that should be included pretty regularly as well.
I think animal proteins and fats are good to keep, even just eggs, butter and fish. There's a lot of nutrition in egg yolks, kidney and/or liver meat and it isn't the same from vegetable sources. Animal protein is also a bit different in terms of absorption than vegetable as well. It's not hard for people to get 100-150g of appropriate protein a day on average either and doesn't have to come from higher animals.
There is no evidence available that "vegetable oil" is unhealthy in any way, other than the calories.
There is no good evidence for example that "Omega-6" rich oils are inflammatory, quite the contrary, we've got several systematic reviews and meta analyses claiming they are not. And the n-6 : n-3 ratio is completely arbitrary (most ratios in nutrition are). We've got much better evidence for example that saturated fat does raise LDL and that LDL is causal in heart disease.
There's also nothing wrong with eating 6 times per day, unless you end up eating too many calories. If you meant to say that people eat too much, then yes, we do eat too much, but meal frequency has nothing to do with it. Many people can easily eat 4000 kcal in a single meal and those with binging problems often do, so while reducing meal frequency can be a good strategy for some people, it's a poor strategy for others. E.g. OMAD is a recipe for eating disorders.
We do agree that animal products can be part of a healthy diet, it's much easier to get adequate protein from lean meat, eggs are a good source of choline, folate, vitamin A and dairy is a good source of calcium. In the standard diets of the western worlds however, we have no shortage of animal products, what we have is a shortage of whole plants.
Modern grain varieties don't resemble their heritage counterparts. Modern wheat (since the 70's) sees something like 19x the immune response. As to seed oils, frankly I just don't see a need to support heavily processed and refined foods in general, in particular margarine and vegetable shortening.
As far as over-eating and meal frequency... hormones are part of the calculation, you can clear more calories with less hormone response in fewer meals. If you look at tribal cultures with a food abundance (near coastal fish) would only eat once a day or so. Spiking glucose/insuline more times a day isn't so great in general.
I think we're mostly on the same page... I'm more than happy to see people eat more from whole plant meals with a more nose to tail approach to meat consumption. Not to mention a huge a shift in the types and qualities of meat and fish.
I think the level of refined sugars, oils and modern grains are a big problem... so is, for that matter, poorly raised animals and mono-farming in general. Optimizing for yield and efficiency seems to have lost a lot along the way imo.
One aside, while some can eat massively in a single meal... it's very hard for most people to overeat in a single meal. Harder still to do it consuming meat/eggs/fish and greens. Calories count, calories are king in terms of what we eat... and hormone response is queen.
I disagree partly here based on personal experience with BJJ. I simply cannot summon fast-twitch muscle "burst" cardio on a full keto diet. After months of trying all kinds of workarounds, I had to carb-load with glucose pills (the kind diabetics take) the night before and pre-workout.
Long-term steady endurance massively increases though. If there's no bursting, I find that I can workout for hours on keto, it's amazing. It's kind of like the difference between regular diesel engines and gasoline+nitrous engines. Patience and focus seriously improve as well.
My limited understanding is that glycogen stores in muscles get depleted on full keto and must be replaced with some kind of carb intake, whether through excess protein-to-carb conversion or through normal carb intake, that "burst" energy simply isn't going to be there.
Example: I'm on the bottom in full mount and I know I need to burst to sweep somehow or shrimp out after bucking. Energy just wasn't there, time and time again. I could do jumping jacks forever, though.
I'd love to hear your feedback on this, like, what your protein intake is vs. fats.
> I disagree partly here based on personal experience with BJJ.
My experience includes BJJ! :)
Of note I've been keto adapted for years, so I am likely an edge case.
That HR recording I linked to is of a kickboxing endurance bag workout (Bas Rutten's routine if you are at all familiar with it), nothing but explosive power against a bag, every punch 100%.
Now at the end of it, can I lift as heavy? No, carb load and I'm adding an extra few pounds to the bars, but it isn't a huge difference.
> I'd love to hear your feedback on this, like, what your protein intake is vs. fats.
I stopped tracking years ago. Probably should start tracking again just to lose some extra lbs. :) Outside of weight loss I do keto just because of the insane energy levels.
The kicker about BJJ is that after class, these guys who are much stronger than me are winded and I'm walking around upset no one wants to keep training. Everyone is doing crap like sitting down and resting!
Awesome, thanks for the reply! Yea, I was trying to find a way to have a permanent high-fat keto diet for BJJ but it just wasn't happening. It was kind of a personal experiment and I was pleased with the outcome. Great way to drop a few extra pounds before weigh-in, though. Discrete carb-loading is unavoidable, though.
>The kicker about BJJ is that after class, these guys who are much stronger than me are winded and I'm walking around upset no one wants to keep training. Everyone is doing crap like sitting down and resting!
As you probably know, they are Doing It Wrong. Most of the higher belts I've known are skinny (sometimes barrel-fat) and not mega-huge muscular because their technique is orders of magnitude better so they don't need to rely on muscling everything. My main professor always skips the heavy warmup on his days and just does enough to get the blood flowing and joints warm which is funny - he's really good.
I really started to think about this once I got my ass handed to me by a teenage girl purple belt who couldn't have weighed more than 90 lbs wet. I was trying on purpose not to use my size and strength but quickly realized my technique was much worse than hers. One of the great benefits of BJJ is this kind of instilled humility. Not much room for silverback gorilla bullies.
Now, competition, particularly no-gi, is a whole different ball game in my experience. There, maximizing strength to weight ratio is of crucial importance because the other person is supposed to be of roughly equal technique and when it comes down to it, whoever's stronger usually has a better chance.
You’re correct here. The long, low intensity type work lends itself to ketosis well, but power and strength not quite as much. This is because of the metabolic availability of energy from the two pathways.
To throw my own anecdotes in, I’ve done more than a few 24-48 hour efforts (backpacking, mountaineering, cycling, climbing) with a range of dietary strategies and so far I’ve felt the best with bacon, hard boiled eggs (with some salt and pepper), and water.
Sorry it did not work for you as an individual, but turning that around to say that anyone else with a more positive experience is just placebo is a bit of a logical fallacy. Why do you think your own personal experience should be the one source of truth for the whole universe? Don't you know the 7 billion people alive all have unique bodies that respond to things differently?
Have you tried anything else health-wise (diets, medicine, exercise plan etc)after Keto? And is it working? If it is, its most likely just a placebo and not really beneficial in of itself. Thats according to the crux of your argument: if something works, its very likely just a placebo.
> most people are in ketosis before eating breakfast in the morning, because the liver's glycogen is partially depleted overnight, enough for the liver to produce significant ketones. And nothing will make you enter ketosis faster like skipping a meal or two
There are two claims here that are pretty important and contrary to my understanding and experience:
1) Liver is depleted after usual sleep
2) Fasting is the fastest way to enter ketosis
Even when practicing a very low carb diet your liver is "topped up" through gluconeogenesis while you are sleeping.
If by ketosis you mean the body is producing enough ketones to power itself than the fastest way I know of kickstarting that process is not having carbs for 6 hours then going for a run or lifting heavy weights.
You don't need to starve yourself, you just need to put your body in a scenario where the energy demands overtake the available energy in the form of blood glucose (and strain the stores in the muscle and liver).
> Even when practicing a very low carb diet your liver is "topped up" through gluconeogenesis while you are sleeping.
Not really, gluconeogenesis is a pretty inefficient pathway, from my reading on the subject you can't make more than 200 calories of glucose per day via gluconeogenesis, which is pretty low and definitely not enough to replenish the glycogen stores, only enough to keep them from being completely depleted. I'm struggling to find the reference.
But you can also ask most doctors — if you give urine or blood in the morning, nobody raises an eyebrow when seeing ketone readings because it's a known effect.
Also note that I'm not saying that all glycogen is depleted. Glycogen stores are never depleted, as the glucose sparing effect eventually kicks in (aka physiological insulin resistance) and yes, some of it is replenished via gluconeogenesis.
---
> by ketosis you mean the body is producing enough ketones to power itself
No, ketosis is a metabolic state in which the liver is producing ketones in response to a short supply of glucose, with significant ketones being detectable in the blood or urine. That's it. And availability of ketones in the blood stream is enough for them to be used.
There is a threshold of 0.5 mmol/L of ketones that people in the keto community use, but it's completely arbitrary — nobody knows why that threshold isn't 0.3 mmol/L. Regardless, I'm at 0.5 mmol/L in the morning while eating between 150 and 200 grams of carbs per day.
---
> "You don't need to starve yourself, you just need to put your body in a scenario where the energy demands overtake the available energy in the form of blood glucose (and strain the stores in the muscle and liver)."
We agree here — yes, once the glycogen stores are depleted enough, the liver starts producing ketones and of course exercise can do the trick.
There is one caveat ... during exercise ketone usage also goes up, and exercise also drives your blood sugar up, so if you measure the ketones immediately after exercise, the readings can be misleading.
But yes, active people can burn through their glycogen stores really fast.
> In spite of popular belief, nothing happens, there's no magic at the end of that rainbow for most people. If you felt anything different, there's a high likelihood it was just self suggestion, aka placebo.
I absolutely noticed a change, and there's no way it's just a placebo. The change I've noticed is that I don't get hungry nearly as quickly as I do when I'm eating carbs, and I don't get "hangry" anymore, either. I do still get hungry, but it's a much more mild effect.
I also used to get headaches quite frequently, especially if I waited too long to eat. That has also stopped since I started doing keto.
> Also the idea that your microbiome has to change and your body/brain to adapt for you to feel any better and that it takes months ... is a complete myth. Your body takes only mere days to adjust to any dietary strategy. Also the dreaded keto flu is just dehydration from all the lost glycogen, which pulls a lot of water on its way out.
Is this something you have a source for, or just something you believe?
> Also most people are in ketosis before eating breakfast in the morning, because the liver's glycogen is partially depleted overnight, enough for the liver to produce significant ketones. And nothing will make you enter ketosis faster like skipping a meal or two (aka starvation ketosis). People with a healthy metabolism cycle in and out of ketosis all the time.
I'm not sure I buy this. Usually if I've been eating carbs for a while, and try to get back into ketosis, it takes me a day or two. If you don't eat for 16 hours, then sure, maybe you enter ketosis near the end, but most people don't go that long without food.
> "Placebo effect caused me to not want a nap in the afternoon?"
No, it was probably the adrenaline being pumped due to the caloric deficit — without which you wouldn't have lost weight — or at the very least your diet being eucaloric, because eating too much does make one sleepy ;-)
> "Not being hungry until meal time?"
This can be attributed to — (1) extra proteins compared with your regular diet and (2) eating foods that aren't highly palatable. (speaking of which, high carb diets made of whole plants also have the advantage of fiber and volume)
There is a lot of evidence in the scientific community for these claims, while there is none for any specific effects of the keto diet. This isn't about anecdotes, although keto proponents sure seem to have a lot of them.
---
> "Did I imagine the 60 pounds weight loss, too?"
Good for you, I lost 55 pounds too (not on keto), I know how challenging losing fat can be. And I'm genuinely glad to see other people succeeding.
If you feel good, keep doing whatever it is you're doing. If not, then know there are plenty of other options.
The keto community has recently learned how to make good meals, it was pretty bad for awhile, but I'd like to note that nearly all Indian curry dishes are keto friendly.
And while ymmv, I consider them rather palatable.
Lots of Chinese dishes as well, obv. not noodle and rice dishes, but a large swath of Chinese cuisine is perfectly keto friendly.
Heck my local ramen shop now offers keto friendly noodles.
I know and it would be pretty hard for Keto meals to not become palatable due to all the fat.
Long term all weight loss diets are equally disappointing, because appetite does come back and compliance becomes an issue. At maintenance we can actually tolerate a lot, esp if we are lightly active, but if you want to lose weight, striving for better tasting food is a poor strategy.
An excelent book on this subject is "The Hungry Brain" by Stephan Guyenet:
This guy's blog is awesome too and if you're interested for example into why the "carbohydrate insulin model" is wrong, checkout this list of references produced by him:
We have a brain hard-wired to seek foods high in calories and salt and we also prefer diversity. People on keto when looking at sweets, like brownies, they see the carbs, however the bigger problem is the fat + refined carbs combination. All junk food is a combination of fat + refined carbs, because this is a recipe for making the food hyper-palatable. This goes for French fries too, it's not the actual potato, because potatoes have a lot of water, a lot of volume and if you eat them boiled, few things are as satiating. Combine potatoes with fat by deep frying, then add some salt and both calories and palatability goes through the roof.
How can you make veggies and greens, like spinach or brocoly, tasty? You add some fat. Incidentally this is how you can trick your brain to like greens.
Most people have issues losing weight while eating brownies, not because you can't lose weight when eaten in moderation, but because it's so hard to not binge on brownies, especially if you have emotional issues too (and many overweight people have emotional issues), foods like brownies being perfect as a comfort food. You can binge on fruits, veggies, lean meat or beans of course, but it doesn't have the same impact.
(N.b. I love brownies, brownies are awesome, they just aren't good to have around when losing weight)
People in the keto community talk about carb cravings, however there is such a thing as craving fat or any food high in calories too, because it's not really about any particular macro nutrient. When I was on keto, I used to binge eat plain full fat butter. I also used to eat 1 Kg of grilled pork chops in a single seating and then I was hungry again at the next meal.
---
On the whole however, both low carb diets and low fat diets lead to a spontaneous loss in appetite in many people. It's why they work short term.
This doesn't necessarily last for long, because you get used to what you eat and because we tend to diversify our meals in our search for better tasting food. Then the dreaded plateau appears, which can happen pretty fast on keto, esp due to the propaganda that calories don't matter.
Such diets are still better than the SAD, but you'd get a similar bang for the buck in terms of satiety and healthfulness ... if you just stuck with whole foods at least 80% of the time.
> Such diets are still better than the SAD, but you'd get a similar bang for the buck in terms of satiety and healthfulness ... if you just stuck with whole foods at least 80% of the time.
Another useful benefit of Keto is that the rules are really simple.
That sticking with whole foods 80% of the time is the hard part, there is temptation everywhere, e.g. the Girlscout cookies on desks at work, free granola bars, etc etc. A decent % of our society is geared towards getting people to eat more.
Keto says "you can't eat any of that junk". Just, flat out. No points, no "a little bit of ice cream", just, no. The easy calories are not an option.
> Then the dreaded plateau appears, which can happen pretty fast on keto, esp due to the propaganda that calories don't matter.
Plateau's happen for many reasons, and a lot of them are not yet fully understood. For years there were stories of people eating below maintenance who aren't losing weight, and just recently science has learned that gut biomes can drop (increase?) their efficiency and result in a lower BMR than normal.
Of course at the end of the day, getting a 6 pack requires being hungry. There is no getting around that! (Well other than being under 24 and very physically active, but that's a very time boxes solution! ;) )
I've been on Keto before — eating whole foods is much simpler, there's no counting of carbs involved, no danger of developing a nutrient deficiency and no fearmongering ;-)
> "Keto says "you can't eat any of that junk". Just, flat out. No points, no "a little bit of ice cream", just, no. The easy calories are not an option."
This is also a recipe for getting an eating disorder. You can't stick with this mentality unless you end up thinking that carbs are poison, which is factually wrong and a very unhealthy mentality. And do you have the same mentality about fats? Those are "easy calories" too.
Sometimes it's OK to just have one cookie. If that doesn't work for you, fine, I've been there and I can understand wanting 100% compliance, but personally I feel much better since giving up on such a goal — because no, food is not poison, food is not alcohol, chronic overeating is the problem (aka energy poisoning) and chronic overeating can happen once you develop what they call "an unhealthy relationship with food".
I now naturally want whole foods, because I get to eat more volume and it keeps me full for longer. Once I got the taste of it, I don't need to fear food categories in order to stay on path.
---
> "For years there were stories of people eating below maintenance who aren't losing weight"
There's no such thing. People that eat below maintenance and not losing weight are either:
(1) underestimating their calories intake or
(2) have overestimated their maintenance requirements
If you're not losing weight, then by definition you're not eating below maintenance. And note that it is true that some medical conditions, like hypothyroidism, lead to a lowered metabolic rate (the thyroid is responsible for raising your body temperature for example), but in all cases we aren't talking about more than 200 - 300 kcal. So in order to lose weight, even people suffering from hypothyroidism can simply eat 2-300 kcal less — it's harder but it can be done. And if you claim a bigger penalty than that, you start breaking the laws of physics.
---
> "just recently science has learned that gut biomes can drop (increase?) their efficiency and result in a lower BMR than normal"
No, that did not happen. The research you're talking about was inconclusive and it was done IN MICE.
There are indications that the health of the microbiome is important, however the associations between the _human_ microbiome and obesity are weak and don't appear to be causal.
I.e. people that are obese tend to eat a less diverse diet (less whole plants). Such people also have less diversity in their microbiome. You cannot infer from that the microbiome is what caused their obesity, the huge confounder in such associations being the diet itself.
It's also a large part electrolyte imbalance from some dehydration... drinking more water with salts can help a lot. It isn't magic, but can help with glucose control without medication, or without as much... eating enough protein, which keto people tend to get plenty, also has higher satiety, which can lead to eating less. Going to 1-2 meals a day will have mostly the same effects.
I think keto and carnivore are really better depending on one's specific metabolic and/or autoimmune issues. For most people, eating less processed crap (junk/fast food and trans fats particularly), less modern grains, less seed oils. Instead, having a well balanced diet which imho should include at least eggs, butter and fish is a great starting point.
The problem is a claim like the body/brain, the cells themselves needing to adapt to a new fuel source before seeing some benefits, taking months before you get there, actually contradicts the body's physiology. I don't really need to provide any citations, because the onus is on the one making those claims. And even if I provide citations, the goal posts will simply be moved, with lines like — the study was not long enough, the diet was not low carb enough, etc, etc.
It also takes a lot of effort to dispel bullshit, much more effort than spreading it. Engaging with flat earthers is exhausting, most people don't do it due to insufficient knowledge and actual scientists don't engage b/c they've got better things to do.
My language is emotionally charged because I've been in the keto community for a long time and I've witnessed a lot of quackery, which I believe can do harm to those in need, just like the anti-vaxers are doing.
---
There are very few studies showing the effects of a ketogenic diet on cognition, in healthy subjects.
Here's one study which merely says that people feel awful for the first two weeks and then start to feel less awful after reintroducing carbs — it's unfortunately not randomized:
https://naldc.nal.usda.gov/download/23706/PDF
Here's a study that shows weight loss itself (the biggest confounder of every claim made by keto proponents) is known to affect mood and cognition and to improve quality of life:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4905696/
Thanks, this is an excellent response. This is super informative.
I do understand your goal post comment. It's super-frustrating that virtually all diet information out there has some tangential agenda (Eg. animal welfare, keto/paleo cultism, etc)
I have always felt that most of proposed benefits of the keto diet are largely just a result of "giving a shit." People go through lives eating garbage all the time, laying around feeling bloated and crappy. Then jump onto <insert any miracle diet> and after a few weeks feel amazing. The secret is they swapped from shoveling garbage into themselves with becoming relatively picky about what they're willing to put in their bodies. Suddenly they look better and feel better, and want to double down on looking and feeling better.
I myself did the keto diet and found success with it, but then I transitioned to just more of a selective generalized diet and experienced identical effects. Keto was just the first time I'd ever had a set of rules to apply to the food I ate, which was ultimately the actual training I needed.
I think you're probably right, that what you don't eat is probably more important that what you do.
However, I did change my diet to be very selective, and felt great. But changing to keto had some additional benefits, the most prominent being a noticeable change in how hungry I felt during the day. It's much easier to go long periods of time without eating when in ketosis.
Your body is composed of many hierarchical control systems. Some of them have feedback loops that imply minimum adaptation times longer than days. For a dietary related one (keto), one such adaptation is liver efficiency to produce fewer ketones + kidney efficiency to filter out uric acid. People who never have had gout but go on a keto diet sometimes get gout flareups because of a uric acid spike from the diet change, and it takes a number of weeks for uric acid levels to subside: https://www.virtahealth.com/blog/keto-adapted
There is plenty of work showing that physical endurance increases after extended periods on keto. Athletes have carefully tracked their performance numbers day by day and demonstrated real changes.
And as someone who participates in activities that require large amounts of endurance, I know on keto my ability to perform for extended periods of time is higher. These aren't "I think" numbers, they are "polar heart rate monitor strapped to my chest" numbers.
The very nature of keto leads to improved endurance, fat is a much more plentiful energy source than glucose, it may be less efficient (lifting heavy on keto is a well known problem), but it /never/ runs out. If someone is doing an activity that doesn't cause excessive lactic acid build up or complete muscle fatigue, then a keto will give an endurance advantage.
> There is plenty of work showing that physical endurance increases after extended periods on keto
Not really.
Yes, athletes do suffer an adaptation, but it's basically about returning to near baseline levels (i.e. from sucking badly to sucking less). And as a matter of fact, the peak performance never recovers to full capacity ;-)
Here's a list of studies on this subject — all of them showing a dicrease in performance:
And endurance exercise could see a benefit in some circumstances, although this is highly debatable, however also in athletes a keto diet can lead to lean mass being lost:
You admit and acknowledge an "adaptation" in this comment, but in another reply to me where I talk out the keto adaptation, you replied:
>everything you're saying is a complete myth. Define what it means for the cells to adapt for "running on ketones".
There's no such thing.
As previously provided:
A ketogenic diet (KD) involves using fat, a high-density substrate, as the main source in daily calorie intake while restricting carbohydrate intake [21,22]. In this way, the liver is forced to produce and release ketone bodies into the circulation [23,24,25,26]. This phenomenon is called nutritional ketosis [27,28,29]. Over time, the body will acclimate to using ketone bodies as a primary fuel, which is called keto-adaptation, an element of fat-adaptation [30,31,32]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410243/
>Several days of dietary carbohydrate restriction to levels < 40–50 g/day, with moderate protein, results in increased circulating beta-hydroxybutyrate (BOHB) by an order of magnitude. When maintained for several consecutive weeks, the metabolic state of ‘nutritional ketosis’ awakens a dormant set of genes and metabolic programs that counteract insulin resistance and manifest in several positive health outcomes. This process, referred to as ‘keto-adaptation’, is characterized by accelerated rates of whole body fatty acid oxidation, while glycolysis, insulin concentrations, insulin receptor activation and signaling, constitutive inflammation and oxidative stress are all decreased. https://www.sciencedirect.com/science/article/abs/pii/S24682....
>Here's a list of studies on this subject — all of them showing a dicrease in performance:
I think most agree for high level athletes in anaerobic sports ketosis isn't going to be the best diet for athletic performance, but these studies don't really support what you claim
>In conclusion, in this study we have demonstrated that VLDL-TG made a significant contribution to fuel utilization during exercise after adaptation to a fat-rich diet. The increased total fat oxidation observed after fat diet adaptation originated from both a higher plasma FA oxidation and utilization of VLDL-TG, and thus circulating VLDL-TG should be included among the lipid fuels that may be utilized during exercise.
>Adaptation to a 6-week HFMP diet in non-highly trained men resulted in increased fat oxidation during exercise and small decrements in peak power output and endurance performance.
This is the most supportive of your position, but it still acknowledges the benefits of ketosis
>It can be concluded that long-term, high fat diets may be favorable for aerobic endurance athletes, during the preparatory season, when a high volume and low to moderate intensity of training loads predominate in the training process. High volume training on a ketogenic diet increases fat metabolism during exercise, reduces body mass and fat content and decreases post exercise muscle damage.
Not claiming that the science is settled, but I when I entered keto over 10 years ago (TL:DR daily 10K+ 'performance' runner, neuropathy from glucose intolerance - genetic, avoid all drugs), I wanted to be sure that I could run without ingesting carbs (since everyone said you couldn't).
Read "The Art and Science of Low Carbohydrate Performance" and can absolutely say that after an initial horrible period that lasted for months, I was eventually able to run further and just as fast as I used to when I was carbo-loading. I can honestly say that running is more difficult now - my legs are generally sore and I don't feel like I'm 'flying along', but I've always tracked my times with Garmin, then Apple, and the stats belie how I feel.
From the book: "[Keto-adaptation] allows even a very lean (10% body fat) athlete access to more than 40,000 kcal from body fat, rather than starting a prolonged event depending primarily on ~2000 kcal of glycogen."
I think the studies you quoted would back-up the authors, but I also wanted to lend my long-term personal experience. I can't recall where I read it, but thought adaption also occurred in leg muscles where they found a massive increase in the number of mitochondria for athletes on keto.
I tested myself daily for years until I found a combination of diet and exercise that worked. My body definitely adapted and became much more efficient at burning fat - there's no performance 'wall' anymore, but I think the experience is different for everyone.
Your last paragraph is just unbelievably flat-out wrong. Maybe you didn't suffer from keto flu, but it can last for a couple weeks to a couple months (my case) and has zero to do with dehydration.
You're literally retraining your body to efficiently burn stored body fat when it never had to much before. This takes time. The idea that it happens in days is laughable, as is the idea that your microbiome adjusts that quickly.
No, you probably suffered from nutrient deficiencies, symptoms that went away once you diversified.
A total guess of what happened to you, but what's not a guess is about the adaptation taking months and being about anything more than dehydration or nutrient deficiency being total bullshit.
Cutting out high-GI foods doesn't produce nutrient deficiencies, since they're generally calorie-dense but low in vitamins etc. If anything, the fact that you're getting more meat and veggies to make up for it increases your nutrient diversity, from day one. So again, you're completely wrong.
As for adaptation taking merely days, what's your source for that? The common wisdom and community consensus that you'll read anywhere is that it takes roughly 2 weeks to 2 months to adjust. You're the one claiming this is wrong. So what exactly is your proof here?
Look, I'm glad it wasn't a problem for you. But claiming that therefore it isn't for others, just doesn't hold water.
I gave up because I felt awful ... problems sleeping, strong heart palpitations, hair falling off, left foot going numb, etc... all symptoms of nutrient deficiencies, which I couldn't correct via food or with supplements and that started disappearing within a week after giving up.
And that entire time I did not lose weight, I actually gained a pound or two.
If you're interested in losing weight, find a strategy for eating less (by playing with what you eat or with meal timing). The only reason keto works for some people is because it leads to a spontaneous drop in appetite, due to cutting entire food groups from the diet, thus making the food you eat less palatable. And the extra protein sure helps. But it only works short term, after which you start enjoying bacon and butter, so the inevitable plateau happens and then you get the line about your metabolism needing to "heal" before losing weight, which is bullshit, as the causality is reversed (i.e. your metabolism is broken because you ate too much and exposed adipocytes tissue to an energy excess, aka energy poisoning, so the solution is to eat less and to lose weight).
I've lost 55 pounds and kept it off, being almost at my ideal weight. Not with keto.
> If you're interested in losing weight, find a strategy for eating less (by playing with what you eat or with meal timing).
I'd just like to chime in and echo this sentiment. I myself have lost and kept off between 2 and 3 times what parent has and it was also no thanks to keto, or any fad-diet bullshit.
There's no magic to losing weight. Consume less, expend more, weight loss ensues. Yes, it is that simple. No, that doesn't mean it is easy. There are many different paths but they all lead to the same place.
This isn't quite true. For many, keto truly is an easier way to achieve the goal of eating less. Our metabolism uses various signals and pathways to detect satiety and even in the early stages of metabolic syndrome some of the pathways get broken due to insulin resistance (e.g. insulin blocking leptin satiety signaling in the brain).
Keto truly is much, much easier for many people. If you explore the keto community a bit, you will notice that it often naturally leads to intermittent fasting - simply because people don't feel like eating all that often.
Of course, it comes with its own difficulties with regards to food selection and social eating. However, in terms of willpower, my experience has been it's zero-effort compared to previous caloric restriction diets I've done.
This is not to say that caloric restriction takes a huge amount of effort and will-power for everyone. But if it does for you, it's worth checking keto out - and it's definitely not just a fad.
I've found that a fairly good selection criterion is people that suffer from post-meal slumps (sleepiness). If you are one of them, its likely that ketogenic diets will be helpful.
>Also most people are in ketosis before eating breakfast in the morning, because the liver's glycogen is partially depleted overnight
This is true...but it gets to my point, just because your body begins breaking down fat and producing ketones (as shown in your tests) does not mean your cells have adapted to using ketones as fuel, that requires the body to adapt.
Based on your numbers you were clearly breaking down fat and making ketones, but based on your not feeling any different I'd say your cells never adapted to ketones as the primary fuel source. This is the same for people depleting their glucose stores over night, yes they are in "ketosis", meaning they are breaking down fat and producing ketones, but that does not mean their cells are efficiently running on ketones.
My guess with you, not knowing more, is you are pretty inactive. At least I would be surprised to learn you engage in lets say an hour of cardio 4-5 times a week. I am not saying keto is the end all be all, or that everyone prefers it, but I have not met anyone who does aerobic cardio and experimented with Ketosis and not experienced a different (again good or bad). On the other hand I have met many people who tried Keto and never noticed any difference, like you describe, and the commonality seems to be they were inactive.
>Yes, everything you're saying is a complete myth. Define what it means for the cells to adapt for "running on ketones".
>A ketogenic diet (KD) involves using fat, a high-density substrate, as the main source in daily calorie intake while restricting carbohydrate intake [21,22]. In this way, the liver is forced to produce and release ketone bodies into the circulation [23,24,25,26]. This phenomenon is called nutritional ketosis [27,28,29]. Over time, the body will acclimate to using ketone bodies as a primary fuel, which is called keto-adaptation, an element of fat-adaptation [30,31,32]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410243/
emphasis added citing the following study:
>Several days of dietary carbohydrate restriction to levels < 40–50 g/day, with moderate protein, results in increased circulating beta-hydroxybutyrate (BOHB) by an order of magnitude. When maintained for several consecutive weeks, the metabolic state of ‘nutritional ketosis’ awakens a dormant set of genes and metabolic programs that counteract insulin resistance and manifest in several positive health outcomes. This process, referred to as ‘keto-adaptation’, is characterized by accelerated rates of whole body fatty acid oxidation, while glycolysis, insulin concentrations, insulin receptor activation and signaling, constitutive inflammation and oxidative stress are all decreased.https://www.sciencedirect.com/science/article/abs/pii/S24682...
It is true that ketosis is more than low carb, but Gluconeogensis has absolutely nothing to do with it. There is a lot of wrong information out there about GNG.
GNG is an on-demand production of glucose, and absolutely does NOT kick the body out of ketosis, or cause the brain to run on glucose. GNG provides enough glucose for the tissues that cannot run on ketones (such as the kidneys). Without GNG, ketosis would not be possible. In fact, ketones regulate GNG, and prevent it from exceeding the needed maintenance levels.
Furthermore, GNG runs at mostly a constant level, does not increase with protein intake, and is at that constant level even when the body is not in ketosis.
What prevent ketosis in stubborn cases? Insulin resistance. To overcome insulin resistance it takes a strict low-carb regime paired with moderate fat intake, and lowering of stress. The process can be dramatically sped up with intermittent fasting.
>GNG is an on-demand production of glucose, and absolutely does NOT kick the body out of ketosis, or cause the brain to run on glucose.
I never said GNG kicks people out of ketosis, I said protein to fat ratios will prohibit ketosis. Yes, in ketosis your body continues to produce minimal amounts of glucose, I never said anything to the contrary.
However, GNG has a lot to do with ketosis vis-a-vis protein to fat ratios, protein to fat intake can not be to high or it will kick you out of ketosis because of GNG
>Furthermore, GNG runs at mostly a constant level, does not increase with protein intake, and is at that constant level even when the body is not in ketosis.
If you over consume fat or carbs, they get stored as fat in fat cells. What happens when you over consume protein? Protein can not be stored as fat, it must first be converted to glucose, which the body will try to burn before it is stored in fat cells. This is why a high protein to fat ratio carnivore diet will prohibit ketosis or kick one out of ketosis, unlike a high fat to protein carnivore diet (again I never said the body stops producing glucose from protein in that situation, but the glucose production is minimal in ketosis because of the ratios and ketones remain the primary fuel source).
>To overcome insulin resistance it takes a strict low-carb regime paired with moderate fat intake, and lowering of stress.
While generally true and correct, I can even come up with examples where this breaks down...whey oxalate being a perfect example. Whey oxalate will typically have 25g of protein and may have as low as 1 gram of carbs, but Whey oxalate will spike insulin in most people and throw most people out of ketosis.
> If you over consume fat or carbs, they get stored as fat in fat cells. What happens when you over consume protein? Protein can not be stored as fat, it must first be converted to glucose, which the body will try to burn before it is stored in fat cells.
No, this is wrong. GNG is capped in the body, i.e., strictly regulated. It does not increase based upon protein intake beyond that cap. Excess protein is neither converted to glucose, nor excreted. It is utilized in protein synthesis and increases lean body mass.
This has been demonstrated in a number of studies. For example, in Bray GA, JAMA 2012, subjects were fed an excess of 1000kcal over their their maintenance calorie needs for 8 weeks. There were three groups: low, moderate, and high protein. Carbs were constant. Fat made up the difference in caloric content, such that the high-protein group (230g a day) received the lowest fat intake. All three groups gained similar amounts of fat over those 8 weeks, with the high protein group gaining slightly less fat. But the medium and high-protein groups gained lean body mass to make up the difference.
So in short, excess protein is not converted to fat via GNG, but is used for protein synthesis, and increases lean body mass.
> This is why a high protein to fat ratio carnivore diet will prohibit ketosis or kick one out of ketosis, unlike a high fat to protein carnivore diet.
This absolutely does not happen, and I have the blood tests to prove it.
Just reading the abstract makes it pretty obvious.
> "A total of twenty-two healthy subjects (ten men and twelve women: age 23 (sem 1) years, BMI 22·1 (sem 0·5) kg/m2) received an isoenergetic high-protein (30/0/70 % of energy from protein/carbohydrate/fat) or normal-protein diet (12/55/33 % of energy from protein/carbohydrate/fat) for 1·5 d in a randomised cross-over design"
It wasn't the increase in protein that stimulated GNG. It was the reduction of carbs. Without sufficient dietary carbohydrate, the body must maintain minimum glucose levels via GNG.
GNG increases when in ketosis, but is still capped because ketones regulate the GNG process. That is the effect which was observed here. It says it right there in the synopsis:
"Glucose concentration was lower (4·09 (sem 0·10) v. 4·89 (sem 0·06) mmol/l, P < 0·001) and β-hydroxybutyrate concentration was higher (1349 (sem 139) v. 234 (sem 25) μmol/l, P < 0·001) after the high-protein compared with the normal-protein diet."
β-hydroxybutyrate is a ketone body.
Note that this contradicts your statements that GNG will kick you out of ketosis. It absolutely will not.
To repeat: GNG is constant, regulated by ketones, and its relative level is not driven by protein demand, but by glucose depletion.
>Note that this contradicts your statements that GNG will kick you out of ketosis. It absolutely will not.
Its really simple, eat nothing but chicken and/or turkey (high protein, low fat, no carb). You will not become keto adapted or fat adapted.
Alternatively enter into nutritional (dietary) ketosis with a high fat diet, then switch to chicken and/or turkey only (high protein, low fat, no carb) you will not remain in ketosis.
Do you disagree with that? Have you seen any study that shows fat/protein ratios are immaterial to nutritional ketosis?
Yes I disagree with that. Dietary fat is not required to enter ketosis. On a lean protein diet, you will indeed go into ketosis, and your body will start using its own fat reserves to produce ketones. However, the transition to ketosis will be more difficult.
In fact, the biggest mistake keto dieters make is to assume that "fat doesn't make you fat". That's just wrong. On any high-fat keto diet you will burn dietary fat before burning your own fat. If weight lost is one's goal, it is essential to limit fat intake to moderate levels, just enough to keep you sated, so that the body is using its own fat reserves.
I'm not aware of any dietary fat requirement to enter or maintain ketosis. I've talked to others that mention a protein/fat ratio but I've not see any literature about it. Citation appreciated.
A low carb and low fat diet is unhealthy for lean people because fat/fatty acids/etc is required for a whole lot of synthesis.
> in protein rich diets your body will convert the protein to glucose which will continue to be the primary fuel for the cells in the brain/body.
This is completely incorrect. Gluconeogenesis is stimulated by the pancreas releasing glucagon in response to low blood sugar. GNG happens in everyone regardless of diet when blood sugar is too low. It has nothing at all to do with the amount of dietary protein you consume.
GNG happens in people in ketosis pretty constantly without stopping ketosis.
How does working out at a high intensity work when in a state of Ketosis? I lift weights and/or do HIIT 5x per week and occasionally add running on top of that. I've always been weary of going low carb or trying a keto diet because I feel like I just won't have the energy to continue my training regimen at its current intensity. The typical advice is to eat your allocated carbs 1-2 hours prior to your workout, however I feel like by not getting the right amount of carbs post-workout I'm basically wasting my time in the gym at best, and at worst asking for an injury due to not being able to recover completely in time for the next workout.
I run marathons and prefer running in ketosis. In ketosis I will follow a long run with some protein for muscle recovery with fats just to maintain ratios rather than carbs to refill depleted glucose stores.
For lifting/HIIT training ketosis may not be ideal. I have done it and its fine, basically I swap whey for hemp protein powder and continue using creatine post workout.
I think for most people unless they are competing or trying to gain mass they would really like the results of ketosis and lifting. You will lean out (both fat loss and less water retention) and maintain muscle mass, don't be afraid of losing your gains. On the down side the adjustment period will probably be a little longer/harder than a relatively inactive person and initially you will likely notice a decline in energy in the gym, but it will be temporary (again your body is learning to use ketones as primary fuel source and that takes time). That said once you adjust you won't find any trouble lifting heavy or running sprints, in fact you will probably be able to go longer. One benefit you really notice is lack of inflammation and soreness following workouts, in my experience the body recovers faster, though this is still about the actual food you consume (healthy omega 3s and green leafy vegetables) and not some automatic benefit of ketosis.
Don't go low-carb. There is no need, it's not unhealthy. Especially if you are sporty (as it sounds).
The current state of affairs is: If you are insulin resistant (either because of genetics, obesity, whatever) then having a low-carb high fat diet is better for you. If your insulin resistance is high, then your pancreas produces much more insulin, meaning your cells will start storing energy instead of using it up. If this keeps up for a long period, your fat tissues, which are supposed to be your fat/energy storage, will fill up and your body (or rather the particles transporting the transformed sugar from the liver) will start sticking to your organs. This starts inflammations and makes your organs weaker, and in turn also raising your insulin resistance. And these malfunctions also spread to the brain and can cause alzheimer and the like. The exact chain of effects is not yet confirmed, so from here on it's a lot of speculation.
But if you now are trying to lose weight, and you just reduce calories, but keeping a "high-carb/low-fat" diet, then you will be hungry. Because either you have too little protein to feed yourself, or you eat enough protein and you automatically eat too many carbs again, producing more and more insulin.
This is how high-fat diets come in handy, as they don't spur liver activity and don't impact insulin as much. This in turn means you can reach ketosis, starting to work the fat on your organs (which is a lot more dangerous then some fat in fat tissues like your belly). Your body will recover, inflammation will go away and your insulin sensitivity goes up again (unless you are genetically diabetic). And with a healthy body your brain can also recover.
The studies for this are still coming in, but I find this explanation very logic and even this study, although the article is weirdly phrased, plays into it.
Some remarks at the end:
- If you do a lot of sports, your muscles use energy even without insulin
- Glucose is spread through the body, while fructose is directly converted to fat (tissue)
- Sport also increases insulin sensitivity
- Diets are very personal, try out things for yourself and see how it works!
- Protein is also increasing insulin (since protein intake signals the body to start storing energy, i. e. protein into muscle cells)
There is a keto adaptation [1] period of at least 6-8 weeks where you might take a hit, but there are several studies that show that it's generally not a concern.
Cipryan, Lukas, Daniel J. Plews, Alessandro Ferretti, Phil B. Maffetone, and Paul B. Laursen. “Effects of a 4-Week Very Low-Carbohydrate Diet on High-Intensity Interval Training Responses.” Journal of Sports Science & Medicine 17, no. 2 (May 14, 2018): 259–68.
Greene, David A., Benjamin J. Varley, Timothy B. Hartwig, Phillip Chapman, and Michael Rigney. “A Low-Carbohydrate Ketogenic Diet Reduces Body Weight Without Compromising Performance in Powerlifting and Olympic Weightlifting Athletes.” The Journal of Strength & Conditioning Research Publish Ahead of Print (October 17, 2018). https://doi.org/10.1519/JSC.0000000000002904.
Paoli, Antonio, Keith Grimaldi, Dominic D’Agostino, Lorenzo Cenci, Tatiana Moro, Antonino Bianco, and Antonio Palma. “Ketogenic Diet Does Not Affect Strength Performance in Elite Artistic Gymnasts.” Journal of the International Society of Sports Nutrition 9 (July 26, 2012): 34. https://doi.org/10.1186/1550-2783-9-34.
Kephart, Wesley C., Coree D. Pledge, Paul A. Roberson, Petey W. Mumford, Matthew A. Romero, Christopher B. Mobley, Jeffrey S. Martin, et al. “The Three-Month Effects of a Ketogenic Diet on Body Composition, Blood Parameters, and Performance Metrics in CrossFit Trainees: A Pilot Study.” Sports 6, no. 1 (January 9, 2018). https://doi.org/10.3390/sports6010001.
If you're interested in the topic of human performance and ketosis, I enjoy Volek's talks - here's one from a relatively recent Jumpstart event: https://www.youtube.com/watch?v=BeS_dhM8dsY
Anecdotally, I find my workout recovery to be much better on keto/fasting diet, but all my markers (and overall inflammation) has improved so much and I'm being mindful of other aspects like stress, sleep, etc that it's hard to necessarily pin down to one cause.
It seems people have pretty individualized responses to this. In general, the research shows decreases in performance except for endurance events. Personally, I found my recovery was great on keto. Better than normal even. I was doing a strength cycle so my weights were increasing at the time and I was getting stronger. I actually felt better in the gym, and I lift pretty heavy. A lot of the aches and pains in my joints seemed to go away. Downsides: my gut felt weird, and you have work hard at getting adequate fiber and stuff. Also, it's hard to eat socially.
I was eating a higher protein diet than usually considered keto, but urinalysis confirmed ketosis.
> How does working out at a high intensity work when in a state of Ketosis?
I've done this. You get tired much faster, you will not be able to sprint for nearly as long, your maximum lift significantly decreases, you hit the muscle fatigue point (can't lift again unless you lower the weight) very quickly.
The usual solution among keto lifters is to have a carbload cheat day once per week _or_ to carb spike with I think (it's been a while) pure glucose syrup a measured amount just before your workout according to how much you think you'll actually use during the workout. The cheat day in practice works pretty well, because if you're slamming your body at the gym every day you can get back into ketosis very quickly after the initial induction phase is done, so you end up with a couple of days of keto per week but not the full week.
The problem isn't lack of energy. The problem is muscle and cardio exhaustion. You feel great, not tired, just your muscles stop working and you run out breath. So I don't think that vitamin, electrolytes, or more calories will help. If you're lifting seriously, you're already consuming plenty of those things.
this was my experience. My endurance was unaffected by ketosis but my ability to generate instant power over and over again (mountain bike) definitely took a hit.
Not the author, but I have experience with this. For me it takes about a week of slugishness before my body adjusts. Once I'm adapted, my performance is actually better. This goes for heavy weights, low weight/high rep weights, and cardio.
After years of doing keto I can get that keto feeling/energy/effect by doing one day of super low carbs and super low calories, I’ll wake up the next day wanting to spring out of bed like you wouldn’t believe.
You have a very stable energy supply on keto. I am on keto right now and went for a run in the morning. For lifting weights and muscle building I am not quite sure whether I can give advice, but have a look at https://www.reddit.com/r/ketogains/ and the subreddits community as this subreddit is focused on working out with keto.
Depends on the diet. Low carb on its own can work because you can eat between 20 and 50 grams of carbs in a day, but ketosis is limited.(which might be okay depending on one's goals)
Keto is shit for working out, in my personal opinion. Some people claim they can have effective workouts on keto, but I hate it, and a lot of others have a hard time having energy when training on keto. Keto is good for weight loss, and I lost 60 lbs in 5 months doing keto, but it's total crap for building muscle, in my experience.
The best compromise, in my experience, is fasting. I'm talking ideally 48 hours between meals. I'll keep it short because I've been spamming threads about this topic recently; because fasting forces the body to solely burn through its glycogen stores, and then body fat once that runs out, ketosis becomes easier to achieve even if there are some carbs in meals, and the presence of carbs in meals provides glycogen for when you workout and train your muscles. I believe this is needed, especially for HIIT. In my experience, you can eat a modest amount of carbs when breaking a fast and still manage to get back into ketosis(fat burning mode!) within a few days. It totally outperforms keto in that it often takes people several days, possibly weeks, to get into deep ketosis.
That said, a low carb, but not necessarily keto, diet can work for someone doing HIIT. Everyone's body is different. A person may find that they want more carbs in order to be effective in the gym, but if they're trying to get lean, then that can compromise their goal, in which case they should reduce their eating frequency a la fasting. A person who is either building muscle or maintaining body composition may not need to do a low carb diet at all.
I don’t self test ketosis, it I believe I can eat slightly extra carbs during/post workout and not hugely interrupt ketosis. I don’t know if this is true, but certainly my body doesn’t feel ‘kicked out’ of ketosis when I do this.
(Keto vs non-keto is night and day for me, brain fog vs no brain fog, energy for life vs not being able to get off the couch)
I confess I don't measure ketosis, and it sounds like we do different sorts of workout. But I do the intermittent fasting variant known as eTRF; I generally eat 7 am - 1 pm. I was worried about how that would interact with my runs, which I usually do in the morning before eating. Enough people online were positive about it that I tried it out and it has been great. On recent Sundays I've done 2-hour runs with little or no food. My times improved and I felt amazing. And the meal after running? Fantastic!
I do similar exercise and when I started keto 8 months ago I had a dip in performance for about 3 weeks.
I do a similar set of exercises on the same day/time every week and it ends with 30 seconds of burpees.
Prior to going on keto I was doing 16 burpees in that 30 seconds. After the first week I was down to twelve. After a couple more weeks I was back to 16 - and two weeks after that I was on 17. I’m now on 18.
I’ve gone from 103kg to 88kg in that time, so it seems likely the weight loss has been a (or the) factor in the improved performance.
I’ve done it. I got extremely ripped and looked great, but actual performance suffered and I started feeling pretty terrible. I like how carbs solve those problems for me. However, if I’m doing 6+ hour efforts, I just eat fats and around hour 7 or 8 I’m still burning hot when I used to burn out when I was feeding with carbs.
I think it really depends on how long you've been in ketosis, and how well adapted you body is to running on fat.
At first you will absolutely have less energy, but it seems like the more fat-adapted you are, the more energy you'll have. At some point it seems like you actually have more energy to work out.
For my understanding this is mostly attributed to insuline resistance vs sensitivity. As you get older and overexposed to sugar, your resistance raises and in order to reverse a lot of the internal inflammations your body has produced from over-intake of sugar you need to force ketosis and burn calories with a low-carb diet.
This in turn helps reduce internal fat and repair organ functions, fundamentally restoring hormone production and refreshing your brain as well.
It does not mean that carbs in general are toxic, nor that this diet is recommended for everybody!
Diets are very personal, it just becomes more and more common because sugar is added everywhere, people are getting older and older and obesity is a global problem. As such, most people are very insulin resistant and work better with low-carb/high-fat diets.
This headline is one of the reasons there is so much misinformation in food and diets
Anything that requires me to radically change my diet to experiment with myself "just to see", that takes a minimum of 2-3 months, is a hard pass. It's just not that interesting to most of us for a vaguely hand-wavey possibly useful experiment.
Full-on keto may not be worth it, but I would highly suggest removing most carbs from your diet (<= 30g per meal). You'll feel completely different within 5 days. This is especially noticeable after the age of 30. I have no scientific backing or research for this, but I've had a number of friends and family make this small change and every single one has not gone back. It's not even that difficult if you already have a somewhat healthy diet.
Yeah; I haven't gone low-carb but i track what i eat, and carbs are ~40% of my diet. So, not low, but lower than many. I've definitely played around quite a bit with making sure i up my protein and fat consumption, and it is pretty remarkable how different fuels work differently in your body.
Yes you will feel like you have no energy during workouts. The primary fuel for muscles is glycogen. Cells use glucose by default. And fats are 9 cal/g, so they’re so easy to overeat. I don’t understand why limiting carbs makes any sense.
Fats are easy to overeat? I can easily eat 4000 kcal in carbs in one sitting, I’d be nauseous reaching the same amount with either proteins or fats or a combination of both.
In fact, since going low carb I have a new mental awareness when I’ve eaten enough: I eat until a switch flicks in my head mid chew and says “that is enough”. It’s mental, not that physical feeling of the stomach being full.
Anything calorie dense (and therefore hyperpalatable) is easy to over eat. Fat is twice as energy dense as carbs or protein, so it adds a lot of calories. Put a tablespoon of olive oil into the skillet, and you're adding an empty 120 calories.
Typical foods you could eat 4000 calories of combine fat and carbs into a delicious combination: french fries, pizza, cookies, milkshakes. I don't look at those foods and think individually carbs or fat is at fault. But on the other hand, carbs are what the body uses for energy, so to avoid them doesn't make sense to me. I'd rather skip out on fat.
I'd just say that what's essential to eat (>50-60 g protein/day and a few grams of omega-3s) is different from what's optimal (what ratio of fat/carbs/protein).
> I don’t understand why limiting carbs makes any sense.
Then why go around saying things like:
> Yes you will feel like you have no energy during workouts. The primary fuel for muscles is glycogen. Cells use glucose by default. And fats are 9 cal/g, so they’re so easy to overeat.
I think that's fine; not everybody has to be an early adopter of everything. If what you're doing is working for you, keep doing it!
But for people who feel vaguely but persistently like things aren't working anymore, I really recommend experimenting with diet. I've tried a variety of things over the years, and have ended up with a combination that has made my life hugely better: better mood, more even-tempered, much more energetic, and physical exercise has gotten a lot more fun. I recently went back to my old diet for a week and felt like warmed-over garbage.
But yes, expect it will take 1-3 months for your body and habits to really adapt. E.g., when I quit refined carbs, I experience 1-3 weeks of withdrawal symptoms. Headaches, low energy, enormously cranky. And it's even longer for the habits to really get established, so I stop feeling like I'm missing out on the old things.
I was about to ask if intermittent fasting would have the same effects as I get the impression that its a healthier way of getting into ketosis.
(When I look, I don't see negative effects associated with IF, and I do with keto diets. The research changes a lot and the conclusions don't seem definitive, but I thought someone on here might have an educated opinion on the matter).
In my personal case I'm not really able to enter and maintain good ketosis levels without also fasting intermittently.
Intermittent fasting is key to enabling me to lower my caloric input because of the momentum of the fasting phase carried over into the eating phase, e.g. smaller stomach and more effective metabolism. I currently fast about 12 hours per day (including the sleep phase), which doesn't sound like much but with the lowered caloric input it's actually pretty good. I can go longer easily when the circumstances demand it, and after crossing 16 hours I actually stop experiencing hunger completely. I plan to extend the fasting periods in the future, if easy and convenient.
As for whether ketosis is necessary - I believe I would not be able to fast intermittently without it, or at least not comfortably, which is necessary for any lifestyle change to be sustainable.
I'm not aware of any negative effects of being in ketosis for prolonged periods of time, and quite the opposite. I don't crave sugary foods anymore, and I dislike anything with even a trace of sweetness. I was surprised to discover how good the body really is at detecting what food is good for it, once in ketosis.
My main food sources currently are avocado, egg, tahini and drinks based on almond or walnut milk. I'm also using vitamin and mineral supplements, mostly in fluid forms. I'm 42 and I wish I had known about keto as early in my life as possible, not when I was forced to explore it due to declining health. Ketosis gives you a stable level of energy through the day and allows you to fully focus on life and the tasks at hand.
Since mid-January this year I have been fasting intemittently. I have zero calories before 5PM, and I am usually in bed by 10. I exercise most weeks between 4 and six days, but only two or so are "vigorous" for me. My workouts are mid-day.
When I eat, I eat normally for me, which is lower carb and higher protein, but not (knowingly) keto or anything.
I have lost about 10 pounds.
I just got my blood lab results, and they are the worst numbers I have ever seen. Highest fasting glucose (borderline diabetic, a rise of 14 points or so from memory), highest cholesterol (doc's gonna make me take meds if it doesn't come down).
I've done this before, but wouldn't I would "only" wait until 2, and I got bad (but not this bad) results as well. I decided to try again, making my eating window truly shorter, but alas...
Curious about your food choices. I've been experimenting with IF. More specifically I'd call it more like timed eating because the bulk of my fasting hours and during sleep. I'm down 20 lbs with solid numbers. As a side note I have some genetic factors as well and trying to counter those.
A lot of lean protein and vegetables; eggs (3 egg-whites + 1 whole egg is a common combination for me), chicken, fish, broccoli, etc. I wasn't trying for low-carb, but low-carb made it easier to stave off cravings. I was paying attention to calories more than anything else.
I do drink, however, straight liquor. Rarely to excess, but also rarely fewer than 2 drinks (almost always 2-3 drinks an evening).
Same, I went from 95kg to 80kg in a few months, then I got stuck at 80kg for a few months on keto. But then all of a sudden I dropped to 72kg in a few weeks (it was such an odd and rapid drop I freaked out and went to the doctors to get checked out)
That's a sample too short, a lot of that can be the momentum carried over from whatever you have been doing previously. You have to understand that as a carb/sugar eater, you may have effectively destroyed your body to the point when it's much harder for it to digest nutrients from food (e.g. fatty liver). And/or you may have a starting diabetes.
Before jumping into the meds death spiral, check Dr. Berg's videos on YouTube, and I'm sure you'll find a way forward. When your body is broken, nutrition isn't a simple thing, trust me, I know.
Other than weight loss, do you feel any differently (body, mind)? I have started IF last fall. Similar diet - low carb, higher protein. I also had considerable weight loss, but no impact on blood quality.
No- before. I eat between 5pm and 10pm. I guess I feel better. With placebo effect and whatnot it’s hard to know. My workouts took a hit initially but eventually got back to their normal intensity.
If you are refering to the HbA1c for the characterization of being prediabetic, take into account that it is an estimator that averages over 8-12 weeks.
Don't confuse Keto, etc. as "high protein", its primarily a very low carb diet, "moderate protein" and "high fat". Too much protein also isn't ideal for Type 2 diabetes or the various stages that lead up to it. One thing that surprised me was for example, how Whey protein can also spike up blood sugar (so much for post-workout whey drinks, etc.)
I recommend the books and videos of Dr. Jason Fung on fasting, as I think he makes a compelling case for the layman how fasting varieties can be beneficial. He is a nephrologist, and since kidney issues are common with diabetes patients, he had many diabetes patients in his office and had good succes with them bettering their condition using fasting methods.
Obligatory: I am not a doctor and you should not swap out medical supervision for random internet advice, but Dr. Jason Fung is definitely worth checking out.
Ok, I hope that wasn't too much of unsolicited advice for you. I wish you all the best and hope that you can get on top of things which whatever method works for you.
I test both via keto urine strips and via keto breath analyzer. But when you are on a strong keto, you simply know it, you can feel it by the increased amounts of body and brain energy, mental clarity. Also your urine is more yellow and has a more specific odor.
I do water fasting (rather "bone broth fasting" like Dr. Jason Fung advocates in his talks on youtube and in his books), and also have done and will do keto when I am not fasting.
I am not quite sure about the "health" class. So roughly speaking I am obese and I do think with every 3 kilograms I loose per month, I am healthier. So keto as a tool for loosing weight is really without a doubt healthy. The correlations between being overweight and associated risks are MUCH stronger than the correlations between food and associated risks.
Now, if you dig deeper into books on keto and fasting by doctors, you see how fragile certain conclusions are that are now the consensus opinion in nutritional science. I am a data-scientist, trained biophysicist and I know I am not an epidemiologist and not a biologist, but I can tell "creative statistics" apart from not-suspicious ones, and a lot of central nutritional science studies that triggered the fat-fear seem to be highly deficient from a statistical perspective, hardly proving any causality.
So I tend to be rather sceptical about dietary advice after 1950 unless it has been (a) shown in humans and not just in experiments with animals (b) based on studies that do interventions, i.e. change the behavior of humans rather than just surveying or asking what people do.
What I also find fascinating is, how the fasting community and the keto community often reach similar conclusion while actually being kind of different communities advocating for different "resolutions".
Anyway, what I was trying to say: If keto and fasting helps the normal weight range at steady 3kg/month, I do think it is healthy for me, when I am in a normal weight range, the priorities may change from "weight loss is really important" to other aspects.
Your body goes into ketosis when it "runs out" of blood-sugar for long enough. It usually takes me 2 - 3 days of staying below 30 net grams (i'm a larger guy, for many people it requires going below 20).
IF can be a part of that, in terms of helping you to control your eating and making the time-period at the end of those 2 - 3 days happen maybe a half-day sooner, but fundamentally it doesn't change carbs are carbs.
Also you might find the relationship almost works the other way. Ketosis makes IF much easier. I haven't eaten breakfast in years. I don't even really consider that an IF regimen as much as like... once you get rid of the habit for a month or two you completely don't miss it and forget why you bothered.
Vigorous exercise, in particular sustained cardio, is the surest way to burn through your glycogen stores. Combined with intermittent fasting and a near-zero carb diet, it’s the fastest way to resume ketosis.
Everyone I know who is on a carnivore diet has a high enough fat:protein ratio to stay in ketosis most of/all the time. The value of that seems to be pretty common wisdom among carnivores.
It is possible, I have done it myself eating a lot of eggs and fatty red meat. Also, in my case I was also already in ketosis for an extended period of time, meaning my microbiome and cells were primed for ketosis.
That said I have also done carnivore and also not been in ketosis, which I think is probably the norm for most people on carnivore because the protein/fat ratios aren't right.
The commonality in ketosis carnivore and non-ketosis carnivore is removal of refined sugar/carbs which means no insulin spikes, which means steady levels of energy without crashing.
Meat also raises insulin, much less than carbs, but on a carnivore diet I can imagine this to happen.
The keto diet with ratios has been designed as a diet for epileptics, so in a ratio that maintains both body weight in a healthy range and induces ketosis and avoids ceizures (note: 1920s medicine or something). So the high fat content kind of is there to actually give you the energy so that you don't loose weight.
One aspect of the "carnivore" diet that is often overlooked, a "human carnivore in the stone age" will not have lived off of chicken breast and lean beef cuts, but easten the entire animal, i.e. the fat cuts as well that are surprisingly hard to get in a western country.
1) That's per 250 kcal. A plate of pasta has significantly fewer calories than a plate of steak. Sauces on either can alter this, but they'll likely have their own indices to pay attention to.
2) The low ends are equal. The high ends are off by a factor of 1.5.
I think that the real question is "What will happen to my insulin if I eat a meal of pasta vs, a meal of steak?". To that, I think that the steak will in fact spike your insulin much higher than the pasta.
That said the beef has a higher satiety score (by almost exactly the same ratio as the high end insulin ratio).
Again, sauces, what your body needs right now, what you'll eat for your next meal,... lots of things can alter the overall health perspective.
This also depends on eating frequency. If someone has a very low eating frequency, like a single meal every 72 hours, even a meal of lean meat may not knock a person out of ketosis, at least for very long. I've fasted that long and eaten a huge meal of lean meat, multiple times, and my keto testing strips always remain dark purple.
As much as I think keto and carnivore are lightyears past the average American's diet, I've found them difficult to maintain because they're very restrictive and I lack the energy to be effective when working out, which is common. Fasting in combination with a low carb diet, even one that incorporates things like berries, has been much more effective and easy to maintain in my experience. Combining macronutrition with eating frequency reduces the penalty of eating carbs or lots of protein by making it much easier to get back into ketosis. When you force your body to burn through its glycogen stores, and you give it no choice but to use your fat store, ketosis will come back in no time.
So you are definitely correct that fatty cuts are better, most of the time, but with fasting the protein to fat ratio almost becomes a non-issue.
I have but in my case it is not caused by continued low carbon diet and should be avoided and is not so nice due all the side effects it has. Everyone who takes any form of diabetic medication should ask their physician about the consequences as it might interfere with the medication or require adjustment and can cause acidosis even if you have normal glucose levels. On the other hand, especially for type 2 diabetics, there is some indication it might be beneficial (if done properly and coordinated).
Ketoacidosis is of course a medical condition and not something one seeks out.
Ketosis is fundamentally different, your bodies mode of metabolizing (body) fat in the state of fasting, which can also be provoked when eating a high-fat moderate protein and <20-30g carbohydrates diet.
And yes, asking a physician may be a good idea if you suffer under certain conditions. Sometimes it may be valuable to find a physician that has knowledge on keto-diets, because that's not really something every physician learns about as a dietary choice.
under 50g and it depends on the physical activity of the individual. Meaning if you're a highly tuned physical machine then you can eat far more than 50g.
Ketosis is a normal supplemental metabolic state that the body enters in between meals to various degrees. There's no hard black/white macro requirement.
Ah, ok. I think I figured out where my confusion was at regarding the catabolic pathways from both gluconeogenic and ketogenic amino acids. The correction looks something like [Keto-Acids[Ketone bodies]]
While most catabolic products are categorically and chemically ketones, the list of ketone bodies mostly falls within the list of Keto-Acids. All of which can get passed to TCA at some point, which in turn can feed into gluconeogenesis if the reaction pathway energy is favorable.
While several people refer to gluconeogenesis, to the best of my knowledge we _can_ make glucose from protein, but rarely do in practice. I have yet to see anyone convincingly show that we do.
This is so so true but so many people don’t believe this is possible. I wish there was a way to formally study this. Once my children are out of the house, I’m going 0 carb. I’m already pretty close to carnivore.
A few parts of your body can't operate on ketones, so there's a backup mechanism to produce glucose from protein (from muscle breakdown, if necessary) called gluconeogenesis.
However, There's no evidence I've see that gluconeogenesis can kick you out of ketosis. As far as I know, gluconeogensis is demand-driven, not supply-driven, so there won't be any extra glucose running around for your ketone-consuming cells to use, regardless of your protein intake.
"The production of glucose from glucogenic amino acids involves these amino acids being converted to alpha keto acids and then to glucose, with both processes occurring in the liver. This mechanism predominates during catabolysis, rising as fasting and starvation increase in severity."
The body can use protein to make glucose, it only will switch into that mode under low carbohydrate conditions like fasting or very low carb diets. It's less energy efficient of a pathway though.
My understanding is that the body will convert protein to Glucose when needed, but it is very carefully regulated, and will prefer ketones for cells that can run on them. However, some cells require glucose, and gluconeogenesis is important for that if you're eating low carb/in ketosis.
No citation, but If you think about it it makes sense: is you have no fat left, and aren't ingesting enough calories, your body would rather burn muscle than organs.
I cannot say that it isn't recommended, because recommendations are quite diverse. But I haven't seen that recommendation before.
Orthodox nutritionists would definitely advice against ketosis, potentially they may be fine with fasting-induced ketosis every once in a while (depends a bit on how they were trained).
People who embrace a low-carb ketosis-inducing diet (aka "Keto diet") or embrace multi-day fasting don't consider it harmful really. For fasting there are of course certain limits but not due to ketosis but for other effects of not eating (refeed effect, general weight-considerations, etc. but there have been overweight people successfully fasting for months under supervision).
No, like other people have said that's ketoacidosis. Both involve some ketones, but one is healthy and natural(ketosis) the other is very bad and you should talk to your doctor about it (or he is most likely the one to find it) that is ketoacidosis.
Had a doctor tell me ketosis was very dangerous (she was confusing it with ketoacidosis). I couldn't help but completely stop listening to her after that.
The biggest issue with ketogenic diets is elevated level of cholesterol, which is generally considered harmful, though there are different views on this topic.
The causality of elevated cholesterol and coronary heart disease isn't entirely proven. What we see in studies is mostly correlations. Cholesterol-reducing drugs have been shown to not lower the risks associated with high cholesterol levels, so I do think this is an area where we may not have the complete picture yet.
Dr. Jason Fung has a few interesting figures in his book, citing studies where the consumption of eggs for example decreases risks, kind of fascinating.
People who are born with unusually low cholesterol levels also seem to be essentially immune to heart attacks. I don't have the link to the study handy since I'm on my phone.
Be careful what evidence you accept on this question. There are billion dollar industries doing their best to confuse the issue.
The issue is the "generally considered harmful." High-fat low-carb diets tend to improve triglyceride profiles. Dietary cholesterol is not the same thing as blood cholesterol levels.
Anecdotally, my father and I discovered separately, in bloodwork unrelated to our individual diets, that a HFLC diet significantly decreased LDL and increased HDL.
I have always had very normal cholesterol numbers. It gives you a better HDL (good chol) to LDL(bad chol, maybe) ratio and is good for lowering triglycerides (definitely bad chol) which is the worst type of cholesterol. Your information is not true and is a common misconception about the diet.
In my observation there are many contradicting studies about LDL and keto, for example this study's results show significant increase in LDL while on keto: https://www.ncbi.nlm.nih.gov/pubmed/31067015
This one is baffling. LDL "significantly increased" while triglycerides "significantly decreased"? Calories/day not stated; if, say, 3200 kcal, that means 40g of carbs.
Afaik there is no top athlete on keto when performing: they are all on high-carb.
Keto is the "burn your body fat" mode. Staying in keto by eating high fat low carb is a trick. Humans never had such easy access to fats as today. Before we made settlements we got a large part of our calories from fruits (which contain short carbs), not unlike the other primates.
> Before we made settlements we got a large part of our calories from fruits (which contain short carbs), not unlike the other primates.
This can't possibly be true. Agriculture is only 12,000 years old or so, but people have been living in Europe for much longer than that. I'm in North America, and there are no fruits available locally for six months out of the year. Before agriculture people must have been living mostly from hunting.
You think a large share of pre-settlement humans lived in non-(sub)tropical regions? I don't think so. We mostly staying in the warmth, and the few daredevils that left had a hard time.
"Together, our results suggest that brain network destabilization may reflect early signs of hypometabolism, associated with dementia. Dietary interventions resulting in ketone utilization increase available energy and thus may show potential in protecting the aging brain."
Definitely skeptical here as well, but the article seems to echo these sentiments fairly accurately. I’ll have to head the study though to say for sure.
Nutrition research seems to change as often as JavaScript framework of the month. I saw one Ted talk that essentially said "everyone is different and no rules apply to everyone".
The real issue is that nutrition science is bad and everyone has a book. Maybe 1 in 20 studies don't have obvious confounding factors that cause us to have no real base facts, but we can find a lot of correlation. Unfortunately, this is kind of the nature of the beast, nutrition science isn't bad because nutrition scientists are bad, but rather because it's so complicated it's tough to have very clean data.
Demonizing fats in favor of sugar as a country has allowed one of the biggest and longest population studies of its kind, and it's pretty obvious from the health of the population that very high calorie, sugar rich diets are overall bad for you (notice the wide strokes we have to make here).
Everyone is different, and no rules apply uniformly to everyone, but general rules do apply to everyone. Fructose in a caloric surplus is more damaging than glucose, for instance, but different bodies are more or less effective at mitigating this. Most people have some inflammation response to gluten, but for the vast majority of people, it's minor. Most things are a sliding scale, on one end is no measurable result, on the other end is acute response.
NOTE: I'm not interested in arguing about what the research says here. I know the pro-gluten party will come out in force, and I've made an enemy with the bread baker's union. I'm not a researcher, I'm just a nutrition hobbyist. There are much smarter people doing much more comprehensive breakdowns and having much more meaningful debates than I can, so go listen to them. Read the research yourself with a skeptical eye. Take all dietary advice with a grain of salt, and check the opposite side of the research, nutrition and biology is WEIRD.
Also, we're still learning very basic things that have massive impacts. No one was talking about "gut health" unless you had a chronic disease roughly 10 years ago. Microbiome didn't have much place in the conversation about health and nutrition, no crossfit people knew about resistant starches, etc.
The government may have been advocating low fat diets but of course people don't follow nutrition advice. If you look at what people were actually eating in the time you describe they started eating more of everything. Consumption of chicken and cheese in particular exploded.
Sugar consumption has actually been in decline for years now and obesity keeps climbing. Yes sugar is bad for you but blaming modern health problems just on sugar is not accurate.
Yeah maybe I should be clear here, I'm not talking about putting granulated sugar in your coffee. I'm talking about the explosion of dumping high fructose corn syrup into everything that occurred during these years. And teaching children that they need to eat foods based off the food pyramid was directly opposite to what was actually good for you. Of course everyone doesn't listen to the government recommendations, but it's naive to say it doesn't have an impact.
In addition to that, eating a bagel for breakfast, a sandwich for lunch, and having bread on the side with dinner is pumping carbohydrates for you body to break down into sugars 24/7. These things are higher in calories.
To reinforce what you're suggesting, I'd need to see trends of added sugars to food going down and the obesity rate increasing. At the end of the day, it's calories in vs calories out, but pumping things with fructose increases the calories and the palatability of food, increasing how much you eat. There are a number of negative health side affects, but sugar likely causes obesity by secondary affect.
> Sugar consumption has actually been in decline for years now and obesity keeps climbing.
Do you have a source for this? Because it seems like unless you cook your own food, it's nearly impossible to avoid foods that have _added_ sugar these days. Maybe sugar consumption has increased, but it's less obvious now.
> Maybe 1 in 20 studies don't have obvious confounding factors that cause us to have no real base facts, but we can find a lot of correlation.
Even worse: Many studies are done on mice, who do not eat the same things as humans
And worse still: Many are done with "food surveys" which lean too much on the poor memory and faulty assumptions of participations (eg what some Americans think of as a serving of "meat" is really a serving of fried breaded bread with condiment levels of meat mixed in. Most Americans do not know that chicken nuggets are half corn. etc )
The people with the worst data may be the scientists, unfortunately. You can draw somewhat accurate conclusions from your own personal testing and anecdotes, but you might draw mightily wrong conclusions from survey data which appears to say something that simply isn't true.
The nutrition "research" you read on internet sites does. But don't confuse this with what nutrition researchers believe. What they believe does not change month to month but over years. And none of them believe things as simplistic as "sugar bad" or "fat bad".
> Nutrition research seems to change as often as JavaScript framework of the month.
Nutrition “science”, like most health-related “sciences”, has approximately zero predictive power. A pretty reasonable strategy is to completely ignore whatever helpful advice the FDA or whomever is currently spouting (food pyramid!) and come up with some plausible first-principles model that matches available anecdata, like trying to match a plausible far-ancestral diet.
Agreed. The problem is that doing actual controlled studies is really hard. You have to take a group of people and randomly assign them the diets you want to study, essentially locking them up for the duration. It could possibly be done, if one of our billionaires took an interest in this problem.
Well, to be fair, it was on purpose. The food pyramid in the US is created by the USDA, whose sole job is to produce and sell food at massive scale. Remember, they are the ones that subsidize crops and pay farmers not to grow corn and soybeans to keep the price up. If things were sensible, it would be produced by the Department of Health & Human Services. Fat may have more calories per gram than carbs but our real problem is insulin control and resistance and that is what those low fat diets turbo charge.
Remember that in the era these policy positions were stood up, you were looking at big advances in medicine and concern about population and food supply.
The guys dying of heart attacks from eating fatty pork and beef at 50 got the message, unfortunately that message shifted the bad habits to bread and sugar.
I think this is mistaking correlation for causation. The problem with sugar is that it's often found in highly palatable foods that contain large quantities of fat and calories. If one monitors their caloric intake/outtake such that one is in a deficit or at maintenance not only do negative markers disappear, they improve. (Even on a high sugar diet.)
That's not to say: 'only eat lion candy bars and all is fine.' (One reason is that that would be too hard to adhere to since the volume of food is so low because they're so calorically dense. Low volume, even if calories are high, causes hunger. Another would be the lack of fiber, protein and micronutrients.)
But it does show that it's not sugar that's the problem but rather consistently being in a caloric surplus such that people become severely overweight.
Unfortunately, nutrition has become such a religious topic that it's become hard to have civil, scientific discussions. Instead, we stick to our tribe, demonize those who show flaws in our reasoning, and selectively search for research that aligns with what we already believe.
I actually think it might be all of at least three things:
1. Too much sugar has direct effects on the body, even for people at a totally healthy weight. Possibly including changing your appetite.
2. What you said: unhealthy foods very often contain sugar; therefore, foods high in sugar are more likely to be unhealthy in other ways too.
3. Sugar has calories but doesn't make you feel full. Too much sugar works against controlling your weight because people want a minimum amount of satiation.
The first point may seem wrong if you tend to think of the body as simply using sugar as fuel so that it only "pays attention" to the energy content. One thing that convinced me it's probably more complicated than that is a study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513783/) showing that if endurance athletes merely swish a sugary beverage in their mouth and then spit it out, it still improves their athletic performance. It can't be merely sweet; artificial sweeteners didn't have the same effect.
This is a pithy statement belies the complexity of nutrition. Besides, researchers that linked heart disease to dietary fat didn't recommend that sugar be substituted in. And the diet heart hypothesis seems alive and well today; lowering blood cholesterol and saturated fat consumption is what health practitioners still recommend today.
No one knows for sure yet. The most convincing theory I've heard is that it actually is fat...
But fat is an umbrella term. Saturated fat is (almost certainly) benign; eat as much (or as little) as you want.
Omega-6 and omega-3 polyunsaturated fats, on the other hand, are precursors to an important class of hormones called eicosanoids. If you eat too few, too much, or the wrong ratios, you will run into problems.
Our current diet is almost certainly way too high in omega-6 fats; the easy fix is just to stop eating vegetable oils.
This kind of conspiratorial thinking blows my mind. The claim is: big ag, with all their grain production, wants Americans to eat lots of grains, and corrupts government agencies to recommend such diets. The real healthy diets include lots of “protein” (meat), but “they don’t want you to know”...
What’s incredibly absurd about this is: where do you think the vast majority of the farmed grain goes? Feeding the cows, chickens, and pigs providing your “high protein” diets. If these “big ag” businesses did have any sway or disinformation campaigns, they’d absolutely be pushing the “eat more meat” narrative.
There’s no conspiracy. There aren’t any u-turns in nutritional science. The USDA guides are almost completely identical to WHO nutritional guides, and the guides for virtually every other modern country. Lots of whole grains, fruits, vegetables. Limit sugars, salt, and fats. As Michael Pollan says: Eat food. Not too much. Mostly plants. That’s pretty much it. We complicate things so much with fear mongering and conspiracy thinking.
It's not a conspiracy per se. I don't think Big Ag and the government got into a room together and said, "we're going to kill everyone over time with a Western diet leading to obesity, type 2 diabetes, and eventually death". It's more simple than that: greed of industry and regulatory failure on the part of government. Mexico has one of the highest rates of Coca Cola consumption, it's even fed to babies instead of formula. You know why it can't be stopped? Multinational power and greed, with trade weaponized against countries who attempt to counter these multinationals [1]. In country, instead of trade, it's campaign contributions to representatives that keep more substantial regulation at bay.
But you simply cannot argue that Western diets aren't causing epidemic levels of obesity and civilization disease [2], and that food producers and government aren't contributing to it.
Sidenote: Was "they don’t want you to know” a Kevin Trudeau reference? If so, I get that reference!
No no. I think we agree that there are capitalist-driven incentives that may be at odds with providing the best nutritional advice.
Where we differ (it seems?) is the implication that a diet rich in animal products (meat, cheese, eggs, etc) isn’t part of the Big Ag industry, but pasta, bread, cereal, etc. are. Livestock consume far more grain than the human population. So again, if big ag had any say (which, of course they do), they’d profit most by encouraging the consumption of meat, cheese, and eggs, not encouraging people to eat bread, pasta, and oatmeal. The fact that the USDA recommends eating whole grains at all is implicit proof that it’s not entirely corrupted by big ag.
I would agree with this, and concede that my original comment was not as accurate as it could be representing historical events that have led us to this point.
Couldn't you also argue that stakeholders who profit off low carb / sugar diets would also have a vested interest to push biased media about the benefits of low carb / fat diets?
Who are the stakeholders in "low carb"? Influencers? Sure, there are always going to be folks selling shovels, but the information on how to adhere to a low carb diet is freely available, and fat/protein macro foods readily available and fungible (I agree you'll have a slightly more difficult time to adhere to low carb if you're vegetarian or vegan, but it can be done, my partner and I tried it for fun to see if we could). You can spend an inordinate amount for your keto lifestyle, but you can also spend modestly and still arrive at the same results (whether that be weight loss, maintenance of a healthy weight, or management of a condition that is exacerbated by high blood sugar levels).
Eat properly ("abs are made in the kitchen", you can't work off excessive carbs consumption). Get enough sleep. Find time to exercise (high impact short duration cardio, weight lifting are best IMHO). These basics will contribute to a long, healthy life.
I hope this is helpful to someone, anyone! I was obese from my early teens (pizza and Mountain Dew, sigh), and only in my 30s after much research and experimentation am now in the best shape of my life (healthy BMI, low mile time, targeting a powerlifting competition this year). Everything I learned was from free online resources (r/fitness, r/keto, r/intermittentfasting wikis and discussions), and most of our food purchased at Aldi and Costco.
Sidenote: Keep in mind pricing is a signal. All of this information is free, and yet people still spend enormous amounts of money in aggregate on similar self-help materials with lesser results. Food for thought.
Arguably the meat industry, since most low carb people eat more meat. Yes, vegetarian is possible, but I don't know any vegetarian low carbers, while I know a lot of vegetarians and a lot of low carbers eating bacon for breakfast, lunch and dinner.
The meat industry probably has a similarly big lobby as the sugar industry.
I've dropped 8Kg in the last half year by going mostly vegetarian and lowering my dairy intake. I eat more carbs than before. I don't think keto is the whole truth.
As always, the "truth" is a moving target and is going to be highly variable depending on circumstance. You should do what works best for you. If that's practicing vegetarianism, awesome. If that's being mostly a carnivore and eating chicken and bacon every meal, go for it. Somewhere in the middle works too (mostly vegetarian, occasional meat, majority of protein sourced from eggs and whey protein). But refined sugars are not your friend. Put that soda down!
Industry lobbying is deplorable, but inevitable. Consumer education (see my comment above) is paramount (with a helping hand of government regulation) in mitigating its impact on consumer behaviors.
>while I know a lot of vegetarians and a lot of low carbers eating bacon for breakfast, lunch and dinner.
is that because everyone has fallen for an extreme of a fad diet?
It's like everyone comes up with the right observation, and the wrong conclusion. "Low carbs are good, so ill eat fat protein. Meat is fat and protein" instead of "seeds and mushrooms." Or "meat is bad" so "ill eat lots of cereals" instead of "leaves and shoots."
Seeds, shoots, and leaves with some bottom feeding ocean animals is a perfectly doable diet.
The USDA food pyramid favored grains because that is what the US farming could produce in greatest quantity at the time it was developed, thanks to machine-assisted farming tasks. Grains had enormous combine harvesters that could be operated by one person and harvest the whole field within a day. Produce like tomatoes were limited by the number of Mexicans and Central Americans that could be admitted by the guest worker program and could carry filled harvest bags to the collection point, for a few weeks at the right time of year.
Now machine harvesting and factory-style farming has expanded to some fruits and vegetables, using things like hydroponic lettuce tracks, horizontal trunk-shakers, vertical limb-shakers, and flexible-fingered robot arms. Or even when hand-harvested, the human pickers can follow behind a processing rig that trims, washes, sorts, and packs right there while rolling over the field, and transports the product out via portable conveyor belt.
Cauliflower, muskmelons, lettuces, culinary herbs, cabbages, and tree nuts have all benefited from harvest mechanization. Farms can even, at minimum, use a fleet of golf-cart-like vehicles, so that human harvesters can gather the crop from a seated position, rather than, standing, stooped, or crouched, and allow the vehicle carry the weight of the produce, thus making each human harvester more productive, even when the harvest still requires hands, eyes, and blades.
The machines, of course, represent a hefty barrier to entry from the capital investment, and favor mega-agribusinesses. Farms that can't hire enough cheap transient laborers or buy the specialized machinery are priced out of the industry.
But it does bring cheaper lower-carbohydrate foods to the consumer in greater quantity.
I’ve been on a keto diet almost exclusively for over 2 years now.
Results have been very impressive for me.
Not just in weight management, but also for fitness/performance.
Anecdotally, cognitive performance/output feels like I’ve moved the needle in the right direction.
Not sure if related, but multiple tests on telomere measurement(associated with cellular ageing) show “genetic age” well below my chronological age.
Despite all of this, I really don’t know.
The low carb and no sugar diet really seems to work for me.
If I had to guess, I’d say there is no single overwhelming factor to increasing longevity.
I think brain health is a mix of:
Healthy nutrition
Hydration
Fitness/activity level
Sufficient sleep
Low stress(but not no stress)
Purpose
People in your life
Traumatic brain injury prevention
Life long education
Reading as a hobby
No smoking
But in terms of mental agility(if not brain aging), I have a feeling that some low level of hunger is a positive indicator of short term mental agility.
I reckon there’s a high performance zone for brain health/performance for both short-term and long-term.
I look forward to more quantifiable research in this space.
I think the prevailing theory will eventually be that a diet rich in monosaccharides is detrimental to health. It's been demonstrated that low carb, high meat diets are not the optimal diet, in that most adults will eat red meat or some type of processed meat and little fiber. Both add to the numerator when looking at myocardial infarction, stroke, and colorectal cancer. When one is in kidney failure it is recommended by the American Society of Nephrologists to attenuate protein derived from animal products.
Essentially, balance is what the current recommendations say, but also to stay completely away from sugar.
All my sources shamelessly stolen from Uptodate:
> U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/
>Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga. Lancet.
>Changes in diet and lifestyle and long-term weight gain in women and men. Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. N Engl J Med.
>Meta-analysis of the association between whole grain intake and coronary heart disease risk. Tang G, Wang D, Long J, Yang F, Si L. Am J Cardiol. 2015;115(5):625. Epub 2014 Dec 18.
I miss my up to date access. Tangential -- I do not think people realize a resource like UpToDate exists. Well written up to date summaries of various medical topics based on the latest research. Were something like this to be publicly accessible it would do wonders. If anyone is working on or wants to work on this type of problem please let me know, I'd love to help out (programmer, former MD).
Is it too much to ask that anyone promoting low-carb based on personal experience post bloodwork? I think it's pretty clear no one on here is well-versed in nutrition as we're all programmers, so maybe it'd be good to have some intellectual integrity.
I'm interested in prolactin, thyroid, liver, cholesterol, CO2.
I've gone through several thousand papers the past year or two so I feel like I'm more well-versed in nutrition than most nutritionists/dieticians at this point, certainly in my understanding the recent clinical/research literature. I rarely post any nutritional/health related statements without citations to peer-reviewed work (see: https://news.ycombinator.com/threads?id=lhl )
A very strange set of lab markers you're interested in btw - prolactin has very little clinical value for men (and is almost never tested), but I tested my testosterone at the one year mark (it's fine, 772ng/dL, I have not sequential tests). I had a thyroid panel last year as well and TSH, FT3, and FT4 were all in range. My CO2 has stayed the same regardless of diet - I don't know why that would be relevant at all.
For people looking to track their metabolic health, the bloodwork I think is most useful to track over time: CMP, CBC w/ diff, basic lipid panel (fasted 12h), A1c, fasting insulin, Vitamin D, hsCRP. I also was getting a full iron panel, and it was interesting to see my ferritin remained elevated last year (but is within range now - likely a marker of resolving MetS).
The thing that almost no one gets measured that is almost criminal IMO is fasting insulin - while it's highly mobile, it's also dirt cheap ($8 more than FBG+A1c direct-to-consumer price), allows calculating the best IR indices, and is a 10-15y leading indicator for chronic metabolic disease.
At home, waist circumference to height ratio (WHtR, WSR) is the best simple marker for tracking metabolic health.
Ashwell, Margaret, and Sigrid Gibson. “Waist-to-Height Ratio as an Indicator of ‘Early Health Risk’: Simpler and More Predictive than Using a ‘Matrix’ Based on BMI and Waist Circumference.” BMJ Open 6, no. 3 (March 14, 2016). https://doi.org/10.1136/bmjopen-2015-010159.
This is really cool and I think you're doing more due diligence than any HN user I've ever seen. The confounding variable is that you lost a lot of weight, of course, and I think many people who lose weight will be healthier at least in the short term. A question I've had in my head for a while is whether someone who has to stay on a ketogenic diet to be a healthy weight has "healed" or has just masked the underlying issue.
Would be interested to see your thyroid numbers as you continue on your ketogenic/fasting diet. "In range" does not necessarily mean optimal, and in general I'd be worried about T3 uptake going from 33 to 23 even though both are in range. The liver converts T4 to T3 in response to glucose availability -- this happens in many tissues, but they all depend on a liver enzyme, and most of the conversion occurs in the liver.
Low CO2 is a sign of kidney stress and acidosis. I also believe it's a marker of a low metabolic rate, much like thyroid.
Prolactin is a longer discussion I don't want to get into here (much like you on your LDL-C :)) but I'll definitely be following your posts as I think you're doing your part and have done more research than I have so maybe I'll comment on your blog sometime. Put very briefly I believe high prolactin in men can be a sign of chronic stress and calcium deficiency. It's been linked to gynecomastia, for example, which makes a lot of sense. In general I like to look for tests that show whether something's wrong, rather than what's specifically wrong. Someone might have alright D but still have issues properly metabolizing calcium.
I'd argue that weight loss isn't a confounding variable, as resolving dyslipidemia and MetS is actually one of the main points of the intervention. As for "masking the underlying issue" - let's face it, if you go back to regularly eating a terrible diet, yes, you'll become unhealthy again, but the same would go be true for any chronic insult.
Personally, I'm a believer in metabolic flexibility and I do take time off (vacations, parties and special events, or just when I feel like it) to indulge. The difference now is that I am more acutely paying attention to how the food is making me feel (turns out for example when I have excess bread/sugar, I end up getting a pimple or two that I had originally never connected to being driven by dietary excesses), having a framework to think about how the food will affect my health (what do I think my liver glycogen levels are at?), and much pickier in general about how much I'll eat (my "worth it" taste bar is much higher - if it doesn't taste good I can now just stop). I also feel like I now have effective tools to pull various metabolic levers, whereas before I didn't.
Regarding thyroid numbers, IMO taking about what is "optimal" is actually much trickier than "in range" (which are just standard deviations) because they need to be taken in the context of how you actually feel and if you present any symptoms (for hypothyroidism that would be fatigue, increased sensitivity to cold, weight gain, muscle weakness, etc) - which may be another reason people don't post numbers. Surrogate markers are most useful 1) sequentially per individual and 2) need to be considered with whether those numbers actually correlate with symptoms/reflect pathophysiology. Some are pretty obvious, but thyroid numbers seem to be one of those that requires a lot of careful nuance, but seems not worth the trouble (tracking TSH, T3, T4, rT3, rT4, TPO, Tg) unless you're presenting.
For kidney issues, eGFR is something you'd look at, you'd want to take a look if any of your CMP numbers are out of wack, but I personally wouldn't be worried about acidosis - it's almost never a problem for non T1Ds (would be a sign of a major insulin:glucagon issue at least) but you'd definitely know (and need to know) if it were an issue well outside of regular bloodwork.
If metabolic rate is a concern, I think RMR and DXA are a much better combo for tracking, btw.
As for prolactin, if that's something you want to track and can use as a long term marker that is actionable for you, great, more power to you. It looks like it's only $60 out of pocket, so not terrible, but just recognize that if you throw it out there as something that a number that people should know or care about, or that you want to compare with, it simply won't be.
For chronic stress, I'd suggest 24h cortisol, and maybe some inflammatory markers (I use hsCRP as my one catch all canary, but other common ones include ESR, IL6, TNFa), but for most people, you'd probably get more value day to day from mood and sleep tracking (especially ones that can track HRV or CNS values like the EMFIT).
Calcium is measured via the CMP and deficiencies would I suppose show up in a DXA as well (eg if your bone density Z-score was quite low), but again, I think that's a thing where you'd only be worried about it if you were presenting symptoms (extreme fatigue, hair and nail issues, sleep issues, etc).
I do think that if you are trying to track down nonspecific issues (eg "fatigue") you're going to have to do a bunch of detective work, which may involve more and more esoteric labs, but I'd also posit that most of those could probably also be addressed by relatively simple lifestyle interventions, starting with an appropriate/nutrient-dense diet and the most basic mood/energy tracking (eg:1-5 phone app like MySymptoms or Daylio correlated with interventions), and an engineering mindset.
I think a lot of people are aware of prolactin because a lot of overweight men have manboobs and don't want them. But up to you, at least you're testing liver and cholesterol -- not everyone can say that. I listed it first because if someone would only agree to test one thing and nothing else, I think it should be prolactin.
Well the suggestion wasn't for me personally, it was for people doing keto. My contention is that if any of those numbers are off, they're probably wrong or missing something about keto.
Interesting pts on the thyroid stuff, I'll have to think about it
OK, so I haven't done much research on this particular issue, but lets say you have an issue with gynecomastia - this presents itself as a fairly obvious physical symptom. Does prolactin measurement change either your diagnosis or the intervention - eg, does it tell you anything you don't know beforehand or change how you would correct the issue?
Personally, if we're talking about single markers, I think fasting insulin is the one I would pick because it does fulfill those criteria - it gives you a 10y+ lens before other markers do on diabetic pathophysiology (which now affects 80%+ of American adults) and also give you guidance on how to treat/how effective your interventions are. The negative is that there is no home test (yet, this is being worked on by some people), so it's not as good as something that can be measured more often/continously.
Everyone who gets an annual physical/bloodwork should be getting their liver numbers (at least AST/ALT, although in the US GGT is not standard) with their CMP, although most people (clinicians too) don't really understand what they mean. I like this presentation on liver markers btw: A/Prof. Ken Sikaris - "Fatty Liver & Chemical Pathology." https://www.youtube.com/watch?v=2c_QYbCxC6g.
It's also important to get these sequentially to see what the actually progression is (the time frames are usually not captured since people tend to get these tests once a year at most).
A basic lipid panel is cheap and is somewhat useful for diagnosing gross dyslipidemia but it's worth noting that it's also much more mobile than most clinicians believe:
Grant, Azure D., and Gary I. Wolf. “Free-Living Humans Cross Cardiovascular Disease Risk Categories Due to Daily Rhythms in Cholesterol and Triglycerides.” Journal of Circadian Rhythms 17, no. 1 (April 24, 2019): 3. https://doi.org/10.5334/jcr.178.
For what it’s worth I’ve had blood tests recently after 3 weeks zero carb (pure carnivore)
Everything in the norm, high cholesterol but low triglycerides, glucose (HbA1c) bang on in the middle of the normal scale. Blood pressure going down, heart rate quite high that resolved itself after a few days (due to fat adaptation)
Eating probably 10g of salt per day, lower now that my body went past the adaptation phase. (My BP medication has a diuretic in it, so I need more than other people I guess)
No more stuffy nose, not feeling hungry at all, eating below or at my TDEE.
Surprisingly Vit D3 in the norm, and I don’t get any sun at all.
No palpitations I had when doing keto, no bloating, perfect bowel movements every 2 or 3 days.
I wanted to get bloodwork done to get some hard data, but I'm not sure which data points are the most important ones. Cholesterol and liver I understand, why prolactin, thyroid and CO2?
Not sure if I believe all the hype about these wild benefits low carb/keto diets have but I will say I've felt so much better on it...I rarely feel tired anymore and have been weirdly healthy the last 2 years. My doctor was surprised with my blood tests and weight loss when she heard what I eat lol. I'd never go back to the amount of carbs I was eating.
Same for me. I caught my first cold a few weeks ago but I was at a funeral (the stress of the death I'm sure reduced my immune system) hugging a bunch of people I hadn't seen in years so it's no surprise that I did. The thing is, several times over the past two years since starting Keto I felt a cold coming on but the next day it was gone. It's the weirdest thing. So weird that I have trouble attributing it all to Keto but I don't know what else other than Brazilian Jiu-Jitsu (which I started at the same time as Keto) to attribute it to. I do know that exercise does help improve immunity but I ran a lot before starting Keto and BJJ and still caught colds.
My doctor was also surprised at my results. At first he was skeptical about what I was eating until he looked at my numbers. The shock on his face visible. Then he said, "These look so good that I guess you should keep doing what you're doing."
You need to add some butter, oil and heavy cream, or chances are you are not in ketosis: 80% of you calories intake should come from fat to guarantee ketosis.
Reading that FAQ, the idea behind low fat intake is that body will provide fat, which means you need to have some high calories restrictions to initiate process.
E.g. you need 2k calories for your day-to day life.
If you don't want to eat lots of fat, to get into ketosis you need to decrease your food intake to say 1k, with idea is that 0.05k calories will come from carbs in food, say 0.2k calories will come from protein in food, 0.75k calories will come from fat in food, and another 1k will come from body fat.
1. Dietary cholesterol is only weakly correlated to blood cholesterol.
2. Most people eat wayy too much. Calories are calories, consume less calories and run your body in calorie deficit if you wanna lose weight and surplus if you wanna gain weight.
3. LDL aka bad cholesterol might not be that bad. There are some new studies which claim that people who had low LDL suffered more from heart issues. What gives?
4. People who eat more sometimes do so to comfort themselves (they've deeper psychological issues), they'll benefit from eating less.
5. Polysaturated fats are good fats, monosaturated fats are bad fats.
6. Carbs are not bad, consuming too much carb is bad for you. Want to lose weight? Reduce your calorie intake (preferably dinner). Reduce feeding window, do not eat after 7pm, eat only after 10am.
7. Lift weight and perform cardio.
That's your current nutritional knowledge.
Want to increase muscles? Much better to start from skinny state and consume protein, workout and slowly build lean mass through progressive overload. Eat more protein will not build muscle faster, body will only use what it needs, not what's given
Most guys/gals on fitness YouTube channels and magnize have achieved that physique through use of drugs. So do not compare yourself to them and be disappointed.
I read some time ago about the Keto diet showing good results even in Alzheimer/dementia cases. Keto is not the same as low carb but it's close enough.
Our molecular biology and internal chemical reactions are still areas of research in early phases.
Just on a different topic, but in the same direction - last 10 years research discovered that immunity boosting has much better results in certain types of cancer than all the other non-surgery treatments (chemical or radiation).
"Diet supplementation with ketone bodies (acetoacetate and β‐hydroxybuturate) or medium‐length fatty acids generating ketone bodies has consistently been found to cause modest improvement of mental function in Alzheimer's patients. It was suggested that the therapeutic effect might be more pronounced if treatment was begun at a pre‐clinical stage of the disease instead of well after its manifestation."
I am a bit conflicted. According to the comments, one should do very low carb diet to adapt to Ketones as energy. For example, fasting would not be enough for this purpose.
But that implies the need for a ketogenic diet.
Very low carb diets are difficult to do, at least if you are not very rich: Most of them require a lot of meat.
Now, that differs by country. These diets are probably easiest to do in the USA with its huge industrial meat industry.
In other countries, like here in Europe, you'd probably need to be a millionaire to buy that much meat in the first place. I don't know anyone doing this successfully.
But in any case: is it ethical? I doubt that this would be sustainable for everyone. If everyone would eat mostly red meat, we'd probably roast our planet pretty quickly. I don't think free range farming would support 7 billion carnivores, nor would the fish in the sea.
I realize the people doing Low Carb are not necessarily the same who care about sustainability. But if there is such a benefit to Ketogenic diets - for all our sakes - we should think about what happens if everyone wants to do it.
Of course there are options. There are low carb Vegans (e.g. https://www.reddit.com/r/veganketo/), but boy is it a chore to do. Also, I doubt this can be done with anything resembling local and unprocessed products.
Furthermore, a lot of vegan protein products are high in soy. Which is fine really for any amount you'd normally consume. But if you are serious about low carb, you might eat so much that we get into that "questionable" range in terms of recent research.
Perhaps carbs need not be too low. Yeah we can eat a lot of veggies, probably. But it'll be a challenge, I think.
Or not?
Say, you eat meat once a week. How do you do a ketogenic diet without losing your mind in planning etc?
There are two things being conflated, eating cheap keto and eating vegan keto.
Cheap keto its eating tons of eggs, berries, cauliflower, zuchinni and soy beans. Eggs are really the main thing though...tons and tons of eggs. Luckily there are hundreds of different ways to make them.
I don't really understand the briefing here; so would taking exogenous ketones also help mirror the beneficial effects of ketosis seen in this study? They did mention feeding their participants exogenous ketones but didn't say anything about those peoples' carb/fat ratios.
I'm all for jumping on the high fat/low carb diet; however, I love getting all my polyphenols and other beneficial compounds that are part and parcel with eating plants (higher carb). As many benefits we see from being in ketosis, we also have tons of data on the health benefits of eating plants, so I've been confused as to how to get the best of both worlds here.
I have been on Keto for about 8 months, felt terrible and interrupted the diet, only to later find that a lot of the theory behind it (the CIM model) is complete bullshit.
And whenever seeing claims of the effects of low carb or keto diets, most claims are confounded by the diet being hypocaloric, or with a significant variance in protein when compared with control, with its proponents constantly shifting the goal posts.
This study seems interesting and it has been known that ketosis can help epileptics. But take it with a grain of salt ;-)
What exactly did you eat, and in what quantities?
List all that you ate, if possible.
Unfortunately keto has such a broad definition that a lot of harmful stuff (like seed oils) can be considered part of the diet.
“The bad news is that we see the first signs of brain aging much earlier than was previously thought. However, the good news is that we may be able to prevent or reverse these effects with diet, mitigating the impact of encroaching hypometabolism by exchanging glucose for ketones as fuel for neurons.”
The alternation with ketosis as source of energy is key as it seems...
The brain’s response to diet was tested in two ways. The first was holistic, comparing brain network stability after participants had spent one week on a standard (unrestricted) vs. low carb (for example: meat or fish with salad, but no sugar, grains, rice, starchy vegetables) diet. In a standard diet, the primary fuel metabolized is glucose, whereas in a low-carb diet, the primary fuel metabolized is ketones. However, there might have been other differences between diets driving the observed effects. Therefore, to isolate glucose vs. ketones as the crucial difference between the diets, an independent set of participants was scanned before and after drinking a small dose of glucose on one day, and ketones on the other, where the two fuels were individually weight-dosed and calorically matched. The results replicated, showing that the differences between the diets could be attributed to the type of fuel they provide to the brain.
The reason I refuse to read about keto is that pretty much all doctors and public health organizations I’ve seen recommend basically the same things: whole grains, fruits, vegetables, replace saturated fats with unsaturated if possible, low fat dairy, nuts, legumes, fish, some poultry sometimes, strictly controlled alcohol.
Until these guys start recommending something such as keto my basic assumption is that it’s either a weird fringe diet or a diet only applicable to very specific medical issues (eg seizures) that me (not a medical professional) should not try on myself.
If I go to a doctor and they ask how my diet is and I tell them I eat the stuff I listed above, I’m fairly certain they will tell me good job. If I do some extreme fringe thing, I doubt it will be their response with the same likelihood (though a few probably like it).
Noted that the underlying cause for the improvement comes from ketones. This should indicate that intermittent fasting would also show similar results. Low carb diet, keto diet, intermittent fasting, they're all just different ways to switch the fuel source from glucose to ketones.
Would a time restricted feeding type of intermittent fasting, with a 16/8 schedule, really result in the production of ketones? I thought that it would take about a day and a half or longer to exhaust carbs and start the switch to ketones. Then it’s only the longer fasts (like 5/2 days) that could help.
I'm no expert, but from my vast knowledge gained through the internet[1], it seems that ketosis starts at around the 12 hour mark. But I think it would depend on how glucose saturated you already are.
I.. don't think that's true at all. Ketones in your urine is indicative of ketosis. Smell of alcohol on breath is indicative of ketosis. Urine color is not an indicator for ketosis, it's an indicator for hydration.
You are correct. Urine color is an indicator of hydration. But sugar in your urine will cause your urine to be cloudy and more opaque. I've noticed that when I'm in ketosis that my urine is super transparent (just looking at transparency/opaqueness, not at color).
I think it would depend on how close you are to ketosis before you start calorie restriction. And how severely you restrict. And probably a dozen other variables.
There's a lot of exciting research going on in this area but I believe that what you're hinting at is true. All of the things we know we should do, actually work. For whatever reason. Don't eat too much, go without sometimes, when you do eat, don't eat garbage, exercise on occasion, etc.
This also lends support to "bonk training", which is an exercise fad designed to exhaust glycogen stores and then continue working out, just as a distance runner that hits the wall continues beyond to finish the marathon, or a cyclist that bonks keeps pedaling to finish the leg.
I think the point is to get your body to make the glycogen to ketone switch more smoothly, and after the bonk every calorie you burn comes directly from fat stores. For most people, exercising in ketone-mode is absolute misery, you physically can't perform at more than about 80% of what you could do with glycogen, and you can't pass your lactate threshold. So bonk trainers do that. On purpose.
I came to comment the same thing. First an aside that I agree with Peter Attia that IF is a confusing term, and instead Time Restricted Feeding (TRF) should be used. The current thought seems to be that many of the benefits from TRF (ie, skipping breakfast) come from causing the body to start generating ketones.
I'd be cautious if you're doing TRF by skipping breakfast.
>Interestingly, TRF improved weight loss and cardiometabolic endpoints—such as insulin levels, insulin sensitivity, and blood pressure—when participants ate early or in the middle of the day [18,19,41,42,43,44,45], but worsened cardiometabolic health or had null effects when participants ate late in the day [46,47,48].
My largest meal of the day has naturally become lunch. My dinner is typically a few hours before bed. So, maybe I'm not bumping into what the study above found. I sleep fine.
Since I started TRF ~2 years ago I have dropped BF, and am the leanest I have ever been. I've always been very active and tend to exercise every day, but have never been this 'cut'. I also tended to eat ok naturally. I'm not a sweets person, and when I cleaned up my diet a few years back the main thing I dropped was potato chips (I love that crunchy, salty goodness). But even after cleaning up my diet I still wasn't getting the BF % I was interested so thought I'd give TFR a try. It's been awesome. I have more energy, and am in the best shape of my life.
The issue that people, at least Americans, run into is that consuming a “normal amount of carbs” is shockingly hard if you’re not consciously trying to avoid them. Foods that don’t really need sugar in them often have it in huge amounts because it delivers more flavor oomph (and separately delivers a dopamine hit). This is especially true in the aftermath of the war on fat because, shocker, fat tastes really good and when you remove it, food tastes worse. How do you make up for that? Add sugar.
Do you believe that a plain bagel is less healthy than a slice of pie as a result? The pie will definitely have more added sugars. A plain bagel would make for a reasonable breakfast. Pie?
>Eating normal ammounts of carbs isn't going to kill you, it's literally our main energy source.
Its only the main energy source because its the main dietary intake. If you change your dietary intake consistent with dietary ketosis then carbs/glucose will not be the main energy source, ketones will become the main energy source.
Consider two things: 1) when in a fasted state, the body will begin to produce ketones and begins to run off of ketones instead of glucose (which our body can continue to make without eating carbs) suggesting ketones are the default energy source until we introduce dietary carbs that spike insulin; and 2) as the study notes ketones are the more efficient fuel source for the brain only because our modern diets carb laden and insulin spiking our brains are contantly using glucose instead of ketones.
What is the current, best thinking on managing LDL, especially while doing paleo?
I got huge benefits from paleo and partial calorie restriction. The biggest being my very bad psoriasis all but disappeared.
But it also spiked my LDL.
The statins didn't agree with me. I settled on eating every kind of soluble fiber I can find. eg: My morning porridge is steel cut oats, quinoa, chia seeds. I also resumed eating high(est) fiber rice.
Alas, all these seeds and grains have carbs.
I'd like to find strategies for high soluble fiber while reducing carbs. Even better, would be managing LDL directly.
PS- I spotted u/eatmyshorts comments about LDL and misc.
IF has really saved my life. I definitely feel like i reverse aged a few years as a result of it. I enjoy food more now, weight is in check, I look younger.. hard to beat the benefits.
As it turns out, insulin resistance, like that associated with type-2 diabetes, is also related to inflammation (apparently due to cytokines: https://www.webmd.com/diabetes/inflammation-and-diabetes), which in turn is correlated with heart disease.
As I understand it (disclaimer: I'm not a doctor), the inflammation results in damage to the blood vessels, which your body repairs by using cholesterol, among other things, that are in your blood. When LDL cholesterol (the "bad" kind of cholesterol) is used in this way, it calcifies over time, leading to hardening of the arteries. As someone with a high CAC score and premature calcification of my arteries, my doctors have advised me to move to a low-carb diet and combine that with statin drugs to lower my LDL cholesterol. Low carbs generally means lots of meat and lots of saturated fat, which is the opposite advice that doctors traditionally have given for patients at risk of heart disease.
Lately there have been lots of studies that show that dietary LDL cholesterol is only very loosely correlated with LDL cholesterol in your blood--primarily because the cholesterol in your blood is produced in your pancreas, not ingested/absorbed from your stomach. So I did a self experiment--go on a ketosis diet for 3 months before I started taking my statins and test to see if my LDL cholesterol changed. It didn't--it went slightly down in my case. Then I went on statins--now my LDL cholesterol is at "normal" levels.
So, basically as I understand it, low carb diets can help prevent your body damaging your arteries in the first place, such that they don't need repair. Then, the statins lower my LDL cholesterol such that when my arteries do need repair, the cholesterol that is used doesn't calcify over time. Basically I'm attempting to address my heart disease from both sides: prevent the damage in the first place, and remove calcifying LDL cholesterol from my bloodstream when arterial repair is necessary.
Note that this is all pretty cutting edge stuff, and we don't have good studies to demonstrate its effectiveness yet. If you have issues with calcification of your arteries, it is best to work with your doctor to find a program that works for you.
Dietary cholesterol is very directly correlated with blood cholesterol levels. You can feed someone cholesterol and directly watch their levels spike. But your body will clear it if you give it time which is why your fasting cholesterol may not show this if you have naturally low levels.
But during that window if time that cholesterol is active in your blood it's not doing you any favors. This is why heart attacks very often follow shortly after a meal.
Note that dietary cholesterol only correlates to blood cholesterol in about 40% of the population. And even within that group, "Even though dietary cholesterol modestly increases LDL in these individuals, it does not seem to increase their risk of heart disease" (https://www.healthline.com/nutrition/dietary-cholesterol-doe... -- emphasis is mine)
You're talking about baseline or fasting cholesterol. You can do the experiment of feeding someone a high cholesterol meal, then immediately take a blood sample and see the spike in their blood. This has been confirmed many times.
> Dietary cholesterol is very directly correlated with blood cholesterol levels. You can feed someone cholesterol and directly watch their levels spike.
This is not true. In fact, I doubt dietary cholesterol has any affects on blood cholesterol.
Source: eating >= 6 full eggs daily for years; have 8 pack; blood work always on point.
And also I've done the same exact thing you mention and it didn't affect my blood levels at all.
Mostly plant based (occasional pizza or gelato maybe once a month), I do alternate day fasting, something like 40:8, fast 40 hours eat for 8.. try to avoid night eating, it makes me feel worse the next day.. maybe a bit much for some but I feel so much stronger as a result. Low caffeine.. probably too much fake meat/soy products for my own good..
Since I’ve started fasting it’s hard for me to sleep past 4-5am, which is nice because at least in my culture, it’s supposed to be a good time to get up and meditate and think.. it’s not so intense but I don’t do intense physical activity, maybe 30 minutes of ashtanga yoga a day..
A lot of folks here are using the term "intermittent fasting". This is a term that can make people struggling with eating disorders kinda lose their minds.
May suggest to replace this term with what's probably a better way of saying it anyway, because it's more accurate to what people are really doing when they say IF: Call it "time-restricted eating". You're eating the food you eat for a day in a smaller window. Not really fasting.
A popular split on Intermittent Fasting is alternate day eating.
So on one day you eat nothing, and the other days you eat a normal amount of food. So it is Fasting. Also the 4-3 split is popular.
But I agree with you people who just skip breakfast and have lunch and dinner should probably just call it an "eating window".
A diet that has worked for 50 years is just, stop snacking after dinner and go to bed. But it's much cooler to say "I'm Intermittent Fasting" than "I just don't bring a bag of Oreos to bed anymore".
There is some correlation between the benefits of "time-restricted eating" and full-blown fasting (autophagy, etc), so it makes some sense to talk about them similarly. There are many benefits to full water fasts, even for 2-3 days (and it's much easier to do successfully if one is already in ketosis). See the work of Dr. Jason Fung: https://thefastingmethod.com/
While we're at it: "Intermittent fasting" versus ... fasting until you die? All fasting is intermittent. IF just doesn't communicate anything regardless. I think it's clear it's just a bad term. Time restricted eating actually describes something specific.
Haha, point. To the extent that the term still applies, "periodic fasting" would be more accurate; but then, that could just as easily refer to yearly fasting during Ramadan. Does one describe the action, or the absence of action? The norm, or the exception? I dunno, language is a funny thing. :)
I’m confused because I thought the brain liked sugars:
“The bold implication of this idea is that the effects of ego depletion could be undone by ingesting glucose, and Baumeister and his colleagues have confirmed this hypothesis in several experiments.”
Kahneman, D. “Thinking, Fast and Slow”. 2011. pg. 43, para. 2, Se. 5.
Ego depletion was one of the key losers of the replication crisis in psych. Book was published right before the peak of the crisis.
Basically it's impossible because the body can't even digest the glucose in time for the purported effect. Baumeister is also a hack who refuses to let go of the idea while others have moved on.
This is the first time I've seen something reference ingesting or drinking ketones. While I imagine it doesn't have the dietary benefit for losing fat, if this is a thing, and it's safe, I'm surprised it's not made it's way into energy drinks.
These are ketone ester drinks, but nothing really mainstream or in energy drinks. Esters are far too expensive and the taste far too bad for that. Most people have never even heard of these, in my experience.
I have a fair amount of experience with ketone esters and did some research. They taste terrible, but not as bad as I expected and definitely wasn't a deal breaker for me. I got more used to it over time. They're great for fueling from fat instead of glycogen, especially during exercise, (was very helpful for not having to down a ton of gels during a marathon) and not very helpful for weight loss (as you suggest).
How about weight training and low carb and sometimes IF? Would weight training prevent age related effects within the brain? Also you can't go full keto if you also want weight training, imo.
Yep working fine here on ‘full’ keto (not sure what other kind there is) Depends what you want from your weight training. I enjoy it but I’m not trying to get massive gains.
I’ve recently restarted weight training after a few years off due to injury.
I already do plenty of other exercise (martial arts, swimming, yoga, a decent amount of fast paced walking, circuit training) and I used to weight train so my form’s okay and I haven’t experienced anything unusual in terms of soreness.
I’ve been from light weights (~70% of my previous max) slowly up to my previous max from a few years back and not experienced any problems. I feel like I’m close to the limit on each exercise but I’m already at my previous max weights.
And... since I used to do this, I’ve gone keto. So being on keto doesn’t seem to have any observable negative effect on my weight training.
I can’t say what I’m going to hit because I’m moving slowly and carefully. For some real stats you’ll need to find studies. I could just be lucky.
Many of us suffer from autism or anxiety or some other mental issue and hope to cure it with some strange diet. That's why despite being some of the most intelligent people on the internet people here will latch on to some singular model of human metabolism that's being promoted by the Russians or the Chinese right now (kidding, but only partly) and use it to justify a new "experiment".
Imposter syndrome fits in there. I didn't feel like I was good at my job or any of the things people think I'm good at, so I wanted to be this jack of all trades mad scientist character who uses himself as a guinea pig. Inevitably the low confidence leads to latching onto pseudoscientific theories -- it's a vicious cycle.
Others feel out of control of their lives and try to feel some sense of control through disordered eating (looking at you, "fasting"). I don't think I was really in this camp but I know people who are.
Intermittent fasting works. Talk to people that can show you results. Enough with the "theory".
I've heard many theories from obese people and it's always bullshit. Everyone can find far fetched theories for anything on this planet. That's why results talk. You know how they say "money talks"? Same here: results talk.
I, on the other hand, can tell you what works 100%, based on results (like 8% bodyfat, in very good shape):
Eat clean food, exercise daily, eat in 6-8 hours per day. Don't eat too many calories in total.
Do this for some time and I guarantee you will see effects. It only takes will and it's not rocket science.
Most bodybuilders that I see are people that are just, you know, dumb. And they can do it. So I promise you it's not complicated or anything. So I don't know what's stopping people from doing it.
Intermittent fasting is basically skipping breakfast for most people. Wake up late or sleep in a little extra, maybe make some coffee, go to work or school. Something most teenagers and college students do or have been doing for years. My self included as I much prefer extra sleep. I've some how been doing fasting since grade school and didn't even know it was controversial, disordered, or even called fasting until recently. My dad, who has done multiples of marathons and even Iron Man triathlons never ate breakfast and usually not lunch either. He seems fine and no one ever mentioned he had disordered eating.
Eating real food, having a preference towards certain real foods you like (some people just like more meat or eggs instead of fruit or potatoes or rice) and not being overly gluttonous is some how disordered eating. I don't buy that.
I'm in the camp of you should do what works for you or what makes you happy (life-lengthening/hacking/whatever be damned), but any extensive reading I've done in trying to treat myself well has just brought me back to the same old information: balance and calories in < calories out.
Well here I am again. Here are things I think people should know:
Gluconeogenisis does not kick you out of ketosis nor is it’s existence a counter-point to the keto diet.
I have first hand experience with keto and psychosis. I experienced something traumatic a while ago and began to have psychotic symptoms similar to schizophrenia. I had read an article beforehand written by a doctor claiming that keto benefited his psych patients, so I tried it. It cured me. Most symptoms gone in a couple days, total remission within a couple weeks. So PSA: if you or someone you know is having problems with psychotic mental health problems, keto may help you.
And I should add I was formally diagnosed with psychosis and prescribed antipsychotics. And the symptoms correlated perfectly with going on and off keto. Very little ambiguity. They are doing a study on this in Finland but results won’t be out till December.
"Low carb" as the title currently reads does not necessarily result in ketosis and your body/brain running on ketones, which appears to be the scope of this study. There is more to dietary ketosis than low carb, just as an example carnivore or paleo diets are low carb, but those will generally not result in ketosis, in protein rich diets your body will convert the protein to glucose which will continue to be the primary fuel for the cells in the brain/body.
If you have never entered ketosis and experienced your brain running on ketones, I would suggest you experiment for yourself. I would say a minimum 2-3 months which should be enough time for your microbiome to change and your body/brain to adapt primarily running on ketones.