Category Archives: Ketosis

Eating in the absence of hunger

Good idea? Bad idea? … a bit of a rant

Some gurus swear by the “only eat when hungry” mantra.  I’m neutral on the issue.  In my opinion, it can work for people who are good planners because if you wait until you’re hungry and haven’t planned or prepared a meal yet, then it might be a while until you finally get to eat.  Maybe you’re an hour from home: unlucky => by the time you start cooking, you’re famished and end up overeating.  So you try to repent by skipping breakfast the following morning but fall into the same trap.  Of course, however, it’s not gonna be like this for everyone.

 

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A timeline of ketoadaptation

This is how ketoadaptation works (when it works), chronologically, on physical performance (I think):

 

 

Dark grey line: the gradual increase in performance for someone training on a regular diet.

Red line: performance declines on keto initially, but is back to baseline (light blue line) by week 3.

Light grey line: as long as ketoadaptation doesn’t impair performance, similar gradual increase in performance for someone training on a regular diet.  Parallel to the dark grey line.  May even catch up to the dark grey line.  I don’t know, but probably not as per FASTER – long-term LC athletes were not superior to their LF counterparts.

 

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Protein, ketosis, and lean mass

Most people make a big deal about protein.  I do, too.  Low carb diets aren’t muscle-sparing.  Again.

 

 

Comparison of a Low-Fat Diet to a Low-Carbohydrate Diet on Weight Loss, Body Composition, and Risk Factors for Diabetes and Cardiovascular Disease in Free-Living, Overweight Men and Women (Meckling et al., 2004)

Part 1.  Hunger Free Diet(s)

Focus on what they’re eliminating:

LC diet: “limit intake of breads, pastas, rice, and desserts, eliminating intake of deep-fried foods, dried fruit, candy, sweetened soft drinks, and sugar, and increased consumption of vegetables, lean meats, eggs, and nuts”

LF diet: “eliminate high-fat dairy products and substitute with no-fat or LF alternatives, to increase intake of fruits, vegetables, whole-grain breads, and pastas and to eliminate fried foods, cream sauces, and high-fat/sugar cakes, pastries, chocolate, and candy. They were also asked to reduce use of oil products in cooking. As with LC subjects, LF subjects were encouraged to consume lean meats as alternatives to high-fat meat products.”

 

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Ketones, NLRP3, and IL-1 beta

Interleukin-1 beta: produced by activated M1 macrophages, classical fever-inducing cytokine, mediates cellular inflammation, and induces COX-2 (target of NSAIDs).  Also involved in autoimmunity.  You don’t want none of it but you certainly don’t want a lot of it.

The ketone metabolite beta-hydroxybutyrate blocks NLRP3 inflammasone-mediated inflammatory disease (Youm et al., 2015)

This is a very specific effect: 1) many structurally similar compounds don’t block NLRP3; and 2) beta-hydroxybutyrate doesn’t block activation of other inflammasomes.

 




 

“In vivo, BHB or a ketogenic diet attenuates caspase-1 activation and IL-1b secretion in mouse models of NLRP3-mediated diseases such as Muckle-Wells syndrome, familial cold autoinflammatory syndrome and urate crystal-induced peritonitis. Our findings suggest that the anti-inflammatory effects of caloric restriction or ketogenic diets may be linked to BHB-mediated inhibition of the NLRP3 inflammasome.”

 

 

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LCHF negates performance benefit of training. O_o

It takes about 3 weeks to become fully ketoadapted and you don’t really get more ketoadapted thereafter, at least as per max fat oxidation rates (which seems a pretty good surrogate, imo).

Important point: “Athletes who drop carbs cold turkey suddenly suck.”  And performance usually recovers by around week 3.  This has been confirmed in nearly every proper study on the subject, in a variety of contexts.

 




 

Which brings me to the latest alleged slam on keto & physical performance:

Low carbohydrate, high fat diet impairs exercise economy and negates the performance benefit of intensified training in elite race walkers (Burke et al., 2016)

 

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HANGRY! (part deux)

Effects of diet composition on postprandial energy availability during weight loss maintenance (Walsh et al., 2013)

Now, we’re getting somewhere!

3 diets (carbs 10%, 40% or 60%; protein was higher in the lowest carb group). Four weeks. CROSSOVER.

Then a test meal which approximated the diet assignment. Total “energy availability” in the blood was approximated by measuring the calories in blood glucose, free fatty acids, and ketones.

 

energy availability and metabolic rate

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These dudes ate a ton of sat fats and nothing bad happened

Study: 12 weeks, obese men, very high fat low carb (VHFLC) vs. low fat high carb (LFHC) (Veum et al., 2016) #FATFUNC

 

Pictorially:

 

 




 

It wasn’t explicitly AD LIB, but pretty close.  I say this because that is the magnitude of appetite decline we might expect when people go on The Hunger Free Diet(s), eg,

 

^^^ GOOD IDEA

 

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Ketones inhibit lipolysis

Petro just posted a brief article about acipimox & the insulin hypothesis.  Similar to insulin’s forte, acipimox inhibits lipolysis.  This leads to expansion of adipose tissue, and eventually, weight gain.

Acipimox acts on the same receptor as niacin and ketones, GPR109a.  That is, all three of those agents inhibit lipolysis.  We’ve discussed some of the implications of this on fuel partitioning HERE.

 

ketone-supp-physiology

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VEG*N

I’m not vegan but the “Anti-Vegan Because B12” argument is lame.  B12 insufficiency is largely due to malabsorption, not steak deficiency.

Also, oysters SMOKE meat for B12. Seriously, over a full day’s supply in one medium-sized oyster. Can meat do that?

Many people take supps, but somehow anti-vegans think B12 invalidates veganism.  It doesn’t.  Also, 1) tons of B12 in oysters; 2) nori B12 works in humans and rats; and 3) mushrooms still haven’t been ruled out as a legit source.  Whether you consider these foods vegan or not is a different story.  Many non-vegans are B12-deficient, too -> all the steak in the world won’t help if you can’t absorb it.

I’m not undermining the severity of B12 deficiency, just noting some basic facts.

My bias: things like T2DM, obesity, and even some cancers and mood disorders are due primarily to circadian arrhythmia, sleep, & LIGHT… and secondarily to diet.

When it comes to diet, mostly plants plus some animal is optimal for humans in our modern #context, regardless of which Ice-Age Paleo-Fairy Tale™ you subscribe to.  Things like sleep, LIGHT, and activity, among others, seem way more important than debating historical [theoretical] dietary minutiae.

Lastly, this particular debate isn’t “vegan vs. keto.”  THEY’RE NOT MUTUALLY EXCLUSIVE.  “Eco-Atkins” is a thing.  Animals provide a convenient source of LC protein, but it can be done without them.

 

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The poor, misunderstood autophagy

Autophagy isn’t a big deal in the way some Internet Bro’s think it is.  Yes, Dr Ohsumi received a Nobel Prize for cracking deeply into this nut, but that in no way means “intermittent fasting is awesome because autophagy.”  Autophagy isn’t awesome like that.

Alternate title: The dark side of autophagy.

For example: Autophagy contributes to muscle wasting in cancer cachexia (Penna et al., 2013)

Cachexia (muscle wasting) is one of the leading contributors to poor quality of life in cancer patients.  Thanks, autophagy.

“Autophagy is the major process for degradation of cellular constituents, its rate being enhanced under stress conditions leading to organelle damage…”

 

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