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+1 more anecdote, I was never diabetic, but doing keto for a year helped me lose 60 lbs and regain my insulin sensitivity.

Even now if I eat keto for breakfast and lunch and moderate carb for supper. Even when I have the occasional high-carb meal, I feel dramatically different than I did before keto/weight loss.

I don't know about the pancreas, but both abstaining form alcohol and keto are shown to dramatically reduce the amount of fat stored in the liver.

kruhft 3850 days ago

What signs made you know it was safe to go off your bipolar meds?

viewer5 3850 days ago

For anyone reading: Please consult your doctor before altering your dosage of mind-altering medications. Some of them, for example, have to be stepped down in dosage gradually, lest bad side effects happen.

hyperchase 3850 days ago

My psychologist decided they weren't needed any more.

kruhft 3850 days ago

I'm curious how your psychologist came to that conclusion. Was it your suggestion to come off the meds and they agreed?

https://scholar.google.com/scholar?hl=en&q=ketogenic+diet+bi...

jawilson2 3850 days ago

I don't think this is standard-of-care yet, though some docs I know will go this route. There is a good amount of emerging research of the positive effects of the keto diet on brain health, including bipolar disorder:

https://scholar.google.com/scholar?q=ketogenic+diet+neuropro...

culturestate 3850 days ago

I'm not diabetic, but I completely agree with the subjective improvement that comes with a low-carb diet. Even a light-ish carby meal -- say, penne with pesto -- makes me feel substantially heavier and more bloated than eating a steak slathered with butter.

brandonmenc 3850 days ago

Anecdotally, my father didn't develop the disease until after he went on a ketogenic diet, but the doctors believe chronic lack of sleep caused his diabetes so diet probably was not a factor either way.

hyperchase 3850 days ago

That's unfortunate. Type 1 or 2 diabetes? My mother is T1 and she cannot do a low-carb diet because of the possibility of ketoacidosis, which she's already been hospitalized once for.

datiecher 3850 days ago

I would suggest she tries the program created by Dr. Neil Barnard in this case as he actually uses a low fat high carb diet in order to reverse diabetes. Both my father and father-in-law got rid of the medications (my inlaw even had to take insulin before the program) and have overall improved their health, lost weight and are feeling much more energetic. My father was able to be out of his medications after two months and my father-in-law in 4 months.

Here's the Amazon link for book about the program and you can also read the reviews of many people who have successfully changed their for the better as well: http://www.amazon.com/Neal-Barnards-Program-Reversing-Diabet...

beachstartup 3850 days ago

i'm a keto True Believer[tm] but removing carbs also just immediately removes a ton of calories which directly contributes to weight loss. you can eat a surprising amount of protein and fat and veg and won't replace the calories lost.

a hamburger bun, and a plate of french fries is honestly like a thousand calories. one thousand! that's like a huge ribeye steak.

you don't even want to know how many calories are in a mission-style burrito tortilla. it's completely out of control. that kind of food is meant for hard labor, not internet finger tapping.

Removing fat and alcohol would do you much more good, if calories are your primary concern -

    Fat: 1 gram = 9 calories 
    Alcohol: 1 gram = 7 calories 
    Carbohydrates: 1 gram = 4 calories
    Protein: 1 gram = 4 calories

beachstartup 3850 days ago

these discussions always devolve into a bunch of numbers by diet pedants who seemingly have no passion for cuisine.

i'm sorry but all the numbers in the world will not make me give up a nice fatty spiced chicken shawarma, or a juicy sausage and kraut, or a nice ribeye steak with a glass of pinot noir. i'd rather be dead and in the ground.

on the other hand, i'm fine skipping the bread and eating just a couple of fries.

https://www.ncbi.nlm.nih.gov/pubmed/21757270

The incredible thing is, our tastes physically change in just a matter of several weeks. You're encouraged to try healthy eating as an experiment for just three weeks - I think you may change your mind on consuming unhealthy foods.

> An inability to perceive low concentrations of fatty acids in foods was associated with greater consumption of fatty foods, specifically butter, meat, dairy, and increasing BMI.

> Within a behavioral economic perspective, the reinforcement value of low-fat foods may increase following a low-fat dietary intervention, whereas the reinforcing properties of high-fat foods may decline. This is desirable as low-fat foods hold many advantages over high-fat foods in terms of weight maintenance.

https://www.ncbi.nlm.nih.gov/pubmed/12725716

> The preference results of this study demonstrate a steady, progressive decline in liking for salt in soup following dietary intervention and monitoring activities aimed at reducing sodium intake. Approximately 3 mo were required for preferences to stabilize at a significantly lower salt level, which was maintained at 1 yr. This may be of relevance in clinical settings where low-sodium diets are used for treatment or prevention of hypertension.

https://www.ncbi.nlm.nih.gov/pubmed/3728360

> Alterations in the fat content of the diet modulated taste sensitivity to C18:1 among lean subjects, which was increased following a 4-week period of fat restriction and attenuated following the high-fat diet. The failure of the high-fat diet to alter fatty acid taste thresholds among OW/OB subjects suggests that these individuals were 'adapted' to high-fat exposure, perhaps because of differences in habitual fat consumption. Taken together, these data suggest that excessive dietary fat attenuates nutrient sensing epithelia response in the oral cavity, which could be associated with changes in diet and weight status.

https://www.ncbi.nlm.nih.gov/pubmed/21829156

eclipxe 3850 days ago

Another vote of confidence here. Keto makes a huge difference.

atom-morgan 3850 days ago

Paleo here. Can confirm it's been great for me as well. And I just wrapped up a month with no sugar (drinks, candy, added sugar, etc).

BlakePetersen 3850 days ago

Diabetes isn't about sugar specifically, it's about carbohydrates. I'm sure you didn't have a "no carb" month -- which means your point is kinda meaningless. You may have avoided the 38 grams of sugar in that can of coke, but did you compensate by eating 4 handfuls of grapes?

To a diabetic, all carbs are bad, not just the ones that rot your teeth.

https://www.ncbi.nlm.nih.gov/pubmed/23050853

I believe you're meaning to allude to refined carbohydrates, like the ones found in soda drinks. "No carbs" would mean consuming no fruit or vegetables, at all - not exactly a practical strategy for healthful eating. (Note: grapes are especially high on the glycemic index and not an ideal representation of healthy carbohydrate, so your likening them to a can of soda isn't entirely inaccurate)

> The vegetarian diet (~60% of energy from carbohydrates,15% protein and 25% fat) consisted of vegetables, grains,legumes, fruits and nuts. Animal products were limited to amaximum of one portion of low-fat yogurt a day.

> In conclusion, a vegetarian diet led to a greater improve-ment in quality of life and mood. Patients consuming a vegetarian diet felt less constrained than those consuming the conventional diet. Disinhibition decreased with a vegetarian diet. The decrease in feelings of hunger tended to be greater in the vegetarian group. All these results suggest that a vegetarian diet is sustainable in the long term and may exhibit desired improvements not only in physical, but also in mental health of patients with Type 2 diabetes.

atom-morgan 3850 days ago

Never said it was. The topic just made me think of it is all. And I didn't substitute with a ton of fruits. I barely ate any. I also eat very little carbs.

aantix 3850 days ago

Is there any way to quickly induce ketosis?

itchyouch 3850 days ago

Semi-strenuous exercise to deplete available glucose, immediately followed by fasting.

Cardio works well for this. Options aren't limited to running. Speed walking or slow walking at a 5-15% incline on a treadmill for some amount of time can achieve the necessary glycogen depletion.

Consuming coconut milk as a fat source with its high level of medium chain triglycerides also generates more ketones per fat ingested then other fat sources

Since glycogen storage requires lots of water, losing 1-5lbs in water weight after exercising is a good sign that the glycogen stores have been depleted enough for the body to start looking for other sources of energy. One should be able to hit the scale, go exercise and sweat a ton, then go back to the scale 30mins to an hour later and see the water depletion. For myself I will hit the treadmill walking at 15% incline @ 2-4mph for 45mins to an hour while profusely sweating from the 3min mark till I stop.

DrScump 3850 days ago

Low-intensity exercise uses free fatty acids, not glucose/glycogen, as its primary fuel.

This is not a binary thing, as intensity increases the substrate gradually shifts from FFAs to glucose. If one has been starving, fasting or eating very low carb for a while, the muscles will also use ketone bodies in place of glucose.

Not really, ketosis starts when the liver is depleted of glycogen. While you can try to use vigorous exercise to speed this along, vigorous exercise will primarily target the glycogen stored in your muscle which does not effect ketosis. If you simply start eating < 25g of net carbs you will be in ketosis in 18-36 hours, no magic or pain needed. Do keep in mind that insulin (which you will not be producing much of) also controls electrolyte retention so you may need to increase your intake or supplement (see r/keto for details and advice) .

hyperchase 3850 days ago

Eat less than 25g of carbohydrates per day, you will be in ketosis in about 24 hours when your liver glycogen is depleted. Drink lots of water, and suppliment electrolytes (sodium, magnesium, potasium -- drinking a cup of beef broth every day and using a "No-Salt" substitute on nearly all my food is what I do) to avoid the dreaded "keto flu".

CompelTechnic 3850 days ago

Stop eating.

wavefunction 3850 days ago

No, this just puts your body into starvation mode.

You should eat proteins, vegetables (especially leafy green ones) and a moderate amount of fruit. Natural fats like animal fats are ok too, depending on other health factors.

I am not a doctor but a ketogenic diet helped me lose weight and feel great. 230lb back down to 165lbs, but I am healthiest it seems around 183lbs.

https://www.drmcdougall.com/health/education/health-science/...

> This same condition, ketosis, occurs naturally when people are literally starving to death or seriously ill. During starvation this metabolic state is a kindness of nature allowing the victim to suffer much reduced pains of hunger while dying. During illness the suppression of the appetite frees the person to rest and recuperate, rather then be forced by hunger to gather and prepare food. Because ketogenic diets simulate this metabolic state seen with serious illness, I refer to them as “the make yourself sick diets.” As we will see below, another reason low-carbohydrate, high-protein diets deserve this title is they contain significant amounts of the very foods — the meats — that the American Cancer Society and the Heart Association tell us contribute to our most common causes of death and disability.

> A plant-based diet beat out the conventional American Diabetes Association diet in a head-to-head randomized controlled clinical trial, without restricting portions, no calorie or carb counting. A review of all such studies found that individuals following plant-based diets experience improved reductions in blood sugars, body weight, and cardiovascular risk, compared with those following diets that included animal products.

http://nutritionfacts.org/video/plant-based-diets-for-diabet...

http://authoritynutrition.com/23-studies-on-low-carb-and-low...

The diets most keto advocates support is not high protein; rather, it is high fat, moderate protein, very low carb (< 25 net grabs daily). The science to date supports that as being a very healthy diet, especially if your fat source is not omega-6 polyunsaturated fat, but is instead dominated by monounsaturated, omega-3 polyunsaturated and yes, saturated fat.

Oh, dear.

First study:

> Dr. Hill reports having received consulting fees from HealtheTech, Johnson & Johnson, Procter & Gamble, Coca-Cola

Second study:

> This study proves a principle and does not provide clinical guidance; given the known benefits of fat restriction, future studies evaluating long-term cardiovascular outcomes are needed before a carbohydrate-restricted diet can be endorsed.

Third study:

> The study was designed to compare weight loss and cardiovascular risk in the short term; our long-term results, although appearing successful, must be considered as anecdotal, and further long-term follow-up studies must be conducted to confirm these findings.

Fourth study:

> Although advocates for very low carbohydrate diets are likely to embrace the results of this study, several points of caution need to be emphasized. First, a single study of a specific dietary regimen cannot provide a full assessment of safety and efficacy. Despite this study being the longest randomized, controlled trial of a very low carbohydrate diet reported, our results are still limited by the 6-month time frame. Whether the very low carbohydrate diet will produce sustained weight loss and continued improvement in cardiovascular risk factors over longer periods of time remains to be determined; the gradual increase in carbohydrate consumption in the final 3 months of the study suggests that some degree of recidivism is likely in persons on this diet. In addition, increased dietary fat has been linked to certain types of cancer and may have effects on cardiovascular health beyond the risk factors assessed in this study.

Fifth study:

> Financial Interest: Dr Hennekens is funded by the Agatston Research Institute, a nonprofit foundation, as Director of Research.

Sixth study:

> Participants were healthy and were followed for only 24 weeks, factors that limit generalization of our results. The low-carbohydrate diet has not been studied extensively in patients with chronic illness, and certain patients may require close medical supervision when following this diet. Furthermore, weight loss resulting from the low-carbohydrate diet may be difficult to maintain after 24 weeks.

> Potential Financial Conflicts of Interests: Grants received: E.C. Westman (Robert C. Atkins Foundation); Grants pending: E.C. Westman and W.S. Yancy Jr. (Robert C. Atkins Foundation)

Seventh study:

> This study was supported by a grant from The Dr. Robert C. Atkins Foundation, New York, NY.

Eight study:

> There were initially 20 subjects enrolled in each experimental group [...] Over the course of the study, four subjects dropped out of the LF group and five dropped out of the LC group.

Ninth study:

> 28 overweight premenopausal women consumed either a low-carb or a low-fat diet for 6 weeks. The low-fat group was calorie restricted. [calorie restriction does not work in the long term, period]

Tenth study:

> Carbohydrate restriction was an effective method of achieving short-term weight loss compared with standard advice, but this was at the expense of an increase in relative saturated fat intake. [saturated fat causes CVD and other chronic illness]

Eleventh study:

> Mood and other symptoms were evaluated by participant self-report using the Atkins Health Indicator Test [I'm sure that's not at all biased /s]

Twelfth study:

> Limitations included the lack of a valid and comparable assessment of individual adherence to the 4 different diets, the lack of data on whether participants had familiarity using any of the specific study diets prior to enrolling in the trial, and the lack of assessment of satiety.

Thirteenth study:

> Whether either of these diets would produce similar outcomes over longer periods and under ad libitum conditions or in populations that are more vulnerable to adverse effects, such as persons with specific psychological difficulties, requires further investigation.

Seriously, I had to stop at that. I'm sure the rest are also short-sighted and cannot be generalized as a healthful diet.

Care to explain why the many people who post their bloodwork every week on r/keto have lowered body weight, improved lipid panels, better fasting glucose scores? Its easy to say these are anecdotal, but when it happens weekly for years- (That of course not to say its well controlled, because of course its not, or that there may not be some sampling bias).

I gave it a try myself and judged it by all the objective and subjective measures at my disposal. It works (at least for me).

I can respect your skepticism, are the pending studies being done by http://nusi.org/ well enough designed to be considered weighty by you?

You've basically nailed it - the evidence is anecdotal and, coming from a keto echo-chamber, is obviously subject to confirmation bias. Therefore, these findings cannot be trusted as statistically significant.

By the same measure, we could argue smoking cigarettes is a reasonable, even healthful thing to do (on a slight tangent: exactly that was suggested by doctors in the 50's and 60's) - after all, we all know heavy smokers who haven't dropped dead, but on the contrary seem alive and thriving.

I'm glad it worked for you, but have you also fairly and objectively evaluated a plant-based, high-carb, low-fat diet? I think only then can the two be compared without bias, at least as I see it.

Regarding NuSI - I could write many paragraphs about the organization. If you have some time, please do check out these critical, detailed videos: http://plantpositive.com/warning-signs-nusi-guys-1/ and let me know what you think.

DrScump 3850 days ago

"During starvation this metabolic state is a kindness of nature allowing the victim to suffer much reduced pains of hunger while dying."

I hope you have a cite for that, as it ignores the basics of natural selection.

There is no way "nature" would select for a means to reduce the discomfort of starving to death, as death would remove that being from the gene pool, leaving that mechanism out of the gene pool as well.

nitrogen 3850 days ago

What appears to work best on the scale of a clinical study may not work so well for some subsets of the population. I've yet to find any sort of plant-based meal that makes me nearly as energetic and satisfied as one that includes animal protein of some kind.

Please check my related comment below about adjusting taste preferences. While it's true a greater amount of non-animal foods are necessary on account of them being generally less calorically dense (while at the same time being more nutrient dense), you can certainly find meals to satisfy your desires with patience and resolve. Start small - replace the beef patty with a black bean patty, for instance.

Do you realize that most people that "do keto" end up eating more veggies that they did before? There are tons of keto friendly veggies.

You can eat a ketogenic diet and eat nearly unrestricted amounts (except by satiety) amounts of things like cabbage, cauliflower, radishes (great cooked btw), brussel sprouts, spinach, green onions, broccoli, kohlrabi, lettuce, avocado, sprouts, green beans, rutabaga, leeks, yellow squash, zucchini, mushrooms, herbs.

Add that with some fish, meat, nuts and/or cheese and you have a very healthy diet.

Between the satiety of fat/protein and high-fiber foods above, its very easy to hit one's caloric goals and have a minimal blood glucose level.

Thanks - I wasn't aware of such diets, and I'm glad to hear people are eating their greens regardless of which diet they follow.

However, you're incorrect to assume adding meats and dairy products - even so-called "lean" ones - which are laden with cholesterol, saturated and trans fats - is at all healthy. All credible evidence suggests quite the opposite. If you have any studies which contradict my assertion, I would love for us to examine them together.

I mean you no offense, but to me it sounds like your understanding of nutrition science is 10 years in the past.

I do want to point out naturally occurring transfat has very different properties than the artificial common forms. I have never seen a well designed study show a low-fat diet to be superior to a high-fat-moderate-protien-very-low-carb one (usually referred to as VHFLC). I'd be interested if you know of any.

It is no longer generally accepted that dietary cholesterol is dominate factor unless you have mutation such as some of the PCSK9 mutations. Your body syntheses much more cholesterol everyday than you actually eat. The latest US government dietary guidelines has drastically shifted its position on cholesterol, write-up: https://www.washingtonpost.com/news/wonk/wp/2015/02/10/feds-...

We have since learned many things such as the importance of HDL/LDL ratio as being predictive over just LDL for example.

This is a very complex topic and I would recommend this series written by a MD: http://eatingacademy.com/nutrition/the-straight-dope-on-chol...

This is a 5 part series befitting the complexity of the issue at hand.

DrScump 3850 days ago

"However, you're incorrect to assume adding meats and dairy products - even so-called "lean" ones - which are laden with cholesterol, saturated and trans fats"

Oh, dear.

First of all, meat and dairy don't HAVE meaningful amounts of transfat. Problematic transfats are man-made.

Secondly, there is NO proven link at all between dietary cholesterol and blood cholesterol absent carbs, Essentially all blood cholesterol is manufactured by the liver.

By all means, display your "credible evidence" to the contrary.