Reads like beginning of a new fad just like keto diet.
My idea is that sugar in quantities we ingest nowadays damages all and makes more problems. It is not that ketones are some magic thing. Only that sugar is rocket fuel for the brain so it should not be used without care.
The keto diet has been around over 100 years and it was developed in a clinical setting for children with epilepsy to reproduce the benefits of fasting - which has been known for thousands of years to prevent seizures - while providing a long term solution and not deprive children of calories.
It’s not exactly a fad, it’s just that there are a lot more studies being conducted on the benefits - like fasting studies which lead the discovery of autophagy and the Nobel prize in 2016.
The idea sugar is rocket fuel for the brain, is a little misguided. Certain sugars spike insulin triggering anabolic response getting glucose to the cells quickly, but that doesn’t make glucose more efficient for the brain.
Ketones are smaller than glucose molecules and more efficient at crossing the blood brain barrier. Rocket fuel for the brain is being in a deep state of ketosis and consuming medium chain fatty acids (e.g. coconut oil) or beta hydroxybutyrate (i.e. exogenous ketones).
> The keto diet has been around over 100 years and it was developed in a clinical setting for children with epilepsy
Yes, exactly. It was developed and studied in the context of epilepsy treatment.
The current wave of keto influencers are pushing it as something else, though.
I have tried keto and noticed some interesting effects, but the impact on certain parameters of my lipid bloodwork was undeniably bad no matter what I tried. The keto community works overtime to downplay the possible negative effects of the diet, but actual cardio and lipid researchers have very different opinions.
And you are probably basing that on the fact that the two standard lipid markers for HDL and LDL went up, right?
And you probably ignored any that the ratio probably improved between "good" and "bad" lipids? I guess you didn't just eat lots of bad fats but also improved the composition of fats you ate?
Lipid research is sponsored by pharma a lot. They need to push their statins.
Anecdotal datum of one: I happen to have high cholesterol no matter what I do. You have to fast in order to do the lipid blood tests. Sometimes I forgot to fast and have even eaten eggs. My lipid profile was better in those cases. I also got muscle cramps from taking statins. The heart is a muscle and those cramps can kill you. Instantly.
> And you probably ignored any that the ratio probably improved between "good" and "bad" lipids?
"For predicting your risk of heart disease, many healthcare professionals now believe that determining your non-HDL cholesterol level may be more useful than calculating your cholesterol ratio"[1]. Additionally, "extremely high HDL-C levels are associated with an increased risk of age-related macular degeneration (also genetically), infectious disease, and all-cause mortality."[2]
[1] It's funny. My Browser shows I visited that link before ;)
A comment in a keto/low carb discussion believing in a statin conspiracy? shocked.
I'm not on Keto. I'm not on an actual low carb diet. I'm just not afraid of eating lots of good fats. I'm not afraid of eggs or cream any longer.
I don't believe in a "statin conspiracy". There's no conspiracy needed. We've seen over and over again with lots of things that companies favor funding research that shows something that sells their product or they outright lie (sorry "do marketing"). Leaded gasoline? Milk is good for you, make your children drink more? Butter is bad?
The statins causing muscle cramps are a fact and not a conspiracy. I got statins in ever increasing dosages because they didn't help. When the cramps started, my doctor took me off statins. When I then did try Keto all of my blood markers that were either bad or borderline went into completely normal territory. Except for lipids that did the usual "hover around some really high and absolutely bad for you territory".
Again, a datum of one. But when all the things done to me with evidence from statistically relevant studies and research doesn't help and actually makes things worse but the statistically not significant thing works to improve all of the markers of statistically proven blood testing, then this anecdotal internet person here will stick with what works. YMMV as always.
Entirely irrelevant
My anecdotal datum of one was marked as such. On purpose. No need for this entirely irrelevant comment of yours. The person I replied to did not and drew a wide ranging societally generalizing argument from his datum of one.
I don’t think it’s so insidious. People see real benefit and results from highly restricting carbs. Something is happening, it’s not just a fad. Sure, it’s fine to debate the pros and cons but to outright disparage it because there a community of excited people who have had life changing experiences talking about it positively seems overly reactionary.
these are not mutually exclusive. It is a fad AND something is happening.
That something comes down to two major things about low carb/carnivore diets:
1. You are removing processed foods. Going from a Standard American Diet to basically anything that involves more whole foods is going to be healthier for you and make you feel better. This doesn't mean that the new diet is optimal but it can be a step in the right direction.
2. Restricting your diet down to a few types of food is going to remove a lot of allergens. If you only eat meat for example, you are removing literally every single non-meat allergen in your diet - most people have some sort of food sensitivity (lactose intolerance being a common one) so you are going to feel better when you remove those allergens. However, this does not mean that accidental elimination diets are the long term solution. You should slowly add back foods and see what you react to so you can do something less extreme but still feel good doing it.
So yes a lot of people feel better on these diets but that does not indicate they are healthy long term or superior to other options.
It also doesn’t indicate they are worse for you. After 3 months I went from almost prediabetic and bad (not awful, just “take care”levels)of LDL/HDL(ratio) to Ideal ranges and dropped 28lbs. I do believe that keto lifestyle is as valid as the Mediterranean and DASH diets, both of which I tried and failed to stick with, as they were more effort. I’ve been in the ideal range for over a year now (just got retested). So I say go with what works as long as you work with your doctor and get your biomarkers checked. The only exercise I really do is some mild resistance training and 8-10k steps a day, but I was doing that before my weight loss.
Yeah, those excited folks go often a bit mental over the board and praise it like second coming of Jesus, that's what most folks have problems with. Rational discussion about pros and cons is rare.
Discovering health tends to do that to people. It doesn’t matter if it’s discovering keto, carnivore, vegetarian, vegan, or exercise.
When people commit to improving their health, and begin to experience improvements, for better or worse it is like the second coming of Jesus. Particularly diabetics that make lifestyle changes, lose significant amounts of weight and get off insulin. Nearly everyone who experiences that feels that if they can do it anyone can do it, and they tend to share their experiences enthusiastically and rightfully so.
When you’ve been unhealthy and struggling to maintain a healthy body for years in a society that indexes way way way to heavily on carbs because they’re cheap and equally isn’t honest about the toxicity of glucose, you can kinda see why people get so enthusiastic about it. Sure it can be annoying but there are problems on both sides and people that say sugar is fine eat it at will are starting to come off as maliciously delusional to me of late.
Keto influencers? My doctor recommended it for weight loss and it’s probably saved my life. You’re being pretty negative because of your once experience on something that does help people and does have results.
I think you are throwing the baby out with the bath water, sure there are probably influencers pedaling keto product, just like corn, eggs, coffee, sugar, cereal, and meat have entire lobbying industries pedaling bad science and bad food stuffs.
But when you reply “yes, exactly” to the fact that the keto diet was developed in a clinical setting over 100 years ago to mimic the benefits of fasting and offer a n=1 anecdote about your lipid panel, that’s no better than anyone you are accusing of downplaying possible negative effects.
> it was developed in a clinical setting for children with epilepsy to reproduce the benefits of fasting - which has been known for thousands of years to prevent seizures - while providing a long term solution and not deprive children of calories.
I don't know why people still use this as any sort of argument for keto in the general population. Most people are not children with epilepsy and even for children, the keto/low carb diets has many downsides most notably growth retardation, kidney stones and bone mineral loss.
When people wrongly claim keto is a new “fad diet” you don’t know why people would point out that it’s been around for over 100 years highlighting there are ample subjects that had adhered to it their entire lives from childhood?
Are there many diets that have lifelong adherents over their lifetimes over the last 100 years from the general population that have been studied?
> When people wrongly claim keto is a new “fad diet” you don’t know why people would point out that it’s been around for over 100 years
Again, these are not mutually exclusive. Even if the idea of a keto diet has been around for 100 years, that doesn't mean that right now it is not a fad (a style, activity, or interest that is very popular for a short period of time). It was never popular before, it is now and it almost certainly won't be in 10 years or so.
>Are there many diets that have lifelong adherents over their lifetimes over the last 100 years from the general population that have been studied?
who are these people who have done keto their whole lives and have been studied? Can you share the case studies?
>Keto is a fad
>no it’s a diet developed in clinical setting been around more than 100 years
>I don’t know why people bring up that its not relevant
>yes, it directly contradicts what OP said
>it’s no mutually exclusive, sure it’s been around 100 years, but it’s a far and won’t be around in 10
>Are there diets that have life long adherents over the last 100 years that have been studied?
>show your studies
I think someone like you would be better off googling. You should easily find studies supporting as many as 70% of epilepsy patients who are treated with keto as children can get off of keto after 5 years without any seizures and no longer need any medication. You should also be able to find studies of long term keto diets, ‘long term’ as defined within the studies themselves, covering various types of individuals and get yourself a healthy perspective on the overwhelmingly positive outcomes and to a fat lesser extent the negative outcomes.
"Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes: a secondary analysis of routine clinic data including HbA1c, weight and prescribing over 6 years"
"What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss"
Neither of these papers are keto diets specifically. It looks like these patients just had way more personal one on one time with their doctors, dedicated group sessions, and carb information. Without actual carb counts there’s no way to know if this is actually keto. Importantly, neither paper specified the high fat part of the keto diet, which makes me think neither paper actually supports keto.
Btw I’m not personally an anti-keto guy I just dislike mindless paper citations.
You linked two papers about reducing carbohydrate intake, which is not a ketogenic diet.
A ketogenic diet involves severe carbohydrate restriction and even major protein restriction. The research you shared isn’t applicable.
This is a huge problem in online keto discourse: People share a lot of “research” that isn’t applicable, such as these low-carb papers or other research about treating epilepsy with keto diets.
You can’t just look for studies about lower carb with positive conclusions and assume that this implies the keto diet is good.
I was with my wife during her gestational diabetes nutrition session. The diet they recommended was for all intents and purposes a ketogenic diet. The only carbs were from natural sugars in fruits and veggies. They just didn’t push the fat and squeeze the carbs as much as you see in keto enthusiast literature. I have a hypothesis though: the keto community does this as a “failsafe” way to instruct curious people how to experience ketosis for the first time. People practicing keto long term (once they’ve experienced the acute benefits and/or initial weight loss) are almost always landing on their own personal watermark which very likely looks like taking in 60+g of carbs a day in a state of “nutritional” ketosis where there are only slightly elevated levels of keytones (~0.4-1.0 mmol/l) in the blood compared to the level of “therapeutic” ketosis used to treat epilepsy (3.0-5.0 mmol/l).
There is no specific ketone cutoff level specified, and of course the impact of X g of carbohydrate will vary per individual, during the day and between days.
The paper I cited are the end stage validation that a treatment works: using it on patient in their normal everyday life (instead of being in clinic/laboratory) - note that they see the doctor 3 times 10 minutes per year.
Of course no one knows how much carbohydrate they take but the guidelines (as presented in the paper) are clearly steering them to nutritional ketosis.
As or clinical studies there are many of them done in the past decades, for a ten years ago summary for example:
Dr Westman (the main author, Past-President and Master Fellow of the Obesity Medicine Association and Fellow of The Obesity Society, he also has a youtube channel) uses 20g/day carbohydrate guideline and does not recommand the use of a ketone meter for his patients.
I don’t need 20 peer reviewed papers to call out something being a fad - when I get loads of replies calling out it is not a fad on a small comment and YouTubers advertising it on almost all videos.
Well, Alcohol is an even more easily accessible fuel that your body can readily use for a variety of activities... but its negatives are well understood...
Just because something is less pleasant doesn't automatically mean it's good. On the surface, it would be weird for ketones to improve brain activity - after all "keto flu" is a thing, and it is definitely is not a state of high performance. And if ketones were that healthy then diabetics would the the healthiest people of all. Instead, they are poison, and this is well documented.
> On the surface, it would be weird for ketones to improve brain activity - after all "keto flu" is a thing, and it is definitely is not a state of high performance.
Keto flu is from a low level of ketones, not a high level. Once enough ketones become available there is no more keto flu. From there most people feel at least normal, and many feel a bit better than normal because the cycles of both energy and satiety are smoothed out by the change in fuel sources.
> And if ketones were that healthy then diabetics would the the healthiest people of all.
Diabetics have health complications precisely because they cannot moderate their blood glucose, with or without ketones. Ketones do not regulate blood glucose, insulin does. Unlike glucose, excess ketones are harmlessly urinated out, they do not need insulin to process them.
Glucose in the blood is toxic [1] if it isn't metabolised because of lack of insulin, and even most diabetics consume enough carbohydrates for this to be a risk. There is a clear relationship between availability of insulin and safe levels of glucose consumption, in fact injecting insulin is usually the first intervention if blood glucose is at dangerously high levels. Search for insulin in that paper.
Ketones don't enter into this picture at all as either a toxin or the solution to toxicity. Precisely the point is that ketones can substitute for most of your glucose needs without risking toxicity like glucose does.
If all of that isn't enough, diabetics often do better following a ketogenic diet [2], not worse. When you can't naturally produce enough insulin to process the glucose you consume for daily energy, producing ketones instead is a safe workaround which your body performs naturally. What part of that is evidence for ketones themselves being the problem?
Furthermore there is some indication that people experiencing type 2 diabetes are suffering from essentially a worn out pancreas. In other words their insulin resistance is a result of constantly eating more sugars/carbs than the organ can keep up with. Switching to a keto diet instead of supplementing insulin gives the organ a break where it can actually start to heal and return to a more normal insulin production routine, ultimately meaning that these people can eat a donut occasionally without requiring the insulin supplement like they otherwise would with a traditional treatment plan where their body hasn’t been given a break from the onslaught of glucose. This can be life changing for a type 2 diabetic, because their lifestyle returns to normal outside of paying attention to their diet.
Insulin resistance is a quality of the cells in your body which cease responding to insulin at their receptors. So higher levels of insulin fail to reduce blood sugar levels. This is the hallmark of T2D.
You are confusing this with beta cell function, which also becomes impaired in many T2D people, where the islet cells become damaged, insulin production is subsequently impaired as well, this is a later stage effect in T2D progression.
T2D likely manifests from prolonged energy surplus leading to oxidative damage to cells and accumulation of excess fat stores, particularly visceral fat stores in the organs - the cell damage and overfull visceral and sometimes subcutaneous fat stores both lead to hormonal and epigenetic changes and directly to insulin resistance.
That's still oversimplified, but it's a useful model.
> diabetics often do better following a ketogenic diet [2]
Your citation is a single case study over a short period of time. It does not support your claim of “often”. This is deceptive citation and undermines your arguments.
> The LCKD improved glycemic control in patients with type 2 diabetes such that diabetes medications were discontinued or reduced in most participants.
> LCD can improve blood glucose more than LFD in Chinese patients with T2DM. It can also regulate blood lipid, reduce BMI, and decrease insulin dose in patients with T2DM.
> The VLCK diet appears to control glycemia and decrease body weight for up to 6 months in people with obesity and diabetes. Beneficial changes in serum triglycerides and high-density lipoprotein cholesterol, along with reductions in antidiabetic medications, continued in the VLCK group until 12 months. However, the quality of currently available evidence is not sufficient to recommend VLCK diets. A major limitation of the VLCK diet is patients' lack of adherence to carbohydrate restriction.
So sure, there are issues with adherence and the volume & quality of data here. That doesn't invalidate the trends seen across every study that looks into this. It's more than one study and, within each study, it indeed seems to benefit most participants.
Keto flu happens when you transition because of loosing too much water that was retained by carbs and electrolytes gets flushed with the water. Very easy to fix by taking a electrolyte supplement when starting keto (LMNT etc).
> then diabetics would the the healthiest people of all. Instead, they are poison, and this is well documented.
It is documented on T1D, where they make no insulin at all! Keto still helps on T1D, you will always need insulin, just less, and have more stable blood glucose (and all the benefits that entails with it).
For T2D, it's the best solution for it (see virtahealth.com for a great company that helps on this).
High blood glucose levels are literally toxic. This will damage every cell in your body. Your body can buffer sugar intake to an extent in order to maintain homeostasis but over time this tends to cause insulin resistance. A little sugar is fine but larger amounts are poisonous. The exact limit depends on a number of factors such as muscle mass and liver glucagon level.
It's perhaps more accurate to say sugars and simple carbs are easy to absorb whereas fats and complex carbs are harder to absorb. A single gram fat is the most calorie dense substance by weight that we can consume I think. It's just in practice it's hard to become fat by consuming only excess fat.
calories in / calories out is a foolproof way to track weight gain/loss over extended periods of time. So people tend to oversimplify nutrition and diet to this one number.
But it is indisputable that your body processes carbs, protein, and fat in very different ways. If you only eat donuts and bacon and candy consistently, in normal
caloric levels, then you will likely develop type 2 diabetes (or more precisely insulin resistance). Glucose in your blood is toxic. Are you really going to argue that this diet is perfectly safe?
> Are you really going to argue that this diet is perfectly safe?
I'm not sure that I ever claimed it was? All I'm saying is there's no point in vilifying those food types as they can be part of a perfectly healthy diet.
There is (and let’s not bey coy: arguing all calories are equal implies a sugar diet is perfectly healthy). People literally don’t understand how bad excessive sugar intake is because it’s not vilified enough. A mature adult understands that everyone has vices and all things are usually fine in moderation, and that’s how we should approach sugar. I strongly believe in 20 years sugar will be seen similar to tobacco. And that’s okay. You and I can still enjoy an occasional donut.
Sugar calories are not equal to say, calories in nuts. The sugar calories are indeed worse. One reason for this is the caloric energy in nuts are not fully absorbed like with sugar. So even though nuts are energy dense, they won’t cause obesity like sugar.
Calories are pretty much meaningless. The kind of food, proportions of carbohydrates, and other components is very critical. Nutrition =/= filling gas in a car.
There are calorie dense foods that are nutrition poor foods, and vice versa. In living things, it's not about energy only, the contents that help keep the body processing and regulating matter by a lot.
The quality of calories matters a lot too.
My idea is that sugar in quantities we ingest nowadays damages all and makes more problems. It is not that ketones are some magic thing. Only that sugar is rocket fuel for the brain so it should not be used without care.