Line in the sand

[Ed_The_Gypsy]

Hi, Audrey,

This is all simply amazing!

I just wanted to lose weight, but wow! This is almost magic. I hope I can persuade my wife to try this, too.

I have discovered Dr. Fung as well. What a change to find doctors who aren't pill-pushers but focus on nutrition. I feel in control of my life. It is exhilarating.

 

[braumeister]

I feel in control of my life. It is exhilarating.

A remarkable thing about this sort of lifestyle choice is that you will often read articles that allegedly compare various "diet programs". They usually characterize LCHF/Keto as "effective but a poor choice because nobody can stay on it for long."

As you're realizing, that's only true for dilettantes who try it for a week or two and then lose interest. The rest of us just shake our heads and go on.

 

[audreyh1]

Hi, Audrey,

This is all simply amazing!

I just wanted to lose weight, but wow! This is almost magic. I hope I can persuade my wife to try this, too.

I have discovered Dr. Fung as well. What a change to find doctors who aren't pill-pushers but focus on nutrition. I feel in control of my life. It is exhilarating.

I tend to believe, as Dr. Fung preaches, that obesity is a side effect of high blood insulin, and high blood insulin is associated with many other symptoms/chronic diseases. So address the hyperinsulinemia, and many health issues are improved/resolved.

 

[bloom2708]

A remarkable thing about this sort of lifestyle choice is that you will often read articles that allegedly compare various "diet programs". They usually characterize LCHF/Keto as "effective but a poor choice because nobody can stay on it for long."

As you're realizing, that's only true for dilettantes who try it for a week or two and then lose interest. The rest of us just shake our heads and go on.

It's true until you give up or your arteries clog up and close. Whichever happens first.

Crazy world.

 

[braumeister]

Crazy world.

Isn't it?

 

[harley]

It's true until you give up or your arteries clog up and close. Whichever happens first.

Crazy world.

Nobody gets out alive. But I'm so much healthier and happier after a year and a half of LCHF/IF that I suspect my day will come much later than it would have otherwise. My lipid numbers are better than they were with "normal" eating and statins. Plus no muscle pain/weakness. Everybody is entitled to their opinion. But I expect that in 20 years this will be accepted medical advice and the old low fat whole grains will be looked at similarly to using leeches.

 

[Ed_The_Gypsy]

update May 21 '20

I have been on a weight plateau for the previous four or five weeks. Still eating low carb (like, zero), high fat & protein diet, trying to do a One Meal Every Other Day but found some difficulties. When water fasting, I have found that I get very hungry the first day. When breaking the fast the next day, I may have eaten too much. This week, I am doing a 5-day water fast and am down to 260 lbs for the first time in 5 years on the fourth day. It is very important to drink a lot of water.

Tomorrow, I go to my PHP and will ask for a wider range of blood tests than they ever gave me before. They have never tested my triglycerides or given a CAC score or fasting insulin levels or glucose tolerance, yet I am prescribed Atorvistatin and Metformin. There is no baseline---yet. I will ask for specific tests for inflammation markers and anything that will give information on my liver health (fatty liver). Also a coronary artery calcium (CAC) test. DW had one yesterday (at my demand) and she had a score of 10, which isn't zero, but much less than the trigger level of 100. It cost us $100, well-spent.

I have learned yesterday that Medicare authorizes only 3 doctor visits a year and only 20 minutes a visit. A detailed report must be made. More than 20 minutes or non-standard subjects require special explanation. If not acceptable to the reviewers, the doctor (and the hospital) will not be paid/"reimbursed" by Medicare insurers. Having read my last report (for the 40 minute visit), I realize that I have to be very careful how I manage my visits or my PHP/hospital/Medicare will be uncooperative. The ketogenic diet is contrary to the textbook. I have also learned that LDL is pretty much useless (also contrary). HDL and triglycerides are much more important. By the way, coffee of any kind can elevate triglycerides, so I am sticking to decaf green tea.

I plan to investigate the studies that say that baby aspirin is good and that everybody must take statins. If I find the conclusions less than convincing, I do not plan to share that with my PHP.

So, maintaining a ketogenic diet has not been hard for me. One-day Intermittent Fasting has been difficult, but 5-day or more is a breeze. Go figure.

 

[braumeister]

You might want to consider getting your own tests done.
requestatest.com and walkinlab.com will both test you for pretty much anything. Compare costs, since many tests are priced differently between them.

I've used both for years.

 

[Danalyst]

Stop the statins, but don't tell your doc. More and more evidence that statins are involved in all sorts of nasty syndromes, but it will take the medical establishment years, maybe decades, to change its tune. (Marion Holman on Twitter tracks the research closely.) Low trigs are much more important than LDL; in fact, there are studies that found LDL to be protective as you age. Why not tell the doc? He or she is reviewed and sometimes compensated on the extent to which patients comply with official recs.

 

[Ed_The_Gypsy]

You might want to consider getting your own tests done.
requestatest.com and walkinlab.com will both test you for pretty much anything. Compare costs, since many tests are priced differently between them.

I've used both for years.

Thanks, Braumeister!

 

[Ed_The_Gypsy]

(Marion Holman on Twitter tracks the research closely.) Low trig's are much more important than LDL; in fact, there are studies that LDL to be protective case you age. Why not tell the doc? He or she is reviewed and sometimes compensated on the extent to which patients comply with official recs.

Thanks, Danalyst, for the Marion Holman info. I know nothing about Twitter, but perhaps I should learn.


Why not tell the doc? BECAUSE I anticipate that some or all of this does NOT comply with official requirements.

 

[PatrickA5]

Thanks, Danalyst, for the Marion Holman info. I know nothing about Twitter, but perhaps I should learn.


Why not tell the doc? BECAUSE I anticipate that some or all of this does NOT comply with official requirements.

Hopefully, you aren't going to allow a anonymous internet poster talk you into doing something and not telling your doctor.

 

[omni550]

You might want to consider getting your own tests done.
requestatest.com and walkinlab.com will both test you for pretty much anything. Compare costs, since many tests are priced differently between them.

I've used both for years.

Also check out LabCorp which offers similar self-pay testing. https://www.labcorp.com/

omni

 

[Ed_The_Gypsy]

update May 23 2020

OK, I completed a 5-day water fast yesterday and lost 7 lbs. (Actually 8 lbs, but I ate dinner yesterday and always weigh first thing in the morning.) I slept very well all week.

My blood ketones jumped up on the 4th day.

Yesterday morning I had a Medicare visit with my PHP and worked out a more complete blood test panel which I took immediately afterwards. I got all the tests I wanted. Some of the results are already in. I have a CAC test scheduled next week.

My PHP was surprisingly supportive and I now have no reservations about being candid with her. My concern originally resulted from reading the account of my last visit which I found suspiciously orthodox. The reason for that turns out to be that she MUST produce an orthodox account in great detail if she takes more than 20 minutes for my visit (and we took about 45 minutes this time, mostly due to difficulties with the hospital software, but she can't use that excuse) if she wants to get paid. It turns out to be something like a little smokescreen. In person, she is very supportive of my unconventional program. SO we are all good now.

One meal every other day did not work very as well as I hoped but a 5-day water fast works very good. I may do another one next week.

More later!

 

[Ed_The_Gypsy]

Hopefully, you aren't going to allow a anonymous internet poster talk you into doing something and not telling your doctor.

Obviously, you don't know me. I am smart enough to listen But I am a rock-headed engineer who does his own research and makes up his own mind.

 

[Ed_The_Gypsy]

Have had a stressful lapse. Bought a condo, moved, then cleaned up and sold the house, and on top of that, DW's heart issues have become very serious recently. Fortunately, the new digs are on the ground floor with no steps or stairs and is wheelchair-friendly (if it comes to that). Weight is still down, but must re-boot.

 

[Ed_The_Gypsy]

I forget (!) if I mentioned this earlier, but we got our 23&me results and I have one APoE4 gene, which predisposes me to Alzheimer's to some extent.
Renews my incentives.

 

[braumeister]

I forget (!) if I mentioned this earlier, but we got our 23&me results and I have one APoE4 gene, which predisposes me to Alzheimer's to some extent.
Renews my incentives.

There are so many other traits that predispose one either positively or negatively, many of which are simply unknown, that I wouldn't obsess over just one of them.

 

[Ed_The_Gypsy]

Yeah. Diabetes and high blood pressure are among them.
I also got a CAC score of over 300 recently.
All of theses can be improved with keto and intermittent fasting. Also taking 20,000 IU of D3 with K2 and magnesium every day for the heart and for resistance to viruses.
We shall see how things go.

There are so many other traits that predispose one either positively or negatively, many of which are simply unknown, that I wouldn't obsess over just one of them.

 

[EastWest Gal]

Yeah. Diabetes and high blood pressure are among them.
I also got a CAC score of over 300 recently.
All of theses can be improved with keto and intermittent fasting. Also taking 20,000 IU of D3 with K2 and magnesium every day for the heart and for resistance to viruses.
We shall see how things go.

I hope you meant 2000 IU, not 20,000. 20,000 is far too much. It can lead to hypercalcemia, kidney stones and heart problems. The upper recommended limit is 4000 IU. You can take higher doses but intermittently. I too take 2000 IU of D3, and also K2. If you’ve been taking that much, get your vitamin D level and calcium checked.

 

[audreyh1]

I forget (!) if I mentioned this earlier, but we got our 23&me results and I have one APoE4 gene, which predisposes me to Alzheimer's to some extent.
Renews my incentives.

Have you done further research? It looks like dementia risks are associated with the western environment. Populations with high prevalence of APoE4 in western countries show risks compared to same ethnic population in home developing countries showing little to no additional risk.

Watching an interesting talk about it on YouTube.

 

[Old Microbiologist]

Ed - Having now been on the Keto diet for 18 months I can attest how hard it was to do at first. Eventually, you get into a routine and once you reach your target weight (mine is 78 kg) then you are more or less set on what you can eat and have a set of meals that work. I don't count calories anymore and I don't count carbs either as I simply don't eat any if I can avoid it. If I know I am going to have a problem (like my wife is cooking) I increase my exercise routine by an additional 300 calories of work. I am more or less on OMAD or more like 1.5 meals a day. I eat nothing after 1900 until no earlier than 1330 the next afternoon other than black coffee and water. If I can stretch it to 1530 it is better.

I work out in the morning doing weight training every other day with HIIT on a bicycle for 30 minutes. I also use an Oculus Quest 2 and various programs for exercising which are fun. On the alternate days I do a flexibility/calisthenics routine coupled with 30 minutes normal pace on the bicycle. I watch Youtube videos while riding using the OC2 VR headset. I have stopped using weight for the weight training and now use elastic bands which are amazingly better and far less damage to my shoulder joints. I do the weight (as much as I can) on a vibration platform and the same for the calisthenics. I ride a real bicycle to where my yacht is stored every day and back home again and add in swimming every day plus some yoga for 45 minutes in the afternoon. I generally don't get back home from sailing until 1400 or so. I often add in a short swim after dinner as well and if my wife is cooking 45 minutes on the OC2 doing something intense to burn extra calories.

I have family and friends who I convinced to go on the keto diet and none of them could stick to it. My wife isn't doing keto diet although she needs to but I cook 5 days a week. She recently had her gall bladder removed (gallstones caused by statins) and we found her sugar and A1C levels are now normal again. She also lost a lot of weight over time and is now 54 kg which she hasn't seen since she was 35 years old. So, she is on a passive keto diet and it is working for her. I think her sugar levels are roughly under 80 grams a day as I watch her pretty closely. She has 2 tsp of sugar a day in coffee and maybe a piece of candy in the evening. She naturally fasts 15 hours a day without trying as she also doesn't eat anything after 1900 and goes to bed at 0230 and gets up at 1030. I go to bed at 2330 and get up at 0600. A lifetime in the military that is actually sleeping late for me. Sleeping really late would be 0730. I have not slept more than 6 hours for my entire adult life and take no naps.

As for food cravings and hunger, these are signs that you weren't keto enough the day before. I learned this from experience. If I have an intense hunger I know my sugar was over my threshold and that triggers me to take it seriously and drop my sugar intake to as low as I can get it. I drink a slug of MCT oil straight from the bottle if I get hungry in the afternoon and that seems to cut it back almost immediately. I also watch my weight pretty close and if it rises to 80 kg I also cut my food intake by dropping my snacks and only eating dinner. That seems to work out pretty well and I can drop 2 kg in 2 days back to 78 kg.

My point to all this meandering stuff is to establish a routine and take it seriously. A weight plateau means you are eating something wrong or not doing enough exercise. I work out around 1,000 calories a day and can add in another 300-500 calories of exercise if I know I will need to drop some weight. I am rigid about fasting daily and no one cares anymore. My wife is shocked I don't eat fruit and I remove pieces of potato if she uses it in some of her Russian soups. She is no longer offended by it but it took a long time for us to reach that point.

 

[audreyh1]

That’s interesting about difficulty sticking to a ketogenic diet.

I counted carbs carefully for 6 months - 20g net then 25g net. After 6 months I added in larger servings of vegetables, my main complaint about the lower net carbs. And some of them higher carb like leeks and carrots. Stayed in ketosis no problem and I suspected that I might have a highish carb threshold because I was often well over 3 mmol/L BHB.

So currently I eat no grains white or potatoes and fruit occasionally. No sugar/sweets except for very dark chocolate. Limit legumes, sweet potatoes. Otherwise I eat about whatever I want as long as it’s “real food” minimal processing. Home cooked. And I’m still in ketosis over 2 years. I check my blood ketones about once a month.

So I actually find this way of eating effortless. I enjoy cooking and have done mostly home cooked food for years. My recipes easily adapted to low carb.

I think for some people their carb threshold for maintaining ketosis is very high, maybe even 100g. For others it’s must be very low. And many in between.

By the way, my goal wasn’t weight loss, it was about metabolic health, particularly bringing triglycerides way down and keeping blood insulin low. I track my blood markers mostly and they are excellent.

 

[Chuckanut]

A few more thoughts for the OP.

I tried very low-carb eating and found that for me it was not sustainable. But, I did find a form of lower-carb, slower-carb eating that is working well for me. And I find it sustianable since it is a bit more liberal in regards to what you can eat. Also, there is lots of science mentioned in this book to back up the Dr.'s views. Dr. Ludwig is a somewhat less edgy version of Dr. Lustig, IMHO.

I have become a bit of a disciple of Dr. Ludwig's methods, which for the most part forbids the worst, most processed foods, and generally allows less processed 'real food' in descent sustainable amounts. (Check out his book "Always Hungry" from your library.) Certain foods that are borderline are allowed in small amounts. For, example, a occasional recipe might call for 2 tablespoons of honey to sweeten a fruit based dessert that feeds six. His wife is a chef and has come up with some amazing recipes such as the faux mashed potatoes made with cauliflower and white beans.