Wasting away again in ketogenic-ville

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
leptic
Posts: 204
Joined: Wed May 18, 2016 9:33 pm
Location: Canada

Wasting away again in ketogenic-ville

Post by leptic » Tue May 31, 2016 12:37 pm

Hi -

I've seen a number of people here relate positive experiences with a ketotic diet, and there does seem to be some decent science (whatever that means) to back this up. My blood glucose is normal and other than borderline high cholesterol my blood tests have been otherwise normal. I used to be really active and quite enjoy many types of physical activity, but the fatigue (presumably in part due to apnea) has really curtailed this.

As I embark on cpap therapy, I would like to make a concerted effort to better manage my diet and regain my former levels of activity. I have two small kids plus a wife who is very skeptical of anything other than portion reduction, but for the next week will be a 'single parent' as my wife will be away on business. It struck me that this could be a good chance to undergo the 72 hour fast that people seem to use to initiate ketosis prior to embarking on the low-carb diet.

I would be grateful for advice on the wisdom of this plan, and advice on how to proceed. I am also taking some personal time from work in order to rest and acclimate to the cpap treatment, so it seems as good a time as any to try something like this.

A few of my questions include:

1) is the 'water and coffee fast' I've heard mentioned considered to be a good option? what exactly does this entail? (other than the obvious)

2) I had also hoped to use my time off to re-establish my exercise habits, but suspect this should wait until after the fast. Comments?

3) because it's unlikely my wife will subscribe to this idea, does anyone have tips on how to limit carb intake when living with others? I suppose I can start offering to cook more (especially if my energy increases through cpap and/or diet) which will give a bit more control.

4) I bought a FreeStyle Precision Neo Blood Glucose and Ketone Monitoring System (pictured below), along with a set of Beta-Ketone Test Strips (I have another unit for glucose monitoring with lots of strips). Are there any other monitoring tools that would be helpful? What does one look for?

5) are there any supplements that people recommend, either for 1) during the fast and 2) when embarking on the ketotic diet (particularly if doing some weight training and high-intensity aerobic exercise).

6) while I can see that there are a great many books out there that look good (i.e. Obesity Code), can anyone recommend a concise reference with guidelines on how to eat, what to monitor, and what if any supplements to consider?

7) would people recommend discussing this with my physician, or can I expect them to be dismissive?

I'm pretty sure that I'm kind of a carb/sugar addict and also noticed that when I indulge this addition I get hit really hard by the insulin spike. My weight was really quite good until a couple of years ago (I'm 6'2" and was 190 lbs in 2013), but I've been going downhill since them and now feel quite unhealthy at 220 lbs.

I have a set of dumbells and bench that I've use for some basic weight lifting and am a big fan of interval training (I live in a nice hilly area and love to do hill work on my bike). I gather these forms of physical activity could have implications with a ketotic diet.

I would like to seize the opportunity this next week to start the ketotic diet, but would like to make sure it will be sustainable.

Thanks in advance for any advice!

Image
Last edited by leptic on Wed Jul 27, 2016 9:33 am, edited 6 times in total.

User avatar
Julie
Posts: 19908
Joined: Tue Feb 28, 2006 12:58 pm

Re: Considering ketotic diet with initial fast - advice please?

Post by Julie » Tue May 31, 2016 12:43 pm

Get your doctor's referral to a licensed dietician/nutritionist and talk to them.

User avatar
leptic
Posts: 204
Joined: Wed May 18, 2016 9:33 pm
Location: Canada

Re: Considering ketotic diet with initial fast - advice please?

Post by leptic » Tue May 31, 2016 1:02 pm

Julie wrote:Get your doctor's referral to a licensed dietician/nutritionist and talk to them.
Thanks - this is an awesome suggestion. The clinic I've been going to does offer services from fully licensed dieticians (Dt.P.) I'm seeing my doctor tomorrow to discuss whether to titrate my SSRI and will ask for referral. I agree with you that it's much better to work with a licensed healthcare professional than go purely on information gleaned of the internet. There is nothing wrong with running ideas past the dietician, and if they support it then it will probably also carry a *lot* more weight with my wife.

User avatar
leptic
Posts: 204
Joined: Wed May 18, 2016 9:33 pm
Location: Canada

Re: Considering ketotic diet with initial fast - advice please?

Post by leptic » Tue May 31, 2016 1:16 pm

Made an appointment with dietician for Friday morning. Thanks again for the suggestion.

User avatar
Gasper62
Posts: 982
Joined: Tue Mar 10, 2015 1:22 pm
Location: Central Maryland

Re: Considering ketotic diet with initial fast - advice please?

Post by Gasper62 » Tue May 31, 2016 1:38 pm

Well, if your dietician is anything like mine was, they'll have you gaining weight and spiking your blood glucose levels in a short amount of time. I cancelled my future appointment and started reading online and watching lots of youtube videos on LCHF diets and fasting. (there's lots of BS on youtube also, so beware. ) Since then, my BG level number averages around 99mg/dl and I've dropped 15 pounds of weight. Try this site for info: https://lowcarbrn.wordpress.com/ I just made some tasty, low carb buttermilk biscuits using almond flour from a recipe found on her fb page ! They're quick and easy, too. Good luck

User avatar
leptic
Posts: 204
Joined: Wed May 18, 2016 9:33 pm
Location: Canada

Re: Considering ketotic diet with initial fast - advice please?

Post by leptic » Tue May 31, 2016 2:27 pm

Gasper62 wrote:Well, if your dietician is anything like mine was, they'll have you gaining weight and spiking your blood glucose levels in a short amount of time. I cancelled my future appointment and started reading online and watching lots of youtube videos on LCHF diets and fasting. (there's lots of BS on youtube also, so beware. ) Since then, my BG level number averages around 99mg/dl and I've dropped 15 pounds of weight. Try this site for info: https://lowcarbrn.wordpress.com/ I just made some tasty, low carb buttermilk biscuits using almond flour from a recipe found on her fb page ! They're quick and easy, too. Good luck
Thanks - the dietician I'm going to see does a lot of work in bariatric surgery, and apparently LCHF (ketotic) diets are gaining legitimacy in that application. Will report back on how it goes.

User avatar
leptic
Posts: 204
Joined: Wed May 18, 2016 9:33 pm
Location: Canada

Re: Considering ketotic diet with initial fast - advice please?

Post by leptic » Tue May 31, 2016 2:35 pm

It is interesting to note that a PubMed search with the keywords "ketogenic diet sleep apnea" gives exactly zero hits:

http://www.ncbi.nlm.nih.gov/pubmed/?ter ... leep+apnea

However, there is at least one relevant article on use of ketogenic diet in bariatric surgery:

http://www.ncbi.nlm.nih.gov/pubmed/25005809

And about 1800 total hits for 'ketogenic diet'. A large portion of those relates to its use in treatment of epilepsy.

User avatar
Hopeful50
Posts: 177
Joined: Fri Feb 12, 2016 3:50 pm
Location: Cupertino, CA

Re: Considering ketotic diet with initial fast - advice please?

Post by Hopeful50 » Tue May 31, 2016 2:47 pm

leptic wrote:... but for the next week will be a 'single parent' as my wife will be away on business. It struck me that this could be a good chance to undergo the 72 hour fast ...
Image
As a grandma, my first thought was that your kids are going to get the short end of the stick next week. Also concerned that you seem to feel the need to keep this a secret from your wife? If so, the plan seems likely doomed to fail.
3) because it's unlikely my wife will subscribe to this idea, does anyone have tips on how to limit carb intake when living with others? I suppose I can start offering to cook more (especially if my energy increases through cpap and/or diet) which will give a bit more control.
And my two cents worth of advice on limiting your carb intake . . . A few years back I lost 50 pounds in 7 months (5'2", went from 223 to 170). My main rule was "no white carbs" -- white flour, white potatoes, white rice, sugar, etc. I dded extra fruit & veggies instead, and ate only whole grains, such as oatmeal and brown rice. A typical dinner was meat and 2-3 veggies, rather than the usual trio of meat, veg, and starch. What I couldn't (didn't want to) believe until it happened was that after struggling through the first two difficult weeks, the carb cravings really did go away. My other two rules were no eating after hubby went to bed, and no fast food. I also rode a stationary bike for 45 minutes a day.

Best of luck to you!

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: Pressure 13-20, EPR 3

User avatar
leptic
Posts: 204
Joined: Wed May 18, 2016 9:33 pm
Location: Canada

Re: Considering ketotic diet with initial fast - advice please?

Post by leptic » Tue May 31, 2016 2:55 pm

Hopeful50 wrote:
leptic wrote:... but for the next week will be a 'single parent' as my wife will be away on business. It struck me that this could be a good chance to undergo the 72 hour fast ...
Image
As a grandma, my first thought was that your kids are going to get the short end of the stick next week.
Well I wasn't going to make the kids fast... if your concern is whether I can take care of them, my hope is that I'll feel a bit more energetic. My motivation for doing this is to try and be a better, more energetic parent. FWIW my wife travels a fair bit, so this won't be the first or last time...
Also concerned that you seem to feel the need to keep this a secret from your wife? If so, the plan seems likely doomed to fail.
That's a legitimate concern!
And my two cents worth of advice on limiting your carb intake . . . A few years back I lost 50 pounds in 7 months (5'2", went from 223 to 170). My main rule was "no white carbs" -- white flour, white potatoes, white rice, sugar, etc. I dded extra fruit & veggies instead, and ate only whole grains, such as oatmeal and brown rice. A typical dinner was meat and 2-3 veggies, rather than the usual trio of meat, veg, and starch. What I couldn't (didn't want to) believe until it happened was that after struggling through the first two difficult weeks, the carb cravings really did go away. My other two rules were no eating after hubby went to bed, and no fast food. I also rode a stationary bike for 45 minutes a day.
That is encouraging! I really think there is something to the insulin/carb cycle - certain foods drive you to crave more, and are not conducive to being active...
Best of luck to you!
Thanks!

User avatar
Sir NoddinOff
Posts: 4190
Joined: Mon May 14, 2012 5:30 pm
Location: California

Re: Considering ketotic diet with initial fast - advice please?

Post by Sir NoddinOff » Tue May 31, 2016 3:49 pm

I did it ten years ago... the weight I lost (20 lbs) came back after a year or two. Subsequently, I went on the exact same diet for a second time and it did not work at all. Same no-carb food, same liquids, nothing different. My niece had the same experience and agrees that for some it's a one shot deal (the moral of the tale is: Don't put the weight back on). Eventually I just settled on a high protein/mod carbohydrate diet with LOTS of exercise. It works okay but there's room for improvement.

_________________
Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments: Sleepyhead software v.0.9.8.1 Open GL and Encore Pro v2.2.
I like my ResMed AirFit F10 FFM - reasonably low leaks for my ASV therapy. I'm currently using a PR S1 AutoSV 960P Advanced. I also keep a ResMed S9 Adapt as backup. I use a heated Hibernite hose. Still rockin' with Win 7 by using GWX to stop Win 10.

lilly747
Posts: 446
Joined: Thu Sep 27, 2012 9:39 am
Location: Northern Calif, USA

Re: Considering ketotic diet with initial fast - advice please?

Post by lilly747 » Tue May 31, 2016 4:22 pm

leptic wrote:....borderline high cholesterol my blood tests have been otherwise normal. I used to be really active and quite enjoy many types of physical activity, but the fatigue (presumably in part due to apnea) has really curtailed this.
Hi leptic...

I would just like to commit on the cholesterol and fatigue, by telling you my experience...

My cholesterol was 230 when I went on the keto diet the first time. Most of my fats/oils came from dairy. Eight weeks later it was 310. This does NOT happen to everyone, just unlucky ones like me... . So I had some tests done and found out why.......I am what's called a super-absorber (my Bata-Sitosterol was very, very high--and my Campesterol was high too....these are cholesterol absorption markers). Just remember, on a high fat diet some people will make too much cholesterol (I do not have this problem), some will absorb too much cholesterol (that would be me).

Now I am back on my keto diet but I get most of my fats from olive oil, MCT oil, avocado oil, Nuts, olives, avocados and MUCH less from dairy.

I am working with a Naturopath to see if I can keep my cholesterol down under 250..for me this would be ok as my lipids are great.

(PLEASE PEOPLE I am NOT saying this high of a cholesterol reading would be ok for everyone.)

As far as the fatigue, well the first time I went on a keto diet, I was Very fatigued for the first 3 weeks. I had a hard time adapting, again NOT everyone does. This last time, the fatigue was slight for the first 2 weeks only.

So I am trying to let you know that everyone is different and if your cholesterol goes high, you have an idea of where to look for the problem...and what you might do to correct it....

good luck....I love Keto....

User avatar
49er
Posts: 5624
Joined: Mon Jan 16, 2012 8:18 am

Re: Considering ketotic diet with initial fast - advice please?

Post by 49er » Tue May 31, 2016 5:42 pm

leptic wrote:Hi -

I've seen a number of people here relate positive experiences with a ketotic diet, and there does seem to be some decent science (whatever that means) to back this up. My blood glucose is normal and other than borderline high cholesterol my blood tests have been otherwise normal. I used to be really active and quite enjoy many types of physical activity, but the fatigue (presumably in part due to apnea) has really curtailed this.

As I embark on cpap therapy, I would like to make a concerted effort to better manage my diet and regain my former levels of activity. I have two small kids plus a wife who is very skeptical of anything other than portion reduction, but for the next week will be a 'single parent' as my wife will be away on business. It struck me that this could be a good chance to undergo the 72 hour fast that people seem to use to initiate ketosis prior to embarking on the low-carb diet.

I would be grateful for advice on the wisdom of this plan, and advice on how to proceed. I am also taking some personal time from work in order to rest and acclimate to the cpap treatment, so it seems as good a time as any to try something like this.

A few of my questions include:

1) is the 'water and coffee fast' I've heard mentioned considered to be a good option? what exactly does this entail? (other than the obvious)

2) I had also hoped to use my time off to re-establish my exercise habits, but suspect this should wait until after the fast. Comments?

3) because it's unlikely my wife will subscribe to this idea, does anyone have tips on how to limit carb intake when living with others? I suppose I can start offering to cook more (especially if my energy increases through cpap and/or diet) which will give a bit more control.

4) I bought a FreeStyle Precision Neo Blood Glucose and Ketone Monitoring System (pictured below), along with a set of Beta-Ketone Test Strips (I have another unit for glucose monitoring with lots of strips). Are there any other monitoring tools that would be helpful? What does one look for?

5) are there any supplements that people recommend, either for 1) during the fast and 2) when embarking on the ketotic diet (particularly if doing some weight training and high-intensity aerobic exercise).

6) while I can see that there are a great many books out there that look good (i.e. Obesity Code), can anyone recommend a concise reference with guidelines on how to eat, what to monitor, and what if any supplements to consider?

7) would people recommend discussing this with my physician, or can I expect them to be dismissive?

I'm pretty sure that I'm kind of a carb/sugar addict and also noticed that when I indulge this addition I get hit really hard by the insulin spike. My weight was really quite good until a couple of years ago (I'm 6'2" and was 190 lbs in 2013), but I've been going downhill since them and now feel quite unhealthy at 220 lbs.

I have a set of dumbells and bench that I've use for some basic weight lifting and am a big fan of interval training (I live in a nice hilly area and love to do hill work on my bike). I gather these forms of physical activity could have implications with a ketotic diet.

I would like to seize the opportunity this next week to start the ketotic diet, but would like to make sure it will be sustainable.

Thanks in advance for any advice!

Image
Hi Leptic,

Here is a great site by lowcarb RN who lost 80 pounds going this route.

https://lowcarbrn.wordpress.com/

On her facebook page, she mentioned she was giving free online seminars. Don't know if she is still doing it but you might want to check.

Good luck.

User avatar
Okie bipap
Posts: 3552
Joined: Thu Oct 15, 2015 4:14 pm
Location: Central Oklahoma

Re: Considering ketotic diet with initial fast - advice please?

Post by Okie bipap » Tue May 31, 2016 6:00 pm

My wife and I use a modified Mediteranian diet. The first two weeks on the diet, we cut out all carbs. After two weeks, we started bringing in whole grain carbs in limited quantities. My wife has dropped over 40 pounds and is not longer a diabetic. I started doing the diet again about three months ago and have dropped over 20 pounds. Due to other medical conditions, I cannot do a lot of exercise, so I am dropping slowly. We normally ride recumbent tricycles almost every day. Right now, we are doing around 8 or 9 miles a day on trikes with 20 inch wheels.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: Evora Full Face Mask - Fitpack
Additional Comments: IPAP 20-25, ps 4, OSCAR software
Growing old is mandatory, but growing up is optional.

User avatar
Sir NoddinOff
Posts: 4190
Joined: Mon May 14, 2012 5:30 pm
Location: California

Re: Considering ketotic diet with initial fast - advice please?

Post by Sir NoddinOff » Tue May 31, 2016 6:29 pm

Okie bipap wrote: Due to other medical conditions, I cannot do a lot of exercise, so I am dropping slowly. We normally ride recumbent tricycles almost every day. Right now, we are doing around 8 or 9 miles a day on trikes with 20 inch wheels.
I don't know what you mean by not a lot of exercise... you're doing great, especially if you do that every day. A lot of people on this forum think getting exercise means ripping open a bag of chips and petting the cat while watching TV.

_________________
Mask: AirFit™ F10 Full Face Mask with Headgear
Additional Comments: Sleepyhead software v.0.9.8.1 Open GL and Encore Pro v2.2.
I like my ResMed AirFit F10 FFM - reasonably low leaks for my ASV therapy. I'm currently using a PR S1 AutoSV 960P Advanced. I also keep a ResMed S9 Adapt as backup. I use a heated Hibernite hose. Still rockin' with Win 7 by using GWX to stop Win 10.

HoseCrusher
Posts: 2744
Joined: Tue Oct 12, 2010 6:42 pm

Re: Considering ketotic diet with initial fast - advice please?

Post by HoseCrusher » Tue May 31, 2016 6:40 pm

Isn't typing exercise...

_________________
Mask: Brevida™ Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine is an AirSense 10 AutoSet For Her with Heated Humidifier.
SpO2 96+% and holding...