[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! ;) )

[bad_user]

I've been on Keto before — eating whole foods is much simpler, there's no counting of carbs involved, no danger of developing a nutrient deficiency and no fearmongering ;-)

> "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."

This is also a recipe for getting an eating disorder. You can't stick with this mentality unless you end up thinking that carbs are poison, which is factually wrong and a very unhealthy mentality. And do you have the same mentality about fats? Those are "easy calories" too.

Sometimes it's OK to just have one cookie. If that doesn't work for you, fine, I've been there and I can understand wanting 100% compliance, but personally I feel much better since giving up on such a goal — because no, food is not poison, food is not alcohol, chronic overeating is the problem (aka energy poisoning) and chronic overeating can happen once you develop what they call "an unhealthy relationship with food".

I now naturally want whole foods, because I get to eat more volume and it keeps me full for longer. Once I got the taste of it, I don't need to fear food categories in order to stay on path.

---

> "For years there were stories of people eating below maintenance who aren't losing weight"

There's no such thing. People that eat below maintenance and not losing weight are either:

(1) underestimating their calories intake or

(2) have overestimated their maintenance requirements

If you're not losing weight, then by definition you're not eating below maintenance. And note that it is true that some medical conditions, like hypothyroidism, lead to a lowered metabolic rate (the thyroid is responsible for raising your body temperature for example), but in all cases we aren't talking about more than 200 - 300 kcal. So in order to lose weight, even people suffering from hypothyroidism can simply eat 2-300 kcal less — it's harder but it can be done. And if you claim a bigger penalty than that, you start breaking the laws of physics.

---

> "just recently science has learned that gut biomes can drop (increase?) their efficiency and result in a lower BMR than normal"

No, that did not happen. The research you're talking about was inconclusive and it was done IN MICE.

There are indications that the health of the microbiome is important, however the associations between the _human_ microbiome and obesity are weak and don't appear to be causal.

I.e. people that are obese tend to eat a less diverse diet (less whole plants). Such people also have less diversity in their microbiome. You cannot infer from that the microbiome is what caused their obesity, the huge confounder in such associations being the diet itself.

[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...

---

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...