Wasting away again in ketogenic-ville

Gasper62 wrote:Please do not let one timid, indecisive mama's boy deter you from posting your information and experiences here, Dreamstalker. That would be a shame !

Uh oh - I think it's too late! Sorry I really didn't mean to drive Dreamstalker off of the forum...

leptic wrote:

Gasper62 wrote:Please do not let one timid, indecisive mama's boy deter you from posting your information and experiences here, Dreamstalker. That would be a shame !

Uh oh - I think it's too late! Sorry I really didn't mean to drive Dreamstalker off of the forum...

Not you. The Canadian Dietitian Whatchamacallit.

jnk... wrote:

leptic wrote:

Gasper62 wrote:Please do not let one timid, indecisive mama's boy deter you from posting your information and experiences here, Dreamstalker. That would be a shame !

Uh oh - I think it's too late! Sorry I really didn't mean to drive Dreamstalker off of the forum...

Not you. The Canadian Dietitian Whatchamacallit.

Phew - I didn't think I had that kind of power... thanks for your thoughtful post JNK.

Ok the Quebec Order of Dieticians also seems to be on the 'brain can only use glucose' wagon:

(page 6) As you read the articles in this issue, you will note that the added value of nutritional intervention in mental health from the first to the third line has become incontrovertible. For example, consider the impact of carbohydrate or vitamin B12 deficiency on brain performance or the secondary metabolic effects of anti-psychotic medication

Please understand that I don't agree with this simplistic presentation. For cryin' out loud I hired one of the guys who co-authored this paper and this paper specifically because I was interested in brain ketone metabolism (i.e. it was after he wrote the papers and I thought the ideas have merit; he's now a post-doc in my lab). That being said, we are currently working on things other than diet and I did not have the experience to plan a practical diet nor the expertise to evaluate this as a recommended practice for my own weight loss. I'm at the end of a couple of weeks off work (taken mainly in order to finally focus on my own health), but when I get back I'll ask my guy if he actually follows a ketogenic diet.

leptic didn't chase me away – I decided on my own that posting my views here is basically a waste of “my” time. Why?

Well ... admittedly, as a professional scientist (whatever that means), my weakness is in the biological sciences (unlike leptic) – as the only formal class I've ever had is 9th grade high school biology about 40 years ago, back when evolution was still taught as part of a high school science curriculum and the US Bill of Rights still had to be memorized for civics class. Additionally, I was also required to take a paleobiology course for my undergraduate degree over 35 years ago (the principles of evolution part was cool but the biomorphology part I didn't really enjoy at all). So my unfortunate weakness in biology is due to the fact that my focus in science since junior high school, has until 3 or 4 years ago, always been in math, chemistry, physics, geoscience, and computer science. So yeah ... to the shock and awe of everyone (and to the absolute horror of Julie I'm sure), I'm NOT a registered dietician or fitness instructor or even a licensed medical doctor. However, in my effort to catch up and strengthen my biological science weakness, I've actually pursued self-teaching myself in health, nutrition, and fitness since 2007 – from of all places, the internet … yes indeed, from internet blogs, YouTube videos, free online university courses, and books sold on Amazon (double gasp I know ).

But allow me to posit my opinion based on my own acquired internet knowledge as well as my personal experience with licensed health professionals (note that I no longer use the terms health and care together as a compound adjective when referencing some allopathic portions of the western medical establishment). IMO, the very nutritional health professionals that Julie continues to advise forum members to seek out are unethical or criminal at the very least if not ignorant and negligent at best. Seriously, the primary reason that people come to this forum to ask questions regarding chronic health issues is because those very health professionals have failed them. Obviously, this opinion of mine is outrageous to some, conspiracy theory to others, not to mention PC non-compliant and offensive to still others. But hey! As a scientist (whatever that means), I call 'em as I see 'em. However, please don't misconstrue my opinion to apply to acute health issues … by all means, if you've suffered a traumatic injury or have been exposed to a dangerous infectious disease, there is no better help to seek out than the western medical system – but when it comes to chronic diseases and chronic health issues, the western medical establishment is more likely to kill you than help you. And that is exactly what that Canadian Dietician web site is promoting … sickness and pre-mature death!



So yeah. IMO, most people here don't want to hear that type of blasphemy against their god-like medical professionals, ergo I'm just wasting my time posting on this forum. Besides, after 9+ years of personal research, the “science” (whatever that means) is as clear as it will ever be to me regarding nutrition, fitness, health, longevity and the cause of most chronic diseases.

Anyway, obviously I did come back this morning to read the rest of this thread while sipping on my ketogenic fat coffee. And after reading and skimming through the link that Jeff posted to that old thread from 2012 that until today, I'd never seen, I felt compelled to come back and explain myself and to offer my apologies to everyone for inadvertently making such a fuss over this thread … as 49'er noted, I was/am indeed quite frustrated with the continued worship of the failed medical approach to chronic diseases ... specifically obesity, diabesity, CVD, and all hyperinsulinemia related diseases for that matter. There really isn't much for me to add to this topic of nutrition that hasn't already been posted somewhere on this forum, or god forbid some other dark recess of the internet (certainly, be skeptical of any health web site endorsed by a government or major national/international corporate industry).

So rather than re-write my statement by statement rebuttal to the Canadian Dietician toxic and lethal web site (Jeff did a very good job already), I'll address the thread's originating post instead.

leptic's questions/concerns were listed as follows:

leptic wrote: snip ...
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)

Water fast … just add water.

Coffee fast … usually refers to “fat coffee” by adding 1 or 2 or more tablespoons of butter and a teaspoon MCT oil (preferably the higher quality caprylic acid fraction) and then using a blender or latte aerator to emulsify the fats into a creamy cup of coffee. I do mine in an Aladdin coffee thermos and then close the air-tight lid and let it set for 30 minutes to an hour and it seems to keep the fats emulsified and from separating from the coffee a lot longer.

You can do tea fast too if that's your preference. For lunch you can have a cup of broth if you like and even add butter and/or MCT oil.

leptic wrote: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?

It depends. Anyone who is extremely physically unfit should probably avoid significant exercise other than trying to walk more if at all possible.

For anyone trying to improve their endurance capacity, the most current science based on Dr. Phil Maffetone's Maximum Aerobic Function (MAF) method is perhaps the best approach. For those seeking to optimize their genetic strength potential, they should follow Dr. Doug McGuff's Body by Science (BBS) approach. For those seeking to maximize their mitochondrial biogenesis, High Intensity Interval Training (HIIT) at your personal 90 to 95 percent maximum heart rate for 100% VO2 max (there are plenty of 100% VO2 maximum heart rate calculators out there in that dangerous place called the internet). You can check into the Tabata, Timmons, and/or Gibala HIIT regimens for more details.

For the average overweight people capable of walking at least a mile or two and who are seeking to maximize fat loss and optimize a healthy hormonal balance – they should use a combination of the above methods such as using: the MAF for walking, hiking, cycling or any other “steady-state” aerobic activity that they enjoy for 30 minutes to an hour 4 or 5 days per week; the BBS super-slow resistance training for about 10 to 15 minutes once per week; and the HIIT training for 10 to 15 minutes once per week or every other week. The MAF approach is best done always in a fasted state before and after exercise. The BBS and HIIT approaches may be quite difficult to do in a fasted state but it would be best to eventually work yourself up gradually to doing them in a fasted state.

leptic wrote: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.

If your family is not supportive, you may just have to use the intermittent fasting approach where you just eat one meal per day (dinner?) with your family and do the best you can to keep it as low carb as possible.

leptic wrote: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?

That is the same meter as the Precision Xtra by Abott Laboratories as I understand it. It is considered by most to be the best DIY blood ketone meter short of having professional blood lab work done. There is another brand, the Nova Max Plus which offers blood ketone strips at about half the price of the Precision Xtra strips. Some have reported that Nova Max blood ketones measurements are not as accurate … but I have both and find both to be about the same each time I have compared with the exact same drop of blood – with the Nova Max being on average about 0.1 mmol/L less than the Prescision Xtra (which is fine for the n=1 experiments that I do).

The glucose measurements for both on the other hand have a greater discrepancy (about 10 mg/dL) but my research suggests that both are inaccurate relative to the Contour Next EZ glucose meter which studies suggest is the most accurate for blood glucose measurements.

leptic wrote: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).

During fasting periods, salt minerals are important, especially potassium, sodium, and magnesium. You can take a daily supplement of multi-vitamins and minerals if you like … I like Dr. Wallach's Youngevity brand but any brand you trust will be fine. If however the purpose of your fasting is autophagy, to cleanse your body of bad or toxic cells, you should do an extended water only fast for 2 weeks or more and just supplement with electrolyte minerals.

Some keto-adapted athletes/researchers like Dr. Dominic D'Agostino and Dr. Peter Attia suggest taking Branched Chain Amino Acids (BCAA), particularly leucine to improve muscle growth.

leptic wrote: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?

Yes many books to choose from and Dr. Jason Fung's is just as good as some of the best out there.

Again, Dr. Fung's blog is just as good as some of the best on how to eat if you like his style. As o'le Butter Bob says however, keeping it as simple as possible is the best approach to achieve your goal(s) … you do have at least one goal right? Also note that one of the Butter Bob links I provided previously contains numerous peer reviewed references regarding ketotic diet and fasting. Once you achieve your goals(s), you can monitor and titrate your diet based on your glucose measurements … if something or some amount of what you eat spikes your blood glucose more than 100 mg/dL, it is likely to drift you back into your old sick state of health and you should probably avoid it and that is how you titrate your long-term diet back into your life.

As for supplements … see response to your above question number 5.

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

My guess is that they will most likely be dismissive though some may not care much and very very few may actually be interested in your outcome.

leptic wrote:… snip …

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.

See above response to your question number 2. Generally, exercise while in ketosis will optimize your keto-adaptation over a 6 to 8 week period .... no exercise would take longer ... how much longer? I dunno but check into Jeff Voleck's and Dr. Stephen Phinney's work.

leptic wrote: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!

A ketosis diet is sustainable but you need to ask yourself for what purpose and what goals are you trying to achieve. For some, a ketogenic diet is a lifestyle either as a nutritional preference for longenvity, or athletic performance, or as a required nutritional disease therapy (like for epileptic, ALS, and cancer patients). Only you can determine if a ketogenic diet is sustainable for the long term for you. A ketogenic diet is also sustainable as a tool to optimize, stimulate, and manipulate your phenotypic expression via the epi-genetic response that you can control … like ketosis for managing the master hormone insulin and all the others tied to it. You get to define sustainable.

I'm pretty much tired of posting about the failed western medical system. I would prefer off topic posts on the failed western agriculture system because I do know a little something about permaculture and I actually have certification in that topic of discussion ... but doubt there is any interest here as it is very politically incorrect. Anyway, again my apologies for the long winded coffee powered response ... ketones on the brain have a way of doing that.

Great post Dream Stalker. You may not have the official credentials but you sure know alot more than most medical professionals.

49er

DreamStalker wrote:leptic didn't chase me away – I decided on my own that posting my views here is basically a waste of “my” time. Why?

Thanks - I totally understand. In a sense it is very literally a waste of time, as it's unlikely that posts on an internet forum will alter the stance of these dietician groups. The status quo may be partly because very few people actually consult a dietician in the way I have done (not ordered to by physician but on own initiative for health improvement). I suspect their bread and butter involves institutional work and patients with specific illnesses - at the end of the day there is not much economic incentive for these groups to change quickly and the stigma attached to anything that could be perceived as a 'fad diet' is substantial in academic circles (even though academics can be quite guilty of following fads based on crummy evidence).

As someone working 'in the system', I may someday be in a position to contribute a tiny increment of progress. This is where my interest in these discussions lies. I would like to know the real reasons why the professional bodies seem so disinterested/dismissive, and where additional evidence might be of ouse.

Thanks for answering all my specific questions - that's very helpful. I am giving it a shot.

49er wrote:Great post Dream Stalker. You may not have the official credentials but you sure know alot more than most medical professionals.

49er

Mmmm thanks, but no ... I don't know more than they do. My expertise lies in a completely different field and discipline which has little or nothing to do with health or biology.

I think the large majority of "medical professionals" simply don't take their Hippocratic Oath seriously anymore ... or quite possibly no longer even take the oath at all.

Though not all of them, I think most of them (at least of the ones I'm personally familiar with) are lazy and unwilling to think for themselves ... and perhaps due to legal, economic, or other reasons, just accept the "standard of care" dogma given to them by government endorsed corporate propaganda for profit of, by, and for the health, insurance, pharmaceutical, and food industries.

On the other hand, my primary care physician (for 16+ years now) has told me that the US health system is collapsing under federal and state regulatory mandates and that medical providers now have more urgent matters to deal with than their patients ... like figuring out how to stay in business. My doc's explanation is quite plausible considering the cost of medical school (or any higher education degrees relative to 40 years ago).

I still think the biggest part of the problem is that health for "profit" and health for "care" are mutually incompatible and the only solution is for people to take control of their own basic preventative health care, which starts with the detoxification of your body and an evolutionary approach to human health ... “Let food be thy medicine and medicine be thy food.” -- Hippocrates

For Julie: http://youtu.be/WIebxoTx408

I worked in a medical field for 20 years, and my observation is that many medical and healthcare practices are based on belief and tradition, not the evidence-based science they claim. Newer, younger practitioners tend to think their predecessors "must have" studied the evidence somewhere along the way, when there really was little or none. We have generations of healthcare providers now who lack critical thinking skills because the way to get to medical school and the way to survive medical school (and allied health professions) is to memorize protocols and follow them. When they don't work or have a bad outcome it's either the patient's fault or a "paradox".

There are so many forces imposed on our doctors these days that have NOTHING to do with our health and needs:insurers, financial issues within medical practice, standards of care that may be based on marketing pressures from pharmaceutical companies (statin's and new diabetes drugs as prime examples), time constraints, etc. I find these all a detriment to my well being, not a contribution to my health.

I think there are some wonderful medical professionals out there, and certainly in medical trauma or crisis I want the best medicine has to offer. But for my day to day health the maxim we often say here applies--"nobody cares more about my health than I do" and I'm knowledgeable enough to understand and appreciate what's best for me, and I know when to seek help.

Newer, younger practitioners tend to think their predecessors "must have" studied the evidence somewhere along the way, when there really was little or none.

It is worse then that. What evidence there is, is skewed by the fact that women were rarely included.

“It’s easier to test men, and if you are going to test women, it’s easier to either ignore the effects of the menstrual cycle or to test them in one specific phase,” Georgie Bruinvels, a PhD candidate at University College London and lead author of the editorial, told BuzzFeed News.
However, those results would only be scientifically vetted and meaningful for half the population. Women don’t stop exercising — or doing anything else — just because they get periods. By cutting out that subset of data, the research leaves a lot of gaps in our practical knowledge about half the population during a significant chunk of their life.
“There’s still a massive gap of understanding around what actually happens at all phases of the menstrual cycle. It’s the same for people on the oral contraceptive — we don’t know the effects of that either,” Bruinvels said.

One place where the biological gender gap remains particularly high is in animal and cell studies. Most of this basic research is done on male cells and male animals, even when the therapy is likely to affect women more. Women are 70 percent more likely to suffer depression than men, for instance, but animal studies on brain disorders are five times as likely to be done on male animals.

DreamStalker wrote:

49er wrote:Great post Dream Stalker. You may not have the official credentials but you sure know alot more than most medical professionals.

49er

Mmmm thanks, but no ... I don't know more than they do. My expertise lies in a completely different field and discipline which has little or nothing to do with health or biology.

I think the large majority of "medical professionals" simply don't take their Hippocratic Oath seriously anymore ... or quite possibly no longer even take the oath at all.

Though not all of them, I think most of them (at least of the ones I'm personally familiar with) are lazy and unwilling to think for themselves ... and perhaps due to legal, economic, or other reasons, just accept the "standard of care" dogma given to them by government endorsed corporate propaganda for profit of, by, and for the health, insurance, pharmaceutical, and food industries.

On the other hand, my primary care physician (for 16+ years now) has told me that the US health system is collapsing under federal and state regulatory mandates and that medical providers now have more urgent matters to deal with than their patients ... like figuring out how to stay in business. My doc's explanation is quite plausible considering the cost of medical school (or any higher education degrees relative to 40 years ago).

I still think the biggest part of the problem is that health for "profit" and health for "care" are mutually incompatible and the only solution is for people to take control of their own basic preventative health care, which starts with the detoxification of your body and an evolutionary approach to human health ... “Let food be thy medicine and medicine be thy food.” -- Hippocrates

I agree with you and I think that, in general, a number of systemic changes have led to a climate in which medical professionals and academic researchers are much less secure than they were in the past (professionally, financially, personally). This has bred a kind of conservatism that's lead to a kind of pathological risk aversion on the one hand, and a rather sad tendency to chase fads/buzzwords on the other.

God forbid that someone be branded a 'quack' or a 'flake' - your career is pretty much over (even though there are plenty of mainstream academics fawning over ideas that qualify for both of the latter labels...)

BlackSpinner wrote:

Newer, younger practitioners tend to think their predecessors "must have" studied the evidence somewhere along the way, when there really was little or none.

It is worse then that. What evidence there is, is skewed by the fact that women were rarely included.

“It’s easier to test men, and if you are going to test women, it’s easier to either ignore the effects of the menstrual cycle or to test them in one specific phase,” Georgie Bruinvels, a PhD candidate at University College London and lead author of the editorial, told BuzzFeed News.
However, those results would only be scientifically vetted and meaningful for half the population. Women don’t stop exercising — or doing anything else — just because they get periods. By cutting out that subset of data, the research leaves a lot of gaps in our practical knowledge about half the population during a significant chunk of their life.
“There’s still a massive gap of understanding around what actually happens at all phases of the menstrual cycle. It’s the same for people on the oral contraceptive — we don’t know the effects of that either,” Bruinvels said.

One place where the biological gender gap remains particularly high is in animal and cell studies. Most of this basic research is done on male cells and male animals, even when the therapy is likely to affect women more. Women are 70 percent more likely to suffer depression than men, for instance, but animal studies on brain disorders are five times as likely to be done on male animals.

Yeah this has been a big issue that's only recently received broad recognition. I run research studies and we have to be quite vigilant to ensure that our cohorts make any kind of demographic sense. This can be surprisingly difficult - you probably know that virtually all research is run by graduate students; these are generally smart, altruistic, and highly motivated individuals but they are also under pressure to get their five-year projects done and graduate (often with the knowledge that their supervisor only has money to pay them for a fixed period). I've seen cohort demographics drift into wildly skewed territory and we had to undergo painful corrections (figuring out why no women/men want to participate in the study, or meet the inclusion criteria, etc.) For a grad student who just wants to write their thesis, this is hell. I have to remind them that 1) we are using taxpayer dollars and it would be nice if they got their money's worth in terms of quality; and 2) the 'health science' research we are doing is supposed to help sick people, but it can't do that if study designs are flawed. I will admit that I've overseen some studies that, when I look back on them, are not to the standard I would have liked. I don't really like compromising and it sucks that this happens out of limited funding, time pressures, human factors, etc. So I can definitely sympathize with taxpaying patients who take mainstream research with a grain of salt (and hey now I'm one myself).

I've been taking the last couple of weeks to reflect on life, career, etc. and even before this discussion I have suffered some moments of disgust at work thinking "how is this possibly ever going to help a sick person" (in regards to initiatives that represent careerist BS and technocratic wankery designed to impress other researchers and administrators more than anything else). I probably shouldn't be so bitter - it's the best job in the world in many ways but my health detour has reminded me that it carries some responsibility as well.

Janknitz wrote:For Julie: http://youtu.be/WIebxoTx408

I worked in a medical field for 20 years, and my observation is that many medical and healthcare practices are based on belief and tradition, not the evidence-based science they claim. Newer, younger practitioners tend to think their predecessors "must have" studied the evidence somewhere along the way, when there really was little or none. We have generations of healthcare providers now who lack critical thinking skills because the way to get to medical school and the way to survive medical school (and allied health professions) is to memorize protocols and follow them. When they don't work or have a bad outcome it's either the patient's fault or a "paradox".

There are so many forces imposed on our doctors these days that have NOTHING to do with our health and needs:insurers, financial issues within medical practice, standards of care that may be based on marketing pressures from pharmaceutical companies (statin's and new diabetes drugs as prime examples), time constraints, etc. I find these all a detriment to my well being, not a contribution to my health.

I think there are some wonderful medical professionals out there, and certainly in medical trauma or crisis I want the best medicine has to offer. But for my day to day health the maxim we often say here applies--"nobody cares more about my health than I do" and I'm knowledgeable enough to understand and appreciate what's best for me, and I know when to seek help.

The head of a certain prominent neurological institute recently gave an interview for this article on an initiative to do a better job of sharing data between scientists, as opposed to the secretive and competitive practices that have sometimes been prevalent. He opens by saying "we're doing a really shitty job" of translating neuroscience research into patient care. While I agree on this and many other points, I have to confess I'm not sure I see the novelty claimed in the article (which reads like an advertisement and is adorned with colourful but utterly irrelevant brain images). Pretty much every place I've worked in the last fifteen years has said they were planning to do the same thing...

My perspective is that biological research has remained a pretty secretive field because people have always been scared of investing a lot of time and money only to get 'scooped'. I've long had one foot in physical sciences in engineering, and the philosophies (in the Science advert) described sound like what people were doing 20 years ago with 'open source' software. Perhaps this is why we are all walking around with supercomputers in our pockets (i.e. what the iPhone would have been considered in 1970), while medical science (with a few exceptions) has had a much harder time making many quantum leaps (of course we can always blame the complexity of the human body).

What I want to know is why the cravings for carbs when one is stressed.

I have been fairly good all week at keeping the carbs down but 2 deaths in the family (BIL & cousin) and the shootings on the weekend have my stuffing my face with all the carbs I can get my hands on.

I haven't seen anything on this at all. Or at least not so that I recognize it.

BlackSpinner wrote:What I want to know is why the cravings for carbs when one is stressed.

I have been fairly good all week at keeping the carbs down but 2 deaths in the family (BIL & cousin) and the shootings on the weekend have my stuffing my face with all the carbs I can get my hands on.

I haven't seen anything on this at all. Or at least not so that I recognize it.

Very sorry to hear about your losses, and don't need to say anything about the horrid shooting episode.

The stock neuroscience response is: when you weigh short-term guilty pleasures against long-term consequences, your are using a network of brain structures called the 'reward system'. There have been very detailed studies showing that one's ability to inhibit impulses with negative long-term consequences is greatly diminished by emotional and physiological stress (coupled with corresponding changes in the activity of reward structures). There may well be other more subtle neuroendocrine interactions between insulin and stress hormones that lead to specific carb cravings, but that's outside my expertise. I think the general principle above is why nagging or shaming someone to stop drinking, eating, drugging, etc. is so counterproductive.

Hope that things get better...