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.

@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

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]

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 ["biggrin:] 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 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?

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]

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.

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]

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!

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, let's 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 http://en.wikipedia.org/wiki/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 don't 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 don't 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.

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.

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]

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.

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]

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.

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]

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.

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

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.

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.

High levels of insulin cause several problems: one of them is high blood pressure. One of the roles of insulin is to assist the storing of excess nutrients. Insulin plays a role in storing magnesium. But if your cells become resistant to insulin, you can't store magnesium so you lose it through urination. Intra-cellular magnesium relaxes muscles. What happens when you can't store magnesium because the cell is resistant? You lose magnesium and your blood vessels constrict. This causes an increase in blood pressure.

Insulin also causes the retention of sodium, which causes fluid retention, which causes high blood pressure and congestive heart failure.

A recent study(1) showed that overweight children with high levels of insulin in their blood are also likely to have high levels of homocysteine, a substance which appears to raise the risk of heart disease, stroke, and birth defects.

Osteoporosis is another potential problem resulting from insulin resistance. Insulin is a master hormone which controls many anabolic hormones such as growth hormone, testosterone, and progesterone. In insulin resistance, the anabolic process is reduced. Bone is built upon the command of such hormones. When these hormones are reduced, the amount of bone building is reduced, and the amount of calcium excreted is increased.

Insulin increases cellular proliferation. How does this affect cancer? It helps it grow. And there are some pretty strong studies(2,3) which show that one of the strongest correlations to breast and colon cancers are levels of insulin...

90% of those with insulin resistance are obese.

http://www.healingdaily.com/detoxification-diet/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 won't 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]

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

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?

 

[Physics-Learner]

those are about the only people who are healthy that way.

but from my research, that seems almost of a unanimous agreement that it is because of the frigid weather in which they live.

i think ketosis will prove to be detrimental to us over the long term.

the body can get some sugar from protein, which is why it may choose to break protein down, if it does so.

not all low-carb diets are the same. some i can agree with, because they basically do what i think is best. they get rid of all the processed carb foods that we gobble down.

but those that produce ketosis are worrisome to me. which is why i am suggesting ways for you to up your carb intake as much as possible, without having your insulin problems.

i don't know if this is possible.

 

[Proton Soup]

i think the deamination of protein is not all that controversial a pathway for generating glucose. gluconeogenesis from fat seems a little more controversial, tho.

http://en.wikipedia.org/wiki/Gluconeogenesis
http://en.wikipedia.org/wiki/Ketosis

i'm kind of annoyed that it's so hard to find a reference with a straight answer on it. my old physio teacher didn't seem to think the brain was capable of running on straight ketones. but i also know that very fat people can go a long time without eating, and they do not lose all their lean tissue in the beginning and die fat, it's much more proportional than that.

but in any case, if you eat more protein than your metabolic needs, it will be deaminated. and if you're dieting, living off your fat stores, excess protein will prevent catabolism of your lean tissue.

 

[Ivan Seeking]

i think the deamination of protein is not all that controversial a pathway for generating glucose. gluconeogenesis from fat seems a little more controversial, tho.

http://en.wikipedia.org/wiki/Gluconeogenesis
http://en.wikipedia.org/wiki/Ketosis

i'm kind of annoyed that it's so hard to find a reference with a straight answer on it. my old physio teacher didn't seem to think the brain was capable of running on straight ketones. but i also know that very fat people can go a long time without eating, and they do not lose all their lean tissue in the beginning and die fat, it's much more proportional than that.

but in any case, if you eat more protein than your metabolic needs, it will be deaminated. and if you're dieting, living off your fat stores, excess protein will prevent catabolism of your lean tissue.

I do have a source handy on the blood-brain barrier issue [whoops, you linked to the wiki page that references this]

During starvation or a long physical training session, the body starts using fatty acids instead of glucose. The brain cannot use long-chain fatty acids for energy because they are completely albumin-bound and cannot cross the blood-brain barrier. Not all medium-chain fatty acids are bound to albumin. The unbound medium-chain fatty acids are soluble in the blood and can cross the blood-brain barrier.[1] The ketone bodies produced in the liver can also cross the blood-brain barrier. In the brain, these ketone bodies are then incorporated into acetyl-CoA and used in the Krebs cycle.

http://en.wikipedia.org/wiki/Ketosis
http://www.ajcn.org/content/52/3/502.full.pdf

 

[Physics-Learner]

from everything i know, fat can not be turned into sugar.

people claim that the brain can run on ketones. most physiologists will tell you that the brain was designed to run on sugar. if i recall, the heart does burn fat as its preferred source of fuel.

i do a lot of vigorous exercising, which would even make it harder for me to try to go into ketosis. not that i would ever choose to do so.

ivan, please try to get in as much sugar as you can. little amounts throughout the day. you will more than likely still only be able to take in a low dosage. but every percent is helpful, in my opinion. just try to max out, until you start having insulin problems.

if i understand correctly, your current diet is not giving you insulin problems ? let's forget about the long-term effect, since we won't know conclusively about that until it is long term - LOL.

so just add a little bit of carbs each week, even if it is just 1 gram extra each week, until you reach your limit.

try to pour on the vegetables as much as possible.

 

[Ivan Seeking]

Btw, I should mention that I'm taking my cues from a friend who pays $5000 a month for intense professional consultation and oversight of his medical status. He is almost 70 years old and can hold his own with competitive, twenty-year-old bicycle racers...and I'm talking about 90-mile races. He is really quite amazing! I made a bit of a leap of faith and decided to follow his lead. I wouldn't normally do something like this without knowing a lot more about it.

It is controversial but these guys [my friend's consulting doctors] are not dummies. This was not a simple matter of reading a diet plan and going for it. On the other hand, I am flying a little too blind here for my own comfort; esp if I want to consider staying on a ketogenic diet.

Incidently, his newest bike cost over $20K He figures that at 68+, he needs every edge he can get.

 

[Ivan Seeking]

from everything i know, fat can not be turned into sugar.

people claim that the brain can run on ketones. most physiologists will tell you that the brain was designed to run on sugar. if i recall, the heart does burn fat as its preferred source of fuel.

i do a lot of vigorous exercising, which would even make it harder for me to try to go into ketosis. not that i would ever choose to do so.

ivan, please try to get in as much sugar as you can. little amounts throughout the day. you will more than likely still only be able to take in a low dosage. but every percent is helpful, in my opinion. just try to max out, until you start having insulin problems.

if i understand correctly, your current diet is not giving you insulin problems ? let's forget about the long-term effect, since we won't know conclusively about that until it is long term - LOL.

so just add a little bit of carbs each week, even if it is just 1 gram extra each week, until you reach your limit.

try to pour on the vegetables as much as possible.

Thanks. I am sticking with the program for a time, but I understand and agree with your concerns. Barring any obvious problems, I am willing to risk this for three or four months, but it could be very unwise to continue beyond that. So far I seem to be on a steady track of about 3 Lbs per week. This gives me a hopeful target of two more months. I plan to start slowly adding carbs before the target date and slow the rate of loss. The problem is, I fully expect to start having blood sugar problems again. It is hard to believe that would change. So I tend to assume a choice will be required before this is over.

One of the reasons I went on this diet was that I had given up on eating well. A "good" diet makes me feel terrible. I was almost on a ketogenic diet anyway, out of necessity. All that was really needed to was lose the milk and processed sugar, and add lots more veggies. Ironically, I was moderating my blood sugar by putting sugar in my coffee. No doubt about it. Before starting the protein I tried to stop the sugar habbit - big problems! Before the choices were, can't eat, can't not eat. Even one piece of 7 grain toast with milk could ruin my morning. The only thing that seemed to keep me level was a very slow and constant intake of sugar - a habbit I didn't understand until the doctor explained it. I knew I could eat eggs and cheese every day for breakfast, but that didn't seem like a good option either. Now, with the whey protein drink in the morning, the sugar cravings and need are gone and there are no hypoglycemic episodes.

 

[nismaratwork]

All I can say Ivan, is that you seem to have the best advice and treatment possible already, and I've researched and found... almost nothing about your condition. You're a unique guy (big shock, right? ) so take it easy and get that bloodwork sooner rather than later.

Still, based on your experience and how nasty excess insulin is... stay the course. One question: any Acanthosis nigricans prior to this, and if so, any change on this diet?

Again, no harm in talking to your doc, or just getting an Rx for a blood draw and seeing a local phlebotomist. It will give you a solid footing to continue with this rather experimental approach, but one that I THINK sounds like a good fit for you.

 

[bobze]

i think the deamination of protein is not all that controversial a pathway for generating glucose. gluconeogenesis from fat seems a little more controversial, tho.

http://en.wikipedia.org/wiki/Gluconeogenesis
http://en.wikipedia.org/wiki/Ketosis

i'm kind of annoyed that it's so hard to find a reference with a straight answer on it. my old physio teacher didn't seem to think the brain was capable of running on straight ketones. but i also know that very fat people can go a long time without eating, and they do not lose all their lean tissue in the beginning and die fat, it's much more proportional than that.

but in any case, if you eat more protein than your metabolic needs, it will be deaminated. and if you're dieting, living off your fat stores, excess protein will prevent catabolism of your lean tissue.

The brain cannot run on straight ketones. Its really designed to run on glucose, evolutionary speaking. However, during starvation or when glucose is less available the brain can run on ketone bodies (KB) to alleviate some of the glycogenic demands placed on the liver.

Last I checked, the brain, during acclimatized starvation, can pull about 40% of its energy demand via KBs.

from everything i know, fat can not be turned into sugar.

people claim that the brain can run on ketones. most physiologists will tell you that the brain was designed to run on sugar. if i recall, the heart does burn fat as its preferred source of fuel.

i do a lot of vigorous exercising, which would even make it harder for me to try to go into ketosis. not that i would ever choose to do so.

ivan, please try to get in as much sugar as you can. little amounts throughout the day. you will more than likely still only be able to take in a low dosage. but every percent is helpful, in my opinion. just try to max out, until you start having insulin problems.

if i understand correctly, your current diet is not giving you insulin problems ? let's forget about the long-term effect, since we won't know conclusively about that until it is long term - LOL.

so just add a little bit of carbs each week, even if it is just 1 gram extra each week, until you reach your limit.

try to pour on the vegetables as much as possible.

The carbons from acetyl CoA (ACoA) aren't used for gluconeogenesis, ACoA is what you get from the beta-oxidation of fatty acids. This is strictly true for ACoA produced from glycolysis, but may have some typical-biologyesq exceptions when it comes to fatty acid metabolism (namely that odd chain FAs end up as propionyl CoA which can be fed back into gluconeogenesis via some hand waving and TCA intermediates, succinyl CoA). This makes whether fat can be "glucogenic" complex (what in biology isn't?), but regardless this probably isn't the status quo of the body (its a huge energy for the body to do this).

The heart will really burn anything--Its kinases basically keep its catabolic (for glucose, fat, lactate etc) always on--Which makes sense, you really don't want the heart to take a break from beating.


The good news is Ivan, if you been diagnosed with diabetic syndrome (aka; metabolic syndrome, aka; pre-diabetes) this can be controlled and corrected through dietary modifications before insulin resistance becomes a problem.

Insulin release from the pancreatic beta cells is controlled by the levels of ATP and NADPH available in them. This is what makes metabolic syndrome so complex--Because, high levels of FA oxidation, can elevate those levels leading to inappropriate responses to glucose. This can be further complicated if the body is inappropriately secreting other hormones which help control insulin levels, such as incretins (like GLP1 and GIP) which are both produced from neurosecretory cells of the GI and lead to increases in insulin levels.

 

[Ivan Seeking]

The good news is Ivan, if you been diagnosed with diabetic syndrome (aka; metabolic syndrome, aka; pre-diabetes) this can be controlled and corrected through dietary modifications before insulin resistance becomes a problem.

This all gets a little dicey as my friend is not a doctor and can get things mixed up. But according to him, right now I am effectively retraining my pancreas. Does this make any sense? Is this what you mean by "corrected"?

 

[Ivan Seeking]

One question: any Acanthosis nigricans prior to this, and if so, any change on this diet?

Not that I've noticed. Vitiligo and psoriasis, but no acanthosis nigricans, which I see is an insulin-related response [didn't know about that one].

 

[nismaratwork]

Not that I've noticed. Vitiligo and psoriasis, but no acanthosis nigricans, which I see is an insulin-related response [didn't know about that one].

Good, that's a good sign.

I have to say, I don't think you're pre-diabetic, and I think "restraining the pancreas" is a good term actually. In essence, your GI/Pancreas/Liver seem to go wildy overboard when exposed to sugars... the solution for now is to monitor blood, and not stress the pancreas above all. You do NOT want pancreatitis...

The Vitiligo and (heartbreak of) psoriasis I doubt are related, but it may indicate some kind of broad spectrum sensitivity. Do you have really horrific environmental allergies, and very VERY rarely get ill?

 

[Ivan Seeking]

The Vitiligo and (heartbreak of) psoriasis I doubt are related, but it may indicate some kind of broad spectrum sensitivity. Do you have really horrific environmental allergies, and very VERY rarely get ill?

I have terrible grass allergies for sure; not sure what else. I have to live on Benadryl four months out of the year. [Didn't realize how bad this was until we moved to the grass seed capital of the world! ] As for getting ill, I don't think there is anything unusual there. But it is hard to tell as my other problems can mimic a feeling of illness. This goes all the way back to the doctor telling mom I was just playing hooky as a kid.

 

[Ivan Seeking]

I do appreciate all of the input.

Getting back to the main point here. One of the outstanding questions in all of this is whether there is any definitive evidence that this diet is dangerous. Controversial, yes, but my take was that applies to both sides of the argument. As far as I know, the Atkins diet has never been shown definitively to do harm.

There are two issues here. First is the question of high-fat diets, where the concern is coronary and vascular disease. Next is more the question of low-carb diets [with added protein and fat to compensate], which could affect not only the liver but also the brain. As I understand it, stress on the liver due to the added protein load is one of the biggest concerns.

 

[Physics-Learner]

ivan,

the low-carb diets have not really had mass appeal until fairly recently. so there is really no long-term study that one can do.

i will reiterate what i said. you have a problem with insulin and sugar. the best route is to try and fix that. what seems to make sense to me is to experiment with how much sugar you can intake. and what sorts of foods are less problematic than others ?

since at least in the short term, your carb intake is going to be considerably lower than average, just try to take in whatever maximum your body allows, before it has adverse reactions.

my thought is that you may be able to gradually increase your carb levels to what they should be, in a normal situation. "gradually" could be 10 years or more. no way to tell until you actually do it for yourself.

there are lots of advanced tests that you can take to see what sorts of problems you may have, that you are not aware of.

try this site - i have used them in the past.

http://www.metametrix.com/

you can get amino acid profile, fatty acids profile, toxics, allergens, etc.

if you take a full array of tests, i am almost positive you will learn about quite a few imbalances that should be corrected. once imbalances get corrected, lots of things start fixing themselves automatically.

 

[Ivan Seeking]

ivan,

the low-carb diets have not really had mass appeal until fairly recently. so there is really no long-term study that one can do.

I don't know about that. It has been around for almost 40 years. It was first popularized beginning 1972.
http://en.wikipedia.org/wiki/Atkins_diet

I appreciate your input and plan to do just as you suggest, but I would like to get back on topic now.

 

[DanP]

You will not burn only fat, even in a state of complete adaptation to starvation, when ketosis runs full steam. Proteolysis is proceeding forward at normal rates, as a result you will loose skeletal muscle mass. Some of the resulting amino-acids will be used in gluconeogensis. Lack of normal levels of insulin (and you have abysmal levels with 20g of carbs / day )result in a catabolic environment, where it is almost impossible for the body to have a level of protein synthesis to maintain balanced protein turnover in the skeletal muscles.

As a result you will gradual deplete your proteins in the skeletal muscles, in addition to shedding fat at a steady rate.

My advice is to eat balanced, engage in a form of exercise (even walking will do-it if you didn't do anything till now, and some light resistance training , even push-ups from your knees and and air squats at least ) and eat under your maintenance levels with ~500 to 700 kcal. Any diet under 1500 Kcal for a man should be supplemented with vitamins and minerals, unless you have access to foods which pack the whole RDI of vitamins and minerals.

You will have to readjust caloric intake several times. In the end, losing fat is first and foremost about energy balance. Yes, hormones, and all that play a key role, but when all is said and done, energy balance remains the main factor.

The best thing which you can do is fork some US$ and consult with a reputable nutritionist, and follow his advice to the letter. Go to an expert and do what he tells you to do. Plan for the future and you'll be happy. Look for silver bullet and you'll end back fat.

Almost all humans I seen dieting on their own lost a lot of muscle, got a weak flabby body, and all for nothing since they regained the weight at alarming rates as soon as they started to feed ad libitum again.

 

[Ivan Seeking]

You will not burn only fat, even in a state of complete adaptation to starvation, when ketosis runs full steam. Proteolysis is proceeding forward at normal rates, as a result you will loose skeletal muscle mass. Some of the resulting amino-acids will be used in gluconeogensis. Lack of normal levels of insulin (and you have abysmal levels with 20g of carbs / day )result in a catabolic environment, where it is almost impossible for the body to have a level of protein synthesis to maintain balanced protein turnover in the skeletal muscles.

As a result you will gradual deplete your proteins in the skeletal muscles, in addition to shedding fat at a steady rate.

As I understand it, one avoids this by consuming large quantities of protein.

 

[DanP]

As I understand it, one avoids this by consuming large quantities of protein.

It's not. Skeletal muscle protein suffers constant breakdown and rebuild in a process called protein turnover. Lacking insulin, the ratio of proteolysis / protein synthesis goes out of whack. This process is under hormonal control, and insulin acts as one of the regulators, for both syntheses and preoteolysis. It up-regulates synthesis and down-regulates breakdown. It's biochem 101. Youll just oxidize most of your large quantities of protein ingested.

Resistance training also up-regulates protein sysnthesis in skeletal muscle, so it will have a protective effect. My advice stands. Consult an expert and follow his advice to the letter. And exercise, if you will get cleared by your MD.

 

[Ivan Seeking]

It's not. Skeletal muscle protein suffers constant breakdown and rebuild in a process called protein turnover. Lacking insulin, the ratio of proteolysis / protein synthesis goes out of whack. This process is under hormonal control, and insulin acts as one of the regulators, for both syntheses and preoteolysis. It up-regulates synthesis and down-regulates breakdown. It's biochem 101. Youll just oxidize most of your large quantities of protein ingested. .

Thanks for the input.

Why would there be a severe lack of insulin? Isn't insulin still released due to protein conversion to sugar [ATP]?

Just to be clear: The point of this diet was not the goal of a silver bullet, but rather I saw it as a way to avoid the problems I have with carb intake. It was an act of desperation. I have been following the normal advice of "eating less and more often" for ten years, with constant blood sugar problems. How can one eat less than one piece of toast for breakfast? Fruit? Out of the question. It sends me into almost instant problems. I don't reject the standard advice, but it hasn't been working and there are no other options to my knowledge.

 

[DanP]

Thanks for the input.

Why would there be a severe lack of insulin? Isn't insulin still released due to protein conversion to sugar [ATP]?

There is a low level on insulin even in complete starvation, which ensures an equilibrium between ketone bodies, gluconeogensis and ffa. Without insulin (or resistance to it) , starvation or ketogenic diets can lead fast metabolic acidosis and serious issues. It's never absent.

You are also probably in caloric restriction if you manage to lose mass. Low carb intake, caloric restriction and the fact that your brain runs on ketone bodies thus requiring less CHO will result in low insulin levels IMO, even if you will get some glucose from alanine and glutamine.

It was an act of desperation. I have been following the normal advice of "eating less and more often" for ten years, with constant blood sugar problems. How can one eat less than one piece of toast for breakfast? Fruit? Out of the question. It sends me into almost instant problems. I don't reject the standard advice, but it hasn't been working and there are no other options to my knowledge.

Well, keto diets can get the work done , no question about it. Not my choiche. Just exercise if you dont's already and make that a habit , it may have a sparing effect on your muscle mass and will help with a whole host of health issues.

 

[Proton Soup]

As I understand it, one avoids this by consuming large quantities of protein.

it will limit loss when coupled with resistance training. but it won't completely eliminate muscle loss. bodybuilders and strength athletes will often diet this way, with a goal of losing more fat than lean when going down, and vice versa.

 

[Proton Soup]

I do appreciate all of the input.

Getting back to the main point here. One of the outstanding questions in all of this is whether there is any definitive evidence that this diet is dangerous. Controversial, yes, but my take was that applies to both sides of the argument. As far as I know, the Atkins diet has never been shown definitively to do harm.

There are two issues here. First is the question of high-fat diets, where the concern is coronary and vascular disease. Next is more the question of low-carb diets [with added protein and fat to compensate], which could affect not only the liver but also the brain. As I understand it, stress on the liver due to the added protein load is one of the biggest concerns.

i think usually the thing mentioned is that some believe high protein diets cause kidney damage. but this is mostly theoretical. good luck finding papers that show it.

ketogenic diets are often used in the management of epilepsy, so one might want to look there for possible health effects. it has potential to limit growth in pediatric patients, but probably not a concern for you now.

if you troll http://www.ncbi.nlm.nih.gov/pubmed" , you'll find more. probably want to look for reviews and free full text articles. here's a couple of examples, don't know helpful they are to you.

http://pediatrics.aappublications.org/cgi/content/full/119/3/535
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2367001/?tool=pubmed

 

[DanP]

Ivan, try to find this to read more and make some edcuate descisions. IMO those are the most relevant papers for somone in your situation

1. Evaluation of a tool for rating popular diet books (William & Williams 2003)
2. Role of calcium and dairy products in energy partitioning and weight management (Zemel 2004)
3. Role of calcium and dairy products in modulating adisposity (Zemel 2003)
4. A Randomized trial of low carbohydrate diet for obesity (Foster& all 2004)
5. The effects of low carbohydrate versus conventional weight loss in severely obese adults: one year follow-up in a randomized trial (Stern & all 2004)
6. Effects of Zone diet macronutrient proportions on blood lipids, blood glucose, body composition and treadmill exercise performance (Bose & all, 2004)
7. The zone diet phenomenon:A closer look to the science behind the claims (Cheuvront 2003)
8. A low fat carbohydrate ketogenic diet vs a low fat diet to treat obesity
and hyperlipidaemia: a randomized controlled trial (Yancy & all 2004)
9. Behavioural treatment of obesity (Wadden & Foster 2004)
10. Metabolic effects of high protein, low carbohydrate diet. (Denke 2001)


Lard is a curse. Get rid of it, your life will be 10x better. Exercise for the rest of your life. If need be, paint your house walls with slogans "Ill never get fat again" , watch what you eat for the whole rest of your life, obsees with weigting yourself once a week, do whatever it takes, just keep it off.

 

[Physics-Learner]

hi ivan,

just to reiterate, make sure that you get consistent testing, so that you can monitor the results of your decisions, whatever they may be.

 

[nismaratwork]

hi ivan,

just to reiterate, make sure that you get consistent testing, so that you can monitor the results of your decisions, whatever they may be.

Amen to that!

@DanP: Good to have you back in the saddle.

So, what I'm taking away from this is BE FIT, but above all, don't burden your body with excess fat, and any healthy means to rid yourself of that is game. In Ivan's case, under the care of an expert, I'd tend to PL's view: take a pint of blood per week for testing! Still... I can't help, but enjoy this human experiment (sorry Ivan!)

 

[Ivan Seeking]

I didn't see that anyone has posted this so here you go. It appears that evidence is mounting that a low carb diet can slow, suppress, or delay the onset of various cancers.

Over the last years, evidence has accumulated suggesting that by systematically reducing the amount of dietary carbohydrates (CHOs) one could suppress, or at least delay, the emergence of cancer, and that proliferation of already existing tumor cells could be slowed down. This hypothesis is supported by the association between modern chronic diseases like the metabolic syndrome and the risk of developing or dying from cancer. CHOs or glucose, to which more complex carbohydrates are ultimately digested, can have direct and indirect effects on tumor cell proliferation: first, contrary to normal cells, most malignant cells depend on steady glucose availability in the blood for their energy and biomass generating demands and are not able to metabolize significant amounts of fatty acids or ketone bodies due to mitochondrial dysfunction. Second, high insulin and insulin-like growth factor (IGF)-1 levels resulting from chronic ingestion of CHO-rich Western diet meals, can directly promote tumor cell proliferation via the insulin/IGF1 signaling pathway. Third, ketone bodies that are elevated when insulin and blood glucose levels are low, have been found to negatively affect proliferation of different malignant cells in vitro or not to be usable by tumor cells for metabolic demands, and a multitude of mouse models have shown anti-tumorigenic properties of very low CHO ketogenic diets. In addition, many cancer patients exhibit an altered glucose metabolism characterized by insulin resistance and may profit from an increased protein and fat intake.

In this review, we address the possible beneficial effects of low CHO diets on cancer prevention and treatment. Emphasis will be placed on the role of insulin and IGF1 signaling in tumorigenesis as well as altered dietary needs of cancer patients...

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267662/

As for me, I've lost 65 pounds, cut 12 inches from my waist [now 32"], added lots of muscle, and am in the best shape I've been in since high school. For the first time since I can remember, my bp is down to 120/80. All of my blood work looks good. I've been doing this for 30 months now.

Oh yes and this is strange: For the first time since I was about ten years old, I don't need to take antacids any more. I used to take as many as ~ten a day. I ALWAYS had Tums or Rolaids in my pocket.

 

[SW VandeCarr]

I didn't see that anyone has posted this so here you go. It appears that evidence is mounting that a low carb diet can slow, suppress, or delay the onset of various cancers.

You realize that a substantial number of posts here are from people who have been banned. Beside you, only Ken Natton and bobze are still around. I'm just making an observation. This is a either a dangerous topic or a strange coincidence.

 

[Ivan Seeking]

You realize that a substantial number of posts here are from people who have been banned. Beside you, only Ken Natton and bobze are still around. I'm just making an observation. This is a either a dangerous topic or a strange coincidence.

Really? Personal innuendo over a published paper?

 

[SW VandeCarr]

Really? Personal innuendo over a published paper?

No. Just caution.

 

[Evo]

You realize that a substantial number of posts here are from people who have been banned. Beside you, only Ken Natton and bobze are still around. I'm just making an observation. This is a either a dangerous topic or a strange coincidence.

LOL, it is a strange coincidence.

 

[sgrondahl]

Hey Ivan,

Metabolic syndrome can be completely reversed if you work at it. It is what in the US they call pre-diabetes. In Europe, they just call it diabetes - they don't have a distinction.

Two things might help you. One is completely free. The other will cost you $100 bucks, more or less.

1) go to: http://www.sparkpeople.com/ and sign up. Like I said, it is completely free. The information available there to solve your problem is amazing!

2) go to https://www.fitbit.com and get a fitbit. I think they have a basic model for $60-ish bucks, and really cool ones for $30 bucks more. (You can also get them at BestBuy and Amazon.) For me, that was a ton of money, because I am a full time student, but, I REALLY needed to get one of these devices.

These two websites can now talk to each other, so your data can be interchanged. Sparkpeople can track all your calories and give you a daily breakdown of what you ingested etc. Fitbit keeps track of your exercise, which is a KEY INGREDIENT to your REVERSAL of metabolic syndrome. This is the KEY to keep this disease from PROGRESSING to full blown diabetes. Both sites have tons of support and groups so you can learn more and understand why diet accompanied by exercise is the only way to undo the damage.

So far, I can't say that I have lost a ton of weight, but I have shrunk considerably. Down quite a few clothes sizes in a short amount of time. More IMPORTANTLY, I have cut my high blood pressure in half, and my body is getting ready to reduce this again! Which is huge.

Aktins diet is amazing. There have been some new studies out there that suggest that Atkins is very appropriate for diabetic patients. Hang in there. Sorry about the milk thing. I have 3 gallons in the frig that will probably be gone in a week... so I totally understand your frustration... :)

One additional note. There are a ton of registered dietitians out there that can seriously help you. You might want to investigate some in your area.

Best of luck.