Author Topic: Ketogenic diet - fad or phenom?  (Read 107871 times)

Ketogenic diet - fad or phenom?
« on: January 23, 2013, 10:30:29 am »
I was always a total believer in the Calories In/Calories Out concept of weight management. That was, until I listened to the audio book "Why we get fat, and what can we do about it?" by Gary Taubes.

Further reading (Messers Volek & Phinney) led me (actually boab, but I was along for the ride) to try an N=1 experiment with a Low Carb, High Fat diet; to impose a state of "Nutritional Ketosis".

I've had to suspend my previous beliefs of Calories In/Calories Out. It looks a lot like it just ain't that simple after all. I've had to accept that the First Law of Thermodynamics actually has fuck all to do with why people get fat. I've had to accept that the "research" into causal links between fats (esp Saturated) and CVD are tenuous at best, and quite possibly completely wrong, having been based on crap science.

I won't bore you with the dietary details. Suffice to say, I was eating a typical western diet, which consisted of 200g to 400g of carbohydrate a day. Now, I eat less than 40g, and most days more like 25-30g - nearly all from berries, leafy salads and veggies (above-ground varieties only).
So far so good. My weight is coming down steadily; and if the tape measure, Tanita scales and calipers are anything to go by, it's mostly fat that's coming off. My appetite is much much more controllable. I have more energy throughout the day, and after an alarming dip early on, performance on the bike (and rowing machine) is coming back.

Early days as yet, but so far so good.

Re: Ketogenic diet - fad or phenom?
« Reply #1 on: January 23, 2013, 10:47:17 am »
'calories' is a poor way to measure the energy content of food anyway, since it takes no account of the processes and wastage in the digestive system. Nothing wrong with first law of thermodynamics, just people applying it in an overly simplistic way.

I've seen someone get very very ill on a ketosis-based diet. Going into ketosis is fine for a short period but not long-term.
<i>Marmite slave</i>

Re: Ketogenic diet - fad or phenom?
« Reply #2 on: January 23, 2013, 10:55:15 am »
I've seen someone get very very ill on a ketosis-based diet. Going into ketosis is fine for a short period but not long-term.

It's a bad idea if you are diabetic or have a history of kidney problems. Also, it's easy to over-do the protein, which can stress the kidneys. My diet is based on 1.5g/Kg LBM of protein, so about 100g a day. A properly formulated low-carb, high-fat diet is pretty benign, and nutritious. It's meat/dairy/fish + salads and veg.

Andrew

Re: Ketogenic diet - fad or phenom?
« Reply #3 on: January 23, 2013, 11:09:32 am »
'calories' is a poor way to measure the energy content of food anyway, since it takes no account of the processes and wastage in the digestive system. Nothing wrong with first law of thermodynamics, just people applying it in an overly simplistic way.

Absolutely!

My own reading on the subject lead me to doubt the overly simplistic 'calories in/calories out' model so prevalent in modern dietary advice. And I've been shouted down by the almost evangelistic zeal of nutritionists who have learned their subject well.

I can understand why the 'calories in/calorie out' model is offered. Like '5 a day', it's simple and easy to remember advice. And, in a very broad sense, it's correct - obviously. If you don't eat you will loose weight. That bit's "not rocket science", as they say.

However, I do believe it overly simplistic and misleading. Imo, it's takes little account of the body's various bio-feedbacks that are constantly ebbing and flowing, micro-tuning our needs. Our body's digestive processes are not like a simple furnace and certainly not a closed system.

I'd go further; I think the notion of calorie, when applied to nutrition, is pretty much an irrelevance. That is to say, I don't think we should be concerned with the calorific value of food. Consider - everything has a calorific value (a gallon of petrol, a length of wood) but that doesn't mean it all has the same calorific value to us, there's clearly something else at play.

Sorry, a bit of sidetrack from ketogenic diets! Just something that interests me.

Re: Ketogenic diet - fad or phenom?
« Reply #4 on: January 23, 2013, 11:21:27 am »
I am wondering if this isn't a slightly "re-packed" version of the Atkins diet?

I used the Atkins diet succesfully some years ago. The only downside was the ketosis breath, and the ability to blow up if making any sort of real effort on the bike.

However, when I re-tried it after a couple of years it really didn't work for me. It was as if my body had "learnt/adapted" from the first time, and this time round it made me feel unwell. Interestingly. several other people I have talked to about this have had the same experience.

The problem with all these things is, of course, to maintain a lower weight. The Agriculturalists amongst us will recognise the term "compensatory growth", which in essence means that when weight has been lost against the genetic blueprint by a restricted diet, the organism becomes "super-efficient" once a fuller diet is given, until the genetic blueprint is reached.

Re: Ketogenic diet - fad or phenom?
« Reply #5 on: January 23, 2013, 11:41:26 am »
I am wondering if this isn't a slightly "re-packed" version of the Atkins diet?

The "New Atkin's diet" - the republished book, is a branded ketogenic diet. Unlike the 70s original, it promotes moderation of protein intake, replacing lost calories with more fat, thereby tending more toward a LCHF (Low Carb, High Fat) diet.

As for why it's harder next time around: Clicky

clarion

  • Tyke
Re: Ketogenic diet - fad or phenom?
« Reply #6 on: January 23, 2013, 01:31:49 pm »
Calories in/out is a simplification, but not a very inaccurate one.

It works for the vast majority of people that if they reduce the calories they are eating and/or do some sort of regular exercise, they lose weight.

There are a very few people for whom this doesn't work, for whatever reason, and it seems sensible to try alternative methods.

However, the risks associated with Atkins are pretty well known.
Getting there...

Re: Ketogenic diet - fad or phenom?
« Reply #7 on: January 23, 2013, 01:52:11 pm »
However, the risks associated with Atkins are pretty well known.

Do you have any links to actual research done on this? I'm genuinely interested. What "risks"?

I've read some anecdotes about people who died of ketoacidosis because they didn't know they were diabetic when embarking on Atkins. As I mentioned - there are issues for diabetics. They also have issues eating a lot of sugar  ;).

clarion

  • Tyke
Re: Ketogenic diet - fad or phenom?
« Reply #8 on: January 23, 2013, 02:00:37 pm »
The issues for diabetics, and the increased risk of bowel cancer are the ones which spring to mind.

Then there's the bad breath and body odour ;D

Don't have any links available for you, as it's not a very current issue in healthcare, the Atkins fad having passed after his death.  However, there is a decent summary in Wikipedia, albeit heavily edited by those in favour of the diet.

The NHS only works in conjunction with Weight Watchers that I am aware of, since that's the only programme with a decent evidence base.

I suspect that the diet you are
Getting there...

Re: Ketogenic diet - fad or phenom?
« Reply #9 on: January 23, 2013, 02:44:45 pm »
I suspect that the diet you are

(waits)...  :)

Not wishing to put words in your hands, but as you may be about to refer to, I'm not following an Atkins diet. Yes, it's low carb, as is Atkins, but so are a lot of other ways of eating. The plan I'm following places some of the emphasis on moderating protein so as to inhibit gluconeogenesis, and most energy comes from dietary fat.






clarion

  • Tyke
Re: Ketogenic diet - fad or phenom?
« Reply #10 on: January 23, 2013, 02:50:00 pm »
Whoops, yes.  I was distracted by work.  I know. ::-)

I was just saying that I expected that, with the amount of effort you've put in looking into this, that your diet isn't anything as rubbish as Atkins or Dukan, and is more balanced.

I still think that this sort of diet should only be tried (except in cases of moderating epilepsy) by those who have tried calorie counting and exercise, with no success (as I know is true in this case).
Getting there...

Jakob

Re: Ketogenic diet - fad or phenom?
« Reply #11 on: January 23, 2013, 08:56:17 pm »
I know a few people who have had amazing results on a Atkins style diet.
I've had moderate success on a low(er) carb diet, but I found it hard to adhere too.
It did however highlight how addicted most of us are to grains/sugar.

andygates

  • Peroxide Viking
Re: Ketogenic diet - fad or phenom?
« Reply #12 on: January 26, 2013, 07:14:53 pm »
Definitions needed: there's a world of difference between something that's good, safe and effective for a limited period at changing your body to your goal, and something that you do for life.

I know nobody who keto's for life, so timescales and parameters are important please!
It takes blood and guts to be this cool but I'm still just a cliché.
OpenStreetMap UK & IRL Streetmap & Topo: ravenfamily.org/andyg/maps updates weekly.

fboab

  • It's a fecking serious business, riding a bike
Re: Ketogenic diet - fad or phenom?
« Reply #13 on: January 26, 2013, 08:09:31 pm »
If this works for me I'll be on it for life.

The theory is that rather than being fuelled by a carbohydrate>glucose>insulin path you're fuelled by fat>ketones.

I'm not a mouse but : Clicky.

I came across this book Why we get fat (available here if you have no morals) and the author makes a claim that stands things on their head.

We don't get fat because we overeat, we overeat because we're fat.

I've spent an awful lot of time counting calories, and attempting to eat healthy low fat food. I ride thousands of kms every year. And I'm fat. I'm so obese I'd get free gym membership from my GP if I lived in Stowmarket. I have no other 'bad health' markers, I have ridiculously low blood pressure, a RHR under 50 and have the 'right' waist-hip ratio.
I religiously counted in and out and it didn't work- reducing my calorie consumption makes very little difference to my weight, it makes me feel grumpy and deprived and living on a net 1200kcal I lose less than 300g a week. How much are you supposed to exercise? 90 minutes a day wasn't enough. And yes, I did do (girly light) weights.

We know that hormones regulate most things. Turns out appetite is one of those. Endocrinologists know this- thyroid isn't the only metabolic regulator.

How about this: when you eat carbohydrates your body produces insulin which stores glucose as fat. And you keep feeding yourself carbs, and you keep producing fat. and it never gets used because you ride for hours, and you keep feeding yourself carbs, otherwise you bonk. So you use all the 'loose' glucose, all the glucose from your liver, and you never break into those stores, you stay fat.

When you reduce those carbs your body has to do something else. So you starve the glucose out, and you start to make ketones instead. Instead of having 2000 calories of glucose swilling around, you have 40,000 calories of fat. I probably have even more than that. And you can use it now, you don't bonk, you have a continuous slow burn of fats turned into ketones that run you.

There's a world of science to back up this theory, there's races of hunter-gatherers who never ate carbs and lived just fine on fat, and (god help us) there're dozens of Americans blogging about it. One thing we do know for sure is: when you stop, all the lost weight comes back. So if this works for me, I'll be on it for ever.

It's not easy. But I'm an all-or-nothing kind of gal and 'don't eat carbs' is easier for me than moderation in all things.
I don't miss cake. I don't miss bread, or rice, or pasta. I miss fruit, and vegetables. (I am eating veg before you all go shouting 'SCURVY!1' at me, but salad, spinach and brassicas are no substitute for carrots and swede and sweet potato, and do you know how many carbohydrates there are in tomatoes? hmm?).
It's early days. Ask me again in 6 months, and I might well say 'it was bollocks, didn't work'. But I might be 15kg lighter on a diet of cheese & spinach omelettes for tea and double cream for breakfast, and become a real evangelist.


I appear to have written an essay. Sorry. Have some footnotes:


1Apparently a diet low in carb, high in fat, and with moderate protein has a much lower requirement for vitamin C. Inuits ate nothing but pemmican (mashed meat & fat) for months and didn't get scurvy. You only need the vitamin C when you have all those carbs to deal with. Apparently.

References: Taubes, Attia, Volek & Phinney, Lustig.
TSS is not Total Sex Score, Chris!

Re: Ketogenic diet - fad or phenom?
« Reply #14 on: January 27, 2013, 08:09:29 am »
To make exercise work for weight loss you also need to be exercising at the right intensity. If you go out too hard you will be burning a high proportion of carbohydrate which has a finite supply, hence a bonk later on. If you go at a steady intensity you will be burning predominantly fat. BW cycles in Bristol offer a personal test that tells you the exact moment your body goes from fat burning into carb burning. It's about £100, but if I was struggling to make exercise work for me, I'd consider it.

Yesterday during a 100km Audax, I spent 26 miles of the middle section with my heart rate rarely dipping below 170bpm. My max is 185! Needless to say, I nearly bonked at the end, despite eating A LOT.

As to weird and wonderful diets, I'm yet to be converted. The only diet I have ever seen work in myself and peers has been the "Calories in versus calories out" diet, which is boring, rarely wrote about and takes a bloody long time.

Out of interest, what does this ketonogenic diet recommend for breakfast? I only ask as I have found this is a make or break for all diets. Poor or no breakfast will always make it difficult to lose weight.

fboab

  • It's a fecking serious business, riding a bike
Re: Ketogenic diet - fad or phenom?
« Reply #15 on: January 27, 2013, 08:35:30 pm »
To make exercise work for weight loss you also need to be exercising at the right intensity.
Er, yeah. So a combination of easy commutes, hard cross training, turbo/intervals and a fair old wodge of audaxing doesn't contain 'the right intensity'? I'd beg to differ.

Out of interest, what does this ketonogenic diet recommend for breakfast? I only ask as I have found this is a make or break for all diets. Poor or no breakfast will always make it difficult to lose weight.
Eggs, mostly. Or bacon and eggs. You can eat whatever you like- as long as you limit the amount of carbohydrates you have, and try to keep protein consumption moderate.
So instead of macro proportions at the current 'recommended' of 60% carbohydrate, this kind of thing you get most of your calories from fat. Yes. Fat. It's quite hard to change the habits that have been ingrained, and learn to love the lard.

Today we did our first ketogenic audax. Calorie consumption: 1400kcal. 204k, 10hr 50 (inc stops) 20+mph winds and gusts over 30mph. And most importantly: I'm not hungry.
I think I'm sold.
TSS is not Total Sex Score, Chris!

hellymedic

  • Just do it!
Re: Ketogenic diet - fad or phenom?
« Reply #16 on: January 27, 2013, 08:41:52 pm »

Today we did our first ketogenic audax. Calorie consumption: 1400kcal. 204k, 10hr 50 (inc stops) 20+mph winds and gusts over 30mph. And most importantly: I'm not hungry.
I think I'm sold.

Did you feel bonked out?
I really never rode at more than 8mph on the flat if I was low on carbs.

fboab

  • It's a fecking serious business, riding a bike
Re: Ketogenic diet - fad or phenom?
« Reply #17 on: January 27, 2013, 08:47:36 pm »
Did you feel bonked out?
I really never rode at more than 8mph on the flat if I was low on carbs.
Not at all helly, it was a revelation.
We stopped for lunch because we did a figure of 8 ending back at Chris's and needed to change our sodden (floodwater) socks. We stopped for coffee because I had hotfoot. 'Hunger' and 'bonking' just didn't feature.
TSS is not Total Sex Score, Chris!

clarion

  • Tyke
Re: Ketogenic diet - fad or phenom?
« Reply #18 on: January 27, 2013, 09:02:15 pm »
I'm really pleased that it's working for you. :thumbsup:
Getting there...

Re: Ketogenic diet - fad or phenom?
« Reply #19 on: January 27, 2013, 09:32:42 pm »
It was almost surreal. We sat in the cafe with coffee (me) and hot water (boab), and both agreed we should have been hungry. We were at 140k - usually a mardy time for me as my energy levels dip - and we just kept rolling - the energy was always there when needed.

I'm finding my "top end" is missing (Oooer Missus). So forget Zone 5 work - there is no zone 5, so hill climbing is (currently) slow and miserable.

We rode with heart rate monitors today, and I again found something that I noticed last week; a complete disconnect between my perceived rate of work, and the HRM. When it was reading >170bpm climbing, I should have been panting like a racehorse with COPD, but I just wasn't. Strange.

So - all in all, a good first long ride on low-carbs.

Re: Ketogenic diet - fad or phenom?
« Reply #20 on: January 27, 2013, 10:17:41 pm »
If you want to exercise and eat low carb. Then a good reference is "The Paleoithic Diet For Athletes" by professor Loren Cordain. I think nature tends to know best, and nature tells us that there are essential fats that humans need to get from diet (9  I think) mostly the omego fats. There are also essentolial proteins we need to get from diet (12 I think) mostly b12 which can be found in complete combination in animal products. There is No Such Thing as an essential carbohydrate!

Andrew

Re: Ketogenic diet - fad or phenom?
« Reply #21 on: January 28, 2013, 03:34:40 pm »
There is No Such Thing as an essential carbohydrate!

I believe there is some brain function that requires a tiny amount of carb.... but I'm stupid anyway so I can live without that. Probably do already.

I bought into low carb (not no carb mind) after I started reading Dr Briffa. 

Re: Ketogenic diet - fad or phenom?
« Reply #22 on: January 28, 2013, 04:15:15 pm »
I think what rideron is trying to say is that that the animal fats and proteins can be broken down into carbs.

That's slower-release than eating carbs directly.

The eggs and bacon breakfast isn't really a practical one to grab in the office, although I guess you could boil an egg and eat it with cheese. Doesn't sound all that appetising though.

There are essential fruit and veg. Getting the bulk of energy from fats and protein is fine, but you need, really need, vitamins.

Any suggestions for vegetarians in your paleo diet books?
<i>Marmite slave</i>

Re: Ketogenic diet - fad or phenom?
« Reply #23 on: January 28, 2013, 04:25:45 pm »
My reading to date has suggested to me that about 25% of the brain's energy needs must come in the form of glucose, the other 75% can come from ketones (once adapted).

The missing 25% is provided by the liver, which converts dietary protein into glucose through gluconeogenesis.

As for breakfast, I've found a great substitute for a bowl of cereal with milk, is a bowl of berries (strawberries, blueberries, raspberries, blackberries - whatever takes your fancy, they are all tolerably low carb in small doses) and lashings of double cream.
If you're a carnivore, you can try a "German" breakfast - ham & cheese.

I can't have eggs unless cooked into something else, so I've tried low carb pancakes (yummy) and Almond rolls (basically ground almonds and egg, with a lot of Olive oil and flax seeds) with butter and Marmite.

Life is a little easier if you're happy to have small quantities of artificial sweetener. Boab made some low-carb mini-cheesecakes at the weekend (4g carb each, and a LOT of fat) which are more moreish than crack cocaine  :thumbsup:.

Another winner this weekend - Cauliflower Mash. It's more like couscous in texture, but really filling - masses of fibre, and very low carb.

ETA: mrcharly - nearly all the vitamins and minerals we need can be found in meat, so as long as your're not veggie, you shouldn't need to supplement. Veggies may need to.
One thing to watch on a LCHF diet is the amount of sodium in the diet. You need much more - because ketosis triggers the kidneys to stop retaining sodium. A couple of mugs of bouillon a day is enough. It's also worth noting that this self experimentation should only really be done with the OK of your doctor if you are diabetic, have a history of kidney disorder, or are having ongoing treatment for hypertension.

Re: Ketogenic diet - fad or phenom?
« Reply #24 on: January 28, 2013, 04:44:09 pm »

ETA: mrcharly - nearly all the vitamins and minerals we need can be found in meat, so as long as your're not veggie, you shouldn't need to supplement. Veggies may need to.

I think the sailors who had scurvy might disagree with you.

Edit.

It seems if you eat fresh meat, particularly lots of liver, then you won't be prone to scurvy.

I remain sceptical as to the long-term health benefits of the ketogenic diet.
<i>Marmite slave</i>