Ketogenic Diet - Powerful Dietary Strategy for Certain Conditions

[Gaby]

Re: Ketogenic Diet - Path To Transformation?

I think those of you who are having all these problems just haven't actually settled into a ketogenic diet - if you had, these cravings and needs for 'diversions' would be gone by now. This is not - in any way - a "tightrope" diet - not even close. It's simple, effective and very satisfying - at least that's been my experience.

That could be my case as I generally do well with almost the exact same meals: sausage or bacon and one egg for breakfast, pork chop plus butter or bone broth at lunch and bone broth at dinner.The problem comes when I skip full nights of sleep, that is when I loose my balance. I'll keep it in mind and relax into whatever extra I need on those days and then focus on restorative sleep and adrenal support.

One thing I eliminated was black tea. My teeth became so white I didn't want to return to it. But I could do with one cup a day for awhile. I'll keep experimenting.

 

[Miss.K]

Re: Ketogenic Diet - Path To Transformation?

Thank you much everyone for all the mayonnaise info (and Carlise for the suggestion of recommending material)

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

I would caution against using grapeseed oil. It's very very high in inflammatory omega-6 fats and is generally a fairly processed oil. I've made mayonnaise with olive oil, avocado oil and lard+bacon fat in the past. The lard one turned out a bit weird in texture, so I think a combination with another oil would be a better way to go, although I haven't tried it myself.

I agree. At one time some of us -- including me -- were using grapeseed oil for cooking because of its high smoke point, but that was before we were fully aware of the dangers of vegetable oils. Grapeseed oil contains quite a bit of monounsaturated and saturated fat, which may help stabilize it, but it is loaded with the omega-6 linoleic acid and contains very little omega-3.

Nasty stuff, high smoke point or not. If smoke point were what was important, we would all be cooking with safflower and soybean oil, I guess. :)

 

[Beau]

Re: Ketogenic Diet - Path To Transformation?

You think so? I think this way of eating is rather "unnatural" and tends to go against what a paleolithic human would fall into based on following hunger signals. To me, this whole diet is like walking a tightrope - too much protein, which is really easy to fall into, and you lose balance. Too much carb and you lose balance. God forbid you have a celebratory feast once in awhile. I find it takes me about a week to get back on track after any diversion from course and that usually means struggling against cravings.

Sounds to me like you take way too many 'diversions' - my experience has not been at all like yours.

Mine either. Obviously if you want to stay ketogenic, you avoid carbs. If you do indulge in 'diversions', that's going to affect your body due to having to burn the carbs which, when you are usually putting fat into it, can cause problems. For me personally I can't even get to the point of overeating protein because I'm full pretty quickly, in fact I don't even get hunger pangs anymore, I just eat on a schedule because the body needs nutrients and fat. Maybe our paleo ancestors didn't eat this exact way, but so what? For me this diet has improved so much of my health, and I don't feel the need to eat very much at all when I do eat. Yes there are carbs in liver pate and eggs, but if you don't overdo those daily it won't ever get above 5 grams/day, which I don't think causes one to 'lose balance' nor have I noticed any problems with doing it like falling out of ketosis. I don't even bother with celebratory feasts (one think I like is baked chicken wings every once in a while) besides the normal foods because that's what I like and I know what the effects of adding unwanted carbs are. But I certainly don't worry about how our ancestors probably ate fruits or veggies so maybe we should. We don't need to copy them if there's a better alternative, which I think the ketogenic diet is based on my experience.

Certainly just following your appetite will not result in this style of eating, OSIT.

I couldn't disagree more - as evidenced by how I've lived and eaten for the past almost two years and how I feel now as a result.

Me too. I've been doing this for 5 months now and I feel better than ever physically. You have to be strict for a while to settle in to burning ketones so my guess is all the issues you are encountering are due to "falling off the wagon" too much. If I were you, I would strictly avoid all carbs for a long period to allow that to happen and make sure to get plenty of fat from bone broth.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

...The way I understand the matter is, that Betaine HCl is the acidic form of Betaine - or TMG. So I think that once the body absorbs the Betaine HCl, at least part of the betaine will be in its non-acidic form.

However, chemistry has never been my forte, so maybe I'm wrong?

I only know what I can dig up, that isn't too far beyond the level of college chemistry that I actually understood. Most of the biochemistry that we are looking at here is in that range, though.

In biochemistry, nothing "just happens." That is why life is a success and not a total flop. The odds of something as complex as life not only surviving but thriving in the face of entropy would seem to be extremely remote, unless it was extremely well designed and its environment was designed to support it. Biochemical processes must be exquisitely regulated.

A rule of thumb seems to be that even if two molecules are "very similar," you have to study them as two different substances, although I think I can imagine exceptions and I do know that these two molecules can coexist in solution. I was going to say that I couldn't easily find any good information about betaine HCl because of all the supplement marketing "noise" that comes up with a Google search, but when I tried searching DeepDyve it gave me a 17 page list of papers, some of which are available (from that service, cheaply) with full text. But that is more technical reading than I am up for today, so I still don't know anything about it. :)

Both glycine betaine and betaine HCl can "assist" with (i.e. regulate) methylation, and I wonder if that has something to do with the effect observed in the paper you cited. I wasn't able to access the full paper either. The abstract mentioned this property of betaine ("...having a biological role as ... a methyl donor ...") but didn't tie that to the conclusions. Without more information, I couldn't conclude anything.

I haven't noticed any great benefit from betaine HCl beyond the initial stages of the ketogenic diet where it did noticeably help with protein digestion. I am still taking it as a precaution (along with chewing well!), to do whatever I can to avoid undigested protein going all the way through my GI tract and causing trouble, but I haven't observed any side benefits.

By the way, I switched away from my original brand after re-reading the label and realizing that it contained nasty ingredients (soy, dairy, or something like that). I also looked for a digestive enzyme supplement like the one I had taken earlier, but couldn't find any on the store shelf that didn't contain milk or soy, so I gave up on that for the time being. Read those supplement labels!

 

[Laura]

Re: Ketogenic Diet - Path To Transformation?

Me too. I've been doing this for 5 months now and I feel better than ever physically. You have to be strict for a while to settle in to burning ketones so my guess is all the issues you are encountering are due to "falling off the wagon" too much. If I were you, I would strictly avoid all carbs for a long period to allow that to happen and make sure to get plenty of fat from bone broth.

I agree. You have to be really IN KETOSIS for a number of months with NO CHEATING to get to that point where, if falling off the wagon happens, you get right back on and back in ketosis in a day. Something has really changed with the way my body does things and it's all good.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

I'd like some advice on recommending material for people who are interested in knowing more about the way I eat...

You actually have a couple of choices there. You can recommend material that we use here that applies to the way you eat, or you can make other suggestions that might not be appropriate for you, now, but that might be more accommodating to people that are not on quite the same path and may not be open to the all potential issues associated with a strict, experimental diet. It depends on the individual, what you know about them and what you can learn by asking.

I agree that Primal Body, Primal Mind can be a good starting point for people looking for a lot of information that is not too technical. It doesn't, however, offer a great deal in the way of meal plans and detailed guidance about how to apply the information, things that are important to many people. That part is relegated to the appendices, and as Laura lamented earlier in the LWB topic, it is rather heavy on veggies. Nora offers a paleo cookbook recommendation, but it doesn't exactly jump out at you on the website so I am not sure how much of a recommendation it really is.

Personally, I have been recommending Diane Sanfilippo's Practical Paleo for people that just want to improve their diet and health. It offers good general background material and a variety of meal plans for people with different health issues, including a track for people that are pretty healthy to begin with. I have mostly heard good things about it (perhaps helping to explain its New York Times bestseller status), although one bit of feedback I have received is that some of the recipes can be a little hard for a beginning cook to follow. It has not been particularly helpful for me because I already had the background information and it doesn't fit all that well with the strict experimental diet that I am following. :) But then I was looking for a book to recommend for others, not another one for me to read.

 

[Chrissy]

Re: Ketogenic Diet - Path To Transformation?

I would caution against using grapeseed oil. It's very very high in inflammatory omega-6 fats and is generally a fairly processed oil. I've made mayonnaise with olive oil, avocado oil and lard+bacon fat in the past. The lard one turned out a bit weird in texture, so I think a combination with another oil would be a better way to go, although I haven't tried it myself.

I agree. At one time some of us -- including me -- were using grapeseed oil for cooking because of its high smoke point, but that was before we were fully aware of the dangers of vegetable oils. Grapeseed oil contains quite a bit of monounsaturated and saturated fat, which may help stabilize it, but it is loaded with the omega-6 linoleic acid and contains very little omega-3.

Nasty stuff, high smoke point or not. If smoke point were what was important, we would all be cooking with safflower and soybean oil, I guess. :)

Thank you for this information on the grapeseed oil. One more item to take off the list which is a good thing.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

...
[quote author=Megan]

I don't think, at this point, we're in the realm of what paleolithic humans did, at least not how people usually think of paleolithic humans. Figuring out protein restriction to suppress mTor pathway and switch out malfunctioning mitochondria for healthy ones is not what our paleolithic ancestors would have stumbled on accidentally. We're in a whole different ballpark here.

Nora suggested that in part; hence the peculiar subtitle of the first edition of her book: "Empower Your Total Health the Way Evolution Intended (…and Didn't)". The thing about paleolithic humans is that many of them tended to be very healthy, without counting anything, and they moved and used their bodies in ways that maintained their mitochondria effectively. The mTOR idea is controversial -- I don't see a consensus forming as yet. Some people think it's just wrong. Personally, I think it is a good idea to avoid unnecessary protein consumption simply because protein is expensive. The importance of autophagy is understood and accepted by most sources I have read recently, and ketogenic paleolithic humans would have encouraged that too, without even knowing about it.

You think so? I think this way of eating is rather "unnatural" and tends to go against what a paleolithic human would fall into based on following hunger signals. To me, this whole diet is like walking a tightrope - too much protein, which is really easy to fall into, and you lose balance. Too much carb and you lose balance. God forbid you have a celebratory feast once in awhile. I find it takes me about a week to get back on track after any diversion from course and that usually means struggling against cravings.

Overall, I find it hard to believe that ketogenic paleolithic humans would have encouraged autophagy without understanding why they were doing it unless they were in tune with their bodies in ways we can't begin to understand. But I suppose that's possible. Certainly just following your appetite will not result in this style of eating, OSIT.
[/quote]

The other replies you have received cover most of what I would have said and more but yes, paleolithic diet supported autophagy because ketogenic diet supports it and paleolithic diet appears to have been typically ketogenic, as are some modern hunter/gatherer diets. That is pretty much the premise on which this KD topic is built. The term ketogenic by itself does not mean zero carb or plant-free, although we are experimenting here with the extreme low end of KD, in the interest of elevating ketones more than usual. It means low enough in starch and sugar to stimulate ketogenesis (nominally at a level of 0.5 mmol BOHB or higher). 50 g/d of carbs or less will typically do it very well, and some people can go quite a bit higher.

With regard to appetite, it is important to distinguish between that and drug addiction. "Appetite" for wheat or (isolated/refined) sugar is really drug addiction (and perhaps dairy too). It certainly isn't because either of these nutrient-poor "foods" is "delicious." Metabolic irregularities can exacerbate cravings and addictive tendencies. If you can address the underlying causes, it is quite possible that your appetite will settle down and behave. Some find this easy; some find it hard, for reasons that can be entirely unclear. But if it is hard, it sure doesn't hurt to look for "messages" in that, irrespective of where the roots may lie.

[quote author=Megan]

[quote author=Megan]
You say that the protein is increasing blood sugar, but have you measured your blood sugar to confirm this?

No, I don't have the means. As I said, I'm only going by what I felt as far as symptoms go. No objective measurements, so I could be wrong. That said, what I was feeling was not a "signal" of the stomach emptying or anything like that. It was low blood sugar symptoms or something that mimicked those - ravenous hunger, crankiness, irritability, sometimes hot or cold flashes, sometimes headaches or lightheadedness. That was a big hint to me that I wasn't in ketosis, because skipping a meal was not the least bit comfortable.

Yes, low blood glucose, not high. Too much protein will stimulate insulin, taking you out of ketosis and lowering blood glucose. Maybe you are especially prone to that. You can buy a glucometer fairly cheaply at a drug store.[/quote]

Hmmm... I hadn't thought of that. So you're suggesting that the excessive protein caused an insulin spike which led to low blood sugar rather than what I had assumed - that protein was being converted to sugar, causing a rise in blood sugar and in turn causing a crash, or at least keeping me in sugar-burner mode. I suppose that could be the case. Perhaps I should get myself a glucometer and do some experimenting.
[/quote]

Some researchers wince a bit at the term "insulin spike," but it's OK. Insulin is a regulatory hormone that goes up or down as needed. It responds to high glucose or protein by going up, and that is a normal kind of response. A typical glucose response curve is a spread-out upside-down "U," weighted a bit to the left (there's your "spike"), and it results from insulin rising and signaling the body to store this stuff somewhere before it does serious damage. (The curve is graphed from the observed blood glucose level over time, not dietary intake of glucose or protein.)

In diabetes, the glucose doesn't come back down adequately, due to lack of insulin response or loss of capacity to produce insulin, and then the serious damage goes ahead and happens.

What you are describing sounds like the "crash" associated with hypoglycemia (my old nemesis). That represents a very different glucose response curve in which the glucose level turns around and drops low after some number of hours. The lower the drop the worse the symptoms -- the "crash." Mine was diagnosed using a 4-hour glucose tolerance test; my mother had a 6-hour test. Hopefully, using a home glucometer you can observe whether this happens without having to endure all those blood draws. I would take a lancet over a syringe any day! (I am not saying that there might not also be advantages to having it done by a lab, and analyzed by a doctor.)

I was very fortunate in being able to resolve my hypoglycemia issues before I started the KD, simply by eliminating grains (which resulted in dropping to the LWB ~72 g/d carb level -- near the ketogenic threshold). At the time I did not yet have the indications for a diagnosis of metabolic syndrome, but I appeared to be heading in that direction with a fasting glucose level of around 104 or so and increasing over time. It ranges 90-100 now, with a preference for the lower end of that range, which is good enough for me.

Perhaps you have more work to do with blood sugar before you can benefit from the KD. I can't remember but have you been checked for metabolic syndrome?

None the less, I think whatever was happening was suppressing ketosis, because once I did start lowering protein consumption I went through ketosis transition symptoms allover again. But I guess I won't know for sure without blood glucose measurements.

OK, first some terms. Ketogenesis is the process of creating ketones from fat. Ketosis is a state of elevated ketones. Keto-adaptation is a term coined by Phinney or Volek (I forget which) that describes the body's adaptation over time to a diet in which less glucose is consumed than will meet the body's demand, resulting in ketogenesis ([ADDED] in addition to neoglucogenesis), resulting (hopefully) in "nutritional" ketosis.

Excess glucose or insulin can knock you right out of ketogenesis. Blood ketone levels can vary quite a bit through the day and I suspect (but don't know for sure) that they will drop rapidly if ketogenesis stops and doesn't restart quickly (due to the brain's heavy energy demand), resulting in loss of ketosis. That in turn would reduce your brain's supply of ketones, assuming that it is indeed keto-adapted, and you could feel that quite a bit -- in the ways that you usually would feel when your brain's energy supply is reduced! (Although it doesn't take a huge amount -- 0.5 mmol of circulating BOHB is a high enough level to supply significant ketone fuel to the brain.) I don't know how quickly the brain can switch back to straight glucose consumption, but I think it is fast (to keep you from dying), so you might not feel it for long. I would like to see some research about this.

You would still be keto-adapted, however, for the time being (meaning among other things that your muscles are preferentially using fat over ketones), and my own dietary excursions have at least confirmed that for me if not anyone else.

The "transition symptoms" that you mentioned are an aspect of keto-adaptation, a slow process that has been observed to require a couple of weeks even in athletes. I haven't seen anything to suggest that anything would remove keto-adaptation quickly, any more than you can achieve it quickly. More likely, you are not fully keto-adapted to begin with, due to metabolic or dietary issues, or possibly even some other cause that hasn't yet been considered.

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

I'd like to share my experience with the ketogenic diet here, following up on the last half-dozen posts or so.

I have been in ketosis for approximately the last 4 months (and I have been measuring my BOHB levels for the last two months). As others have mentioned, I feel great, actually haven't felt that good in many years. I seem to have virtually no negative bodily symptoms of any sorts. While many around me have had flu-like symptoms, I have been largely spared - with just a bit of sniffling for two days at some point (I live in a camp-like environment at the moment, so when someone has the flu, everybody gets it too).

Measuring ketone levels has been a revelation of sorts. While at the beginning it took me days to get into ketosis after I got out of it, I also was much more resistant to high-protein loads. Now it seems to me to be the exact opposite - I am very protein sensitive, but if I fall out of ketosis due to overindulgence of protein (which is very easy to do, as most of us have experienced) I also bounce back much more quickly. It really has been interesting for me to realize, how little protein it actually takes to knock me out of ketosis - so I found that I needed to keep a very close tab on protein levels.

The other thing I found quite staggering is the small amount of food I now need. When I compare my plate to that of my fellow camp mates, it's really a joke. They have plates filled to overflow, while I have a small piece of meat and a dollop of butter on my plate. And that is all I ear for breakfast and for dinner, with added fat offcuts and bone broth for lunch and dinner. Calorie-wise I must have halved my energy intake, but my weight has stabilized, which to me means, that my metabolism has become much more efficient.

I also found that the resistance training confers a certain protection against falling out of ketosis - if I diligently do my 2 sessions of ERT and one session of HIIT per week I am less prone to fall out of ketosis. This small amount of training together with the ketogenic diet has also led to a significant rise in muscle mass and a concurrent loss of body fat (much appreciated - as now I have a "normal" BMI, for what it's worth), but the best part is the way my body feels currently. No back ache (which has been a constant in my life from very early on), blood pressure perfect (too high for the last 20 years) etc.

The only fly in the ointment is the fact that my last standard lipid profile was sky-high (as reported earlier in this thread). I haven't had the opportunity to retest and will only be able to do that in 2 months. I have read a lot of literature about this, but haven't really been able to get a good grip on what's going on in this respect. There is a probability that I may have familiar hypercholesterolaemia (FH) due to the fact that my father (and his father) died of heart related problems at a relatively young age (also in the case of my father stress might well have been a bigger factor). I was unable to find any medical literature on ketogenic diet and FH and there is a problem with diagnosis. There are genetic tests available, but if the test is negative, it doesn't rule out FH because only a handful of the most prevalent genetic loci are tested for, while many more exist. The other question in this respect also is, whether or not to treat FH with a statin. There is a low-dose protocol of rovustatin 5 - 10 mg once a week that seems to be well tolerated, but obviously I am not keen to go down that route at all - for me this would be the last ditch effort to control my lipid levels, if all else fails. Another thing to ponder is the significance of lipid levels in a ketogenic state is really an unknown, because all the studies have been done in the context of a standard high-carb Western diet.

Anyway, I am sold on this way of life and plan to continue doing it - despite the challenges it brings up for me in relation to my relationship and to the difficulties of travelling and in the social context. But I am slowly learning to get a handle on that.

 

[dugdeep]

Re: Ketogenic Diet - Path To Transformation?

I feel like I've misrepresented myself here and wanted to correct that.

You think so? I think this way of eating is rather "unnatural" and tends to go against what a paleolithic human would fall into based on following hunger signals. To me, this whole diet is like walking a tightrope - too much protein, which is really easy to fall into, and you lose balance. Too much carb and you lose balance. God forbid you have a celebratory feast once in awhile. I find it takes me about a week to get back on track after any diversion from course and that usually means struggling against cravings.

Sounds to me like you take way too many 'diversions' - my experience has not been at all like yours. I have steady and high levels of energy (higher than any other time in my life), I don't have cravings, I eat when I'm hungry, which tends to be breakfast (sausage and bacon) and lunch (half a pork chop or an equivalent of that and, sometimes, some bone broth) and then usually bone broth for dinner. That's it - other than some butter/stevia chocolate after meals. I don't "lose balance" - if I miss a meal, no biggie because I don't have blood sugar fluctuations, I just keep burning fat. A celebratory feast for me is just a variation on the same food I usually eat because it makes me feel good

I maybe stated things to strongly in that post. 95% of the time, I'm exactly like you are - stable hunger levels, no cravings, missed meals are a non-issue. But that 5% of the time can be problematic since getting back on track is an issue. You're absolutely right about diversions. For me they almost always involve outside obligations and the vast majority are family related. I'm working on this.

But my original point was not that this diet is hard, simply that it seems to me it would be difficult to stumble upon by accident for our paleolithic ancestors. Yes, once you're in a stable zero-carb-high-fat state it's easy to stay there as long as you follow the rules. But that presupposes that you know those rules. It's all just speculation on my part, but I have trouble with the idea that our ancestors could have come across this way of eating by chance (there is, of course, the possibility that they started off this way and simply never diverged).

All of this is a rather moot point anyway. It reminds me of the nitpicking I see a lot of in the paleo blogs - arguments over what our paleolithic ancestors did or didn't eat. I see paleo as a framework, not an exact replica of what was eaten in the past. What was actually eaten is irrelevant. I think it's pretty clear to all here that the way we're eating now is how humans are "meant" to eat (I realize that's a rather loaded statement so take it with a grain of salt). This was the point I was originally trying to get at, but obviously failed to do so.

I think those of you who are having all these problems just haven't actually settled into a ketogenic diet - if you had, these cravings and needs for 'diversions' would be gone by now. This is not - in any way - a "tightrope" diet - not even close. It's simple, effective and very satisfying - at least that's been my experience.

I agree, and all of my "diversions" have rarely been due to craving something. They've usually been when I've been in a situation away from my normal pattern and when I'm feeling some kind of pressure or social anxiety. I'm working on it.

Certainly just following your appetite will not result in this style of eating, OSIT.

I couldn't disagree more - as evidenced by how I've lived and eaten for the past almost two years and how I feel now as a result.

But again, this presupposes that you were in this state from the beginning and have remained there by following this protocol. My point was that this isn't something you would just happen into naturally by following your appetite from a non-ketogenic state. I agree that, once there, it's not difficult to stay on track, but this requires a certain amount of knowledge from the get-go. Getting into this state is a challenge, at least in my experience, so I have trouble seeing someone mounting that challenge without knowing why they were doing so or whether there would be any sort of payoff.

Hope that clears up my messy thoughts on the subject :)

 

[dugdeep]

Re: Ketogenic Diet - Path To Transformation?

OK, we seem to be having a mis-communication issue, Megan, and although I originally thought it was on your part, after a struggle with self-importance and a thorough analysis of what was being said by both parties, I think it's actually me (see below).

...
Overall, I find it hard to believe that ketogenic paleolithic humans would have encouraged autophagy without understanding why they were doing it unless they were in tune with their bodies in ways we can't begin to understand. But I suppose that's possible. Certainly just following your appetite will not result in this style of eating, OSIT.

The other replies you have received cover most of what I would have said and more but yes, paleolithic diet supported autophagy because ketogenic diet supports it and paleolithic diet appears to have been typically ketogenic, as are some modern hunter/gatherer diets. That is pretty much the premise on which this KD topic is built. The term ketogenic by itself does not mean zero carb or plant-free, although we are experimenting here with the extreme low end of KD, in the interest of elevating ketones more than usual. It means low enough in starch and sugar to stimulate ketogenesis (nominally at a level of 0.5 mmol BOHB or higher). 50 g/d of carbs or less will typically do it very well, and some people can go quite a bit higher.

I see your point, but I still think getting into a autophagic state requires effort that would be difficult to take on were one not fully aware of what they were trying to accomplish and why. But for all my stating of this as being my original point, I'm not very attached to it - maybe our paleo ancestors began as ketogenic and would view falling out of that state as being such a detriment that they would repeat it. At this point, I don't think it matters.

With regard to appetite, it is important to distinguish between that and drug addiction. "Appetite" for wheat or (isolated/refined) sugar is really drug addiction (and perhaps dairy too). It certainly isn't because either of these nutrient-poor "foods" is "delicious." Metabolic irregularities can exacerbate cravings and addictive tendencies. If you can address the underlying causes, it is quite possible that your appetite will settle down and behave. Some find this easy; some find it hard, for reasons that can be entirely unclear. But if it is hard, it sure doesn't hurt to look for "messages" in that, irrespective of where the roots may lie.

You seem to have slipped into present tense here. I'm not experiencing appetite issues right now. This is when I was overeating protein. To me, the underlying issue was that I was overeating protein. The only thing up for debate, as far as I can see, is whether this was because excess protein was being converted to glucose, protein was causing excessive insulin release leading to hypoglycemia ("reactive hypoglycemia", which is what I failed to communicate previously. See below) or something else entirely. As I said before, dropping protein to current levels resolved the issue.

[quote author=Megan]

[quote author=Megan]
You say that the protein is increasing blood sugar, but have you measured your blood sugar to confirm this?

No, I don't have the means. As I said, I'm only going by what I felt as far as symptoms go. No objective measurements, so I could be wrong. That said, what I was feeling was not a "signal" of the stomach emptying or anything like that. It was low blood sugar symptoms or something that mimicked those - ravenous hunger, crankiness, irritability, sometimes hot or cold flashes, sometimes headaches or lightheadedness. That was a big hint to me that I wasn't in ketosis, because skipping a meal was not the least bit comfortable.

Yes, low blood glucose, not high. Too much protein will stimulate insulin, taking you out of ketosis and lowering blood glucose. Maybe you are especially prone to that. You can buy a glucometer fairly cheaply at a drug store.

Hmmm... I hadn't thought of that. So you're suggesting that the excessive protein caused an insulin spike which led to low blood sugar rather than what I had assumed - that protein was being converted to sugar, causing a rise in blood sugar and in turn causing a crash, or at least keeping me in sugar-burner mode. I suppose that could be the case. Perhaps I should get myself a glucometer and do some experimenting.
[/quote]

Some researchers wince a bit at the term "insulin spike," but it's OK. Insulin is a regulatory hormone that goes up or down as needed. It responds to high glucose or protein by going up, and that is a normal kind of response. A typical glucose response curve is a spread-out upside-down "U," weighted a bit to the left (there's your "spike"), and it results from insulin rising and signaling the body to store this stuff somewhere before it does serious damage. (The curve is graphed from the observed blood glucose level over time, not dietary intake of glucose or protein.)
[/quote]

OK, now I see the source of the communication issue. For some reason I took for granted people would know I was talking about 'reactive hypoglycemia' as a consequence of high blood glucose levels as a result of overeating protein. No idea why I would have made that assumption. My thought was that 1) over eating protein leads to protein conversion to glucose, 2) resulting high blood glucose levels, 3) excessive insulin release, 4) resulting hypoglycemia (low blood sugar levels) at which point I would feel the symptoms of low blood sugar. I seem to be having communication issues lately, so I apologize for making you go into a long explanation of insulin.

What you are describing sounds like the "crash" associated with hypoglycemia (my old nemesis). That represents a very different glucose response curve in which the glucose level turns around and drops low after some number of hours. The lower the drop the worse the symptoms -- the "crash." Mine was diagnosed using a 4-hour glucose tolerance test; my mother had a 6-hour test. Hopefully, using a home glucometer you can observe whether this happens without having to endure all those blood draws. I would take a lancet over a syringe any day! (I am not saying that there might not also be advantages to having it done by a lab, and analyzed by a doctor.)

At this point, since the issue is resolved, going for a glucometer and testing blood sugar would be more of a point of curiosity than necessity. I could try feasting on protein one day and measure the resulting blood sugar levels, although I'm not really feeling that. We'll see.

I was very fortunate in being able to resolve my hypoglycemia issues before I started the KD, simply by eliminating grains (which resulted in dropping to the LWB ~72 g/d carb level -- near the ketogenic threshold). At the time I did not yet have the indications for a diagnosis of metabolic syndrome, but I appeared to be heading in that direction with a fasting glucose level of around 104 or so and increasing over time. It ranges 90-100 now, with a preference for the lower end of that range, which is good enough for me.

Perhaps you have more work to do with blood sugar before you can benefit from the KD. I can't remember but have you been checked for metabolic syndrome?

Metabolic syndrome was definitely not my issue. Aside from reactive hypoglycemia, which resolved after dropping protein, I had no symptoms. I'd been following a healthy diet for 5 years or so at that point; with a constantly evolving definition of "healthy" of course, but nothing that would have lead to metabolic syndrome.

And again, you've drifted into the present tense. I'm not currently experiencing any of these issues.

None the less, I think whatever was happening was suppressing ketosis, because once I did start lowering protein consumption I went through ketosis transition symptoms allover again. But I guess I won't know for sure without blood glucose measurements.

OK, first some terms. Ketogenesis is the process of creating ketones from fat. Ketosis is a state of elevated ketones. Keto-adaptation is a term coined by Phinney or Volek (I forget which) that describes the body's adaptation over time to a diet in which less glucose is consumed than will meet the body's demand, resulting in ketogenesis ([ADDED] in addition to neoglucogenesis), resulting (hopefully) in "nutritional" ketosis.

Excess glucose or insulin can knock you right out of ketogenesis. Blood ketone levels can vary quite a bit through the day and I suspect (but don't know for sure) that they will drop rapidly if ketogenesis stops and doesn't restart quickly (due to the brain's heavy energy demand), resulting in loss of ketosis. That in turn would reduce your brain's supply of ketones, assuming that it is indeed keto-adapted, and you could feel that quite a bit -- in the ways that you usually would feel when your brain's energy supply is reduced! (Although it doesn't take a huge amount -- 0.5 mmol of circulating BOHB is a high enough level to supply significant ketone fuel to the brain.) I don't know how quickly the brain can switch back to straight glucose consumption, but I think it is fast (to keep you from dying), so you might not feel it for long. I would like to see some research about this.

So if I'm groking what you're saying here, you're suggesting the symptoms I was experiencing may have been from forcing my brain to switch fuels too quickly. Like raising insulin levels halted ketogenesis leading to low blood ketone levels but there wasn't enough glucose to meet demands. Interesting speculation, but I kind of think the symptoms would have been more severe if that's what was going on. Overall it was mostly just crankiness with maybe some slight light-headedness and a strong compulsion to eat now!

You would still be keto-adapted, however, for the time being (meaning among other things that your muscles are preferentially using fat over ketones), and my own dietary excursions have at least confirmed that for me if not anyone else.

The "transition symptoms" that you mentioned are an aspect of keto-adaptation, a slow process that has been observed to require a couple of weeks even in athletes. I haven't seen anything to suggest that anything would remove keto-adaptation quickly, any more than you can achieve it quickly. More likely, you are not fully keto-adapted to begin with, due to metabolic or dietary issues, or possibly even some other cause that hasn't yet been considered.

Yes, I think I wasn't keto-adapted. That was my point from the get-go. Since I experienced adaptation symptoms once I dropped protein to current levels, it leads me to believe I wasn't adapted in the first place, despite not having consumed any overt carbohydrates for a year (more or less). At this point I don't really know if this is the case, however. When I assumed excess protein is converted to sugar the answer seemed clear - too much protein leads to too much glucose which means not being in fat-burning mode. But, if excess protein is not converted to glucose, I'm not as sure of what was going on.

And I'm not sure it matters now. Since we know the issue is resolved by dropping protein levels, it maybe isn't necessary to delve too much more into the mystery. I kind of feel like this discussion has diverted the thread into intellectual nit-picking territory.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

...my original point was not that this diet is hard, simply that it seems to me it would be difficult to stumble upon by accident for our paleolithic ancestors. Yes, once you're in a stable zero-carb-high-fat state it's easy to stay there as long as you follow the rules. But that presupposes that you know those rules. It's all just speculation on my part, but I have trouble with the idea that our ancestors could have come across this way of eating by chance (there is, of course, the possibility that they started off this way and simply never diverged).

If you are eating a healthy diet, and don't have a food shortage, and aren't under the control of a pathological ruler forcing you to eat crap, you can often tell if a new food has a problem. And if a group of people try something new and it weakens or strengthens them, short term or long term, natural selection comes into play. We are talking about spans of time much greater than 10,000 years in which this was happening, and isolated groups of people that tried very different things (some to their demise, no doubt).

Phinney & Volek put it this way:

The last few decades have yielded a lot of scientific knowledge about low carbohydrate diets, but in the few thousand millennia preceding the development of modern science, our hunting and herding ancestors solved the practical problems needed to live and function well with a minimal carbohydrate intake. They didn’t need to know how it worked, just that it did. Successful dietary practices were integrated into their cultures and passed along across generations.

Phinney, Stephen; Volek, Jeff (2011-07-08). The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable (p. 21). Beyond Obesity LLC. Kindle Edition.

They do suggest that the early process of going from a plant-centered diet to a fat/meat-centered one involved a lot of trial and error, and death when the error was too great, but that they had 2,000,000 years to work it out.

I haven't heard of strong evidence of any group of humans, ancient or modern, that avoided all plant material even when they had a choice, any more than I have heard of any such group avoiding all meat when they had a choice. (As far as we know, there were no ancient vegetarian/vegan tribes.) Phinney & Volek seem to believe that paleolithic plant food consumption was "minimal." Others propose greater intakes. There is room for a range of intake from near 0 to 50 g/d in a ketogenic diet.

Most ancient humans likely took advantage of plant foods as they were available, selecting those species for which they were evolved to withstand the toxins present, as do other plant-eating animals. (That is a whole other side discussion.) People like variety. It all depends on where they lived and when, and what season it was. There is some evidence for this, but not of the quality that one might like.

Those that did survive with no plant foods for at least part of the year had to learn how to do that (P&V go into more detail in TAASOLCL ch. 2), and those that weren't equipped to do it didn't stay or didn't survive. And they didn't eat what we eat today, at least from what can be gleaned from hunter/gathers of the late paleolithic and beyond. Our meat today was their dog food, as P&V point out.

They also weren't doing this group's dietary experiment -- they weren't trying to maximize ketones to see what would happen. They wouldn't have known a ketone if it bit them.

All of this is a rather moot point anyway. It reminds me of the nitpicking I see a lot of in the paleo blogs - arguments over what our paleolithic ancestors did or didn't eat. I see paleo as a framework, not an exact replica of what was eaten in the past. What was actually eaten is irrelevant. I think it's pretty clear to all here that the way we're eating now is how humans are "meant" to eat (I realize that's a rather loaded statement so take it with a grain of salt). This was the point I was originally trying to get at, but obviously failed to do so.

When you start to interpret the data to a greater degree of precision than what is present in the data, you can end up with nonsense. The paleo community has its share of that. But sometimes you just have to guess right or die. (You are allowed to consult yourself in the future.) Natural selection is at work.

I would say that the neo-paleo movement is a rational response to the current health crisis. It's far from a perfect response, but you can learn a great deal from it if you keep a somewhat open mind and don't entirely shut out views that differ from the particular guesses that you have chosen.

 

[Laura]

Re: Ketogenic Diet - Path To Transformation?

As far as I can see from the archaeology and paleontology, it was hominids that were forced into meat eating situations (probably climate stress) that suddenly made that big leap to big brains and true homo sapiens status. Probably ice-age conditions, only thing available was meat, fire-making was learned, meat was cooked, conditions prevailed for thousands of years, etc. So no, fruit, leaf and termite eating critters didn't just "stumble" on it, it was probably "do this or die." And the changes that followed were astonishing.

Then, of course, there is the aquatic ape hypothesis where the environment was stressed AND flooded, and the main source of food was shell-fish, same deal: do this or die followed by amazing evolutionary changes.

What we do notice of real importance is the work on energy allocation that more or less demonstrates that both eating of protein AND cooking is what made us human as opposed to apes.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

As far as I can see from the archaeology and paleontology, it was hominids that were forced into meat eating situations (probably climate stress) that suddenly made that big leap to big brains and true homo sapiens status. Probably ice-age conditions, only thing available was meat, fire-making was learned, meat was cooked, conditions prevailed for thousands of years, etc. So no, fruit, leaf and termite eating critters didn't just "stumble" on it, it was probably "do this or die." And the changes that followed were astonishing.

That is similar to what Phinney & Volek describe in TAASOLCL. Any major transition is likely to be accompanied by a lot of death ("do or die"), as Richard Wrangham points out.

This presumably would have been an earlier ice age? P&V mention 2,000,000 years ago.

Then, of course, there is the aquatic ape hypothesis where the environment was stressed AND flooded, and the main source of food was shell-fish, same deal: do this or die followed by amazing evolutionary changes.

I tend to forget about this part because few mention it. I have been partial to it ever since I encountered it a very long time ago (a version lacking any detail), but I have never really been able to figure out where it goes. So you are saying that there would have been a phase where dry land was scarce? Perhaps when all that ice melted? Whoever survived all that would have been ready for anything, and they might just have had the older species for lunch. This would seem like so much speculation if it weren't for the evidence that can be seen from how we are put together and what kinds of foods work best.

What we do notice of real importance is the work on energy allocation that more or less demonstrates that both eating of protein AND cooking is what made us human as opposed to apes.

Yes, that is becoming more widely accepted, although the cooking aspect is taking more time. Part of the problem is the late date estimates for when cooking began. Wrangham suggests a possible much earlier date (something like 1.8 million years ago, or was it 1.2?), which would seem to fit better with the present configuration of our GI tract. That change is huge, and should have been rather slow to come about unless there was some serious genetic manipulation going on.