[throwaway_tech]

The title is terrible, it should read ketosis/ketones may prevent, reverse age-related effects within the brain.

"Low carb" as the title currently reads does not necessarily result in ketosis and your body/brain running on ketones, which appears to be the scope of this study. There is more to dietary ketosis than low carb, just as an example carnivore or paleo diets are low carb, but those will generally not result in ketosis, in protein rich diets your body will convert the protein to glucose which will continue to be the primary fuel for the cells in the brain/body.

If you have never entered ketosis and experienced your brain running on ketones, I would suggest you experiment for yourself. I would say a minimum 2-3 months which should be enough time for your microbiome to change and your body/brain to adapt primarily running on ketones.

[bad_user]

> If you have never entered ketosis and experienced your brain running on ketones, I would suggest you experiment for yourself. I would say a minimum 2-3 months which should be enough time for your microbiome to change and your body/brain to adapt primarily running on ketones.

I've been on Keto for about 8 months (before giving up), measuring my blood ketones and being in deep ketosis between meals (over 2 mmol/L). I've also seen values going over 4 mmol/L.

In spite of popular belief, nothing happens, there's no magic at the end of that rainbow for most people. If you felt anything different, there's a high likelihood it was just self suggestion, aka placebo.

Also most people are in ketosis before eating breakfast in the morning, because the liver's glycogen is partially depleted overnight, enough for the liver to produce significant ketones. And nothing will make you enter ketosis faster like skipping a meal or two (aka starvation ketosis). People with a healthy metabolism cycle in and out of ketosis all the time.

Also the idea that your microbiome has to change and your body/brain to adapt for you to feel any better and that it takes months ... is a complete myth. Your body takes only mere days to adjust to any dietary strategy. Also the dreaded keto flu is just dehydration from all the lost glycogen, which pulls a lot of water on its way out.

[_brnu]

I actually agree with most all of your posts. The one big difference, though, in my opinion, is that when adapted to a very low carbohydrate diet, it's actually easier for me to not eat. That's it. To me, it's the lone advantage. It's not about the palatability of the low-carb meals. It's that I just seem to be less hungry. I can skip a meal and it's no big deal. When I'm higher carb, missing a meal takes a way bigger toll.

One other thing I'd offer -- for long endurance activities at higher heart rates (e.g., cycling in zone 4 for more than an hour), you absolutely have to supplement with carbs. You can go a long time in Zone 3 on a low carb diet, but as exertion increases, you burn through those sugar stores and bonk. I've tested this repeatedly. In case it's helpful to others, you can consume quite a bit of sugar on a hard ride and be right back in ketosis hours later as your muscles take up the glucose first.

[windexh8er]

When you state "very low carbohydrate diet" - what do you mean? Do you mean you're actively avoiding fruits and vegetables, oats, nuts, etc? Or are you avoiding processed foods and the carbs that go along with that? The "carbs are the devil" argument is a huge misconception with people.

You mentioned that it's easier for you to not eat on a very low carbohydrate diet. My main eating regimen is two feeding periods that are generally between 12:00P and 8:00P. My diet is mainly plant based, so very high in unprocessed carbohydrates - and I do still eat fish and am also not opposed to eggs from time to time. I have no problem not eating. If I don't eat at all until the early evening I am generally never hungry.

So I'm genuinely interested in what you mean by "high carb". Processed carbs and satiety don't go hand in hand, but a "high carb" intake of whole foods is not remotely the same.

[PudgePacket]

It's a tricky subject because everyone uses different definitions of "low carb". I've seen positions from dietary bodies that define "low carb" as less than 40% of your total caloric intake from carbohydrates, which is still a massive proportion.

That is why "very low carb" was introduced, obviously still not ideal.

For _me_, I'd say I eat very low carb, I aim for max 10-20g of total carbs a day.

Yes people tend to get stuck on "carbs" as a single entity and demonise it, which helps nobody.

My perception is most people on low/very low carb diets avoid as much processed food as possible, then get their remaining carbs primarily from non-starchy vegetables like broccoli, spinach, kale, etc.

[hcurtiss]

By "high carb," I only mean to suggest easily-digestible high-glycemic index carbohydrates. I really do think there's something to the blood glucose spike and crash cycle and its relationship to satiety. I suspect you agree with that. However, whether through plants or other foods, I think it's the fat that most effectively satiates. You can get those fats through nuts and plant oils, but I find it's easier and tastier to get it through butter, eggs, and red meat.

[windexh8er]

With regard to agreement, not exactly. There's a lot of research around high fiber intake being one of the most prominent indicators of satiety [0]. Keep in mind most all meats are densely loaded with calories compared to whole plants. Fats are less satiating than fiber in many studies [1]. Hence it's far easier to overconsume fats via meats because no meat contains fiber and, again, is more dense per gram with regard to fat.

[0] https://www.nature.com/articles/s41430-018-0295-7

[1] https://www.ncbi.nlm.nih.gov/books/NBK53550/

[hcurtiss]

I don't actually read either of your linked studies to support what you say. But be that as it may, I think fiber is also satiating. It's just difficult to hit my macros when eating all broccoli. Broccoli, butter, and steak, on the other hand, is a nearly perfect meal. I get the sense you're invested in a plant-based diet. Good for you! I'm sure there are way to engineer the outcomes you want with plants.

[bad_user]

The postprandial hypoglycemic episodes are very rare in people that don't have diabetes, being most of the time a sign that the first-phase insulin action is impaired.

T2D is a disease of glucose intolerance, but diabetics actually deal with two problems ... insulin resistance, which the keto people focus most on, but they also deal with impaired insulin action, i.e. the ability of the pancreas to respond is impaired. What happens is that the first-phase insulin action is delayed such that later insulin action is exaggerated, causing the subsequent blood sugar crash.

And this is still not T1 diabetes, there are people in which insulin action is impaired before the insulin resistance sets in and it's still classified as T2D.

Keto proponents love to talk about this problem, but it's not a common phenomenon, not even in people that are overweight or pre-diabetic.

---

Speaking of which the Keto diet does lead to impaired insulin action, coupled with physiological insulin resistance — mostly due to the "glucose sparing effect", a natural phenomenon that's reversible — but this is why the ocasional treat can send your blood glucose through the roof.

When people on Keto start measuring their glucose, they are surprise to discover just how much the starchy treats can raise their blood glucose, however this effect is misleading, because you wouldn't get the sugar spike if you weren't on Keto ;-)

This is one of the reasons why endocrinologists recommend diets that are over 100 grams in carbs per day to T2 diabetics. Because a very low carb diet requires total compliance, otherwise those hyperglycemia spikes can wreak havoc.

Keto proponents don't like to admit, but high carb diets made mostly of whole plants can be even more effective in keeping blood sugar in control, in dropping HbA1C and in losing weight.

---

> "I think it's the fat that most effectively satiates"

This is a myth. Fat might be more satiating per gram, but not per calorie.

If you look at the satiety index, the foods that are most satiating tend to be low in fat and many of those items are high in carbs (by keto standards). We are speaking of items like boiled potatoes, legumes or vegetables, or lean meats like chicken breast or cod. Potatoes are what you call a "high-glycemic index" food and yet boiled or baked potatoes stay on top in every satiety test.

You should be able to see for yourself actually — compare chicken breast with chicken thigh. Same animal, same kind of protein, different fat and calories amount per gram. Eat the same amount of calories on different days and see how you feel. We have a brain hardwired to seek foods high in calories and a chicken thigh is less satiating than a chicken breast simply because the former has more calories due to the fat and thus we end up liking it more.

More importantly we've got studies on the subject and high fat diets lead to less satiety and more calories being eaten versus low fat diets:

https://europepmc.org/article/med/9225171

Also see this paper on the Swedes:

https://www.researchgate.net/publication/281229072_Politiciz...

---

N.b. foods like boiled eggs are satiating in spite of the fat — unless you're talking about protein and "protein leverage", fat and carbohydrates are energy macros and do not promote satiety in any way, unless you're talking about fiber.

So what promotes satiety is:

1. fiber and volume (found in whole plants)

2. protein (e.g. the "protein leverage" theory, which is still under debate, but at least we've got some evidence for it)

3. blandness

Reasons (2) and (3) are the real reasons Keto works short term. But appetite always comes back, esp in a high fat diet. When I was on Keto I used to binge eat plain full fat butter and used to eat 1 Kg of grilled fatty pork cuts in a single sitting. And I gained weight of course.

[tracker1]

I'd say modern grains and "vegetable oil" are probably the biggest issues... heritage grains in moderation are more okay. We take in a lot of refined grains and sugars. And cook everything in oils people wouldn't recognize as food a couple hundred years ago, let alone trans fats.

That combined with a huge uptick in constantly eating all the time, sugary drinks, etc... eating 6-8 times a day. Most people can get away with 1-2 meals a day and a small snack or coffee outside those main meal(s). Longer fasting has historically been involuntary and/or religious, has other benefits that should be included pretty regularly as well.

I think animal proteins and fats are good to keep, even just eggs, butter and fish. There's a lot of nutrition in egg yolks, kidney and/or liver meat and it isn't the same from vegetable sources. Animal protein is also a bit different in terms of absorption than vegetable as well. It's not hard for people to get 100-150g of appropriate protein a day on average either and doesn't have to come from higher animals.

[bad_user]

There is no evidence available that "vegetable oil" is unhealthy in any way, other than the calories.

There is no good evidence for example that "Omega-6" rich oils are inflammatory, quite the contrary, we've got several systematic reviews and meta analyses claiming they are not. And the n-6 : n-3 ratio is completely arbitrary (most ratios in nutrition are). We've got much better evidence for example that saturated fat does raise LDL and that LDL is causal in heart disease.

There's also nothing wrong with eating 6 times per day, unless you end up eating too many calories. If you meant to say that people eat too much, then yes, we do eat too much, but meal frequency has nothing to do with it. Many people can easily eat 4000 kcal in a single meal and those with binging problems often do, so while reducing meal frequency can be a good strategy for some people, it's a poor strategy for others. E.g. OMAD is a recipe for eating disorders.

We do agree that animal products can be part of a healthy diet, it's much easier to get adequate protein from lean meat, eggs are a good source of choline, folate, vitamin A and dairy is a good source of calcium. In the standard diets of the western worlds however, we have no shortage of animal products, what we have is a shortage of whole plants.

[tracker1]

Modern grain varieties don't resemble their heritage counterparts. Modern wheat (since the 70's) sees something like 19x the immune response. As to seed oils, frankly I just don't see a need to support heavily processed and refined foods in general, in particular margarine and vegetable shortening.

As far as over-eating and meal frequency... hormones are part of the calculation, you can clear more calories with less hormone response in fewer meals. If you look at tribal cultures with a food abundance (near coastal fish) would only eat once a day or so. Spiking glucose/insuline more times a day isn't so great in general.

I think we're mostly on the same page... I'm more than happy to see people eat more from whole plant meals with a more nose to tail approach to meat consumption. Not to mention a huge a shift in the types and qualities of meat and fish.

I think the level of refined sugars, oils and modern grains are a big problem... so is, for that matter, poorly raised animals and mono-farming in general. Optimizing for yield and efficiency seems to have lost a lot along the way imo.

One aside, while some can eat massively in a single meal... it's very hard for most people to overeat in a single meal. Harder still to do it consuming meat/eggs/fish and greens. Calories count, calories are king in terms of what we eat... and hormone response is queen.

[com2kid]

I disagree a bit about the zone 4 thing.

https://imgur.com/a/HvHcOFV

I quit that workout because I got /bored/.

I've done 4 hour MMA training sessions in Keto, no endurance issues at all, no HR strap though so no #s.

[kyuudou]

I disagree partly here based on personal experience with BJJ. I simply cannot summon fast-twitch muscle "burst" cardio on a full keto diet. After months of trying all kinds of workarounds, I had to carb-load with glucose pills (the kind diabetics take) the night before and pre-workout.

Long-term steady endurance massively increases though. If there's no bursting, I find that I can workout for hours on keto, it's amazing. It's kind of like the difference between regular diesel engines and gasoline+nitrous engines. Patience and focus seriously improve as well.

My limited understanding is that glycogen stores in muscles get depleted on full keto and must be replaced with some kind of carb intake, whether through excess protein-to-carb conversion or through normal carb intake, that "burst" energy simply isn't going to be there.

Example: I'm on the bottom in full mount and I know I need to burst to sweep somehow or shrimp out after bucking. Energy just wasn't there, time and time again. I could do jumping jacks forever, though.

I'd love to hear your feedback on this, like, what your protein intake is vs. fats.

[com2kid]

> I disagree partly here based on personal experience with BJJ.

My experience includes BJJ! :)

Of note I've been keto adapted for years, so I am likely an edge case.

That HR recording I linked to is of a kickboxing endurance bag workout (Bas Rutten's routine if you are at all familiar with it), nothing but explosive power against a bag, every punch 100%.

Now at the end of it, can I lift as heavy? No, carb load and I'm adding an extra few pounds to the bars, but it isn't a huge difference.

> I'd love to hear your feedback on this, like, what your protein intake is vs. fats.

I stopped tracking years ago. Probably should start tracking again just to lose some extra lbs. :) Outside of weight loss I do keto just because of the insane energy levels.

The kicker about BJJ is that after class, these guys who are much stronger than me are winded and I'm walking around upset no one wants to keep training. Everyone is doing crap like sitting down and resting!

[kyuudou]

Awesome, thanks for the reply! Yea, I was trying to find a way to have a permanent high-fat keto diet for BJJ but it just wasn't happening. It was kind of a personal experiment and I was pleased with the outcome. Great way to drop a few extra pounds before weigh-in, though. Discrete carb-loading is unavoidable, though.

>The kicker about BJJ is that after class, these guys who are much stronger than me are winded and I'm walking around upset no one wants to keep training. Everyone is doing crap like sitting down and resting!

As you probably know, they are Doing It Wrong. Most of the higher belts I've known are skinny (sometimes barrel-fat) and not mega-huge muscular because their technique is orders of magnitude better so they don't need to rely on muscling everything. My main professor always skips the heavy warmup on his days and just does enough to get the blood flowing and joints warm which is funny - he's really good.

I really started to think about this once I got my ass handed to me by a teenage girl purple belt who couldn't have weighed more than 90 lbs wet. I was trying on purpose not to use my size and strength but quickly realized my technique was much worse than hers. One of the great benefits of BJJ is this kind of instilled humility. Not much room for silverback gorilla bullies.

Now, competition, particularly no-gi, is a whole different ball game in my experience. There, maximizing strength to weight ratio is of crucial importance because the other person is supposed to be of roughly equal technique and when it comes down to it, whoever's stronger usually has a better chance.

[rtkaratekid]

You’re correct here. The long, low intensity type work lends itself to ketosis well, but power and strength not quite as much. This is because of the metabolic availability of energy from the two pathways.

To throw my own anecdotes in, I’ve done more than a few 24-48 hour efforts (backpacking, mountaineering, cycling, climbing) with a range of dietary strategies and so far I’ve felt the best with bacon, hard boiled eggs (with some salt and pepper), and water.

[orange8]

Sorry it did not work for you as an individual, but turning that around to say that anyone else with a more positive experience is just placebo is a bit of a logical fallacy. Why do you think your own personal experience should be the one source of truth for the whole universe? Don't you know the 7 billion people alive all have unique bodies that respond to things differently?

Have you tried anything else health-wise (diets, medicine, exercise plan etc)after Keto? And is it working? If it is, its most likely just a placebo and not really beneficial in of itself. Thats according to the crux of your argument: if something works, its very likely just a placebo.

[ctoscano]

> most people are in ketosis before eating breakfast in the morning, because the liver's glycogen is partially depleted overnight, enough for the liver to produce significant ketones. And nothing will make you enter ketosis faster like skipping a meal or two

There are two claims here that are pretty important and contrary to my understanding and experience: 1) Liver is depleted after usual sleep 2) Fasting is the fastest way to enter ketosis

Even when practicing a very low carb diet your liver is "topped up" through gluconeogenesis while you are sleeping.

If by ketosis you mean the body is producing enough ketones to power itself than the fastest way I know of kickstarting that process is not having carbs for 6 hours then going for a run or lifting heavy weights.

You don't need to starve yourself, you just need to put your body in a scenario where the energy demands overtake the available energy in the form of blood glucose (and strain the stores in the muscle and liver).

[bad_user]

> Even when practicing a very low carb diet your liver is "topped up" through gluconeogenesis while you are sleeping.

Not really, gluconeogenesis is a pretty inefficient pathway, from my reading on the subject you can't make more than 200 calories of glucose per day via gluconeogenesis, which is pretty low and definitely not enough to replenish the glycogen stores, only enough to keep them from being completely depleted. I'm struggling to find the reference. But you can also ask most doctors — if you give urine or blood in the morning, nobody raises an eyebrow when seeing ketone readings because it's a known effect.

Also note that I'm not saying that all glycogen is depleted. Glycogen stores are never depleted, as the glucose sparing effect eventually kicks in (aka physiological insulin resistance) and yes, some of it is replenished via gluconeogenesis.

---

> by ketosis you mean the body is producing enough ketones to power itself

No, ketosis is a metabolic state in which the liver is producing ketones in response to a short supply of glucose, with significant ketones being detectable in the blood or urine. That's it. And availability of ketones in the blood stream is enough for them to be used.

There is a threshold of 0.5 mmol/L of ketones that people in the keto community use, but it's completely arbitrary — nobody knows why that threshold isn't 0.3 mmol/L. Regardless, I'm at 0.5 mmol/L in the morning while eating between 150 and 200 grams of carbs per day.

---

> "You don't need to starve yourself, you just need to put your body in a scenario where the energy demands overtake the available energy in the form of blood glucose (and strain the stores in the muscle and liver)."

We agree here — yes, once the glycogen stores are depleted enough, the liver starts producing ketones and of course exercise can do the trick.

There is one caveat ... during exercise ketone usage also goes up, and exercise also drives your blood sugar up, so if you measure the ketones immediately after exercise, the readings can be misleading.

But yes, active people can burn through their glycogen stores really fast.

[wtetzner]

> In spite of popular belief, nothing happens, there's no magic at the end of that rainbow for most people. If you felt anything different, there's a high likelihood it was just self suggestion, aka placebo.

I absolutely noticed a change, and there's no way it's just a placebo. The change I've noticed is that I don't get hungry nearly as quickly as I do when I'm eating carbs, and I don't get "hangry" anymore, either. I do still get hungry, but it's a much more mild effect.

I also used to get headaches quite frequently, especially if I waited too long to eat. That has also stopped since I started doing keto.

> Also the idea that your microbiome has to change and your body/brain to adapt for you to feel any better and that it takes months ... is a complete myth. Your body takes only mere days to adjust to any dietary strategy. Also the dreaded keto flu is just dehydration from all the lost glycogen, which pulls a lot of water on its way out.

Is this something you have a source for, or just something you believe?

> Also most people are in ketosis before eating breakfast in the morning, because the liver's glycogen is partially depleted overnight, enough for the liver to produce significant ketones. And nothing will make you enter ketosis faster like skipping a meal or two (aka starvation ketosis). People with a healthy metabolism cycle in and out of ketosis all the time.

I'm not sure I buy this. Usually if I've been eating carbs for a while, and try to get back into ketosis, it takes me a day or two. If you don't eat for 16 hours, then sure, maybe you enter ketosis near the end, but most people don't go that long without food.

[LanceH]

So anecdote extrapolated to everyone and anyone who disagrees is just imagining it.

Not being hungry until meal time? Placebo effect caused me to not want a nap in the afternoon? Did I imagine the 60 pounds weight loss, too?

[bad_user]

> "Placebo effect caused me to not want a nap in the afternoon?"

No, it was probably the adrenaline being pumped due to the caloric deficit — without which you wouldn't have lost weight — or at the very least your diet being eucaloric, because eating too much does make one sleepy ;-)

> "Not being hungry until meal time?"

This can be attributed to — (1) extra proteins compared with your regular diet and (2) eating foods that aren't highly palatable. (speaking of which, high carb diets made of whole plants also have the advantage of fiber and volume)

There is a lot of evidence in the scientific community for these claims, while there is none for any specific effects of the keto diet. This isn't about anecdotes, although keto proponents sure seem to have a lot of them.

---

> "Did I imagine the 60 pounds weight loss, too?"

Good for you, I lost 55 pounds too (not on keto), I know how challenging losing fat can be. And I'm genuinely glad to see other people succeeding.

If you feel good, keep doing whatever it is you're doing. If not, then know there are plenty of other options.

[com2kid]

> eating foods that aren't highly palatable.

The keto community has recently learned how to make good meals, it was pretty bad for awhile, but I'd like to note that nearly all Indian curry dishes are keto friendly.

And while ymmv, I consider them rather palatable.

Lots of Chinese dishes as well, obv. not noodle and rice dishes, but a large swath of Chinese cuisine is perfectly keto friendly.

Heck my local ramen shop now offers keto friendly noodles.

[bad_user]

I know and it would be pretty hard for Keto meals to not become palatable due to all the fat.

Long term all weight loss diets are equally disappointing, because appetite does come back and compliance becomes an issue. At maintenance we can actually tolerate a lot, esp if we are lightly active, but if you want to lose weight, striving for better tasting food is a poor strategy.

An excelent book on this subject is "The Hungry Brain" by Stephan Guyenet:

https://www.stephanguyenet.com/thehungrybrain/

This guy's blog is awesome too and if you're interested for example into why the "carbohydrate insulin model" is wrong, checkout this list of references produced by him:

https://www.stephanguyenet.com/references-for-my-debate-with...

---

We have a brain hard-wired to seek foods high in calories and salt and we also prefer diversity. People on keto when looking at sweets, like brownies, they see the carbs, however the bigger problem is the fat + refined carbs combination. All junk food is a combination of fat + refined carbs, because this is a recipe for making the food hyper-palatable. This goes for French fries too, it's not the actual potato, because potatoes have a lot of water, a lot of volume and if you eat them boiled, few things are as satiating. Combine potatoes with fat by deep frying, then add some salt and both calories and palatability goes through the roof.

How can you make veggies and greens, like spinach or brocoly, tasty? You add some fat. Incidentally this is how you can trick your brain to like greens.

Most people have issues losing weight while eating brownies, not because you can't lose weight when eaten in moderation, but because it's so hard to not binge on brownies, especially if you have emotional issues too (and many overweight people have emotional issues), foods like brownies being perfect as a comfort food. You can binge on fruits, veggies, lean meat or beans of course, but it doesn't have the same impact.

(N.b. I love brownies, brownies are awesome, they just aren't good to have around when losing weight)

People in the keto community talk about carb cravings, however there is such a thing as craving fat or any food high in calories too, because it's not really about any particular macro nutrient. When I was on keto, I used to binge eat plain full fat butter. I also used to eat 1 Kg of grilled pork chops in a single seating and then I was hungry again at the next meal.

---

On the whole however, both low carb diets and low fat diets lead to a spontaneous loss in appetite in many people. It's why they work short term.

This doesn't necessarily last for long, because you get used to what you eat and because we tend to diversify our meals in our search for better tasting food. Then the dreaded plateau appears, which can happen pretty fast on keto, esp due to the propaganda that calories don't matter.

Such diets are still better than the SAD, but you'd get a similar bang for the buck in terms of satiety and healthfulness ... if you just stuck with whole foods at least 80% of the time.

[com2kid]

> Such diets are still better than the SAD, but you'd get a similar bang for the buck in terms of satiety and healthfulness ... if you just stuck with whole foods at least 80% of the time.

Another useful benefit of Keto is that the rules are really simple.

That sticking with whole foods 80% of the time is the hard part, there is temptation everywhere, e.g. the Girlscout cookies on desks at work, free granola bars, etc etc. A decent % of our society is geared towards getting people to eat more.

Keto says "you can't eat any of that junk". Just, flat out. No points, no "a little bit of ice cream", just, no. The easy calories are not an option.

> Then the dreaded plateau appears, which can happen pretty fast on keto, esp due to the propaganda that calories don't matter.

Plateau's happen for many reasons, and a lot of them are not yet fully understood. For years there were stories of people eating below maintenance who aren't losing weight, and just recently science has learned that gut biomes can drop (increase?) their efficiency and result in a lower BMR than normal.

Of course at the end of the day, getting a 6 pack requires being hungry. There is no getting around that! (Well other than being under 24 and very physically active, but that's a very time boxes solution! ;) )

[tracker1]

It's also a large part electrolyte imbalance from some dehydration... drinking more water with salts can help a lot. It isn't magic, but can help with glucose control without medication, or without as much... eating enough protein, which keto people tend to get plenty, also has higher satiety, which can lead to eating less. Going to 1-2 meals a day will have mostly the same effects.

I think keto and carnivore are really better depending on one's specific metabolic and/or autoimmune issues. For most people, eating less processed crap (junk/fast food and trans fats particularly), less modern grains, less seed oils. Instead, having a well balanced diet which imho should include at least eggs, butter and fish is a great starting point.

[runjake]

You're spending a lot of time in here making accusations of myths and placebos, but none of your counters offer any form of citation.

You'd make much stronger points if you included citations. If your points are in fact correct, they would be highly useful.

[bad_user]

The problem is a claim like the body/brain, the cells themselves needing to adapt to a new fuel source before seeing some benefits, taking months before you get there, actually contradicts the body's physiology. I don't really need to provide any citations, because the onus is on the one making those claims. And even if I provide citations, the goal posts will simply be moved, with lines like — the study was not long enough, the diet was not low carb enough, etc, etc.

It also takes a lot of effort to dispel bullshit, much more effort than spreading it. Engaging with flat earthers is exhausting, most people don't do it due to insufficient knowledge and actual scientists don't engage b/c they've got better things to do.

My language is emotionally charged because I've been in the keto community for a long time and I've witnessed a lot of quackery, which I believe can do harm to those in need, just like the anti-vaxers are doing.

---

There are very few studies showing the effects of a ketogenic diet on cognition, in healthy subjects.

Here's a study showing that a low-fat diet can have better psychological improvement, versus a low carb diet, even with similar weight loss: https://jamanetwork.com/journals/jamainternalmedicine/articl...

Here's a study that finds similar effects in mood between a low carb and a high carb diet, although the reaction time was improved in the low-fat group: https://academic.oup.com/ajcn/article/86/3/580/4649430

Here's a study comparing cognitive performance between a high carb versus a log carb diet, showing similar results: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789132/

Here's one study which merely says that people feel awful for the first two weeks and then start to feel less awful after reintroducing carbs — it's unfortunately not randomized: https://naldc.nal.usda.gov/download/23706/PDF

Here's a study that shows weight loss itself (the biggest confounder of every claim made by keto proponents) is known to affect mood and cognition and to improve quality of life: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4905696/

Here's one paper arguing that most effects of drugs are attributable to placebo or nocebo: https://www.annualreviews.org/doi/abs/10.1146/annurev-psych-...

People on a diet also tend to do some exercise, here's one arguing about the positive effects of resistance training, which many in the keto community are engaging in: https://jamanetwork.com/journals/jamapsychiatry/article-abst...

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Weight loss, exercise and placebo are actually the best explanations for most of the seemingly miraculous effects of the keto diet.

---

Anyway, here's one for the depletion of glycogen: https://science.sciencemag.org/content/254/5031/573.long

Here's a graph showing roughly the evolution of glycogen and ketones during fasting, from "Harper's Biochemistry": https://pbs.twimg.com/media/D-Q0MSPXUAEK_-r?format=jpg&name=...

[runjake]

Thanks, this is an excellent response. This is super informative.

I do understand your goal post comment. It's super-frustrating that virtually all diet information out there has some tangential agenda (Eg. animal welfare, keto/paleo cultism, etc)

[alexbanks]

I have always felt that most of proposed benefits of the keto diet are largely just a result of "giving a shit." People go through lives eating garbage all the time, laying around feeling bloated and crappy. Then jump onto <insert any miracle diet> and after a few weeks feel amazing. The secret is they swapped from shoveling garbage into themselves with becoming relatively picky about what they're willing to put in their bodies. Suddenly they look better and feel better, and want to double down on looking and feeling better.

I myself did the keto diet and found success with it, but then I transitioned to just more of a selective generalized diet and experienced identical effects. Keto was just the first time I'd ever had a set of rules to apply to the food I ate, which was ultimately the actual training I needed.

[wtetzner]

I think you're probably right, that what you don't eat is probably more important that what you do.

However, I did change my diet to be very selective, and felt great. But changing to keto had some additional benefits, the most prominent being a noticeable change in how hungry I felt during the day. It's much easier to go long periods of time without eating when in ketosis.

[alexbanks]

I did not find those effects to be specific to keto for me, but I'm glad it's going well for you.

[Jach]

Your body is composed of many hierarchical control systems. Some of them have feedback loops that imply minimum adaptation times longer than days. For a dietary related one (keto), one such adaptation is liver efficiency to produce fewer ketones + kidney efficiency to filter out uric acid. People who never have had gout but go on a keto diet sometimes get gout flareups because of a uric acid spike from the diet change, and it takes a number of weeks for uric acid levels to subside: https://www.virtahealth.com/blog/keto-adapted

[com2kid]

There is plenty of work showing that physical endurance increases after extended periods on keto. Athletes have carefully tracked their performance numbers day by day and demonstrated real changes.

And as someone who participates in activities that require large amounts of endurance, I know on keto my ability to perform for extended periods of time is higher. These aren't "I think" numbers, they are "polar heart rate monitor strapped to my chest" numbers.

The very nature of keto leads to improved endurance, fat is a much more plentiful energy source than glucose, it may be less efficient (lifting heavy on keto is a well known problem), but it /never/ runs out. If someone is doing an activity that doesn't cause excessive lactic acid build up or complete muscle fatigue, then a keto will give an endurance advantage.

[bad_user]

> There is plenty of work showing that physical endurance increases after extended periods on keto

Not really.

Yes, athletes do suffer an adaptation, but it's basically about returning to near baseline levels (i.e. from sucking badly to sucking less). And as a matter of fact, the peak performance never recovers to full capacity ;-)

Here's a list of studies on this subject — all of them showing a dicrease in performance:

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2279002/

- https://www.ncbi.nlm.nih.gov/pubmed/14967870

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113752/

There's also this one that shows no difference in endurance performance at low/moderate intensity, a far cry from your claim:

https://www.ncbi.nlm.nih.gov/pubmed/6865776

And endurance exercise could see a benefit in some circumstances, although this is highly debatable, however also in athletes a keto diet can lead to lean mass being lost:

https://commons.lib.jmu.edu/master201019/109/

[throwaway_tech]

>Yes, athletes do suffer an adaptation

You admit and acknowledge an "adaptation" in this comment, but in another reply to me where I talk out the keto adaptation, you replied:

>everything you're saying is a complete myth. Define what it means for the cells to adapt for "running on ketones". There's no such thing.

As previously provided:

A ketogenic diet (KD) involves using fat, a high-density substrate, as the main source in daily calorie intake while restricting carbohydrate intake [21,22]. In this way, the liver is forced to produce and release ketone bodies into the circulation [23,24,25,26]. This phenomenon is called nutritional ketosis [27,28,29]. Over time, the body will acclimate to using ketone bodies as a primary fuel, which is called keto-adaptation, an element of fat-adaptation [30,31,32]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410243/

>Several days of dietary carbohydrate restriction to levels < 40–50 g/day, with moderate protein, results in increased circulating beta-hydroxybutyrate (BOHB) by an order of magnitude. When maintained for several consecutive weeks, the metabolic state of ‘nutritional ketosis’ awakens a dormant set of genes and metabolic programs that counteract insulin resistance and manifest in several positive health outcomes. This process, referred to as ‘keto-adaptation’, is characterized by accelerated rates of whole body fatty acid oxidation, while glycolysis, insulin concentrations, insulin receptor activation and signaling, constitutive inflammation and oxidative stress are all decreased. https://www.sciencedirect.com/science/article/abs/pii/S24682....

>Here's a list of studies on this subject — all of them showing a dicrease in performance:

I think most agree for high level athletes in anaerobic sports ketosis isn't going to be the best diet for athletic performance, but these studies don't really support what you claim

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2279002/

>In conclusion, in this study we have demonstrated that VLDL-TG made a significant contribution to fuel utilization during exercise after adaptation to a fat-rich diet. The increased total fat oxidation observed after fat diet adaptation originated from both a higher plasma FA oxidation and utilization of VLDL-TG, and thus circulating VLDL-TG should be included among the lipid fuels that may be utilized during exercise.

- https://www.ncbi.nlm.nih.gov/pubmed/14967870

>Adaptation to a 6-week HFMP diet in non-highly trained men resulted in increased fat oxidation during exercise and small decrements in peak power output and endurance performance.

- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113752/

This is the most supportive of your position, but it still acknowledges the benefits of ketosis

>It can be concluded that long-term, high fat diets may be favorable for aerobic endurance athletes, during the preparatory season, when a high volume and low to moderate intensity of training loads predominate in the training process. High volume training on a ketogenic diet increases fat metabolism during exercise, reduces body mass and fat content and decreases post exercise muscle damage.

[mountain_peak]

Not claiming that the science is settled, but I when I entered keto over 10 years ago (TL:DR daily 10K+ 'performance' runner, neuropathy from glucose intolerance - genetic, avoid all drugs), I wanted to be sure that I could run without ingesting carbs (since everyone said you couldn't).

Read "The Art and Science of Low Carbohydrate Performance" and can absolutely say that after an initial horrible period that lasted for months, I was eventually able to run further and just as fast as I used to when I was carbo-loading. I can honestly say that running is more difficult now - my legs are generally sore and I don't feel like I'm 'flying along', but I've always tracked my times with Garmin, then Apple, and the stats belie how I feel.

From the book: "[Keto-adaptation] allows even a very lean (10% body fat) athlete access to more than 40,000 kcal from body fat, rather than starting a prolonged event depending primarily on ~2000 kcal of glycogen."

I think the studies you quoted would back-up the authors, but I also wanted to lend my long-term personal experience. I can't recall where I read it, but thought adaption also occurred in leg muscles where they found a massive increase in the number of mitochondria for athletes on keto.

I tested myself daily for years until I found a combination of diet and exercise that worked. My body definitely adapted and became much more efficient at burning fat - there's no performance 'wall' anymore, but I think the experience is different for everyone.

[spion]

This depends a lot on the individual. I would suggest it to anyone who often has post-meal slumps, for example - its likely to work wonders for them.

[crazygringo]

Your last paragraph is just unbelievably flat-out wrong. Maybe you didn't suffer from keto flu, but it can last for a couple weeks to a couple months (my case) and has zero to do with dehydration.

You're literally retraining your body to efficiently burn stored body fat when it never had to much before. This takes time. The idea that it happens in days is laughable, as is the idea that your microbiome adjusts that quickly.

Please don't spread blatant misinformation.

[bad_user]

No, you probably suffered from nutrient deficiencies, symptoms that went away once you diversified.

A total guess of what happened to you, but what's not a guess is about the adaptation taking months and being about anything more than dehydration or nutrient deficiency being total bullshit.

[crazygringo]

Cutting out high-GI foods doesn't produce nutrient deficiencies, since they're generally calorie-dense but low in vitamins etc. If anything, the fact that you're getting more meat and veggies to make up for it increases your nutrient diversity, from day one. So again, you're completely wrong.

As for adaptation taking merely days, what's your source for that? The common wisdom and community consensus that you'll read anywhere is that it takes roughly 2 weeks to 2 months to adjust. You're the one claiming this is wrong. So what exactly is your proof here?

Look, I'm glad it wasn't a problem for you. But claiming that therefore it isn't for others, just doesn't hold water.

[zadokshi]

Saying something is ‘laughable’ is not an argument.

[sizzle]

Why did you give up? How we your energy levels? Did you drop weight easily?

[bad_user]

I gave up because I felt awful ... problems sleeping, strong heart palpitations, hair falling off, left foot going numb, etc... all symptoms of nutrient deficiencies, which I couldn't correct via food or with supplements and that started disappearing within a week after giving up.

And that entire time I did not lose weight, I actually gained a pound or two.

If you're interested in losing weight, find a strategy for eating less (by playing with what you eat or with meal timing). The only reason keto works for some people is because it leads to a spontaneous drop in appetite, due to cutting entire food groups from the diet, thus making the food you eat less palatable. And the extra protein sure helps. But it only works short term, after which you start enjoying bacon and butter, so the inevitable plateau happens and then you get the line about your metabolism needing to "heal" before losing weight, which is bullshit, as the causality is reversed (i.e. your metabolism is broken because you ate too much and exposed adipocytes tissue to an energy excess, aka energy poisoning, so the solution is to eat less and to lose weight).

I've lost 55 pounds and kept it off, being almost at my ideal weight. Not with keto.

[AnIdiotOnTheNet]

> If you're interested in losing weight, find a strategy for eating less (by playing with what you eat or with meal timing).

I'd just like to chime in and echo this sentiment. I myself have lost and kept off between 2 and 3 times what parent has and it was also no thanks to keto, or any fad-diet bullshit.

There's no magic to losing weight. Consume less, expend more, weight loss ensues. Yes, it is that simple. No, that doesn't mean it is easy. There are many different paths but they all lead to the same place.

[spion]

This isn't quite true. For many, keto truly is an easier way to achieve the goal of eating less. Our metabolism uses various signals and pathways to detect satiety and even in the early stages of metabolic syndrome some of the pathways get broken due to insulin resistance (e.g. insulin blocking leptin satiety signaling in the brain).

Keto truly is much, much easier for many people. If you explore the keto community a bit, you will notice that it often naturally leads to intermittent fasting - simply because people don't feel like eating all that often.

Of course, it comes with its own difficulties with regards to food selection and social eating. However, in terms of willpower, my experience has been it's zero-effort compared to previous caloric restriction diets I've done.

This is not to say that caloric restriction takes a huge amount of effort and will-power for everyone. But if it does for you, it's worth checking keto out - and it's definitely not just a fad.

I've found that a fairly good selection criterion is people that suffer from post-meal slumps (sleepiness). If you are one of them, its likely that ketogenic diets will be helpful.

[throwaway_tech]

>Also most people are in ketosis before eating breakfast in the morning, because the liver's glycogen is partially depleted overnight

This is true...but it gets to my point, just because your body begins breaking down fat and producing ketones (as shown in your tests) does not mean your cells have adapted to using ketones as fuel, that requires the body to adapt.

Based on your numbers you were clearly breaking down fat and making ketones, but based on your not feeling any different I'd say your cells never adapted to ketones as the primary fuel source. This is the same for people depleting their glucose stores over night, yes they are in "ketosis", meaning they are breaking down fat and producing ketones, but that does not mean their cells are efficiently running on ketones.

My guess with you, not knowing more, is you are pretty inactive. At least I would be surprised to learn you engage in lets say an hour of cardio 4-5 times a week. I am not saying keto is the end all be all, or that everyone prefers it, but I have not met anyone who does aerobic cardio and experimented with Ketosis and not experienced a different (again good or bad). On the other hand I have met many people who tried Keto and never noticed any difference, like you describe, and the commonality seems to be they were inactive.

[bad_user]

Yes, everything you're saying is a complete myth. Define what it means for the cells to adapt for "running on ketones".

There's no such thing.

> "I would be surprised to learn you engage in lets say an hour of cardio 4-5 times a week"

I ride my bike or walk to/from work about 10 Km every day and I do weight training 3 times per week, which puts me in the moderately active category.

[throwaway_tech]

>Yes, everything you're saying is a complete myth. Define what it means for the cells to adapt for "running on ketones".

>A ketogenic diet (KD) involves using fat, a high-density substrate, as the main source in daily calorie intake while restricting carbohydrate intake [21,22]. In this way, the liver is forced to produce and release ketone bodies into the circulation [23,24,25,26]. This phenomenon is called nutritional ketosis [27,28,29]. Over time, the body will acclimate to using ketone bodies as a primary fuel, which is called keto-adaptation, an element of fat-adaptation [30,31,32]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410243/

emphasis added citing the following study:

>Several days of dietary carbohydrate restriction to levels < 40–50 g/day, with moderate protein, results in increased circulating beta-hydroxybutyrate (BOHB) by an order of magnitude. When maintained for several consecutive weeks, the metabolic state of ‘nutritional ketosis’ awakens a dormant set of genes and metabolic programs that counteract insulin resistance and manifest in several positive health outcomes. This process, referred to as ‘keto-adaptation’, is characterized by accelerated rates of whole body fatty acid oxidation, while glycolysis, insulin concentrations, insulin receptor activation and signaling, constitutive inflammation and oxidative stress are all decreased. https://www.sciencedirect.com/science/article/abs/pii/S24682...

[teilo]

It is true that ketosis is more than low carb, but Gluconeogensis has absolutely nothing to do with it. There is a lot of wrong information out there about GNG.

GNG is an on-demand production of glucose, and absolutely does NOT kick the body out of ketosis, or cause the brain to run on glucose. GNG provides enough glucose for the tissues that cannot run on ketones (such as the kidneys). Without GNG, ketosis would not be possible. In fact, ketones regulate GNG, and prevent it from exceeding the needed maintenance levels.

Furthermore, GNG runs at mostly a constant level, does not increase with protein intake, and is at that constant level even when the body is not in ketosis.

What prevent ketosis in stubborn cases? Insulin resistance. To overcome insulin resistance it takes a strict low-carb regime paired with moderate fat intake, and lowering of stress. The process can be dramatically sped up with intermittent fasting.

[amanaplanacanal]

Thank you! I see claims all the time that eating too much protein will kick you out of ketosis, without any actual science to back it up.

[throwaway_tech]

>GNG is an on-demand production of glucose, and absolutely does NOT kick the body out of ketosis, or cause the brain to run on glucose.

I never said GNG kicks people out of ketosis, I said protein to fat ratios will prohibit ketosis. Yes, in ketosis your body continues to produce minimal amounts of glucose, I never said anything to the contrary.

However, GNG has a lot to do with ketosis vis-a-vis protein to fat ratios, protein to fat intake can not be to high or it will kick you out of ketosis because of GNG

>Furthermore, GNG runs at mostly a constant level, does not increase with protein intake, and is at that constant level even when the body is not in ketosis.

If you over consume fat or carbs, they get stored as fat in fat cells. What happens when you over consume protein? Protein can not be stored as fat, it must first be converted to glucose, which the body will try to burn before it is stored in fat cells. This is why a high protein to fat ratio carnivore diet will prohibit ketosis or kick one out of ketosis, unlike a high fat to protein carnivore diet (again I never said the body stops producing glucose from protein in that situation, but the glucose production is minimal in ketosis because of the ratios and ketones remain the primary fuel source).

>To overcome insulin resistance it takes a strict low-carb regime paired with moderate fat intake, and lowering of stress.

While generally true and correct, I can even come up with examples where this breaks down...whey oxalate being a perfect example. Whey oxalate will typically have 25g of protein and may have as low as 1 gram of carbs, but Whey oxalate will spike insulin in most people and throw most people out of ketosis.

[teilo]

> If you over consume fat or carbs, they get stored as fat in fat cells. What happens when you over consume protein? Protein can not be stored as fat, it must first be converted to glucose, which the body will try to burn before it is stored in fat cells.

No, this is wrong. GNG is capped in the body, i.e., strictly regulated. It does not increase based upon protein intake beyond that cap. Excess protein is neither converted to glucose, nor excreted. It is utilized in protein synthesis and increases lean body mass.

This has been demonstrated in a number of studies. For example, in Bray GA, JAMA 2012, subjects were fed an excess of 1000kcal over their their maintenance calorie needs for 8 weeks. There were three groups: low, moderate, and high protein. Carbs were constant. Fat made up the difference in caloric content, such that the high-protein group (230g a day) received the lowest fat intake. All three groups gained similar amounts of fat over those 8 weeks, with the high protein group gaining slightly less fat. But the medium and high-protein groups gained lean body mass to make up the difference.

So in short, excess protein is not converted to fat via GNG, but is used for protein synthesis, and increases lean body mass.

> This is why a high protein to fat ratio carnivore diet will prohibit ketosis or kick one out of ketosis, unlike a high fat to protein carnivore diet.

This absolutely does not happen, and I have the blood tests to prove it.

[throwaway_tech]

>excess protein is not converted to fat via GNG, but is used for protein synthesis, and increases lean body mass.

>In conclusion, after a high-protein diet, GNG was increased... https://www.cambridge.org/core/journals/british-journal-of-n...

[uberduper]

Just reading the abstract makes it pretty obvious.

> "A total of twenty-two healthy subjects (ten men and twelve women: age 23 (sem 1) years, BMI 22·1 (sem 0·5) kg/m2) received an isoenergetic high-protein (30/0/70 % of energy from protein/carbohydrate/fat) or normal-protein diet (12/55/33 % of energy from protein/carbohydrate/fat) for 1·5 d in a randomised cross-over design"

It wasn't the increase in protein that stimulated GNG. It was the reduction of carbs. Without sufficient dietary carbohydrate, the body must maintain minimum glucose levels via GNG.

[teilo]

GNG increases when in ketosis, but is still capped because ketones regulate the GNG process. That is the effect which was observed here. It says it right there in the synopsis:

"Glucose concentration was lower (4·09 (sem 0·10) v. 4·89 (sem 0·06) mmol/l, P < 0·001) and β-hydroxybutyrate concentration was higher (1349 (sem 139) v. 234 (sem 25) μmol/l, P < 0·001) after the high-protein compared with the normal-protein diet."

β-hydroxybutyrate is a ketone body.

Note that this contradicts your statements that GNG will kick you out of ketosis. It absolutely will not.

To repeat: GNG is constant, regulated by ketones, and its relative level is not driven by protein demand, but by glucose depletion.

[throwaway_tech]

>Note that this contradicts your statements that GNG will kick you out of ketosis. It absolutely will not.

Its really simple, eat nothing but chicken and/or turkey (high protein, low fat, no carb). You will not become keto adapted or fat adapted.

Alternatively enter into nutritional (dietary) ketosis with a high fat diet, then switch to chicken and/or turkey only (high protein, low fat, no carb) you will not remain in ketosis.

Do you disagree with that? Have you seen any study that shows fat/protein ratios are immaterial to nutritional ketosis?

[uberduper]

> in protein rich diets your body will convert the protein to glucose which will continue to be the primary fuel for the cells in the brain/body.

This is completely incorrect. Gluconeogenesis is stimulated by the pancreas releasing glucagon in response to low blood sugar. GNG happens in everyone regardless of diet when blood sugar is too low. It has nothing at all to do with the amount of dietary protein you consume.

GNG happens in people in ketosis pretty constantly without stopping ketosis.

[skizm]

How does working out at a high intensity work when in a state of Ketosis? I lift weights and/or do HIIT 5x per week and occasionally add running on top of that. I've always been weary of going low carb or trying a keto diet because I feel like I just won't have the energy to continue my training regimen at its current intensity. The typical advice is to eat your allocated carbs 1-2 hours prior to your workout, however I feel like by not getting the right amount of carbs post-workout I'm basically wasting my time in the gym at best, and at worst asking for an injury due to not being able to recover completely in time for the next workout.

Thoughts?

[throwaway_tech]

I run marathons and prefer running in ketosis. In ketosis I will follow a long run with some protein for muscle recovery with fats just to maintain ratios rather than carbs to refill depleted glucose stores.

For lifting/HIIT training ketosis may not be ideal. I have done it and its fine, basically I swap whey for hemp protein powder and continue using creatine post workout.

I think for most people unless they are competing or trying to gain mass they would really like the results of ketosis and lifting. You will lean out (both fat loss and less water retention) and maintain muscle mass, don't be afraid of losing your gains. On the down side the adjustment period will probably be a little longer/harder than a relatively inactive person and initially you will likely notice a decline in energy in the gym, but it will be temporary (again your body is learning to use ketones as primary fuel source and that takes time). That said once you adjust you won't find any trouble lifting heavy or running sprints, in fact you will probably be able to go longer. One benefit you really notice is lack of inflammation and soreness following workouts, in my experience the body recovers faster, though this is still about the actual food you consume (healthy omega 3s and green leafy vegetables) and not some automatic benefit of ketosis.

[teraku]

Don't go low-carb. There is no need, it's not unhealthy. Especially if you are sporty (as it sounds).

The current state of affairs is: If you are insulin resistant (either because of genetics, obesity, whatever) then having a low-carb high fat diet is better for you. If your insulin resistance is high, then your pancreas produces much more insulin, meaning your cells will start storing energy instead of using it up. If this keeps up for a long period, your fat tissues, which are supposed to be your fat/energy storage, will fill up and your body (or rather the particles transporting the transformed sugar from the liver) will start sticking to your organs. This starts inflammations and makes your organs weaker, and in turn also raising your insulin resistance. And these malfunctions also spread to the brain and can cause alzheimer and the like. The exact chain of effects is not yet confirmed, so from here on it's a lot of speculation. But if you now are trying to lose weight, and you just reduce calories, but keeping a "high-carb/low-fat" diet, then you will be hungry. Because either you have too little protein to feed yourself, or you eat enough protein and you automatically eat too many carbs again, producing more and more insulin. This is how high-fat diets come in handy, as they don't spur liver activity and don't impact insulin as much. This in turn means you can reach ketosis, starting to work the fat on your organs (which is a lot more dangerous then some fat in fat tissues like your belly). Your body will recover, inflammation will go away and your insulin sensitivity goes up again (unless you are genetically diabetic). And with a healthy body your brain can also recover.

The studies for this are still coming in, but I find this explanation very logic and even this study, although the article is weirdly phrased, plays into it.

Some remarks at the end: - If you do a lot of sports, your muscles use energy even without insulin - Glucose is spread through the body, while fructose is directly converted to fat (tissue) - Sport also increases insulin sensitivity - Diets are very personal, try out things for yourself and see how it works! - Protein is also increasing insulin (since protein intake signals the body to start storing energy, i. e. protein into muscle cells)

[timbit42]

Are you familiar with Sami Inkinen?

https://www.youtube.com/watch?v=EKC9ZZ66jgc

[lhl]

There is a keto adaptation [1] period of at least 6-8 weeks where you might take a hit, but there are several studies that show that it's generally not a concern.

Cipryan, Lukas, Daniel J. Plews, Alessandro Ferretti, Phil B. Maffetone, and Paul B. Laursen. “Effects of a 4-Week Very Low-Carbohydrate Diet on High-Intensity Interval Training Responses.” Journal of Sports Science & Medicine 17, no. 2 (May 14, 2018): 259–68.

Greene, David A., Benjamin J. Varley, Timothy B. Hartwig, Phillip Chapman, and Michael Rigney. “A Low-Carbohydrate Ketogenic Diet Reduces Body Weight Without Compromising Performance in Powerlifting and Olympic Weightlifting Athletes.” The Journal of Strength & Conditioning Research Publish Ahead of Print (October 17, 2018). https://doi.org/10.1519/JSC.0000000000002904.

Paoli, Antonio, Keith Grimaldi, Dominic D’Agostino, Lorenzo Cenci, Tatiana Moro, Antonino Bianco, and Antonio Palma. “Ketogenic Diet Does Not Affect Strength Performance in Elite Artistic Gymnasts.” Journal of the International Society of Sports Nutrition 9 (July 26, 2012): 34. https://doi.org/10.1186/1550-2783-9-34.

Kephart, Wesley C., Coree D. Pledge, Paul A. Roberson, Petey W. Mumford, Matthew A. Romero, Christopher B. Mobley, Jeffrey S. Martin, et al. “The Three-Month Effects of a Ketogenic Diet on Body Composition, Blood Parameters, and Performance Metrics in CrossFit Trainees: A Pilot Study.” Sports 6, no. 1 (January 9, 2018). https://doi.org/10.3390/sports6010001.

If you're interested in the topic of human performance and ketosis, I enjoy Volek's talks - here's one from a relatively recent Jumpstart event: https://www.youtube.com/watch?v=BeS_dhM8dsY

Anecdotally, I find my workout recovery to be much better on keto/fasting diet, but all my markers (and overall inflammation) has improved so much and I'm being mindful of other aspects like stress, sleep, etc that it's hard to necessarily pin down to one cause.

[1] https://blog.virtahealth.com/keto-adapted/

[Enginerrrd]

It seems people have pretty individualized responses to this. In general, the research shows decreases in performance except for endurance events. Personally, I found my recovery was great on keto. Better than normal even. I was doing a strength cycle so my weights were increasing at the time and I was getting stronger. I actually felt better in the gym, and I lift pretty heavy. A lot of the aches and pains in my joints seemed to go away. Downsides: my gut felt weird, and you have work hard at getting adequate fiber and stuff. Also, it's hard to eat socially.

I was eating a higher protein diet than usually considered keto, but urinalysis confirmed ketosis.

[ebg13]

> How does working out at a high intensity work when in a state of Ketosis?

I've done this. You get tired much faster, you will not be able to sprint for nearly as long, your maximum lift significantly decreases, you hit the muscle fatigue point (can't lift again unless you lower the weight) very quickly.

The usual solution among keto lifters is to have a carbload cheat day once per week _or_ to carb spike with I think (it's been a while) pure glucose syrup a measured amount just before your workout according to how much you think you'll actually use during the workout. The cheat day in practice works pretty well, because if you're slamming your body at the gym every day you can get back into ketosis very quickly after the initial induction phase is done, so you end up with a couple of days of keto per week but not the full week.

[sizzle]

Can you take vitamins like B complex with electrolytes and sugar free, no carb protein shakes with caffeine to get some energy back?

[ebg13]

The problem isn't lack of energy. The problem is muscle and cardio exhaustion. You feel great, not tired, just your muscles stop working and you run out breath. So I don't think that vitamin, electrolytes, or more calories will help. If you're lifting seriously, you're already consuming plenty of those things.

[pawelduda]

Agreed. The difference was noticeable and as soon as I started eating carbs again, my strength increased in a matter of day or two.

[wtetzner]

How long were you in ketosis before you stared eating carbs again?

[pawelduda]

Between 2 and 3 months

[achenatx]

this was my experience. My endurance was unaffected by ketosis but my ability to generate instant power over and over again (mountain bike) definitely took a hit.

[sputknick]

Not the author, but I have experience with this. For me it takes about a week of slugishness before my body adjusts. Once I'm adapted, my performance is actually better. This goes for heavy weights, low weight/high rep weights, and cardio.

[zadokshi]

The first few times it was like this for me.

After years of doing keto I can get that keto feeling/energy/effect by doing one day of super low carbs and super low calories, I’ll wake up the next day wanting to spring out of bed like you wouldn’t believe.

[wirrbel]

You have a very stable energy supply on keto. I am on keto right now and went for a run in the morning. For lifting weights and muscle building I am not quite sure whether I can give advice, but have a look at https://www.reddit.com/r/ketogains/ and the subreddits community as this subreddit is focused on working out with keto.

[ravenstine]

Depends on the diet. Low carb on its own can work because you can eat between 20 and 50 grams of carbs in a day, but ketosis is limited.(which might be okay depending on one's goals)

Keto is shit for working out, in my personal opinion. Some people claim they can have effective workouts on keto, but I hate it, and a lot of others have a hard time having energy when training on keto. Keto is good for weight loss, and I lost 60 lbs in 5 months doing keto, but it's total crap for building muscle, in my experience.

The best compromise, in my experience, is fasting. I'm talking ideally 48 hours between meals. I'll keep it short because I've been spamming threads about this topic recently; because fasting forces the body to solely burn through its glycogen stores, and then body fat once that runs out, ketosis becomes easier to achieve even if there are some carbs in meals, and the presence of carbs in meals provides glycogen for when you workout and train your muscles. I believe this is needed, especially for HIIT. In my experience, you can eat a modest amount of carbs when breaking a fast and still manage to get back into ketosis(fat burning mode!) within a few days. It totally outperforms keto in that it often takes people several days, possibly weeks, to get into deep ketosis.

That said, a low carb, but not necessarily keto, diet can work for someone doing HIIT. Everyone's body is different. A person may find that they want more carbs in order to be effective in the gym, but if they're trying to get lean, then that can compromise their goal, in which case they should reduce their eating frequency a la fasting. A person who is either building muscle or maintaining body composition may not need to do a low carb diet at all.

[zadokshi]

I don’t self test ketosis, it I believe I can eat slightly extra carbs during/post workout and not hugely interrupt ketosis. I don’t know if this is true, but certainly my body doesn’t feel ‘kicked out’ of ketosis when I do this.

(Keto vs non-keto is night and day for me, brain fog vs no brain fog, energy for life vs not being able to get off the couch)

[wpietri]

I confess I don't measure ketosis, and it sounds like we do different sorts of workout. But I do the intermittent fasting variant known as eTRF; I generally eat 7 am - 1 pm. I was worried about how that would interact with my runs, which I usually do in the morning before eating. Enough people online were positive about it that I tried it out and it has been great. On recent Sundays I've done 2-hour runs with little or no food. My times improved and I felt amazing. And the meal after running? Fantastic!

[tokamak-teapot]

I do similar exercise and when I started keto 8 months ago I had a dip in performance for about 3 weeks.

I do a similar set of exercises on the same day/time every week and it ends with 30 seconds of burpees.

Prior to going on keto I was doing 16 burpees in that 30 seconds. After the first week I was down to twelve. After a couple more weeks I was back to 16 - and two weeks after that I was on 17. I’m now on 18.

I’ve gone from 103kg to 88kg in that time, so it seems likely the weight loss has been a (or the) factor in the improved performance.

[rtkaratekid]

I’ve done it. I got extremely ripped and looked great, but actual performance suffered and I started feeling pretty terrible. I like how carbs solve those problems for me. However, if I’m doing 6+ hour efforts, I just eat fats and around hour 7 or 8 I’m still burning hot when I used to burn out when I was feeding with carbs.

[wtetzner]

I think it really depends on how long you've been in ketosis, and how well adapted you body is to running on fat.

At first you will absolutely have less energy, but it seems like the more fat-adapted you are, the more energy you'll have. At some point it seems like you actually have more energy to work out.

[timbit42]

Sami Inkonen and his SO rowed to Hawaii on a keto diet but were fat adapted first: https://www.youtube.com/watch?v

[teraku]

For my understanding this is mostly attributed to insuline resistance vs sensitivity. As you get older and overexposed to sugar, your resistance raises and in order to reverse a lot of the internal inflammations your body has produced from over-intake of sugar you need to force ketosis and burn calories with a low-carb diet. This in turn helps reduce internal fat and repair organ functions, fundamentally restoring hormone production and refreshing your brain as well.

It does not mean that carbs in general are toxic, nor that this diet is recommended for everybody! Diets are very personal, it just becomes more and more common because sugar is added everywhere, people are getting older and older and obesity is a global problem. As such, most people are very insulin resistant and work better with low-carb/high-fat diets.

This headline is one of the reasons there is so much misinformation in food and diets

[rconti]

Anything that requires me to radically change my diet to experiment with myself "just to see", that takes a minimum of 2-3 months, is a hard pass. It's just not that interesting to most of us for a vaguely hand-wavey possibly useful experiment.

[ryanSrich]

Full-on keto may not be worth it, but I would highly suggest removing most carbs from your diet (<= 30g per meal). You'll feel completely different within 5 days. This is especially noticeable after the age of 30. I have no scientific backing or research for this, but I've had a number of friends and family make this small change and every single one has not gone back. It's not even that difficult if you already have a somewhat healthy diet.

[rconti]

Yeah; I haven't gone low-carb but i track what i eat, and carbs are ~40% of my diet. So, not low, but lower than many. I've definitely played around quite a bit with making sure i up my protein and fat consumption, and it is pretty remarkable how different fuels work differently in your body.

[dnhz]

Yes you will feel like you have no energy during workouts. The primary fuel for muscles is glycogen. Cells use glucose by default. And fats are 9 cal/g, so they’re so easy to overeat. I don’t understand why limiting carbs makes any sense.

[sph]

Fats are easy to overeat? I can easily eat 4000 kcal in carbs in one sitting, I’d be nauseous reaching the same amount with either proteins or fats or a combination of both.

In fact, since going low carb I have a new mental awareness when I’ve eaten enough: I eat until a switch flicks in my head mid chew and says “that is enough”. It’s mental, not that physical feeling of the stomach being full.

This is completely new to me.

[dnhz]

Anything calorie dense (and therefore hyperpalatable) is easy to over eat. Fat is twice as energy dense as carbs or protein, so it adds a lot of calories. Put a tablespoon of olive oil into the skillet, and you're adding an empty 120 calories.

Typical foods you could eat 4000 calories of combine fat and carbs into a delicious combination: french fries, pizza, cookies, milkshakes. I don't look at those foods and think individually carbs or fat is at fault. But on the other hand, carbs are what the body uses for energy, so to avoid them doesn't make sense to me. I'd rather skip out on fat.

[1_player]

Carbs is not the only fuel. Fats can be used as well. Proteins too, in case of emergency.

The rule of thumb is proteins and fats are essential, carbs are not. How much of each is still up for debate.

[uberduper]

> I don’t understand why limiting carbs makes any sense.

Then why go around saying things like:

> Yes you will feel like you have no energy during workouts. The primary fuel for muscles is glycogen. Cells use glucose by default. And fats are 9 cal/g, so they’re so easy to overeat.

[dnhz]

What I wrote makes perfect sense. Carbs fuel the body. Going low carb is miserable.

[wtetzner]

> Carbs fuel the body. Going low carb is miserable.

Having been on keto for a few months now, I disagree. I feel way better than when I'm eating carbs, and have so much more energy.

[wpietri]

I think that's fine; not everybody has to be an early adopter of everything. If what you're doing is working for you, keep doing it!

But for people who feel vaguely but persistently like things aren't working anymore, I really recommend experimenting with diet. I've tried a variety of things over the years, and have ended up with a combination that has made my life hugely better: better mood, more even-tempered, much more energetic, and physical exercise has gotten a lot more fun. I recently went back to my old diet for a week and felt like warmed-over garbage.

But yes, expect it will take 1-3 months for your body and habits to really adapt. E.g., when I quit refined carbs, I experience 1-3 weeks of withdrawal symptoms. Headaches, low energy, enormously cranky. And it's even longer for the habits to really get established, so I stop feeling like I'm missing out on the old things.

[collyw]

I was about to ask if intermittent fasting would have the same effects as I get the impression that its a healthier way of getting into ketosis.

(When I look, I don't see negative effects associated with IF, and I do with keto diets. The research changes a lot and the conclusions don't seem definitive, but I thought someone on here might have an educated opinion on the matter).

[ypcx]

In my personal case I'm not really able to enter and maintain good ketosis levels without also fasting intermittently.

Intermittent fasting is key to enabling me to lower my caloric input because of the momentum of the fasting phase carried over into the eating phase, e.g. smaller stomach and more effective metabolism. I currently fast about 12 hours per day (including the sleep phase), which doesn't sound like much but with the lowered caloric input it's actually pretty good. I can go longer easily when the circumstances demand it, and after crossing 16 hours I actually stop experiencing hunger completely. I plan to extend the fasting periods in the future, if easy and convenient.

As for whether ketosis is necessary - I believe I would not be able to fast intermittently without it, or at least not comfortably, which is necessary for any lifestyle change to be sustainable.

I'm not aware of any negative effects of being in ketosis for prolonged periods of time, and quite the opposite. I don't crave sugary foods anymore, and I dislike anything with even a trace of sweetness. I was surprised to discover how good the body really is at detecting what food is good for it, once in ketosis.

My main food sources currently are avocado, egg, tahini and drinks based on almond or walnut milk. I'm also using vitamin and mineral supplements, mostly in fluid forms. I'm 42 and I wish I had known about keto as early in my life as possible, not when I was forced to explore it due to declining health. Ketosis gives you a stable level of energy through the day and allows you to fully focus on life and the tasks at hand.

[dhimes]

As an N of one, I present my situation:

Since mid-January this year I have been fasting intemittently. I have zero calories before 5PM, and I am usually in bed by 10. I exercise most weeks between 4 and six days, but only two or so are "vigorous" for me. My workouts are mid-day.

When I eat, I eat normally for me, which is lower carb and higher protein, but not (knowingly) keto or anything.

I have lost about 10 pounds.

I just got my blood lab results, and they are the worst numbers I have ever seen. Highest fasting glucose (borderline diabetic, a rise of 14 points or so from memory), highest cholesterol (doc's gonna make me take meds if it doesn't come down).

I've done this before, but wouldn't I would "only" wait until 2, and I got bad (but not this bad) results as well. I decided to try again, making my eating window truly shorter, but alas...

I was devastated by the results. Total bummer.

[tvjunky]

Curious about your food choices. I've been experimenting with IF. More specifically I'd call it more like timed eating because the bulk of my fasting hours and during sleep. I'm down 20 lbs with solid numbers. As a side note I have some genetic factors as well and trying to counter those.

[dhimes]

A lot of lean protein and vegetables; eggs (3 egg-whites + 1 whole egg is a common combination for me), chicken, fish, broccoli, etc. I wasn't trying for low-carb, but low-carb made it easier to stave off cravings. I was paying attention to calories more than anything else.

I do drink, however, straight liquor. Rarely to excess, but also rarely fewer than 2 drinks (almost always 2-3 drinks an evening).

[wtetzner]

Why not just eat the whole eggs? The fat in the yolks is really good, assuming you're getting pasture-raised eggs.

[shitgoose]

Same here, 10 kg down very quickly. Now weight is fixed at 80kg no matter what I eat. The only difference is when I eat.

[zadokshi]

Same, I went from 95kg to 80kg in a few months, then I got stuck at 80kg for a few months on keto. But then all of a sudden I dropped to 72kg in a few weeks (it was such an odd and rapid drop I freaked out and went to the doctors to get checked out)

[ypcx]

>Since mid-January this year

That's a sample too short, a lot of that can be the momentum carried over from whatever you have been doing previously. You have to understand that as a carb/sugar eater, you may have effectively destroyed your body to the point when it's much harder for it to digest nutrients from food (e.g. fatty liver). And/or you may have a starting diabetes.

Before jumping into the meds death spiral, check Dr. Berg's videos on YouTube, and I'm sure you'll find a way forward. When your body is broken, nutrition isn't a simple thing, trust me, I know.

[dhimes]

Thank you. I'll do it.

[lanternslight]

Reduce your protein and increase your fat intake. Ideally, 80-90% of your calories should be from fat. Excess protein is converted to glucose.

[dhimes]

Will that cause a problem with cholesterol?

[shitgoose]

"I have zero calories before 5PM"

Did you mean after 5PM?

Other than weight loss, do you feel any differently (body, mind)? I have started IF last fall. Similar diet - low carb, higher protein. I also had considerable weight loss, but no impact on blood quality.

[dhimes]

No- before. I eat between 5pm and 10pm. I guess I feel better. With placebo effect and whatnot it’s hard to know. My workouts took a hit initially but eventually got back to their normal intensity.

[wirrbel]

when was your last test before the one you had?

[lubonay]

That's a very reasonable question - for all we know, the numbers might have been even worse!

[dhimes]

Indeed- it was about a year prior.

[hanniabu]

> In my personal case I'm not really able to enter and maintain good ketosis levels

How do you know if you've entered ketosis or what the levels are?

[ypcx]

I test both via keto urine strips and via keto breath analyzer. But when you are on a strong keto, you simply know it, you can feel it by the increased amounts of body and brain energy, mental clarity. Also your urine is more yellow and has a more specific odor.

[wtetzner]

Not the OP, but I've been using this to test my blood for ketones: https://www.amazon.com/gp/product/B0789G8KTG/

[wirrbel]

I do water fasting (rather "bone broth fasting" like Dr. Jason Fung advocates in his talks on youtube and in his books), and also have done and will do keto when I am not fasting.

I am not quite sure about the "health" class. So roughly speaking I am obese and I do think with every 3 kilograms I loose per month, I am healthier. So keto as a tool for loosing weight is really without a doubt healthy. The correlations between being overweight and associated risks are MUCH stronger than the correlations between food and associated risks.

Now, if you dig deeper into books on keto and fasting by doctors, you see how fragile certain conclusions are that are now the consensus opinion in nutritional science. I am a data-scientist, trained biophysicist and I know I am not an epidemiologist and not a biologist, but I can tell "creative statistics" apart from not-suspicious ones, and a lot of central nutritional science studies that triggered the fat-fear seem to be highly deficient from a statistical perspective, hardly proving any causality.

So I tend to be rather sceptical about dietary advice after 1950 unless it has been (a) shown in humans and not just in experiments with animals (b) based on studies that do interventions, i.e. change the behavior of humans rather than just surveying or asking what people do.

What I also find fascinating is, how the fasting community and the keto community often reach similar conclusion while actually being kind of different communities advocating for different "resolutions".

Anyway, what I was trying to say: If keto and fasting helps the normal weight range at steady 3kg/month, I do think it is healthy for me, when I am in a normal weight range, the priorities may change from "weight loss is really important" to other aspects.

[cagenut]

Your body goes into ketosis when it "runs out" of blood-sugar for long enough. It usually takes me 2 - 3 days of staying below 30 net grams (i'm a larger guy, for many people it requires going below 20).

IF can be a part of that, in terms of helping you to control your eating and making the time-period at the end of those 2 - 3 days happen maybe a half-day sooner, but fundamentally it doesn't change carbs are carbs.

Also you might find the relationship almost works the other way. Ketosis makes IF much easier. I haven't eaten breakfast in years. I don't even really consider that an IF regimen as much as like... once you get rid of the habit for a month or two you completely don't miss it and forget why you bothered.

[koolba]

Vigorous exercise, in particular sustained cardio, is the surest way to burn through your glycogen stores. Combined with intermittent fasting and a near-zero carb diet, it’s the fastest way to resume ketosis.

[jvanderbot]

Yes. Perhaps stronger effects w IF, according to this.

https://www.businessinsider.com/fasting-diet-ketosis-brain-b...

[wyager]

Everyone I know who is on a carnivore diet has a high enough fat:protein ratio to stay in ketosis most of/all the time. The value of that seems to be pretty common wisdom among carnivores.

[throwaway_tech]

It is possible, I have done it myself eating a lot of eggs and fatty red meat. Also, in my case I was also already in ketosis for an extended period of time, meaning my microbiome and cells were primed for ketosis.

That said I have also done carnivore and also not been in ketosis, which I think is probably the norm for most people on carnivore because the protein/fat ratios aren't right.

The commonality in ketosis carnivore and non-ketosis carnivore is removal of refined sugar/carbs which means no insulin spikes, which means steady levels of energy without crashing.

[wirrbel]

Meat also raises insulin, much less than carbs, but on a carnivore diet I can imagine this to happen.

The keto diet with ratios has been designed as a diet for epileptics, so in a ratio that maintains both body weight in a healthy range and induces ketosis and avoids ceizures (note: 1920s medicine or something). So the high fat content kind of is there to actually give you the energy so that you don't loose weight.

One aspect of the "carnivore" diet that is often overlooked, a "human carnivore in the stone age" will not have lived off of chicken breast and lean beef cuts, but easten the entire animal, i.e. the fat cuts as well that are surprisingly hard to get in a western country.

[cageface]

Meat raises insulin levels significantly. A steak spikes your insulin harder than a plate of spaghetti.

[pengaru]

They're pretty close according to https://en.wikipedia.org/wiki/Insulin_index

"White pasta" 40 ±5 vs. "Beef" 51 ±16

[dabraham1248]

1) That's per 250 kcal. A plate of pasta has significantly fewer calories than a plate of steak. Sauces on either can alter this, but they'll likely have their own indices to pay attention to. 2) The low ends are equal. The high ends are off by a factor of 1.5.

I think that the real question is "What will happen to my insulin if I eat a meal of pasta vs, a meal of steak?". To that, I think that the steak will in fact spike your insulin much higher than the pasta.

That said the beef has a higher satiety score (by almost exactly the same ratio as the high end insulin ratio).

Again, sauces, what your body needs right now, what you'll eat for your next meal,... lots of things can alter the overall health perspective.

[lanternslight]

Study link?

[cageface]

Consult any chart of the glycemic index of various foods.

[1MachineElf]

Unless one has too much lean meat. The body will convert excess protien into carbs. It's better to stick with fatty cuts only.

[ravenstine]

This also depends on eating frequency. If someone has a very low eating frequency, like a single meal every 72 hours, even a meal of lean meat may not knock a person out of ketosis, at least for very long. I've fasted that long and eaten a huge meal of lean meat, multiple times, and my keto testing strips always remain dark purple.

As much as I think keto and carnivore are lightyears past the average American's diet, I've found them difficult to maintain because they're very restrictive and I lack the energy to be effective when working out, which is common. Fasting in combination with a low carb diet, even one that incorporates things like berries, has been much more effective and easy to maintain in my experience. Combining macronutrition with eating frequency reduces the penalty of eating carbs or lots of protein by making it much easier to get back into ketosis. When you force your body to burn through its glycogen stores, and you give it no choice but to use your fat store, ketosis will come back in no time.

So you are definitely correct that fatty cuts are better, most of the time, but with fasting the protein to fat ratio almost becomes a non-issue.

[dhimes]

I lack the energy to be effective when working out

I found that I cramped, also. Eating 1/2 apple immediately before working out seemed to do the trick.

[lanternslight]

How many calories are you eating, and what is your fat/protein ratio? A higher fat rate might get you the energy you seem to be lacking.

[fudged71]

Lean meat will kill you if it's your only nutritional source. Look up "rabbit starvation" or "caribou starvation". Also called protein poisoning

[consp]

I have but in my case it is not caused by continued low carbon diet and should be avoided and is not so nice due all the side effects it has. Everyone who takes any form of diabetic medication should ask their physician about the consequences as it might interfere with the medication or require adjustment and can cause acidosis even if you have normal glucose levels. On the other hand, especially for type 2 diabetics, there is some indication it might be beneficial (if done properly and coordinated).

[wirrbel]

Ketoacidosis is of course a medical condition and not something one seeks out.

Ketosis is fundamentally different, your bodies mode of metabolizing (body) fat in the state of fasting, which can also be provoked when eating a high-fat moderate protein and <20-30g carbohydrates diet.

And yes, asking a physician may be a good idea if you suffer under certain conditions. Sometimes it may be valuable to find a physician that has knowledge on keto-diets, because that's not really something every physician learns about as a dietary choice.

[hellofunk]

> If you have never entered ketosis and experienced your brain running on ketones, I would suggest you experiment for yourself.

How do you do that? If the low-carb diet isn't enough, what is?

[kaibee]

Low carb is generally considered to be under 100g carbs/day. Ketosis requires under 20g carbs/day.

[whb07]

under 50g and it depends on the physical activity of the individual. Meaning if you're a highly tuned physical machine then you can eat far more than 50g.

[eatmyshorts]

Closer to 50g/day, not 20....but the lower you go the more ketones your body produces.

[richthegeek]

This is a net/gross carb confusion. Less than 50g including fiber, or 20g excluding fiber.

[wnmurphy]

Ketosis is a normal supplemental metabolic state that the body enters in between meals to various degrees. There's no hard black/white macro requirement.

[CuriouslyC]

Fasting

[text70]

I am having trouble agreeing with the statement that "...your body will convert the protein to glucose..."

Could you elaborate on that logic?

[pc86]

This[0] is a good starting point. Dietary protein can readily be converted to glucose in the body and either stored as fat or used as energy.

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636610/

[letharion]

The article says in multiple places that in practice, little of the protein was converted to glucose.

[wtetzner]

Yes, my understanding is that it will only convert as much as it needs to support the parts of the body that actually require glucose to run.

[text70]

Ah, ok. I think I figured out where my confusion was at regarding the catabolic pathways from both gluconeogenic and ketogenic amino acids. The correction looks something like [Keto-Acids[Ketone bodies]]

While most catabolic products are categorically and chemically ketones, the list of ketone bodies mostly falls within the list of Keto-Acids. All of which can get passed to TCA at some point, which in turn can feed into gluconeogenesis if the reaction pathway energy is favorable.

[letharion]

While several people refer to gluconeogenesis, to the best of my knowledge we _can_ make glucose from protein, but rarely do in practice. I have yet to see anyone convincingly show that we do.

Also check out diet doctors take on it which refers to actual studies. "Does protein adversely affect blood sugar?" https://www.dietdoctor.com/low-carb/protein

[uberduper]

Anyone on a zero/near zero carb diet should be proof enough. We can't survive with _no_ glucose.

[johnkpaul]

This is so so true but so many people don’t believe this is possible. I wish there was a way to formally study this. Once my children are out of the house, I’m going 0 carb. I’m already pretty close to carnivore.

[johnkpaul]

This is a very well understood pathway in biochemistry called gluconeonesis. https://en.wikipedia.org/wiki/Gluconeogenesis

[jnwatson]

A few parts of your body can't operate on ketones, so there's a backup mechanism to produce glucose from protein (from muscle breakdown, if necessary) called gluconeogenesis.

However, There's no evidence I've see that gluconeogenesis can kick you out of ketosis. As far as I know, gluconeogensis is demand-driven, not supply-driven, so there won't be any extra glucose running around for your ketone-consuming cells to use, regardless of your protein intake.

Disclaimer: I'm not a nutritionist or biologist.

[dnhz]

"The production of glucose from glucogenic amino acids involves these amino acids being converted to alpha keto acids and then to glucose, with both processes occurring in the liver. This mechanism predominates during catabolysis, rising as fasting and starvation increase in severity."

https://en.wikipedia.org/wiki/Glucogenic_amino_acid

[Dumblydorr]

The body can use protein to make glucose, it only will switch into that mode under low carbohydrate conditions like fasting or very low carb diets. It's less energy efficient of a pathway though.

[_vn5r]

gluconeogenesis

[whiddershins]

I would like a citation on the protein to glucose claim.

My understanding is the body would much rather run on ketones than go down that path.

[wtetzner]

My understanding is that the body will convert protein to Glucose when needed, but it is very carefully regulated, and will prefer ketones for cells that can run on them. However, some cells require glucose, and gluconeogenesis is important for that if you're eating low carb/in ketosis.

[lanternslight]

No citation, but If you think about it it makes sense: is you have no fat left, and aren't ingesting enough calories, your body would rather burn muscle than organs.

[ebg13]

https://en.wikipedia.org/wiki/Gluconeogenesis

[simonebrunozzi]

Any specific reading on how to get into ketosis that you would suggest? Something that you find scientifically sound?

[projektfu]

https://www.reddit.com/r/keto/wiki/faq

[lanternslight]

Join the CSK group on FB.

[brightball]

I always thought it wasn't recommended to stay in ketosis for more than 2 weeks at a time?

[wirrbel]

I cannot say that it isn't recommended, because recommendations are quite diverse. But I haven't seen that recommendation before.

Orthodox nutritionists would definitely advice against ketosis, potentially they may be fine with fasting-induced ketosis every once in a while (depends a bit on how they were trained).

People who embrace a low-carb ketosis-inducing diet (aka "Keto diet") or embrace multi-day fasting don't consider it harmful really. For fasting there are of course certain limits but not due to ketosis but for other effects of not eating (refeed effect, general weight-considerations, etc. but there have been overweight people successfully fasting for months under supervision).

[thrownblown]

there was that one dude who went on a year plus water fast and lost like 300 lbs

https://en.wikipedia.org/wiki/Angus_Barbieri%27s_fast

[brightball]

I believe that was the Atkins recommendation

[agumonkey]

isn't ketosis very subtle to maintain otherwise it can harmful effects ?

[stjohnswarts]

No, like other people have said that's ketoacidosis. Both involve some ketones, but one is healthy and natural(ketosis) the other is very bad and you should talk to your doctor about it (or he is most likely the one to find it) that is ketoacidosis.

[PaulHoule]

People confuse it with ketoacidosis, which is very dangerous. Ketosis is benign.

[wnmurphy]

Had a doctor tell me ketosis was very dangerous (she was confusing it with ketoacidosis). I couldn't help but completely stop listening to her after that.

[agumonkey]

Did you give her a hint about the mistake ?

if she just slipped it sucks (let's say doctors have a lot to worry so this is not bad)

if she did truly misunderstand, it's tough to tell

[riku_iki]

The biggest issue with ketogenic diets is elevated level of cholesterol, which is generally considered harmful, though there are different views on this topic.

[throw_away]

This is a side effect of how many people eating keto diets go all in on meat and cheeses. Vegan keto is possible: https://www.reddit.com/r/veganketo/

[jnwatson]

Lots of people on ketogenic diets are losing weight. The process of losing weight will naturally increase your cholesterol.

You're right, there are different views on this topic, in particular in the types of cholesterol elevated and decreased.

[wnmurphy]

The issue is the "generally considered harmful." High-fat low-carb diets tend to improve triglyceride profiles. Dietary cholesterol is not the same thing as blood cholesterol levels.

Anecdotally, my father and I discovered separately, in bloodwork unrelated to our individual diets, that a HFLC diet significantly decreased LDL and increased HDL.

[wirrbel]

The causality of elevated cholesterol and coronary heart disease isn't entirely proven. What we see in studies is mostly correlations. Cholesterol-reducing drugs have been shown to not lower the risks associated with high cholesterol levels, so I do think this is an area where we may not have the complete picture yet.

Dr. Jason Fung has a few interesting figures in his book, citing studies where the consumption of eggs for example decreases risks, kind of fascinating.

[cageface]

People who are born with unusually low cholesterol levels also seem to be essentially immune to heart attacks. I don't have the link to the study handy since I'm on my phone.

Be careful what evidence you accept on this question. There are billion dollar industries doing their best to confuse the issue.

[stjohnswarts]

I have always had very normal cholesterol numbers. It gives you a better HDL (good chol) to LDL(bad chol, maybe) ratio and is good for lowering triglycerides (definitely bad chol) which is the worst type of cholesterol. Your information is not true and is a common misconception about the diet.

[riku_iki]

> It gives you a better HDL (good chol) to LDL(bad chol, maybe)

also try to search "ldl blood test" on r/keto, there are tons of people report much higher ldl after switching to keto.

[riku_iki]

In my observation there are many contradicting studies about LDL and keto, for example this study's results show significant increase in LDL while on keto: https://www.ncbi.nlm.nih.gov/pubmed/31067015

[DrScump]

This one is baffling. LDL "significantly increased" while triglycerides "significantly decreased"? Calories/day not stated; if, say, 3200 kcal, that means 40g of carbs.

n=17, so who knows.

[agumonkey]

> contradicting studies about

this could be pubmed <title>

the more you dig the less certain

[agumonkey]

indeed..

[cies]

Afaik there is no top athlete on keto when performing: they are all on high-carb.

Keto is the "burn your body fat" mode. Staying in keto by eating high fat low carb is a trick. Humans never had such easy access to fats as today. Before we made settlements we got a large part of our calories from fruits (which contain short carbs), not unlike the other primates.

[amanaplanacanal]

> Before we made settlements we got a large part of our calories from fruits (which contain short carbs), not unlike the other primates.

This can't possibly be true. Agriculture is only 12,000 years old or so, but people have been living in Europe for much longer than that. I'm in North America, and there are no fruits available locally for six months out of the year. Before agriculture people must have been living mostly from hunting.

[cies]

You think a large share of pre-settlement humans lived in non-(sub)tropical regions? I don't think so. We mostly staying in the warmth, and the few daredevils that left had a hard time.

[DrScump]

You know the dietary practices of "all" top athletes?

Athletes in sports favoring fast-twitch muscle presumably wouldn't do keto, but endurance athletes, sure.

The SF Giants' Hunter Pence is a vocal keto practitioner.