Metabolizing fat, ketogenic and Atkins-like diets

Ivan Seeking

If a person is calorie-deprived and in ketosis, and then eats a small meal high in fat and protein, is the fat metabolized quickly for energy use, or does the body utilize existing fat reserves first?

I am curious, for example, if saturated fat is harmful [LDLs] for a starving person in the same way it is for person who has consumed enough or too many calories already that day. Is the harm due to saturated fats purely a function of the fat itself, or is this more a result of eating too many calories and not needing the extra energy; leaving the fat available to cause other problem?

Physics-Learner

saturated fat is not harmful in a sense that it is toxic. most people just eat too much of it, just like they eat too much sugar, which also is not harmful in and of itself. the body needs and uses sugar. the brain runs mostly on sugar.

it is the amounts that we eat, and the overall diet that we eat, that gets us into trouble.

Ken Natton

I know that you were hoping for a more expert response Ivan and I can anticipate that my understandings are of little interest to you or that anything that I am about to say is nothing new to you. You are, of course, perfectly free to ignore this post.

Yes, basically, the body’s quickest access to answer immediate energy needs is in the food you have just eaten and are actively digesting. That is where it will go first. Thus it absolutely can be that consumption of even high cholesterol saturated fats are not particularly harmful, if you burn them immediately. The next piece of information was a big surprise to me, so I’ll just quickly outline my source, which was someone I spoke to face to face. This guy is a medic and his specialisation is in all matters gastric. I am a person who suffers from acid reflux and this was the man who first explained to me exactly what is going on with that condition and exactly how Losec works and why it is such an effective drug against that particular condition. In any case, he told me that when it comes to drawing on its reserves, the body actually turns lean muscle tissue back into energy more easily than it does fat stores. That is why, when we do intensive exercise, the muscles get broken down, and of course it is in the subsequent repair of that muscle that it consequently becomes stronger. The point is, stored fat is basically source of last resource when the body needs energy. That is why it can be so difficult to shift.

Famously, children have a much faster metabolism than do adults which is why they can get away with eating high cholesterol saturated fats and still remain skinny. The point is that, enjoyment of such foods is somewhat habit forming, which is then why it is wise to discourage kids from eating such foods so that it is easier for them to stay away from them later in life when they are more problematic.

And perhaps the final point worth mentioning is that, however unsightly, the stored fat is not necessarily the most serious health risk. Of course, large amounts of stored fat are very unhealthy. Large body weight is a heavy load on the heart, it is strongly related to diabetes and so forth. But the point I am trying to drive at is that the high cholesterol saturated fats are most problematic because of the build up in the arteries. And lots of exercise, to get the heart pumping and get the blood flowing does help to break that down and improve the situation hugely even if you are not necessarily moving the unsightly stored stuff. As I would think most people understand, if someone is very overweight, they need to take it slowly and gradually, overdoing it too soon can actually be very dangerous. That is not relevant to the question asked but I felt the need to add it after my previous assertion.

nismaratwork

I would just correct one point: "last resorts" go in the order:

Fat
Muscle
Organs

@Ivan: Your question is at the heart of an ongoing debate and studies into "Atkins" type diets. To give you an answer would be to guess or lie, but Physics-Learner is certainly expressing the consensus view that I'd tend toward

Ivan Seeking

Thanks.

Dead on; at least, for me this seemed to be the outstanding question.

I wasn't going to do this but it seems worth the effort. I have extreme sugar sensitivity and have since I was a small child. I didn't understand this until about fifteen years ago when I passed out in my chair after lunch. When I eat carbs, I release too much insulin, which sends me into low blood sugar - might go as low as 20. I get the sweaty palm, shakes, nausea, and in some cases, pass out, It has been a huge problem. The only medication available is for me intolerable - a cure worse than the disease. This makes the consumption of any carbs problematic. I normally feel terrible after eating an ordinary meal. So I have tried to manage by managing my diet.

Also true, unfortunately, I have gotten fat - ~ 2 Lbs per year for 25 years. Given that I was always athletic and still have a few things to do, I decided to take this problem on once and for all. I have essentially been on the Atkins diet for the last two months [and lifting weights] and have lost 25 pounds, with a target of 50, which will put me back to a lean and mean [] 190 - more or less my ideal weight given good tone. I also know this diet is a bit risky, but given my blood-sugar problems, a low-carb diet makes a lot of sense. And in fact I feel better than I have for thirty years!

A key element of this, as I understand it, is the problem of high-fat foods. One bypass to this is whey protein. It is popular with the health-food and athletic crowd, and was recommended for my parents by their doctors or nurses. This provides a quality source of protein without the high saturated fat content. I am buying body-building brand that also has essential and non-essential amino acids. I had my uncle run it by his doctor as a brand choice and he seemed to be happy with it. Currently I consume 104 grams of whey protein each day in addition to a very healthy meal with tons of veggies, and enough fat, mostly unsaturated fats, to provide a the caloric intake target of 1500 calories per day.

I consume no more than 20-30 grams of carbs each day. As I approach my target weight, I will slowly increase this until I stop losing weight at 2000 calories a day or so. Even now I am fudging a bit and hit 35 sometimes, but there is no doubt that even two glasses of milk along with the carbs from the veggies can throw me out of ketosis. There is no mistaking the dry mouth and metallic taste when producing ketones.

One huge surprise in all of this for me is that about 14 grams per 8 oz serving, milk is basically liquid sugar. I love milk but it was causing me big problems and I never knew it. I always attributed bad reactions to the other foods I’d been eating. It seems that back in the 80’s, I was brainwashed into believing that milk is almost a perfect food. The ratio of protein, carbs, and fat, were at that time almost exactly the same as the recommended ratios. At most I worried about the fat in milk, not the sugar. I now know I was drinking waaaaaaay too much milk.

I have been in ketosis for two months.

Comments?

nismaratwork

I think that as long as your CBC and lipid panels are clear, you're probably avoiding potentially dangerous issues with your pancreas or liver. You are however, something of a special case, and if I had to make a generic comment I'd say you should see an endocrinologist...
...You already have though, haven't you?

As for being thrown out of ketosis by milk, I'm not surprised, that's a LOAD of sugar and carbs, and the body is quick to stop burning reserves.

Ivan Seeking

It took one of the nation's top endocrinolgists to diagnose my problem. I have not consulted with a doctor on this diet because I know it is controversial - no hope of a useful answer. I do plan to get in for a complete physical soon but wanted to give this a bit of time first. I know this approach is a bit reckless but I am otherwise being careful. But, I know, I need to get my doctor in the loop.

Can't fly a Mig if I'm 50 Lbs overweight!

nismaratwork

Heh... crazy man. Well, in my unprofessional opinion, just keep up on your bloodwork and stick with the diet if it's working and you're not feeling exhausted or fainting.

Just make sure to do that CBC with lipid panel by 3-4 months, OK? Still, I wouldn't say reckless... daring perhaps... foolhardy maybe, but since it's working, lets call it "smart".

Point is, you're losing weight and you're not having serious hypoglycemic episodes... I call these good things.

Proton Soup

so you have reactive hypoglycemia? if you intend to stay on ketogenic diets, you might want to check out lyle's book.

http://www.bodyrecomposition.com/the-ketogenic-diet

or just hop on the forum and ask him. if he doesn't think it's useful for you, he'll say so.

http://forums.lylemcdonald.com/index.php

low-carb diets over there are pretty common, but mostly just used by people for cutting fat. usually as a protein-sparing modified fast diet that also cuts most fats and lower calorie than the more sensible approach you're using now. weight training while cutting is great to maintain lean mass, but don't expect much in gains while cutting unless you're completely new to it. the whey you're consuming is excellent, one of the best proteins. eggs are great and cheap, too, and fit into your fat-consuming diet.

as for the milk... it actually is one of the best post exercise foods you can get. even chocolate milk with extra sugar in it. unless maybe you've got reactive hypoglycemia.

oh yeah, about atkins. people always think the induction phase is the diet, but it's actually a series of diets. coming out of ketosis and going into continuing weightloss, then maintenance is still atkins. you will also gain some of that weight back because going ketogenic and using up glycogen stores causes you to excrete a lot of water. it can be several pounds worth, so don't be discouraged if you see some rebound.

oh, and if simple carbs are the only thing causing your symptoms, i guess that's great. but protein meals will also cause insulin secretion. hopefully you can still eat large steaks in one sitting.

Physics-Learner

hi ivan,

as nis said, your problem seems a bit unique - such that i dont feel comfortable giving you any "solid" advice.

too much sugar brings that feeling on for everyone. but "too much sugar" is not an exact amount. you seem to have a very low tolerance, which can sometimes be common amongst people who have abused sugar.

are you diabetic, or close to it ?

the problem that most people have with milk products is that we dont do well with the sugar that is in milk. most people are allergic to milk at some point. usually the first symptom is creating lots of mucus.

one thing i might suggest that i do think will work for you is to make sure you eat lots of SMALL meals.

once you can get to the point of being pretty healthy, you may find that some of your problems are lessening. i am very much against those low-carb diets for the average person.

but you need to do what is working for you. if at some point, you can start adding a more normal amount of carbs in your diet, i think it would be better. but carbs from a candy bar is not the same as carbs from an apple.

good luck.

Ivan Seeking

Thanks again for any and all input offered. I know this is all controversial and we can't get into "medical advice", but information is a good thing; esp when taking a bit of risk with life and limb.

This gets to the crux of my concerns. Now there is one qualifier here - the milk. Everything I believe to be true about problem foods [wrt blood sugar] is in question. I now know the milk alone can cause a blood sugar reaction.

That said, it seems that high-fat and high-protein foods eaten in moderation cause me no problems. All carbs do; even complex carbs. Something like oatmeal, which has a very low glycemic index, causes me to crash. On the other hand, last week I had a rather large steak with veggies and, for the first time in probably twenty years, didn't have my blood sugar crash after a dinner out.

So, once I get close to my target weight I have to make a determination. Can I slowly blend low-glycemic carbs into my diet without causing problems again, or do I need to stay on a ketogenic diet in order to avoid blood sugar issues. And if I do stay on a low-carb, relatively high-fat diet, am I begging for a heart attack or stroke? Does limiting calories make fats tolerable?

Reactive hypoglycemia is not the name my doctor used when first diagnosed - he referred to it as a diabetic syndrome that is not well understood - but that should be the same animal. Also, it is clear that I have had this problem since age 5 or so. Some of my earliest memories of school take me right to memories of feeling terrible after breakfast - usually Oatmeal or Cream of Wheat, or eggs, w/ oj, milk, and toast. Waffles and pancakes with syrup were a real issue. But when you grow up with this and the doctor tells mom you're just playing hooky - in spite of several unexplained episodes of syncope! - you assume it is normal. It is only clear now in retrospect.

Ivan Seeking

Another related point. I haven't verified this yet, but I am told that insulin locks up sugar by converting it to fat. [Funny, I had never considered what happens to sugar after insulin is released]. If I understood this correctly, and if true, then it seems to suggest that I tend to rapidly convert all carbs consumed to fat, which could explain my weight gain over the years. My total caloric intake wasn't typically that high. And based on the notion that one should consume a lot of grains and complex carbs, I have tried to do so as much as I could tolerate it.

Also, as I understand the state of things, it seems that insulin is now seen as a real problem in its own right. Among other things, apparently it is thought to play a significant indirect role in cardiovascular disease. So I have to wonder which is worse, eating fatty foods, or constantly releasing too much insulin, which helps to make the fatty foods more dangerous.

nismaratwork

I know it's no fun, but the only way to resolve that for you personally, is to check your lipid panel... if it's good, I'd keep it up.

Proton Soup

i would think of insulin more as a blood sugar control hormone. it will cause that dangerously high blood sugar to go somewhere. if you've just been working out, some of it will go in your muscles. if muscle glycogen is full, it will be going other places, like liver glycogen, or, as most people notice because they never exercise enough to deplete glycogen, their fat cells.

insulin is not bad per se. without it, you will die. your body's cells will starve and you will wither away. blood sugar levels are the thing you need to watch out for. and much of the blood lipid stuff will be controlled by not being in a constant state of waist expansion.


some of the things you say make me wonder if the amount of fat in your meal may be the biggest factor in how you respond glycemically. but i guess that is something you and your doc will determine experimentally.

Ivan Seeking

Makes sense. I guess for now that is the best approach. If things don't well, then I'll worry about the next step.

Unfortunately, excess insulin is also a problem. This is something insulin-dependent diabetics have to watch. Not the best source but it covers a few highlights.

http://www.healingdaily.com/detoxifi...et/insulin.htm

I'm not likely insulin resistant in the normal sense, but the effect is the same. With decades of too much insulin being released, insulin resistance is bound to follow. I Don't know if obesity is normally related to the cause, or an effect.

Again, this is not verified, but the claim is made that insulin causes inflamation in the lining of the blood vessels, causing them to trap plaque more readily. The vessels also become stiffer. So far most or all of this stuff has checked out but I haven't had a chance to check everything yet. So that one is only as reported.

Physics-Learner

your low level of carbs concerns me. but if there is nothing you can do to absorb them normally, you may have limited choices.

if you need to have a high fat intake, just make doubly sure that you are eating good foods. nuts and seeds, flax meal. these foods have lots of omega 3, 6, and 9 in them.

saturated fat is not bad, per se. it is the amount and the proportion that we eat, in comparison to the other good fats.

some of the long chain saturated fats are used in anabolism (creating tissue, etc.).

as nis said, make sure that you monitor your blood. take a look at your blood glucose, your cholesterol (hdl, ldl), triclycerides.

with regard to sugar, can you try taking small amounts of it at a time ? this is why i was referring to many small meals. for example, take one bite of a banana. wait 15 minutes or so. take another bite. maybe it takes you a couple hours.

but if your intake is slow enough, perhaps your insulin wont be too much of a problem ?

i just think it is harmful to be breaking down lots of protein, and burning that for energy.

Ivan Seeking

This is one point that confuses me a bit. The way I understand this, the point of being in ketosis is to burn fat, not protein. Clearly I am consuming more protein than normal, but it isn't clear how this plays into the total energy scheme. I do know the whey protein is easily metabolized compared to other sources of protein. This is why it is recommeneded for the elderly and infirmed.

I know that doctors will warn about stressing the liver on this diet.

It has been shown that people [runners] in ketosis who consume significant quantities of fat do not lose energy over time, whereas low fat intake results in energy loss even with the protein. There are also some issues related to liver damage were the diet strictly high-protein. I haven't quite sorted this out other than fat is considered to be critical to the program.

One point made in defense of a ketogenic diet is that the innuit lived on a ketogenic diet for thousands of years. My first thought upon reading this was: Yeah, and when was the last time you saw a skinny Eskimo?