LCHF

Nutritional Ketosis 101: A Personal Account

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Carrying a lot of excess bodily “cargo,” I decided to embark upon a bifurcated journey of nutritional ketosis, or keto for short. First, I seek to lose at least 20 percent of my body weight. Second, I want to compare my pre-ketosis blood test results — specifically the lipid panel — with the values after being in nutritional ketosis.

What is Nutritional Ketosis?

In short, nutritional ketosis is the metabolic state of burning fat while on a low-carbohydrate, moderate-protein, high-fat diet. The words “high fat” usually conjure a vision of the cardiovascular system laden with animal fats. But this is mistaken because mainstream medicine and news outlets equate “high fat” to high cholesterol, and believe high cholesterol heightens the risk of heart disease. Nothing could be further from the truth.

Consuming healthy saturated and non-saturated fat as part of a ketogenic diet makes the body feel great. Health benefits include: effective weight loss and maintenance; satiety; stabilized blood sugar and restored insulin sensitivity; and eliminated heartburn to name a few. Furthermore, my blood lipid panel values — cholesterols and triglycerides –- plummeted after keeping keto for about two weeks! My physician exclaimed, “Impressive!”

Scientific research including rigorous preclinical and clinical studies indicates that a ketogenic diet offers “a promising and powerful option for adjuvant therapy for a range of cancers.” For example, University researchers in Salzburg, Austria concluded in the February 2018 issue the journal Aging that a ketogenic diet induces ketosis that can starve cancer cells of energy while normal cells use their ketone bodies to survive. In addition, the reduction of blood glucose normalizes insulin, resulting in less fuel for cancer cells.

How Do I Enter Ketosis?

A ketogenic diet burns fat; whereas, high carbohydrate consumption burns sugar, usually not getting past the stores of glucose to achieve the state of burning fat. We know that many diets are replete with carbohydrates – bread, pasta, rice, sugar, cereal, processed foods – and, many people (including me) who ingest those carbs are waddling around wondering how they became overweight or obese. (I endeavor to become a former overweight person.)

Simply stated, get all sugar out of your diet. In today’s world eschewing sugar presents a daily challenge, given hidden sugars lurking in processed foods including dressings and sauces. Sugar is almost everywhere! But there are ways to eliminate it from your daily diet.

So, what can you eat? Mainly foods high in fat. Such as bacon, egg yolks, beef, and sausage. Also healthy fats such as avocado, coconut oil, extra virgin olive oil, and organic butter.

I understand that many of these foods are perceived as “no no’s” in our diets. However, they are necessary to achieve and maintain ketosis—to enjoy a healthier and slimmer life.

How Do I Test for Nutritional Ketosis?

Ketones, fuel for our mitochondria, are the overall product of nutritional ketosis for which testing can be easy, relatively inexpensive, and private.

The most common ketosis test involves urinating on a disposable strip containing a small chemical pad to detect the level of acetoacetate (AcAc) – the primary ketone body in urine. Another test can be performed at home by measuring beta-hydroxybutyrate (BHB) in the blood. A third way of evaluating ketones entails using a breathing device to measure acetone, the main ketone body in the breath.

Ketosis Versus Ketoacidosis

It is imperative to understand that when maintaining your blood sugar level in the normal range (less than 100 mg/dL) and producing insulin, the presence of ketosis is not harmful! However, if you encounter any doubters, including medical professionals, who claim that nutritional ketosis is unhealthy, see if they have confused “ketosis” with “ketoacidosis”.

Ketoacidosis occurs in diabetics who have both high blood glucose (greater than 240 mg/dL) and elevated blood ketone values (greater than 10 mill molar/L). Diabetic ketoacidosis occurs primarily in Type 1 diabetics who cannot produce insulin. Some Type 2 diabetics who have excess blood sugar and blood ketones as well as dependence on insulin also need to beware of ketoacidosis.

How Do I Attain My Ketosis Goals?

Often referred to as the father of medicine, Hippocrates wisely stated,

“If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.”

Based on my recent experience with ketosis and moderate exercise (a rowing machine), I may have found the “sweet spot”: 1) steadily losing weight and inches, 2) feeling healthy and satiated, and 3) attaining and maintaining healthy cholesterol and triglycerides. And I am confident that my risk of cancer as well as a long list of medical conditions is being reduced as I enjoy delicious food and healthy exercise.

I penned this article with the intention of presenting the reader a brief introduction to a nutritional ketogenic diet. For additional information, I recommend consulting ketogenic diet books including:

  • Keto Clarity. Moore with Eric C. Westman, MD. Victory Belt Publishing LLC. 2014.
  • The Obesity Code. Jason Fung, MD. Greystone Books. 2016.

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About the Author: Susan Rex Ryan enjoys research and writing about health as well as experiencing its amazing benefits. She authored the award-winning and perennial bestselling book called Defend Your Life about her journey with vitamin D3. Ms. Ryan recently wrote her second book called Silent Inheritance: Are You Predisposed to Depression about understanding depression and how to cope with it.

Visit Sue’s blog at smilinsuepubs.com for a plethora of health articles. Follow her on Facebook and Twitter @vitD3Sue.

© 2018 Smilin Sue Publishing, LLC. All rights reserved.

Anecdotal Evidence Butts Heads with Science on Matters of Diet

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Have you noticed how the nutritional world is changing all around you? Latest news on television: the drop in sugar consumption placed manufacturers at a tipping point of collapse. News a few weeks earlier: grocery stores are redesigning their stores and the products they carry because the middle aisles are not used by shoppers (that is where they usually keep cereals, grains, sugars, and canned or boxed processed foods, cooking oils). McDonald’s announced not too many months ago that they are dropping high fructose corn syrup from their buns and several other fast food chains advertise wholesome fresh foods without sugar. Restaurants are popping up where glutinous grains are not served.

The interesting commonality about all of this is that these are all anecdotal evidences that the scientific world refuses to notice. What will it take scientists to become curious? A change in funding sources for research perhaps?

No one is suggesting that anecdotal evidence is science. It is not. Anecdotal evidence is defined as follows:

“Anecdotal evidence is evidence from anecdotes, i.e., evidence collected in a casual or informal manner and relying heavily or entirely on personal testimony. … Thus, even when accurate, anecdotal evidence is not necessarily representative of a typical experience.” (Wikipedia)

By definition, scientific “evidence” doesn’t exist. So, we must use the scientific method’s definition:

“A systematic approach to solving a problem by discovering knowledge, investigating a phenomenon, verifying and integrating previous knowledge. It follows a series of steps that evaluates the veracity or the feasibility of a prediction through research and experimentation from where the information obtained will be used as a basis in making conclusions.

The fundamental steps of scientific method are:

(1) Identifying the problem to solve

(2) Formulating a tentative answer or hypothesis

(3) Testing the hypothesis

(4) Gathering and analyzing data

(5) Making conclusions” (from the biology online dictionary)”

Looking at it this way, the only way scientific examination can yield any results that can be interpreted in usefulness (or lack thereof) and officially applied to a population is by experimenting in a controlled environment, testing every possible outcome, and finding what does or does not work, and most importantly: find out why and/or how.

The Evidence for Diet: Anecdotal or Scientific?

One of the most studied databases for scientific research is the Women’s Health Initiative (WHI), which is an ongoing study of over 80 years. As you can see at this link, the data has been collected three ways: self-administered forms, interviews, and clinical measurements, such as a general physical exam. You can see here the data collection methods. There is absolutely no scientific method whatsoever in this study. The only difference between this study and a survey posted anywhere on the internet about what people eat, is who does the asking, the data collection, and where the funding comes from.

Another famous dataset that researchers constantly analyze is the National Health and Nutrition Examination Survey, the NHANES dataset. This too is based on surveys and questionnaires. The questionnaires for 2015 are found here. There is no scientific method applied in them whatsoever.

However, both the WHI and the NHANES have been treated as the gold standard for scientific evaluation to the degree of making health and nutrition regulation for the US over the past nearly 60+ years. The nutrition guideline (even the latest one created in 2015), the heart-health movement, high cholesterol treatment with the statin ideology, the low fat hypothesis by Ancel Keys, and several other nutritional and medical decisions, including reduced salt intake requirement for hypertension, originally called the Rice Diet founded by Walter Kemper, had all been made based on datasets like these. Note that these datasets are all just anecdotal evidence. They twisted our imagination into believing that they are science because of the funding source (often National Institutes of Health, the NIH), the scope, and the length of the data collection.

While there is no science in data collection, so much of our lives have been changed (often destroyed) by the regulations made based on the often-faulty statistical analysis of these datasets that it is scary. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) tells us that 2 out of 3 (67%) Americans are overweight or obese and 1 in 3 (33%) are obese. In 2014 (the latest statistics available), over 9% of the population had diabetes. In 2015, a JAMA report suggested that over 50% of the US population was either pre-diabetic or had diabetes by 2012. This is scary indeed!

Although the cause of these very sad changes are highly debated and controversial, it is important to note a very strong point: the start of the deteriorating health of the US population coincides with the nutrition and health regulations brought about as a result of these two and several other similar databases. Note that thee databases are collections of anecdotal evidence that masquerade as scientific evidence—they are not. There has never been any shred of scientific evidence that a high carbohydrate diet is healthier than a low carbohydrate diet, yet current nutritional guidelines suggest that there is such evidence. There isn’t any. There are many research papers published based on the assumption that these guidelines are correct, in which the researchers tried to prove that they are correct. However, in science, one cannot prove something correct. The role of science is to try to disprove by replication and finding mistakes and if all attempts at disproving fail, perhaps the findings stand. There is not a single research paper published according to these guidelines based on the above noted datasets.

The Diet Underground

While scientists argue and face-off in debates of trying to make each other look bad, there is a different movement taking place that is apparently unnoticed by scientists: it is an underground grassroots movement of people changing their dietary habits and shaking obesity, insulin resistance, type 2 diabetes, non-alcoholic fatty liver disease, hypertension, and all kinds of other health conditions. And they are doing it all by self-initiated dietary changes—not with the help of nutritional experts or doctors and definitely not with any medicines. It is because of this underground movement that grocery stores are now reevaluating the products they carry, why McDonald’s and other fast food chains dropped HFCS, and why people are stopping the consumption of vegetable oils and cook with animal fats instead.

Anecdotal evidence is piling up in favor of the health benefits of the “modern human” who no longer eats grains or sugar and who cooks with animal fats.

Social Media and the Rise of Anecdotal Evidence

I counted the number of weight loss groups on Facebook. There are over 500. At least five of these groups have over 20,000 members, so that is over 100,000 people. Ketogenic groups are much larger; many have over 70,000 members and one had almost 400,000 members. There are more ketogenic groups on Facebook than weight loss groups—I could never reach the end of the list after five minutes of scrolling so I gave up. I estimate the number of people in ketogenic groups to be over one million. Although the Atkins Diet is the original ketogenic diet, since few people realize that, there are about 100 Atkins Diet groups, with one boasting nearly 400,000 members and several over 10,000 so I estimate about 500,000 people on the Atkins Diet just on Facebook. Similarly, there are about 300 low carbs high fat (LCHF) groups of Facebook with several groups over 10 thousand in membership, one close to 40,000 so I estimate approximately 100,000 members in the LCHF groups.

If you visit any of these groups, you will find amazing success stories of weight loss, reversal of type 2 diabetes, pre-diabetes, insulin resistance, non-alcoholic fatty liver disease, allergies, arthritis, asthma, etc. In total, I just noted ~2 million people (granted some people may be in many groups but as a rough estimate) as anecdotal evidence (just on Facebook alone) who have proven (to themselves and to scientists who wish to listen) everything that flies in the face of nutrition and medicine guidelines currently enforced and practiced. Since scientists dismiss the movement as a fad, few scientists like me participate in observation, let alone practicing this “fad” to see if it really is better than the official guidelines-driven nutrition and healthcare.

As a scientist myself, I do participate actively in some of these Facebook groups, and even have several of my own, in which members practice these so called “fads” and indeed are shedding weight, healing from migraines, diabetes, insulin resistance, hypertension, etc. A scientist may now say that “but these are only placebo effects.” That is very hard to envision since these people also stop all their medicines, all of which came through clinical trials tested for efficacy against placebo. Increating to weight 400 lbs over the years on the officially supported nutritional guidelines in spite of all efforts to get rid of the weight, and then losing it all in a year by a nutritional change and becoming healthier at the same time, speaks volumes!! And I see this happen over and over again!

I often hear that “oh but this is just short term.” I have yet to have any scientist define what “short term” versus “long term” means in their experimental mode but someone who has been on a changed nutritional diet for over two years (me) is definitely not short term. There are many people who have been following these new nutritional paradigms for over 10, 15, and some 20 years. Is that really short term?

The Winners

The ultimate decision is not in the hands of the scientists, the nutritional experts, or the healthcare providers. The judgment of what people will do is in the hands of the people. It seems, just by sheer numbers and success stories, that science is losing out big time. Instead of opening their minds and evaluating why and how these nutritional changes work, most scientists stay closed off in their dogmatic corners. There are a few scientists who try to publish their findings of the benefits of the “fad” nutrition but they seldom get published because the publishers are members of the dogmatic team. In reality though, none of that matters. What matters is information exchange and the changing markets as a result of pressure by the majority who want out from under the dogma umbrella. One way or another the new and healthy will win. Whether you join or are left behind is only up to you.

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The Ketogenic Diet: What You Need to Know

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There is hardly a day that passes without seeing a new article popping up about the damage sugar and refined carbs can cause but only lately is the connection of sugar to obesity and metabolic disorders starting to be realized. Many people we know may have some weight problems or metabolic health conditions and follow some weight loss program—none of which seems to be effective in the long run. This makes sense. If any weight loss program had led to permanent weight loss, those using it could stop and the company promoting it would go out of business. Long-term (often life-long) membership is essential if one wants to avoid yoyo dieting.

Lately, I see many people rushing to change from the Standard American Diet (SAD) to various new diets, such as the Low Carbs High Fat (LCHF) or the Ketogenic diets. Are all these “diets” for weight loss? Some people call these “fad” diets, but are they?

There was a time when sugar covered cereals were called “fads” but look what has become of that fad! It has become our everyday SAD. Fad is “a practice or interest followed for a time with exaggerated zeal: craze” (here). Sugar covered cereals have been with us for over 100 years, so definitely not a fad. What about the LCHF and the ketogenic Diets? Are they fads? Maybe, maybe not. Let’s dig a little deeper into the ketogenic diet since I consider the LCHF a less strict version of the ketogenic diet.

Is the Ketogenic Diet a Fad?

Looking at its history, “[ketogenic] dietary regimens have been used to treat epilepsy since at least 500 BC” (here). The ketogenic diet utilizes a metabolic process that can be awakened by fasting—though fasting is not necessary. “The ketogenic diet was introduced by modern physicians as a treatment for epilepsy in the 1920s” (here). Therefore, we can safely say it is not a fad. Since it has been used therapeutically for seizures for a very long time, it is not a diet either. What it this ketogenic “thing”?

Ketogenic Metabolic Process

Ketogenic is the human native metabolic process. It is a different metabolic process from the process SAD requires. The ketogenic diet is mostly fat, limited amount of protein, and very small amounts of carbohydrates—the exact opposite of SAD. Eating carbohydrates or protein require insulin for conversion to glucose. Fat is the only macro-nutrient that doesn’t need insulin to generate ATP (Adenosine triphosphate)–in ketosis the role of insulin is fat regulation rather than glucose management to generate ATP (here). ATP is cellular energy, which, after all, is the goal of eating macro-nutrients.

Metabolic Processes

Image from Ketopia.

As you can see in the above image, the end-product for all metabolic processes is the same: energy. However, the complexity differs—this metabolism map is simplified. Note something very important: we can completely remove carbohydrates from the above diagram and not miss a beat in our energy creation. Protein only partially needs to be converted to glucose at the pyruvate step but some protein can directly turn into energy without conversion to glucose. We can remove all sugar, pasta, pizza, cereal, whole wheat bread, all fruits and vegetables from our diet and eat fat and protein instead to meet all our energy need. Most minerals and vitamins are found in meat and dairy so supplementation or eating fruits and veggies may not be necessary. Vitamin C is found in eggs and organ meats.

Why is Ketogenic Important?

Carbohydrates joined our evolutionary path several times, depending on how far you wish to go back. I choose to go back to just before farming. Prior to farming, carbohydrates were hard to come by, especially during the Ice Age. Even civilizations in hot parts of the world, such as the Masai in Africa, don’t eat carbohydrates because they have too little nutritional value. They eat meat, fat, milk, and blood—all high fat and nutrient-dense food. Carbohydrates are not nutrient dense since they lack many amino acids and fatty acids.

The ketogenic metabolic process, on the other hand, is rich in amino and fatty acids, minerals, and vitamins. See the chart below for vitamin and minerals and where we can find most of them.

nutrition in meat

Ketogenic is a simpler metabolic process that burns fat, so the belly you built up over the years can be used up as energy. Furthermore, since our brain is mostly made from fat, we might as well feed it fat. Feeding the brain fat is beneficial to your health in many ways. The ketogenic diet has been used therapeutically because of the high fat. It is used as curative today for epilepsy, cancer, type 2 diabetes, obesity, for neuromuscular diseases like Parkinson’s, Alzheimer’s, MS, sleep disorders and autism, and even migraines and much more. It appears that the ketogenic way of eating cures the negative consequences of the SAD diet.

Is Ketosis a Starvation Diet?

People often label ketosis, the method of fat burning in the ketogenic diet, a “starvation” diet. Some even call it a state of “acid-base disturbance” without realizing its importance. However, ketosis is far from being a state of starvation since our body has a lot more fat-storage ability than glucose (glycogen) storage at any given time. While our liver can retain maximum 500 grams of glucose equivalent in glycogen (about 2000 calories worth of energy), our body contains tens or hundreds of thousands of fat calories (depending on how much fat you carry). Should a famine ever arrive, the ones starving to death will be those who depend on the availability of carbohydrates and not those who can store and burn their fat.

We need to turn the “starvation” theory up-side-down. Carbohydrates (prior to our commercialization) were only available for short periods of time and only in some places where the climate was favorable. How did humans survive in cold climates or seasons? Eating fat and meat – of course – from the animals they captured.

How Can More Calories be Generated by Starvation?

From each gram of fat 9 calories of energy are generated, whereas from a gram of carbohydrates only 4 calories of energy is generated Which one is the starvation mode in your opinion? It seems that consuming carbohydrates makes sense only as a desperation move in times of fat shortages.

Note that if you eat only carbohydrates, you need to eat 2.25 times as much as when you eat fat since carbs only generate 4 Calories whereas fat 9 (simple math). I would think that a starvation diet becomes necessary when nothing better is available. In this case, carbohydrates offer less than half the energy so that is indeed the starvation diet. Furthermore, the length of time one needs to eat also matters. Surviving on carbohydrates takes 2.25 times as long eating-time as surviving on fat if we want to eat the same amount in calories. This translates very well to our modern society where eating three main meals and two snacks is necessary to survive on a carbohydrate rich SAD diet while those on the ketogenic diet may eat only once a day to get the same calories (this is because of the calorie differences macro-nutrient types provide). Since the ketogenic diet is so much more advantageous, let’s evaluate some common beliefs about it.

Keto Flu

Keto flu is not an illness. It represents a transition time for your body from carbohydrate to fat burning mode. It requires the cooperation of many hormones and the replacement of some cells since these metabolic processes are extremely different. During this initial period you don’t burn fat efficiently, you may feel more tired during workout, have a headache, cramps, or bad breath. This period may last anywhere from a couple of days to several months. It does dissipate, however, but most academic research has been conducted for too short a time period for the keto flu to pass and much fight is ongoing to prove that. The subject is still only discussed within academic circles.

Individuals who try the ketogenic diet have little support from their doctors and nutritionists, most of whom have never heard of the ketogenic diet because they must follow the dietary guidelines of the USDA or the American Heart Association. As a result, people must rely on the often inaccurate ketogenic material found on the Internet, as this dieter explains.

Useful Ketogenic Information

Ketogenic diet is inhospitable to most parasitic and bacterial life in the human body (here). Bacterial infections, yeast and perhaps even mold find it impossible to survive in an environment that uses fat rather than glucose for metabolism (here). Cancer is a metabolic disease that feeds on glucose (here). Where there is no glucose (or a very limited amount), there is a much smaller likelihood of cancer–cancer is a metabolic disease (here).

My Experiences with Dairy

Whole milk doesn’t affect ketosis . Whole milk has no sugar (in spite of the label on the box). It has lactose. Lactose is a disaccharide, meaning two molecules are bonded: glucose and galactose. Lactose requires the enzyme lactase to break it up and this happens in the intestines. Therefore, the sugar from milk doesn’t increase in the blood until the enzymes have broken lactose into glucose and galactose (here). Since lactose is a disaccharide bond between glucose and galactose, only 50% of it is glucose. While glucose certainly finds its way back to the blood from the intestines, it does so slowly and perhaps some happy bacteria already fermented some of it. So, even the assumption of 50% returning as glucose is very generous.

Lactose free milk affects your glucose levels immediately because in this type of milk the lactose is already broken up into the simple sugars of glucose and galactose (here). Don’t drink lactose free milk in ketosis.

Yogurt interferes with ketosis because of the fermenting of lactose by the bacterial cultures produce lactic acid (here). This means that much of the lactose bonds have been broken before you put yogurt into your mouth. Yogurt will likely bring you out of ketosis—depending on how much glucose is left unfermented in it.

Medicines, Supplements, and Ketosis

Prescription medicines as well as some supplements may interfere with ketosis (here). This is rarely if ever talked about but I can pass on my experience. Many medicines and supplements use insulin receptors to get into our cells. A notorious prescription medicine to instantly bring you out of ketosis is Prednisone—including corticosteroid epidurals. Prednisone uses up all the insulin your body is capable to produce (it can induce type 2 diabetes) and starve the brain of glucose (some brain parts always need glucose though small amounts). The more the brain demands glucose, the more glycogen the liver pumps into the blood but as there are no free insulin receptors, blood sugar levels may reach near diabetic level (mine did from Prednisone).

Some vitamins, such as vitamins D and C also use insulin receptors and you may find similar behavior to Prednisone (here). Some medicines may work against ketosis. The ketogenic diet works best in a medicine free body because this “diet and nutritional supplements improve so many conditions that the prescriptions often become an overdose or unnecessarily strong” (here). Furthermore, Western Medicines are made to work in a carbs-burning metabolic process so it is not at all surprising that they don’t work in a fat burning metabolism.

For example, some seizure or heart arrhythmia medications may become agonists in a ketogenic metabolic process. Ketosis is a state when your body is in recovery mode, rebuilding fat and cholesterol in your brain and heart to insulate your voltage passing neurons. Medicines that block these neurons from working, such as voltage gated calcium channel blockers or voltage gated sodium-potassium pumps or channels blockers, may end up amplifying the  condition by working against the medicine while the medicine is working against the ketogenic repair process—this happened to me.

A person should not come in and out of ketosis. One is either in the ketogenic metabolic mode or out. A body can only have one metabolic process at a time given that both processes use insulin but for very different purpose–as described earlier. When a body is not used to eating carbohydrates, the insulin resets to a healthy level. This means that the reaction to a cheat day may bring with it a diabetic level insulin spike. Repeat this often and this may become a factor in insulin resistance that perhaps nothing can reverse. So make a decision and stick with it. As my body proved it to me (and to a few others in the ketogenic mild for migraine group on Facebook), once the body is in efficient fat-burning mode, it wants to stay there.

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