Ketogenic diet - fad or phenom?

[LMT]

I'm about halfway through this, interesting read

"Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review"
http://bjsm.bmj.com/content/51/2/133.full

As soon as I saw Noakes name at the top I stopped reading.

No surprise there.

Not exactly objective, and the man is not a picture of good health imo, unlike Barnard, Greger et al.

[mattc]

You don't need to be in good health to do good science.

[JohnR]

Talking of dessert, I had Greek yogurt last week and noticed it had 9.7g fat and 5g of carbs in it, I also had a few blueberries to help the flavour.

I am just reducing my crap carbs and increasing my fat intake at present and am noticing that when I increase fat the protein also increases. I thought we were supposed to be keeping protein low also, or am I missing something?

[Chris S]

I am just reducing my crap carbs and increasing my fat intake at present and am noticing that when I increase fat the protein also increases. I thought we were supposed to be keeping protein low also, or am I missing something?

Yes, and that is one of the hardest things to get right. I try and keep my protein under 80g a day, or 80-100g if I'm particularly active, refeeding after a fast, or I'm doing resistance training.

The energy balance needs to be made up with fat, so that means:

Eating fatty meat, or offal (yuk!).
Never ever ever buy "low fat" stuff - always go full fat.
Smother your veggies in butter.
Eat fatty fish.
Smother your salad in Olive Oil dressing.

Fat is energy dense - so you don't need vast amounts make up the calories - and you'll feel satiated, and the food tastes richer, and yummier.

[Auntie Helen]

I initially found my protein was a bit high too so I have reduced my meat intake a bit and I go for more veg and more butter/oil. I am managing roughly 70% fat, 20% protein and 10% carbs as a target.

[LMT]

You don't need to be in good health to do good science.

You do when you are advocating eating a particular type of diet. Turns out now that 'bad' LDL is not 'bad' at all. There is bad bad and good bad. Honestly what a load of shite. Fact is feed any herbivore dietary cholesterol and they will develop heart disease. This whole bad bad, good bad LDL is smoke and mirrors.

[mattc]

You don't need to be in good health to do good science.

You do when you are advocating eating a particular type of diet.

Nonsense!

What if your scientist has specific conditions that stop him/her eating that diet, or made him ill before he started his research? Are you going to ignore him, and listen to some genetically lucky elite athlete who can't spell, let alone understand biochemistry?

[LMT]

You don't need to be in good health to do good science.

You do when you are advocating eating a particular type of diet.

Nonsense!

What if your scientist has specific conditions that stop him/her eating that diet, or made him ill before he started his research? Are you going to ignore him, and listen to some genetically lucky elite athlete who can't spell, let alone understand biochemistry?

What are you going on about? <shakes head>

[closetleftie]

The issue about Noakes being in "good health" (or not) is beside the point, of course, as the question isn't whether a given diet is good for him, rather whether it is a good diet per se. However, he has completed a number of ultramarathons including the Comrades , which is around 60 miles with around 2500m of ascent. It would be difficult to judge his health or otherwise from pictures alone.

[DrMekon]

Fat is energy dense - so you don't need vast amounts make up the calories - and you'll feel satiated, and the food tastes richer, and yummier.

I went through some of John Blundell's work (he came up with the satiety cascade, and his office was diagonal from mine - James Stubbs, ex of slimming world has it now) to see what it said about fat and satiety, because I don't find fat especially satiety inducing, esp compared to protein and fibre, and targeting bulky low density foods and enouraging sensory specific satiety with restricted choice.

"The human appetite system contains central and peripheral mechanisms that interact with environmental features, especially with the physical and nutrient composition of the food supply. Foods varying in nutrient composition exert different physiologic effects, some of which function as satiety signals. High-fat diets (low food quotient) lead to high levels of energy intake. This effect is termed passive overconsumption and overcomes fat-induced physiological satiety signals. High-fat foods exert a weak effect on satiation (intra-meal satiety), and fat has a weaker effect, joule for joule, on postingestive satiety than do other macronutrients. The frequency of obesity is greater among high-fat than low-fat consumers. However, the development of obesity on a high-fat diet is not a biological inevitability. The investigation of people who resist the weight-inducing properties of high-fat diets is a key research strategy. Understanding the appetite control system suggests behavioral, nutritional, and pharmacologic strategies for modifying dietary fat intake."

from http://www.annualreviews.org/doi/abs/10.1146/annurev.nu.16.070196.001441?journalCode=nutr (shout if you want the pdf)

I know a couple of people from his research group looking at keto diets. For those who are interested in making their food more satiating, van Kleef's review was a good intro for me.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662086/

[The French Tandem]

Not strictly following a keto diet, but we tried to reduce refined sugar as much as possible. There is one very annoying downside for me: everything now seems to have a sugary taste, from beer, to tomato juice. I never realized before that all beers have a sweet taste! Am I the only one to be annoyed by this effect?

[Chris S]

Not strictly following a keto diet, but we tried to reduce refined sugar as much as possible. There is one very annoying downside for me: everything now seems to have a sugary taste, from beer, to tomato juice. I never realized before that all beers have a sweet taste! Am I the only one to be annoyed by this effect?

Actually, quite the contrary - it means that I can eat fruit like berries, lemons and other citrus, with little or no sweetener. Veggies that previously tasted bland, now have a sweetness to them - carrots for instance. As for sweet potato, it's almost too sweet.

I had half a tin of soup recently (Heinz chicken noodle) and couldn't finish it because it was SO sweet - like eating dessert. It had added sugar, but really not that much.

[The French Tandem]

I had half a tin of soup recently (Heinz chicken noodle) and couldn't finish it because it was SO sweet

That's exactly my opinion too! Thanks Chris, I was worried that I could suffer from a weird disorder!

Alain

[Chinaski]

http://sigmanutrition.com/episode164/

Interesting research

[NeilH]

Can one derive useful benefits from being "a little bit LCHF"? Or is that like being a "a little bit pregnant?".

I'm wondering to what extent moderately reducing carb intake (say, for example, using LCHF recipes for some but not all meals) might help with weight loss and endurance cycling?

Or does one need to stay off the starchy carbs all the time, and stick with the ketogenic state 24/7 to reap the claimed benefits?

[mattc]

"a little bit LCHF"

I don't have any evidence, but given that our metabolisms work across a spectrum of different nutrients ( and % fat/carb contents, etc), it seems very likely that some adaptation will occur with any change.

My personal belief is that you can get useful tangible benefits, but as I said, no hard evidence here (apart from some feeble anecdata) ...

EDIT: some soft evidence? Pretty sure that lots of marathon runners have been using "train low, race high" approaches with success. More of a performance approach than weight-loss probably!

[L CC]

The danger is that rather than being a little bit LCHF you end up HCHF and everyone agrees that's a Bad Thing.

That said, at home, it's easy easy easy to do without all those omnipresent carbohydrates, you simply don't invite them in. Out there in the big wide world it's more difficult. When I start riding again I can't imagine I'll be able to stay righteous in the face of a choice between Costa and KFC.

The big benefit (for me) is appetite management and I don't think you'd get that without diving fully in.

[sojournermike]

The danger is that rather than being a little bit LCHF you end up HCHF and everyone agrees that's a Bad Thing.

At this point you are likely to prove the calorie hypothesis of weight gain;)

[Auntie Helen]

I'm mulling this over a bit too.

I'm 7 weeks into LCHF and have found the last two weeks harder, plus my weight has crept slightly upward over that time (statistical noise I think as I am doing everything the same). I have started to think fondly of a few items with carbs such as apples which I would like to eat.

I said I would do this until the end of March and am wondering if afterwards I could be LCHF at home but allow myself occasional cake when riding and also if going out for a meal, a bit more of a choice of food. Plus my GerMan makes a mean pasta dish and I would like to occasionally be able to try it.

I don't think I could stick with this current regime for life, I find it too restrictive food-wise. It has helped keep hunger at bay, but there is less satisfaction in food choices and I think I would prefer to be a bit lardier and be able to eat ice cream and chocolate. But I will see how I feel after the end of next month.

[Chinaski]

I'm mulling this over a bit too.

I'm 7 weeks into LCHF and have found the last two weeks harder, plus my weight has crept slightly upward over that time (statistical noise I think as I am doing everything the same). I have started to think fondly of a few items with carbs such as apples which I would like to eat

Irrespective of diet/lifestyle choice to drop weight, you are now where most people who struggle with weight normally get to.

If you have dropped fat, the body's circuitry which monitors body fat has taken notice.

It is primarily regulated by the hypothalamus and leptin while ghrelin, insulin etc also play a role. If you continue to drop fat I'd expect lower energy levels, while being very motivated by food especially something which ticks all food reward boxes salt/sugar/fat/texture lie ice cream/chocolate. You might be best to try and maintain for a while and see if your body can get used to a "new lower set point" of body fat before restricting excess again.

 

[sojournermike]

I think I agree with Chinaski here. Losing weight in a series of smaller steps and allowing some stability at each pause may ultimately be easier and more permanent. There does seem to be evidence emerging no that suggests your body will always try to go back up I'm afraid.

I am increasingly focused on diet for health, of which weight only forms one part - albeit quite a significant one of course

Mike

[Auntie Helen]

Thank you for the comments.

Interestingly I am almost at my 'natural' weight of 93kg. This is my usual summer weight which I find myself at when riding a lot in the summer and being more outdoorsy. Of course it is a very high weight for a 176cm woman but I have always been overweight. If I forget about food and just enjoy the summer I tend to end up at this weight, so I do wonder if this is somehow my default weight (I've hovered around here for the last 20 years). I would like to get my weight lower as that would make life easier but I am basically pleased to have dropped the extra 8kg that I had put on over winter. I will see where things go - I'm on holiday next week in Tenerife so I am guessing the nice food will be rather a draw, although salads will be more appealing when it's 23 degrees outside...

[Chinaski]

Thank you for the comments.

Interestingly I am almost at my 'natural' weight of 93kg. This is my usual summer weight which I find myself at when riding a lot in the summer and being more outdoorsy. Of course it is a very high weight for a 176cm woman but I have always been overweight. If I forget about food and just enjoy the summer I tend to end up at this weight, so I do wonder if this is somehow my default weight (I've hovered around here for the last 20 years). I would like to get my weight lower as that would make life easier but I am basically pleased to have dropped the extra 8kg that I had put on over winter. I will see where things go - I'm on holiday next week in Tenerife so I am guessing the nice food will be rather a draw, although salads will be more appealing when it's 23 degrees outside...

This is an OK summary
https://authoritynutrition.com/leptin-101/

It's pretty simplified and also doesn't refer to hedonic eating; the eating that allows us to find room for desert (s) no matter how big the meal.

There is other research out there ( between St Vincents hospital in Dublin and Harvard  I think) which is looking at damage to immune system from prolonged obesity.

I'm not sure how reversible any of these dysfunctions are; there is probably a ceiling there for most in the long term.

[campagman]

This is interesting.

[sojournermike]

This is interesting.

Yes, and he is the ex president of the world heart federation. The organsations website hasn't updated its guidance yet though.