Tag Archives: Atkins

The current state of affairs in nutri-Twitter

Rant.

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1) It’s almost as if you’re either:

a red meat-eating 110% keto-advocate

or

you think red meat and a ketogenic diet is harmful.

 

If you don’t say the diet is magical, the zealots will try to trick you into, or outright accuse you of saying it’s harmful.

Further,

 

2. And the protein/kidney debate re-surfaced again recently. To be clear: no studies have shown direct harmful effects of protein on kidney function. The studies cited by KDOQI are observational and on end-stage renal disease. Not mild kidney disease or slightly impaired renal function. If I had ESRD, I’d rather play it safe and not enroll in one of Jose Antonio’s high protein diet studies (~4.4 g/kg lol).

I’m pro-LC and HP but not anti-LF. Humans have thrived on a wide variety of diets over time regardless of macronutrient composition. Food quality seems more important in this context.

3. If ketones are muscle-sparing, then…

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The neuroprotective properties of ketone bodies.

There is some overlap between the metabolic effects of calorie restriction (CR) and ketogenic diets (Maalouf et al., 2009). A lot of the underlying mechanisms are related to mitochondrial quality and quantity, anti-apoptotic factors, and neurotrophic factors (eg, BDNF induced by ketosis).

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Metabolism of starvation/fasting =/= low carb diet

The Biology of Starvation (intro)

The Biology of Starvation: Renal Gluconeogenesis

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One of the major [obvious] differences in metabolism between fasting and low carb dieting is nitrogen metabolism… because you’re eating protein on a low carb diet, not so much while fasting. During fasting/starvation your body tries to downregulate the urea cycle because you can’t really afford to be ‘wasting’ amino acids/protein. I bet you never thought about the muscle-sparing effect of fat-derived fuels like that!

 

 

“Glucose production in starvation” is important because you need to make all of it and reduce the use of it.

 

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Low carb diet. NAFLD.

An integrated understanding of the rapid metabolic benefits of a carbohydrate-restricted diet on hepatic steatosis in humans (Mardinoglu et al., 2018)

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Critique and analysis.

They did two very small (n=10 & n=7) 2-week long studies of low carb, high protein. Carb/fat/protein was 4/72/24 compared to 20/42/18 at baseline. There was no control group, so the results were compared to baseline.

 

 

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Yet another study showing low carb doesn’t impair performance +

and by some metrics, at least in this study, might even improve it.

Ketoadaptation enhances exercise performance and body composition responses to training in endurance athletes (McSwiney et al., 2017)

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Advantage of this study over previous ones: 12 weeks. I believe the choice to opt for self-selection over randomization was to improve adherence (which was pretty good for this 12 week-long study). Downside is, well, it’s not randomized. Crossover RCT is best but it’s always a trade-off: sample size, duration, tools, etc., everything has a price. Literally.

Tl;dr: Ketoadaptation doesn’t diminish performance at high intensity even after “draining the tank.”

The study: we aren’t told much about the diets, just high carb vs. ketogenic. And keto group was advised to drink broths for salts, mins, electrolytes, etc.* Speaking of which 🙂 Kettle & Fire is offering 20% off their delish broths/stock HERE.

*I don’t think this qualifies as cheating in this #context.

Before and after the 12-week dietary intervention, a battery of tests were performed: a six second all-out bicycle sprint (SS), immediately followed by a 100 km time trial (TT), immediately followed by a 3-minute sprint (CPT).

These were well-trained, healthy individuals who continued their training throughout the study. This & duration are two important nuances of this study (more on this below).

The biggest finding …*drumroll* … significantly greater fat loss in the keto group and this wasn’t even a weight loss study. They also jacked up protein intake so they didn’t lose muscle mass. Protein declined in the high carb group, but they were able to maintain muscle because carbs increased.

 

WHERE HAVE WE SEEN THIS BEFORE

HINT: HERE

 

 

Whether they knew it or not, this study was designed to test peak power output before (SS) and after (CPT) exhaustively draining the tank (TT). The theory is that ketoadaptation: 1) spares glycogen so there’s some juice left in the tank for the second peak power test, although racing 100 km is pretty tough so there couldn’t have been much juice left in either group; and 2) ketoadaptation relies more on fatty acids at every level of output, as evidenced by the RER figure (below). Fuel usage comes close at high levels of output (both groups rely more heavily on glucose), but ketoadapted is always a little lower (eg, see the right-most point in the figure below). And fat stores are basically limitless whereas glycogen is not. This may or may not have been a factor here.

 

PEAK PERFORMANCE

I don’t know why the authors reported peak power relative to body weight. I could understand lean mass, maybe, but keto lost a lot of weight via body fat. If peak power remained the same (as has previously been shown), it would [falsely] appear to increase in this study.

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Ketosis in an evolutionary context

Humans are unique in their remarkable ability to enter ketosis.  They’re also situated near the top of the food chain.  Coincidence?

During starvation, humans rapidly enter ketosis; they do this better than king penguins, and bears don’t do it at all.

Starvation ketosis

 

Starvation ketosis

Humans maintain a high level of functionality during starvation.  We can still hunt & plan; some would even argue it’s a more finely tuned state, cognitively.  And that’s important, because if we became progressively weaker and slower, chances of acquiring food would rapidly decline.

Perhaps this is why fasting bears just sleep most of the time: no ketones = no bueno..?

Observation: chronic ketosis is relatively rare in nature. This doen’t mean animals evolved a protective  mechanism against ketosis.

 

 

Animals with a low brain/carcass weight ratio (ie, small brain) don’t need it. Babies and children have a higher brain/carcass weight ratio, so they develop ketosis more rapidly than adults. Is this a harmful process? No, more likely an evolutionary adaptation which supports the brain.

ketones age

The brain of newborn babies consumes a huge amount of total daily energy, and nearly half comes from ketones.  A week or so later, even after the carbohydrate content of breast milk increases, they still don’t get “kicked out of ketosis” (Bourneres et al., 1986).  If this were a harmful state, why would Nature have done this?  …and all those anecdotes, like babies learn at incredibly rapid rates… coincidence?  Maybe they’re myths.  Maybe not.




 

Ketosis in the animal kingdom

Imagine a hibernating bear: huge adipose tissue but small brain fuel requirement relative to body size and total energy expenditure.  No ketosis, because brain accounts for less than 5% of total metabolism.  In adult humans, this is around 19-23%, and babies are much higher (eg, Cahill and Veech, 2003Hayes et al., 2012).

 

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Endurance Performance Doesn’t Decline on a Low Carb Diet

The new study by Zinn and colleagues doesn’t debunk ketoadaptation. And the authors agree!

In brief, it was 5 ~50-year old recreational endurance athletes. They’ve been training a lot for a very long time. In other words, one way to view this study is the opposite of n00b gainz. Experienced exercisers don’t typically make gains in 10 weeks without drastically changing their training program or increasing protein intake – neither of which occurred in this study.

 

 

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Long-term fat adaptation.

Ketoadaptation

More on physical performance and ketoadaptation

A timeline of ketoadaptation.

 

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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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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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Non sequiter dietary fats

Tl;dr: SFA and DHA

Essential fatty acids?  Well, there’s really only one, DHA, and we really only need a gram or two.  In other words, our entire requirement for dietary fat can be met by about 2% of total calories (plus a few extra grams to accommodate fat-soluble vitamins) (plus DHA is never the sole fat in a food, so you’d be getting a few more grams of other fats, too).  But still, a very low fat diet!  But impractical and probably not very palatable or healthy.

On average, dietary fat comprises about a third of calories, roughly equally divided between SFA, MUFA, and PUFA (slightly less PUFA).

Major sources of SFA are pizza and desserts – no wonder SFA gets a bad rap!

 

cheese-crust-pizza

 

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