Ketogenic Diet (Keto) - Ineffective and Dangerous

[ChicagoGranny]

It's still quite convincing that energy balance is the immediate driving factor. This 7-year old study seems to cover it well in the brief summary.

However, as the environment has gradually changed to one in which high levels of physical activity are not required in daily life and in which food is abundant, inexpensive and served in large portions, the physiological regulation of body weight appears to be insufficient to oppose positive energy balance, weight gain and obesity.

https://www.ncbi.nlm.nih.gov/pmc/articl ... /#S11title

As far as those "overweight doctors", they probably can't get through the culture to reach a negative energy balance.

[ChicagoGranny]

Maria (https://www.facebook.com/FitnessRe/) is my buddy. I try to read her FB posts several times a week. I'm aged, but I can still walk and lift some small dumbbells.

[jnk...]

It is not convincing to researchers, as acknowledged by the "appears to be" phrase in your quote. That's another way of saying "it's still what many of us assume, despite having no science on the matter." In fact the "energy-balance" of calories-in/calories-out has now been thoroughly debunked, since it ignores all well-established hormonal and environmental factors.

If someone attempts to fake a so-called "negative energy balance," in an attempt to force a body to counteract its DNA and disease states, most bodies are smart enough to lower metabolism to reduce expenditure and will react hormonally to make corrections and overcome future similar attempts.

Those with a low-weight set point in their metabolic function can be happy they have it, but they can't take credit for it as a conscious decision they made. And they would do well not to condemn those without a similar metabolic makeup in their attempts to blame victims as being lazy gluttons. That would not be ethical, scientific, or loving. It would only be the same as the rich blaming the poor for not being as rich as they are.

[ChicagoGranny]

And they would do well not to condemn those without a similar metabolic makeup in their attempts to blame victims as being lazy gluttons.

No one has said that in this thread. Why insert it?

[jnk...]

And they would do well not to condemn those without a similar metabolic makeup in their attempts to blame victims as being lazy gluttons.

No one has said that in this thread. Why insert it?

Do you have a different interpretation of the meaning of the words from the doctor quoted in your OP?:

Diabetes and obesity are . . . the symptom of caloric excess, dietary indiscretion, and torpor.

Fancy doc-speak don't hide ugly thoughts betraying the doc's unscientific, unfounded (though common) view of patients seeking real medical solutions from those who offer none--other than maybe cutting into a healthy, functioning organ.

[ChicagoGranny]

Well, when you pull out individual sentences, he does sound like he has an ax to grind.

[ChicagoGranny]

Oh, I see he is a vegan. Blechh. https://twitter.com/sjoshimd

[jnk...]

I guess that ax may come in handy when he chops his veggies! Keto can be very vegetarian-friendly.

Interesting post. Interesting thread. Thanks, CG.

[palerider]

Oh, I see he is a vegan. Blechh. https://twitter.com/sjoshimd

I LOVE VEGANS... Vegans are delicious...

Cows are vegan.

[Arlene1963]

I subscribe to Zoe Harcombe's blog and today she discussed a recent study that was published in the BMJ (and that was written up in the New York Times a few days ago.)

I thought that forum members who commented on this thread might find the article in the NY Times interesting.

The aim of the study was to determine the effects of diets varying in carbohydrate to fat ratio on total energy expenditure during weight loss maintenance. So, the study focused on understanding the impact of carbohydrate and fat ratios on weight maintenance, after weight loss.

https://www.nytimes.com/2018/11/14/well ... eight.html

Here's a link to the senior researcher's comments on the study (Dr Ludwig)

https://medium.com/@davidludwigmd/major ... 7d47a571d9

Here is a link to the actual study in the BMJ, and not a "commentary"

https://www.bmj.com/content/363/bmj.k4583

[SewTired]

One of the points that was made "but the underlying glucose resistance may still be present" is true. They found the same thing to happen with cats. Even cats fed raw food diet develop diabetes in the absence of carbs. They confirmed this when these cats (those who developed diabetes) developed chronic kidney failure and were switched to low protein, higher carb food to reduce strain on kidneys.

Jan has excellent control, but when she increases her carb level, the glucose resistance is likely still there. Just so long as you realize that, it's a non-problem. Now, why would she increase her carb level? That may happen if she develops certain illnesses where meat protein is replaced with other protein (either plant or grain). If she does not and maintains her current status quo, non-problem.

My endo is fine with a keto program, but told me what my limit of protein was. So long as I don't go over, he's not worried about it. He has had some patients who have had success with it.

[SewTired]

continuing to "prescribe" high-carb diets

Are you saying many doctors or nutritionists do that? (Sorry, I wouldn't know because no one in my family is obese or diabetic.)

Nutritionists get their liscencing from places like the ADA (American Diabetes Association) so they are more or less stuck with pitching those recommendations. The recommendation for 45 carbs per meal and 15 per snack is great AS A START since many Americans eat many, many more carb grams than that. However, for someone who is diabetic, 100 gr per DAY should be the second maximum goal. If you can manage less than that, even better. STAYING at 45/15 carbs will nearly always result in worsening diabetes as it is too many carbs for someone with T2.

[Grace~~~]

Do any of you wear the continuous glucose monitoring?

[ChicagoGranny]

continuing to "prescribe" high-carb diets

Are you saying many doctors or nutritionists do that? (Sorry, I wouldn't know because no one in my family is obese or diabetic.)

Nutritionists get their liscencing from places like the ADA (American Diabetes Association) so they are more or less stuck with pitching those recommendations. The recommendation for 45 carbs per meal and 15 per snack is great AS A START since many Americans eat many, many more carb grams than that. However, for someone who is diabetic, 100 gr per DAY should be the second maximum goal. If you can manage less than that, even better. STAYING at 45/15 carbs will nearly always result in worsening diabetes as it is too many carbs for someone with T2.

Thank you, SewT. I just got word that a friend of mine who has T2 is in the hospital with a virus. He retired two years ago and started hitting the gym regularly. He works out very hard and got himself into a great looking, slim shape. I don't know about his diet, but he has told me he regularly goes to a restaurant near his house that specializes in fried chicken, fried fish, and cheeseburgers.

[Janknitz]

One of the points that was made "but the underlying glucose resistance may still be present" is true. They found the same thing to happen with cats. Even cats fed raw food diet develop diabetes in the absence of carbs. They confirmed this when these cats (those who developed diabetes) developed chronic kidney failure and were switched to low protein, higher carb food to reduce strain on kidneys.

Jan has excellent control, but when she increases her carb level, the glucose resistance is likely still there. Just so long as you realize that, it's a non-problem. Now, why would she increase her carb level? That may happen if she develops certain illnesses where meat protein is replaced with other protein (either plant or grain). If she does not and maintains her current status quo, non-problem.

My endo is fine with a keto program, but told me what my limit of protein was. So long as I don't go over, he's not worried about it. He has had some patients who have had success with it.

Understand this is not a problem of “glucose resistance”. The issue is hyperINSULEMIA and INSULIN resistance. A very important distinction. Insulin is the hormone which (among other things) causes cells of the body to store energy in the form of fat.

I’m not sure what cat study you are referring to, but cat metabolism is not the same as human metabolism (neither is mouse metabolism) so I’m not sure what conclusions could be drawn. And I’m curious about that conclusion. Cats are obligate carnivores so I’m not sure what the sources of carbohydrates would be in their natural, wild diet. Do lions and tigers need their whole wheat bread to prevent diabetes???

Apparently there are some mosquitos that carry a bacteria or virus that can cause a severe allergy to meat. But barring that I cannot imagine any illness or condition that would require one to get protein only from non-animal sources. And your endo is again lumping keto with high protein diets. Generally keto is moderate protein. (Some people do otherwise, but high protein isn’t the usual form of keto).

It’s very true that people with insulin resistance aren’t “cured” by a ketogenic diet and the same problems will recur when carbohydrates are increased. But the condition is controlled and the damage carbohydrates cause can be reversed on keto or low carb.

Ultimately insulin resistance is a condition of carbohydrate intolerance. So clearly it makes no more sense for someone who is carbohydrate intolerant to eat a lot of carbohydrates than it does for someone with a food allergy to eat the food they are allergic to. Avoidance doesn’t “cure” the allergy, but certainly improves the quality of life. There’s not much logic in continuing to eat the so-called Standard American Diet and getting sicker and fatter simply because the keto diet may not “cure” insulin resistance.