Ketogenic Diet - Powerful Dietary Strategy for Certain Conditions

[mcb]

Re: Ketogenic Diet - Path To Transformation?

...Yeah I'm aware of the mold thing. We've been trying many different coffees, some very expensive, and they all have the exact same effect on me, so I think it's more likely to be just coffee in general than the mold. Interestingly black tea, and even green tea, both mess with me as well, giving me a fluid-like pressure in my head, ears, and neck lots of mucous in my nose and throat. It's frustrating when I have to speak to clients and have a very nasal voice with no resonance. Doing some lymphatic massage seems to ease it slightly.
So it may be that I'm just particularly sensitive to caffeinated or acidic drinks, though white tea has always been a good'un for me :)

Today has been my first day off caffeine in a while, just fighting through mild withdrawl symptoms but I've been much more balanced and stable over all.

There are a number of ways coffee can cause trouble in individuals. If you have tested good-quality coffees and had problems with them, that's a good sign that it is something to avoid, period. I suspect from what I have seen here in the forum that people that experience a benefit from it without apparent negative side effects are in the minority.

It's hard to characterize a substance that is addictive for one person, insulin stimulating for another, and serves as a mild laxative for another.

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

I have gone back to one cup of coffee per week - a Sunday morning treat. It seems to be working fine so far, fingers crossed. I don't miss it too much, interestingly, even though I was a very heavy caffeine user. Also I make sure that the coffee is highest quality - otherwise I skip it.

My wife is a heavy coffee drinker, so I have decided to start roasting my own to get the highest quality beans. Green beans are easily stored under vacuum for 3 years, but roasted beans seem to go off within a few weeks. Where I live it is next to impossible to get freshly roasted coffee.

Then also green orgnic beans are about a third of the price of roasted coffee ... so this should pay for the roaster in less than a year given current consumption levels.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

I have reached the end of the Veech paper (reference 3), which is interesting and remarkably clear (relatively speaking) in its own right. It doesn't directly say anything about CNS utilization of ketones per se that I can find, but it does talk about a blood ketone (BOHB) level of around 4 mmol/L or more being needed to effectively treat refractory epilepsy (20+ seizures per day). Evidently some of studies have monitored urinary ketones instead (!) and the blood BOHB levels can only be estimated as being around 4.0.

The paper also confirms the fasting BOHB range as about 5-7. All this is interesting, but doesn't say a lot about the threshold level at which the brain benefits. So on to the 2nd paper (reference 6) by Fukao et al. See you in a bit...

The second paper was an interesting read as well, but it doesn't say anything about levels at which the CNS begins to utilize ketones. For that I can only refer to the work of Phinney & Volek and others, but they point to utilization beginning at around 0.5 mmol/L -- the common threshold used to identify "ketosis." There is another element for this work -- it takes typically 2 weeks or more of a ketogenic diet for keto-adaptation to be established, during which the brain, skeletal muscle, and anybody else with an interest in ketones determine on their portions of the available fuel sources. If things are working right, the brain wins the ketone lottery.

Going back to the Paoli et al paper, they seem to simply be making an inference, based on a significant assumption:

The main KB produced in the liver is acetoacetate but the primary circulating ketone is β-hydroxybutyrate although the latter is not, strictly speaking, a KB because the ketone moiety has been reduced to a hydroxyl group. Under normal conditions of adequate dietary carbohydrate, the production of free acetoacetic acid is negligible and it is rapidly metabolized by various tissues, especially the skeletal and heart muscles. In conditions of overproduction of acetoacetic acid, it accumulates above normal levels and part of it is converted to the other two KBs leading to ketonemia and ketonuria (presence of KBs in the blood and urine). The characteristic ‘sweet’ breath odour of ketosis is caused by acetone, which, being a very volatile compound, is eliminated mainly via respiration in the lungs. The pathway that results in the formation of 3-hydroxy-3-methylglutaryl–CoA from acetyl CoA also occurs in the cytosol of hepatic cells where it is used instead for the biosynthesis of cholesterol. Under normal conditions, the concentration of KBs is very low (<0.3 mmol/l) compared with glucose (~4 mmol), and as glucose and KBs have a similar kM for glucose transport to the brain the KBs begin to be utilized as an energy source by the CNS when they reach a concentration of about 4 mmol/l, which is close to the Km for the monocarboxylate transporter.

So first of all, they do not appear to be talking about a keto-adapted state when they bring up ketonemia and ketonuria. That's what happens at the beginning, when you are just starting to adapt. You might retain some elevated AA in your urine -- mine still reads high according to my doctor -- but hopefully not at those initial levels. They seem to be talking about a carbivore that has just made the switch.

Second, they then return to "normal conditions," which earlier in the paragraph meant "adequate dietary carbohydrate." They talk about (presumably) fasting serum BOHB and glucose levels of <0.3 and ~4.0 mmol/L (postprandial glucose would be more like 5.5 mmol/l in the absence of disease). <0.3 mmol/L fasting BOHB also probably implies not keto-adapted. They then infer that when the fasting BOHB level reaches the glucose level, KBs will become available to the CNS, based on the observation that the Km (Michaelis constant - yeah, I had to look it up) for monocarboxylate transporters (MCT transport presumably comparable to whatever would transport BOHB) and glucose transporters are similar, if I read that right. What caused this increase in KBs? We don't know. Maybe they are talking about fasting, which is how a carbivore under "normal conditions" would be able to make good use of ketones.

In any event, earlier they imply that "drastically reduced carbohydrate consumption (below 50 g/day)" is ketogenic, and it is not clear to me that that upper limit carb intake is going to yield 4 mmol/L during waking hours with any consistency from person to person. I would expect it to yield something in the range 0.5 to 3.0, per Phinney & Volek. So I'd be careful about basing anything much on that 4.0 value.

Therapeutic KDs that produce high ketone levels may actually carry a risk, not from the ketones, but from the high levels of dietary fat intake. If this results in burning excessive amounts of free fatty acids, it can be trouble. The Veech paper goes into some of the details. The bottom line of that is "pathological decreases in cardiac efficiency" (the paper focuses on rat's hearts). I have seen other warnings as well about possible metabolic consequences of eating a truly high-fat diet, when free fatty acids are metabolized. Apparently they aren't good for work energy -- they reduce coupling efficiency and produce heat. But it all quickly goes over my head.

 

[beetlemaniac]

Re: Ketogenic Diet - Path To Transformation?

The second paper was an interesting read as well, but it doesn't say anything about levels at which the CNS begins to utilize ketones. For that I can only refer to the work of Phinney & Volek and others, but they point to utilization beginning at around 0.5 mmol/L -- the common threshold used to identify "ketosis." There is another element for this work -- it takes typically 2 weeks or more of a ketogenic diet for keto-adaptation to be established, during which the brain, skeletal muscle, and anybody else with an interest in ketones determine on their portions of the available fuel sources. If things are working right, the brain wins the ketone lottery.

From what I understand, in a low carb diet, the brain tends to still use glucose at a significant percentage (maybe it depends on the individual's metabolism), until the situation requires it to shift to a more KB-oriented metabolism.

Second, they then return to "normal conditions," which earlier in the paragraph meant "adequate dietary carbohydrate." They talk about (presumably) fasting serum BOHB and glucose levels of <0.3 and ~4.0 mmol/L (postprandial glucose would be more like 5.5 mmol/l in the absence of disease). <0.3 mmol/L fasting BOHB also probably implies not keto-adapted. They then infer that when the fasting BOHB level reaches the glucose level, KBs will become available to the CNS, based on the observation that the Km (Michaelis constant - yeah, I had to look it up) for monocarboxylate transporters (MCT transport presumably comparable to whatever would transport BOHB) and glucose transporters are similar, if I read that right. What caused this increase in KBs? We don't know. Maybe they are talking about fasting, which is how a carbivore under "normal conditions" would be able to make good use of ketones.

Thanks for the clarification! I was wondering what Km was all about. That's an interesting assumption but very theoretical. I was thinking that the figure was in the context of a ketogenic diet specifically formulated to treat neurological disorders -- probably close to zero carb -- but that's just me.

In any event, earlier they imply that "drastically reduced carbohydrate consumption (below 50 g/day)" is ketogenic, and it is not clear to me that that upper limit carb intake is going to yield 4 mmol/L during waking hours with any consistency from person to person. I would expect it to yield something in the range 0.5 to 3.0, per Phinney & Volek. So I'd be careful about basing anything much on that 4.0 value.

That's the problem with definitions. I think 50g of carbs per day for me would likely put me out of ketosis pretty easily. But I've never measured for it, since I never go beyond maybe 20-30g. I guess we'll have to put the 4.0 in the realm of speculation for now. I've run out of test strips, too! Argh.

Therapeutic KDs that produce high ketone levels may actually carry a risk, not from the ketones, but from the high levels of dietary fat intake. If this results in burning excessive amounts of free fatty acids, it can be trouble. The Veech paper goes into some of the details. The bottom line of that is "pathological decreases in cardiac efficiency" (the paper focuses on rat's hearts). I have seen other warnings as well about possible metabolic consequences of eating a truly high-fat diet, when free fatty acids are metabolized. Apparently they aren't good for work energy -- they reduce coupling efficiency and produce heat. But it all quickly goes over my head.

I don't know. I find it odd because of what we know about the heart preferentially using fatty acids for energy, as per LWB.

 

[beetlemaniac]

Re: Ketogenic Diet - Path To Transformation?

Just to update on going back on the high-fat regimen. I don't think I can actually consume enough fat to reach the 1800 calorie mark. One very, very welcome benefit is really good stool regularity, although they seem to be floating, ie. I'm not fully absorbing the fat, thus I see no point in pushing the fat to the 180g figure I initially calculated. Hunger-wise it's been very manageable. I don't have any hunger pangs, just noticing how I love having something to do with my mouth, like smoking or drinking tea. I'm also losing appetite for muscle meat. So the 48g of protein seems about right or even slightly higher than what I would eat. As I anticipated I'd have to see to it that I do get enough protein. Maybe organ meats would be a more nutritious source of protein.

My mental clarity and performance has been fluctuating, but the range of fluctuation seems to have decreased. I also seem to be able to be more aware when troublesome emotions strike. Although this could all be attributed to something else, I am just not sure.

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

Having followed the last dozen or so posts I am starting to wonder if we are not missing a crucial bit of information in the whole ketosis business. Many of us have gone on a ketotic diet with considerable success, but some haven't and it seems to me that there are a lot of questions that haven't been solved. Of course there are other issues that blur the picture like the complex issues of healing the gut, detoxing etc., that need to be addressed, before one can successfully embark on the ketosis journey.

Kruse comes to mind - and looking back at how our ancestors lived when they were in ketosis, not only didn't they have much green or grain stuff to feed them, but it also would have been mostly very cold. Kruse mentions studies that were apparently done by NASA in the sixties with sherpas showing that they had a VO2max of 400 - 500% higher than compared to the Westerners that climbed Mt. Everest. Towards the top of the climb they would switch almost entirely to eating yak fat. But - and this might be the crucial point - they also were cold adapted, which changes the entire energy metabolism. I have not been able to find these original studies published anywhere yet - so if someone has a link or an idea where to search, I'd be grateful (tried PubMed without much success, but I am not very good at searching it).

I am pondering these issues because of the fact that despite eating a VLC diet, my cholesterol levels are way to high. I am currently trying a few other things that purportedly influence cholesterol levels in a positive way - and I am not sure how relevant high levels are in the first place if your body is low on inflammation. But these are all hypothetical things and it's a complex web of interrelating factors.

So maybe cold adaptation is the missing link that goes together with a ketogenic diet to bring health to an optimal level? But then also the question comes to mind, how did those adapt their diet living in more temperate climates, like the southern hemisphere, that was mostly ice-free during the last ice-age?

To me the whole ketosis business is not as clearcut anymore as I thought it was a few months ago ... and that is mainly the fault of Megan and her inquiring mind, which I really appreciate!

:)

Thanks for that!

 

[happyliza]

Re: Ketogenic Diet - Path To Transformation?

I haven't really grocked the supplements properly despite reading threads and writing down from the books. I have written down the legal and illegal foods the Megan recommended bearing in mind a lot does not apply to us but does assist gut problems.

Like I said, I think you really need to simplify. So, let's look at what you've got.

I certainly agree!

Would you recommend I take the following select supplements?:

Vitamin C - because body cannot provide it. (Biocare Vit C powder at present though have to take capsules when run out)

Have you had your ferritin levels tested?
Last time was in March. Ferritin was 90.75 BUT red blood cells 2.950 (should be 4 -4.5) so I was deficient in iron and anemic. A week later in UK all tests came back normal which is not possible according to the doctor that did the 2nd test! So asap I need to get to a lab here so see where I currently stand. BTW apart from the above what are all the other indicators i should have checked at the same time as they already have taken my blood?

I actually rarely take Vitamin C now because there is a different system that operates in the body when your carbs are very low and you don't need it. I only take it when I feel I need an extra detox or I'm sick.

I was not aware of this from the books etc so this is good news - more savings towards good food!

Vitamin B - Complex 100 - Solgar - too support my nervous system

If you are eating plenty of meat protein, AND taking a good digestive aid such as betaine hcl, and thus, your food is digesting, you probably don't need B vitamins either. If you are low on any of them, you might want to just stick with a sublingual B-12 and maybe a B-6 at night.
Do I not need the Folic acid either? I will try to find some that are separate. Not heard of sublingual before.

Omega 3 Fish Oil - Higher Nature - I still have shoulder/joint problems

Fish oil is always good. So is conjugated linoleic acid taken along with. If you have joint pains, you really need to ditch the coffee.

Coffee ditched, had herbal tea this am. I have some organic teabags so will try black tea too.

Digestive Aid - Veridian -this was what I bought to try next. It still has Betaine in it so I hope that is not the culprit.

Well, I guess you'll see. I'm finding the betaine to be very helpful. But if it is too much for you, there are others to try.

Zinc - I am not sure whether I will be able to get enough of this from my food sources. Am a bit wary of letting this one go now.

Zinc is good. Low doses a couple times a day. However, if you have an iron problem or a heavy metal problem, the zinc won't do much good.

Until I have a new blood test/assessment I don't know but I guess I must be still on the low iron side so zinc would help isot.

Magnesium Maleate - I only have one bottle of this but can will use it now I need it most. Perhaps Magnesium baths will suffice after that?

If you have the salts for the bath, that is fine and eliminates one set of pills. I like to really minimize.

I just have Epsom salts so hope this is the right magnesium.

Beatlemaniac : Hot broth in this heat doesn't sound very appealing - even my black coffee was ice coffee! But I will see if I can order some marrow bones, trotters etc from the pork shop and make another batch. At least it ensures I have a full breakfast.

I start my day with strong black tea and a bit of xylitol. It blocks iron absorption, too, and I have a bit of iron overload still. I've done about 6 donations and maybe one more will do me and then I'll get on a regular schedule 3 or 4 times a year.

Maybe I shouldn't block iron absorption if I am quite low? So is it tea or xylitol that blocks? Luckily I gave up sugar 20 years ago but obviously still get sugar (carb) cravings for sugar ie chocolate, deserts etc.

Our breakfast every single day for a couple of years now is bacon and sausages. Some have eggs too, but I couldn't eat eggs for a couple of years. I have them occasionally now, but they bother me if I eat them two days in a row. Ham is good for breakfast, so are hamburgers. You need a good meaty breakfast, no carbs in the morning. wait until between 2 and five for your second meal of the day to have your potatoes. Usually, we only eat twice a day.

Had a good meaty breakfast this am - small pork chop and burger (I found some coconut to melt in the goose fat - quite palatable). I had no idea about not having carbs in the morning so this is a great help. Also just eat twice a day. Not sure if solid coconut cream counts as carbs though?

Can anyone recommend what I can order to drink in cafes. This is my only social life and meet ups here and they are not too keen on me sitting there just with water!

Not too hard to figure out, tea or a tisane. I have black tea all day until 5 in the afternoon. None after then.

Lemonade is good as long as you sweeten it with xylitol or stevia. Just order sparkling water with lemon, carry your own sweetener in your bag everywhere you go.

Well we certainly have a lot of lemon trees here so I used to make it with honey. Stevia discoloured it alot but I will persevere as it is so thirst quenching. Also, unusually, I had some blended with fresh mint - it was even more refreshing and delicious. Will ask for water and extra lemons in cafes as they use so much sugar and sugar syrup here. BTW I didn't even know what a tisane was! Thanks.

I think to go cold-turkey into ketosis only works if your body is not too damaged. So I can wholeheartedly support Laura's advice - take it slowly and only change one thing at the time. As to supplements I would consider only taking magnesium (preferably the maleate variety) and see how you go.

Definitely. Like I said, you need to back up and regroup.

Well it is more enjoyable to do so. Try as I might I could not really understand exactly what I was doing!

Probiotic tablets are pretty much worthless if they are not "enteric coated" - they dissolve in the stomach and never make it "further south". If you have intractable diarrhoea and you want to rebuild your intestinal flora one new concept that has arisen is "fecal transplant" - I know that sounds very yucky, but the benefits might be very far reaching.

If you can get enough acid going in your stomach, you'll digest better and even if you have leaky gut, it won't be undigested stuff passing into your system as long as you don't eat a bunch of veggies which do NOT digest in the stomach... they spend ages rotting in the intestines and aggravating the leaky gut. To really heal the gut, you need LOW RESIDUE foods and they need to digest in the stomach.

Good to know.

More than anything I need to protect my MITOCHONDRIA it seems, if they haven't been hammered to death already by low fat and carbs.

Why the heck are you even worrying about your mitochondria at this point when your whole system is going kaflooey because you are doing too much, too soon? Fuggedaboutit and take it easy on yourself. Sounds like you flogged yourself with low fat and too many carbs and now you are flogging yourself the other way. You gotta take this serious and let the body have a break fer cryin out loud!

Agreed - I do tend to go in at the deep end sometimes. I have a chance with the explanations now.

I think I now need to give the machine a good while to stabilise. How would I know when a good time to start the elimination would be? I know my dentist was amazed at how quickly I detoxed with the chelation after I had my amalgams out, but that was 3 years ago now. However i was nearly off the scale on toxic metals at the time. I still have some of the chelation herbal mixture left - would that be good to use?

Herbal chelators are almost worthless. If you haven't done DMSA and EDTA, you ain't detoxed. But geezus, don't think about that NOW!

Maybe you could add lactoferrin - take it first thing in the morning on an empty stomach. That will help in a gentle way.

Interesting point about the herbal chelators. I do have DMSA, but looked up EDTA and didn't realise I could use it as a descaler too! Perhaps I can replace the Calgon? Joking apart it seems I didn't detox after all.
I don't think I have heard of Lactoferrin before but on looking it up it seems marvelous and something I think i need to take. I hope I can get some here.

After these 2 episodes I don't trust myself to 'know' when my body would be up for elimination. Do I get the book 'Detoxify or Die' and follow what she says? Or do you mean do what Laura suggests, which I will do, stick to that for quite a while, then introduce one more item slowly, so that by the time I do that, it will be possible to monitor everything and note any abnormalities. eg say intro broccoli for 3 days and see how it goes or do you mean we are allowed the low carb foods anyway and intro say tomatoes (belladonna family)? A bit confused on what foods I introduce. Sorry.

Don't even worry about all that right now. Obviously, you are doing damage to your body all over the place by trying too much, too soon. Back off!

Thanks, noted, and point taken seriously.

People, happyliza is having problems keeping things straight and organizing herself on this. She is getting too much from too many people and she needs to just settle down and get stable.

Thank you, I am sure I am not the only one. With such long threads and so many changes in strategies throughout. It is hard to decipher, especially as I don't really know my machine. I know it is a step at a tiime but it is confusing amassing, assessing and then figuring out what applies to me. I know this is what research is all about, however, sciences etc were very much my weak point especially the terminology. This is why I reverted back to the books but kept up with the threads - thus I WAS all over the place admittedly. I know it is still early days, and that mention was made of a book being in the pipeline at some stage - it would certainly help with the 'guesswork' and as a basic, to go along with EE.

Thank you for noticing I was all over the place, simplification and clarification - my body will certainly appreciate it - I was doing more damage than YOYO dieting. I got the overall picture and of the why's but not the understanding of what to apply properly. I greatly appreciate your time and empathy on this.

It will take you at least three months to get into a position to take the next step. So forget about all those complicated things, testings and so forth. Just don't eat it if it isn't meat/fish with a bit of mashed potato and green peas or green beans, and or a small green salad. Don't drink it if it isn't tea or water, plain or fizzy. That's not so hard, now is it?

Appreciated - in fact it is more than i was allowing myself to eat before. I can now enjoy my new lifestyle with confidence rather than intrepidation..

## Apologies my replies were meant to be in blue, however it didn't work out.

 

[Gaby]

Re: Ketogenic Diet - Path To Transformation?

So maybe cold adaptation is the missing link that goes together with a ketogenic diet to bring health to an optimal level? But then also the question comes to mind, how did those adapt their diet living in more temperate climates, like the southern hemisphere, that was mostly ice-free during the last ice-age?

I think that is a very good point. Perhaps doing all our ketosis readings in the middle of summer might lead to some frustration?

Back in the 90s, there was more diabetes in Costa Rica (and other countries) compared to the rest of the world, supposedly from eating industrialized sugar and carbs as opposed to a paleo diet. It was speculated that people in the tropics could handle natural sources of carbs better, but once they substituted that for industrialized sugar, it all went down hill. Now environmental issues are so stressful, that diabetes has become an epidemic around the world and the numbers for third world countries are pretty scary where cheap industrialized grains become the staple food. But perhaps there is a relatively paleo carb tolerance in those who adapted in more tropical climates? Hard to know and recreate what it might have been in this case.

But for cold adaptation, I think the odds will be in our favor. According to the longevity research, high temperatures disrupt molecules and denatures proteins, it also leads to greater accumulation of irreversible damage that causes death. A diet rich in protein is also the one that raises temperature the best. Eating lots of protein will also increase glycation, oxidative damage and Insulin growth factor-1.

It also reminds me of the Brown Adipose Tissue research where cold naturally stimulates the production of brown fat (BAT) and as a byproduct it produces a whole load of healthy mitochondria which run best on a ketogenic diet. So perhaps with cold, our mitochondria will gear up to use natural ketosis in a more effective way?

Kruse doesn't distill things in an easy way, but from what I understood, it is related with temperature regulation in the hypothalamus and leptin, which helps put our metabolism in fat burning mode.

It will be interesting to read several ketone blood levels with the same diet in winter, see if it improves.

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

It's winter where I am at the moment and BOHB levels are definitely higher - but at the same time I also restricted protein somewhat to around 0.8 - 1 g/kg, so hard to say which is which ...

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

Thanks for the clarification! I was wondering what Km was all about. That's an interesting assumption but very theoretical. I was thinking that the figure was in the context of a ketogenic diet specifically formulated to treat neurological disorders -- probably close to zero carb -- but that's just me.

They don't appear to go there. In the minds of the authors, "normal" apparently implies "adequate dietary carbohydrate." Which seems to say, they have the same view as most researchers. Therapeutic KD is, by any ordinary measure, "abnormal," so I can't really blame them. Traditionally, though doctors have tended to go a bit overboard in their dietary formulations, creating unnecessary additional problems for their already seriously-ill patients. I suppose that in the pursuit of "do no harm," people can end up not reducing harm either, when in working in unexplored territory.

One interesting aspect of the Fukao paper (cited in the original paper) is that they take the trouble to point out quite a number of things that are still unknown, or at least that were unknown as of 2004 when the paper was published. I find it quite helpful to have that perspective. And when authors go a bit out on a limb, as these authors seem to have done with their speculations about when ketones really kick in, it may just be to try to offer a little insight even in the face of so many unknowns. If the research were primarily directed toward real human needs rather than toward fake "miracle drugs" that nobody needs, things might be different. But then that would be a different world.

I didn't quote from either of the cited papers because they are for sale, like so many research papers, at a considerable price, and my access is via "rental," and the only way I can quote is to grab a screen shot and process it through OCR (which is a pain, for a quick quote, when I have already spent half a day reading and researching). As it happens, though, there is often somebody out there that ignores the copyright or has the right to publish and posts the fulltext anyway, and if you were to take a peek at _http://www.coconutketones.com/pdfs/veech%202004_therapeutic_implications.pdf you might just find the Veech paper in full.

I didn't come across anything like that for the Fukao et al paper, "Pathways and control of ketone body metabolism: on the fringe of lipid biochemistry," but it's a good paper and it only costs a few dollars to read it at DeepDyve.com, if you are into that sort of thing. For those that have not built up a good biochemical/metabolic vocabulary it might be of less value but still possibly worthwhile. I LIKE papers where the authors are not ashamed to repeat the basics, and folks can always augment their vocabulary by looking things up on WikiPedia (like I do). That applies to both papers, I think.

In any event, earlier they imply that "drastically reduced carbohydrate consumption (below 50 g/day)" is ketogenic, and it is not clear to me that that upper limit carb intake is going to yield 4 mmol/L during waking hours with any consistency from person to person. I would expect it to yield something in the range 0.5 to 3.0, per Phinney & Volek. So I'd be careful about basing anything much on that 4.0 value.

That's the problem with definitions. I think 50g of carbs per day for me would likely put me out of ketosis pretty easily. But I've never measured for it, since I never go beyond maybe 20-30g. I guess we'll have to put the 4.0 in the realm of speculation for now. I've run out of test strips, too! Argh.

There is always a "varies by the individual" qualification, whether expressed or implied. What is slowly emerging, however, (sorry if I sound like a broken record) is that many of those individual differences could be due to our microbiomes, as well as to the usual things we think about such as genetics, epigenetics, and existing pathology. I am afraid that by the time it finally does emerge I will be history, but it's fascinating anyway.

I use the ketone test strips very sparingly. I find that the glucose strips tell me most of what I need to know, now that I am familiar with my own patterns, and they are much cheaper. I just bought a box of 50 for $20 or something like that. I just hope I bought the right strips - I haven't opened the box yet. I don't search for the lowest possible price, both because it can be time consuming to do so and because I don't want to risk counterfeit products that could give me bad readings.

Therapeutic KDs that produce high ketone levels may actually carry a risk, not from the ketones, but from the high levels of dietary fat intake. If this results in burning excessive amounts of free fatty acids, it can be trouble. The Veech paper goes into some of the details. The bottom line of that is "pathological decreases in cardiac efficiency" (the paper focuses on rat's hearts). I have seen other warnings as well about possible metabolic consequences of eating a truly high-fat diet, when free fatty acids are metabolized. Apparently they aren't good for work energy -- they reduce coupling efficiency and produce heat. But it all quickly goes over my head.

I don't know. I find it odd because of what we know about the heart preferentially using fatty acids for energy, as per LWB.

As I already warned, it's over my head, but I think the issue may be with the beta oxidation of "free" fatty acids. If I were retired, I might be able to clear this up in a few days.

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

I have never heard of Pu'erh - can you give me a bit more info about it? I doubt if I can find it here but with more info perhaps someone going over the border could get it for me?

Pu'erh is a post-fermented Chinese black tea. White tea is unoxidised, green tea is partially oxidised and black tea is fully oxidised. Pu'erh comes from either green or black tea and is fermented later on. There are basically two methods, raw and ripened. The raw variety is just stored under specific conditions and aged that way for at least 4 years, but they apparently mature with age and some teas can be bought that are 50 years old. Ripened is a newer process developed to speed up the maturing process - it only takes about a year.
Conaisseurs say that there is a difference in taste - I am new to this tea so I cannot say yet.

Pu'erh is named after the capital of Yunnan province in China but is produced in many other places in China.

The only fly in the ointment is the fact that some mold fungi apparently produce lovastatin (a statinin like in Mevacor) in pu'erh teas - so they are hailed as good for your cholesterol. Not sure if the "natural" variety is any different from the pharmaceutically produced one, but I'll see what my cholesterol does in a few months.

It's hard to find here in Australia - T2 has one, but there is little information about it (it must be ripened), but some online stores have a wider range.

Hope that helps.

 

[dugdeep]

Re: Ketogenic Diet - Path To Transformation?

This thread is clipping along at a heck of a rate, and I'm just now caught up, but I wanted to address something from a couple of pages back.

Probiotic tablets are pretty much worthless if they are not "enteric coated" - they dissolve in the stomach and never make it "further south".

This is actually untrue. There is a great deal of research out there that shows that the probiotic strains that are native to the human system have the ability to survive the digestive process. Think about it - the good bacteria in fermented foods like sauerkraut aren't enteric coated, yet their benefit to imbalanced digestive systems is well documented.

I'm sorry I don't have studies at the ready for this. I had a training with a guy named Nigel Plummer, the head probiotic research guy from Genestra (makers of the HMF line of probiotics) awhile back; he's actually got a PhD in microbial physiology. He showed us studies that showed a clear positive adjustment in the bacterial content of the stool of those taking probiotics that weren't enteric coated. It all depends on the strains used, some being more resistant to acidic environments than others. His opinion was that enteric coatings weren't necessary if you're using human-sourced strains and, until they could find an enteric coating method that didn't contain pthalates, it was a much better option to go without.

One thing he did say, however, is that you should always take your probiotic with food. The food helps to buffer the bacteria from the acid, or so it's theorized, allowing them to complete the journey unhindered.

FWIW.

 

[mcb]

Re: Ketogenic Diet - Path To Transformation?

...This is actually untrue. There is a great deal of research out there that shows that the probiotic strains that are native to the human system have the ability to survive the digestive process. Think about it - the good bacteria in fermented foods like sauerkraut aren't enteric coated, yet their benefit to imbalanced digestive systems is well documented...

Back before there were capsules, there were soilborne bacteria. They somehow got through. Now we think that is bad, and we scrub them off and cook them off, and our bodily bacterial colonies can't get the information they need to do their job, and our immune systems can't condition themselves to do their job. Only in a psychopath-driven world would any of this make sense, including getting our bacteria from capsules.

I guess you do what you have to do, and that might involve swallowing capsules full of bacteria, but if you can allow your body to communicate better with its environment without running afoul of pathogens put there by pathological humans and their corporations, go for it.

 

[nicklebleu]

Re: Ketogenic Diet - Path To Transformation?

This thread is clipping along at a heck of a rate, and I'm just now caught up, but I wanted to address something from a couple of pages back.

Probiotic tablets are pretty much worthless if they are not "enteric coated" - they dissolve in the stomach and never make it "further south".

This is actually untrue. There is a great deal of research out there that shows that the probiotic strains that are native to the human system have the ability to survive the digestive process. Think about it - the good bacteria in fermented foods like sauerkraut aren't enteric coated, yet their benefit to imbalanced digestive systems is well documented.

I'm sorry I don't have studies at the ready for this. I had a training with a guy named Nigel Plummer, the head probiotic research guy from Genestra (makers of the HMF line of probiotics) awhile back; he's actually got a PhD in microbial physiology. He showed us studies that showed a clear positive adjustment in the bacterial content of the stool of those taking probiotics that weren't enteric coated. It all depends on the strains used, some being more resistant to acidic environments than others. His opinion was that enteric coatings weren't necessary if you're using human-sourced strains and, until they could find an enteric coating method that didn't contain pthalates, it was a much better option to go without.

One thing he did say, however, is that you should always take your probiotic with food. The food helps to buffer the bacteria from the acid, or so it's theorized, allowing them to complete the journey unhindered.

FWIW.

I know, it's a controversial issue ... I would have to read the studies to make up my mind. To be honest I haven't studied this issue in depth.

However two things come to mind:
1) Plummer is a bit in the same position as all the PhDs in pharmaceutical companies - essentially their message is self-serving. I am not saying that he is wrong, just that studies coming from this end need to be evaluated very carefully.
2) The benefits of sauerkraut may well lie elsewhere than in the bacterias travelling down the GI tract. It might be in the fact that fermentation changes many substances to make them more digestible to gut bacteria already there.

I am not saying that what you say is incorrect, I just would have to really dig all this stuff up to get a clear idea about it, which at this present time I am unable to do - so probably I need to retract this somewhat unqualified statement.

 

[dugdeep]

Re: Ketogenic Diet - Path To Transformation?

...This is actually untrue. There is a great deal of research out there that shows that the probiotic strains that are native to the human system have the ability to survive the digestive process. Think about it - the good bacteria in fermented foods like sauerkraut aren't enteric coated, yet their benefit to imbalanced digestive systems is well documented...

Back before there were capsules, there were soilborne bacteria. They somehow got through. Now we think that is bad, and we scrub them off and cook them off, and our bodily bacterial colonies can't get the information they need to do their job, and our immune systems can't condition themselves to do their job. Only in a psychopath-driven world would any of this make sense, including getting our bacteria from capsules.

I guess you do what you have to do, and that might involve swallowing capsules full of bacteria, but if you can allow your body to communicate better with its environment without running afoul of pathogens put there by pathological humans and their corporations, go for it.

This assumes that soil borne bacteria are the same as human strains. They're not, for the most part. Probiotic supplements generally come in three varieties - plant strains (soil borne, fermented foods, etc.), dairy strains (yogurt, eg.) and human strains (like those found in fecal transplants). They're not the same, and it's really only the human strains that are shown to adhere to the digestive tract, reproduce and recolonize. This isn't a hard and fast rule, mind you - there are trillions of different types of bacteria in complicated relationships, both antagonistic and cooperative. Obviously there are going to be individual differences among the strains, but overall, while plant strains can be quite helpful in shifting a pathogenic bacterial environment to one that is healthy, human strains appear to be the most beneficial in really turning things around.

Now, in regards to not favouring getting probiotics from capsules, remember that our paleo ancestors had digestive tracts that didn't have to deal with antibiotics (either prescribed or in the food supply at large), chlorinated water, chemical additives, pesticides, herbicides, toxic air, toxic water... need I go on? Their bacterial environment, which they inherited from their mothers during a natural childbirth, stayed with them throughout their lives, relatively unaffected. Today's generation is lucky if they inherited any bacterial culture from previous generations, and even luckier if they've managed to keep them relatively unscathed.

I don't need to tell you that we don't live in that world. While I think you're right that bacterial supplements are 'unnatural' (my words), I don't think we should be rejecting supplemental interventions given the fact that counteracting the affects of our world may call for drastic measures.