Adventures in Ketosis (long)

[footenote]

Are there any suggestions on moving into a Keto diet by gradually reducing carbs? I have a bit of tough situation, as I am T2, but after a case of pancreatitis/gallbladder removal, I was told to eat low fat. In reality, I have not done very well in either area in trying to keep carbs down for diabetes and low fat for the other situation. That said, right now I am trying to gradually reduce my carb intake and increase fats and see how far I can go. I am just not sure I can reduce down to less than 50g carb/day and go into a keto state. I guess time will tell.

I got to my LCHF destination very slowly while DH was motivated by being pre-diabetic and went "cold turkey."

Although my blood sugar was normal, my brother is T2, so I lowered my carbs slowly. Over about three years, I've gradually stopped wanting many carbs and I now have zero appetite for sugar.

Try gradually eliminating one type of high-carb food at a time. (Example: breads.) Start with the ones you're least attached to and stop buying them.

At the same time, ensure you're eating enough healthy fats as they satisfy/make you feel full. Bacon and butter are your friends! Good luck

 

[RAE]

I agree that the diet is worse for the environment and that if everyone switched tomorrow, we'd all go down the tubes, but I'm not willing to eat an unhealthy diet for the sake of the planet.

Well...........the problem is that we are now trying to feed 7.7 billion people (soon to be 10-11 billion). Anything you do to the land on the scale large enough to feed all those mouths is going to do damage to the planet. For example, grains like corn and wheat, along with soybeans, feed a large number of people, and the way those crops are grown is anything but planet-friendly (think mile upon mile of monoculture row crops, tons of chemical fertilizers and pesticides (some of which wash into the Mississippi River every year), the "Dead Zone" in the Gulf of Mexico, etc..

 

[RonBoyd]

I get a Mayo Clinic newsletter that brought this to my attention several months ago. I, of course, didn't join -- $9.90 a month is way beyond my tolerance level. (However, they claim "Join the DNA Diet Plan today and get your money back upon completion as additional motivation.") I am keeping my eye on it in case it does turn out to be a diet plan that works for everyone.

A personalized weight loss plan from a diet based on DNA
Here's what you'll get from the DNA Diet Plan:
Science-based information on weight loss, healthy living and genetics developed exclusively for DNA Diet by Mayo Clinic
A weight loss profile including your genetic obesity risk
Insights into the relationship between DNA and weight loss
Delicious meal plans with DNA-based food substitutions
Choice of standard weight loss or fasting options
Easy-to-use weight loss tracker to keep you on track
Quirky facts about your taste preferences
At-home exercise plans to boost fat loss
12 week DNA Diet Plan to help support your weight loss

https://www.dnadietplan.com/us/

 

[braumeister]

"Join the DNA Diet Plan today and get your money back upon completion as additional motivation.") I am keeping my eye on it in case it does turn out to be a diet plan that works for everyone.

Since this recommendation is on that website, I think it's fair to say it would not work for everyone:

Limit total daily consumption of meat, poultry and fish to 3 ounces — the size of a deck of cards. If you consume dairy products, use only skim milk and low-fat varieties, and consume them in moderation. Full-fat dairy products contain saturated fat that can raise your cholesterol. Even lean cuts of meat and skinless poultry have some saturated fat and cholesterol and can be high in calories.

 

[RAE]

I get a Mayo Clinic newsletter that brought this to my attention several months ago. I, of course, didn't join -- $9.90 a month is way beyond my tolerance level. (However, they claim "Join the DNA Diet Plan today and get your money back upon completion as additional motivation.") I am keeping my eye on it in case it does turn out to be a diet plan that works for everyone./

Recent study shows that matching DNA to a diet does not work:

https://www.scientificamerican.com/article/matching-dna-to-a-diet-does-not-work/

“There was no significant difference in weight change among participants matched vs mismatched to their diet assignment,” the researchers wrote. There was also no DNA/diet interaction for waist circumference, body mass index, or body fat percentage."

 

[6miths]

I guess I would have to be considered a genetic outlier by most here. For all of my adult life, I followed a low fat, high carb diet: vegetables, fruits, pastas, breads (mostly breads without a lot of added oil), very few other added oils, very small amounts of lean white meats and fish, and even refined grains (bagels are a favorite) and some sugar (in processed foods like jams, cereals). I never dieted; I ate when and as much as I wanted. In the past 7 years, my fat intake has gone up some (nuts), sugars down, refined grains down (but more whole grains), and I went vegan. So pretty much being anti-LCHF, I'm like the devil to some here; and I guess you could say that I "doubled-down" on that with the vegan thing in the past 8 years.

Here's what is so weird. While there are posts here that people gained lots of weight on that diet, my BMI throughout my life has never been above 19, and now is around 18. When I went vegan, I dropped 15 pounds even though I didn't go vegan to lose weight (my guess is that was due to a reduction in calorie "density" of the food I am eating - whatever, it was unexpected). I'm sure that some here think that is too thin, but my doctor at the Mayo Clinic is very supportive. Blood sugar numbers have always been great. I'm not proselytizing about any of this, or bragging; neither of those is of any interest to me; we all are old enough to think and decide for ourselves. It's just crazy interesting to see how different people have such different outcomes with food.

You might think there's some other factor, like that I'm really active. I am in my first year of retirement and, yes, I'm very active right now, but there were many, previous work years when I didn't do much exercising at all. I have been a "binge exerciser" my whole life. So I don't think that's it; otherwise, my weight through life would not have been so constant (+/- 5 pounds, until the vegan drop).

I do have a poor sense of smell, which affects my sense of taste. Because of this or some other reason, I "eat to live" rather than "live to eat" (no love affair with food).

Clearly my body somehow is balancing my caloric intake with my caloric expenditure. So is it the genes? Maybe so and/or there are multiple pathways to healthy living. Just weird how the outcomes can be so different for people.

You don't have to be a genetic outlier at all. The natural state of the fasting human body is ketosis. Until relatively recently, humans spent most of their time in the fasting state - thus were busy burning their stored fat (which they had socked away the last time they were able to eat) by making ketones to fuel pretty much their entire metabolism (with very few exceptions). Then came along 'plenty' and 'convenience foods' and the belief that lipids (fats) were very bad for people, et voila - Non-stop carbs. Body never gets into a fasting state, unable to burn stored fats, gets hunger signals, eats more (mainly carbs), insulin goes up (which prevents fat mobilization and ketone formation and causes more fat storage). The path to an obese world.

Like you I have been a high carb intake person all of my adult life with a normal BMI and good health but inadvertently was also an intermittent faster. No sugar on board, drop insulin, mobilize fat, ketosis. Whether one goes the LCHF or intermittent fasting (and I am only talking about the way people used to eat 40 years ago - 2 or 3 meals per day - no crazy snacking all the time due to the belief that the body needs a non-stop glucose infusion for energy - it certainly does not), the metabolic result can be similar - lower insulin, a chance to mobilize fats, better response to hunger/satiety signals, better health.

Great discussion.

 

[audreyh1]

That's what I thought ten years ago. I figured it would take just a few years before the conventional view would shift.

Not to sound like a conspiracy theorist, but I wonder how much the sugar industry has been working to keep the status quo.

Oh I’m sure! All of the sugar, corn syrup, soft drinks, juice, etc.

Not to mention the companies producing grain-based products, and all the companies selling insulin and other diabetes treatment drugs to a large portion of the population.

It’s really unbelievable that most diabetic and other folks with metabolic disease are given dietary advice that makes their condition worse! “Chronic and progressive” - I wonder why?!?

Aha - I see you already posted a pic illustrating the insanity.

 

[audreyh1]

Are there any suggestions on moving into a Keto diet by gradually reducing carbs? I have a bit of tough situation, as I am T2, but after a case of pancreatitis/gallbladder removal, I was told to eat low fat. In reality, I have not done very well in either area in trying to keep carbs down for diabetes and low fat for the other situation. That said, right now I am trying to gradually reduce my carb intake and increase fats and see how far I can go. I am just not sure I can reduce down to less than 50g carb/day and go into a keto state. I guess time will tell.

There is a lot of info on the web about people doing Keto with no gallbladder. Worth searching and reading from several sources.

Here is just one example video, and you can read the comments where other share their experiences.

Note: Dr. Berry recommends a gradual approach to increasing fat.

 

[RonBoyd]

Since this recommendation is on that website, I think it's fair to say it would not work for everyone:

Again, I stated it poorly... I should have said "everyone individually."

I am searching for that solution which finds (tailors each individual to) a specific diet plan without the n=1 research used today to "discover" what works for one specifically. Shouldn't that be the goal of all the money, time and effort being put into this issue?

 

[RonBoyd]

 

[TromboneAl]

 

[braumeister]

I am searching for that solution which finds (tailors each individual to) a specific diet plan without the n=1 research used today to "discover" what works for one specifically. Shouldn't that be the goal of all the money, time and effort being put into this issue?

I look at it from the other direction. I find it amazing that the industry has been able to develop so many things that work so well for so many of us. Considering the huge "YMMV factor" in body chemistry, I think they are doing a superb job. Expensive in some cases, but still impressive.

 

[eytonxav]

There is a lot of info on the web about people doing Keto with no gallbladder. Worth searching and reading from several sources.

Here is just one example video, and you can read the comments where other share their experiences.

Note: Dr. Berry recommends a gradual approach to increasing fat.

Thank you Audrey. I am going to approach both lowering carbs and increasing fat slowly and see how it goes. In just cutting back all the carb meals and snacks, I have lost almost 5 lbs the past 7 days. I have a blood test in a few weeks, but this will not be enough time to effect my A1C. I am looking forward to the next test after that. My A1C has varied from 5.4 to 5.9 over the last ten years after I was declared diabetic by my PCP when it hit 6.4. My last two tests both where 5.9 which elevated my concern, so I appreciate the info you and others have provided in this thread.

 

[DeborahB]

ROTFLMAO

 

[audreyh1]

My new fasting insulin came back. It's now 5.6 uIU/mL! Dropped from 8.6.

So it's already well below the under 7.5 goal my doctor set for me.

 

[Golden sunsets]

My new fasting insulin came back. It's now 5.6 uIU/mL! Dropped from 8.6.

So it's already well below the 7.5 goal my doctor wanted for me.

That's terrific Audrey Congratulations! Hopefully your TG's will have dropped in a similar manner.

I've been reading some of the detailed info on Trig:HDL ratios and the different types of LDL and I find it very enlightening. I also just started listening to the Diet Doctor Podcast #9.

My own ratios for TG:HDL over the last 16 years(I keep a spreadsheet of health numbers, nerd that I am) range from a low of .6 to a high of 1.4 back in 2006. I had always calculated the ratios of TC:HDL, with a desired ratio of less than 5. I guess that thinking went out the window a while ago.

Unfortunately DH's TG:HDL are bad, primarily because his HDL is always abysmal and the TG's are moderate. It will be interesting to see what his numbers are after being on a low carb diet.

 

[footenote]

My new fasting insulin came back. It's now 5.6 uIU/mL! Dropped from 8.6.

So it's already well below the under 7.5 goal my doctor set for me.

Wow - that is an astounding improvement. Great job! Please post your doctor's reaction.

(As a fellow LCHF follower, I've enjoyed your posts immensely.)

 

[bmcgonig]

Interesting review of Keyto by the Skeptical Cardiologist, who now admits to being keto friendly

https://theskepticalcardiologist.com/2019/08/11/i-am-a-keto-friendly-cardiologist-and-i-love-keyto/

 

[DeborahB]

Interesting to find a cardiologist who likes Keto. He sells the keyto breathalyzer. I couldn’t find it on amazon but didn’t search elsewhere.

I lost almost 5 pounds in 10 days or so. !!!!

 

[audreyh1]

Back with more results - a very complete lipid panel, etc.

• Fasting insulin dropped from 8.6 to 5.6 - delighted with that. Target was below 7.5.
  
• Fasting glucose dropped from 88 to 69 - wow!
  
• HbA1C - dropped from 5.2 to 4.7 - again, wow!
  
• Triglycerides - dropped from 142 to 85 - wow - 40% drop!
  
• HDL was 62, essentially unchanged. Theoretically HDL should have gone up.

So - clearly major improvements in all markers of insulin resistance (my HDL was already a good number). Doc still wants Triglycerides below 80.

The bad (?) news - my LDL (calculated) went up by 30, and my total cholesterol was up. My LDL and TC have been drifting up the last few years, and this result even higher!

However, my Trig:HDL ratio improved dramatically, went from 2.25 to 1.37. Below 2 is optimal for low heart disease risk from what I read.

So I should have more large fluffy LDL?

Since I am female, and almost 60, I have found from research that higher cholesterol is protective as I age. I'm not worried about the doc that ordered these tests. But my PCP may freak. We'll see.

 

[bmcgonig]

Back with more results - a very complete lipid panel, etc.

• Fasting insulin dropped from 8.6 to 5.6 - delighted with that. Target was below 7.5.
  
• Fasting glucose dropped from 88 to 69 - wow!
  
• HbA1C - dropped from 5.2 to 4.7 - again, wow!
  
• Triglycerides - dropped from 142 to 85 - wow - 40% drop!
  
• HDL was 62, essentially unchanged. Theoretically HDL should have gone up.

So - clearly major improvements in all markers of insulin resistance (my HDL was already a good number). Doc still wants Triglycerides below 80.

The bad (?) news - my LDL (calculated) went up by 30, and my total cholesterol was up. My LDL and TC have been drifting up the last few years, and this result even higher!

However, my Trig:HDL ratio improved dramatically, went from 2.25 to 1.37. Below 2 is optimal for low heart disease risk from what I read.

So I should have more large fluffy LDL?

Since I am female, and almost 60, I have found from research that higher cholesterol is protective as I age. I'm not worried about the doc that ordered these tests. But my PCP may freak. We'll see.

Lots of real [emoji108] wows there. Congratulations. Let us know what PCP says.

 

[Golden sunsets]

Great Audrey. Is there no test of LDL that measures small particle LDL vs fluffy large cell LDL, that would mitigate the rise?

 

[audreyh1]

Great Audrey. Is there no test of LDL that measures small particle LDL vs fluffy large cell LDL, that would mitigate the rise?

Yes, an NMR lipid panel will do a particle count. High particle count indicates a majority of small dense LDL, the “dangerous” kind. Low particle count indicates mostly large fluffy LDL.

I’ll wait until my weight stabilizes before deciding to do such a test, however, because I suspect weight loss is messing with the blood lipids at the moment. In the meantime my LDL may drop some and my HDL go up more.

 

[audreyh1]

Lots of real [emoji108] wows there. Congratulations. Let us know what PCP says.

She’ll do her own panel in a couple of months, so we’ll see how things have changed.

I plan to let her know I’ve been on a ketogenic diet anyway.

 

[Golden sunsets]

That's terrific Audrey Congratulations! Hopefully your TG's will have dropped in a similar manner.

I've been reading some of the detailed info on Trig:HDL ratios and the different types of LDL and I find it very enlightening. I also just started listening to the Diet Doctor Podcast #9.

My own ratios for TG:HDL over the last 16 years(I keep a spreadsheet of health numbers, nerd that I am) range from a low of .6 to a high of 1.4 back in 2006. I had always calculated the ratios of TC:HDL, with a desired ratio of less than 5. I guess that thinking went out the window a while ago.

Unfortunately DH's TG:HDL are bad, primarily because his HDL is always abysmal and the TG's are moderate. It will be interesting to see what his numbers are after being on a low carb diet.

A bit of an update. We went into our PCP's office this afternoon, spur of the moment, to get a monthly Vitamin B shot for DH, and low and behold, our PCP was sitting at the reception desk, filling in for his vacationing Nurse/Receptionist, so I hit him with a barage of questions and comments.

1) Told him I'd been on keto and noticed that my lipid panel taken after cutting my statin in half showed decreased trig's, decreased LDL and increased HDL. I told him my theory was that the diet had more than compensated for the cut in statin. He agreed that the diet was responsible on the trig's and LDL but not do much HDL. My HDL always hovers just below or above 100.

2) Shared my concern about DH, based on my recent education on Trig's/HDL and healthy and non healthy ratios. As noted above, his ratios are bad. He said that low HDL has always been a concern for heart disease, and high Trig's has always been a concern for heart disease, but the two numbers are independent of each other. One could have low Trig's and low HDL, have a ratio of less than 2 or lower, but due to low HDL, still be at risk for heart disease. Likewise, the reverse, high Trig's and high HDL might give a low ratio, but still indicative of risk. At any rate, I asked him to run the lipids on DH again, after being on Keto for 11 weeks and he agreed to do that. Will report back results. I'm interested to see if his LDL goes up. He is on a statin.

3) Doc clearly still feels that LDL is a risk factor, but also subscribed to the current knowledge that one of the four forms of LDL is not a risk factor.

4) He has been on Keto himself, understands the value LCHF, but is currently back on carbs, not as a nonbeliever, but due to his love of certain carbs. [emoji19] Neither he nor DH and I have glucose levels issues, so no discussion on that.

And all of this without a visit fee. And he administered the shot to DH himself. There are benefits to seeing a one doc shop.[emoji1]