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  #1   ^
Old Mon, Jul-09-18, 09:05
teaser's Avatar
teaser teaser is online now
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Posts: 13,078
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default ketosis doesn't matter

https://www.youtube.com/watch?v=G4_HLyxQly8

Actually a keto-"friendly" video, I think the guy's a neurosurgeon, somewhere in that field anyways. Uses a modified ketogenic diet with patients. About 22 minutes in, there's discussion about it being a myth that a keto diet needs to put you into ketosis to be effective. I think that's a good point, but at the same time--yeesh. So why call it keto? If you don't think it's important, why give it the headline?

At any rate, ketosis not being important is just a contention--certainly non-ketogenic diets can be therapeutic, but anecdotally and clinically there are a lot of people out there who for instance only get seizure relief when their diet is a higher fat ratio ketogenic diet and their ketones are high. That still doesn't mean that the ketones are responsible for the therapeutic effect, I do better when I increase the fat ratio of my diet to a certain point, better mood, better energy, better workouts. But I haven't isolated ketosis as a cause, any of the things I do to increase ketosis might have some other effect.

I think there's a place for a looser approach--even if it were less effective, greater adherence might make for more benefits in a given population. I'm not up for making the toolbox smaller and turning people like me who need a slightly different approach away.
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  #2   ^
Old Mon, Jul-09-18, 09:09
teaser's Avatar
teaser teaser is online now
Senior Member
Posts: 13,078
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default

When the term "modified ketogenic diet" is used and the "modified" means lack of ketones, that's sort of hilarious, though.
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  #3   ^
Old Mon, Jul-09-18, 09:25
teaser's Avatar
teaser teaser is online now
Senior Member
Posts: 13,078
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default

Actually not an unreasonable discussion so far overall. But they keep goring my personal oxen. Next up is talking about how weight loss is due to lower insulin, not ketones. Maybe so--I maintained a 20 pound weight loss for something over 10 years, often dipping down another ten pounds and then bouncing back up to that initial 20 pound loss. Since going more ketogenic, I'm down another ten pounds, that's lasted several years, long enough to say okay, this is a real thing. It could be the insulin or something else--but if by the time my insulin is low enough to sustain this further weight loss, I'm in a much higher state of ketosis--I might not need to be ketotic, but the diet that brings my insulin sufficiently low makes me more ketotic, so I'd need to be in ketosis but not for the ketones, by that logic. Which I'm fine with as a theory, but unless I go hog-wild on some exogenous ketone experiment, I don't think you can rule out the ketones as a factor in somebody like me.
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  #4   ^
Old Mon, Jul-09-18, 09:50
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
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Posts: 9,187
 
Plan: atkins
Stats: 247/217/153 Female 5'8"
BF:
Progress: 32%
Location: Massachusetts
Default

This leaves me with a question---if insulin is kept low, how is low measured, as usually use lowcarbers use ketones and wieighloss as the guide. Not sure Im clear---if insulin is kept at its lowest, ketosis is not an option.Right? Maybe he means, carbs are low enough that over , say 24 hrs, the body drops into ketosis before the next feeding.

Trying to understand.
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  #5   ^
Old Mon, Jul-09-18, 10:50
teaser's Avatar
teaser teaser is online now
Senior Member
Posts: 13,078
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default

That does seem to be where he's at--a diet where people may or may not come in and out of ketosis, he's saying that for most people it doesn't matter that much. My own experience--at a higher body weight, a slightly more insulinogenic, less ketogenic diet gave me good results, including some of the mood benefits, kept appetite in check etc. It's at a lower body weight that I need to tighten things up.

I think maybe you could look at it as insulin level vs. fat stores. Lowering insulin is like taking a log off a dam, the water/fat finds a new, lower level--and at that point to get further benefit, insulin needs to be lower still. Take another log off. Not so much minimizing insulin for fat loss as lowering it relative to current fat mass. A bit simplistic but it seems to hold true for me, at least. Do I need to be in ketosis? Maybe even indirectly, because by the time ketones start rising, glucose availability is going to be low enough that they are needed--so that by definition, if your diet needs to be low enough in carbohydrate and protein to get insulin low enough to maintain a given bodyweight that significant ketosis develops, then you actually do need to be in ketosis. Which is to say, when things are working right, your body is in ketosis when it needs to be.

That's still not being in ketosis for the sake of being in ketosis. If a blood ketone meter told me my current plan didn't have me in ketosis, I wouldn't worry, since things seem to be going okay, I'd just wonder where my brain was finding enough alternate fuel to not need it. At any rate, if insulin is what matters, certainly the more ketogenic a diet is, the less insulinogenic, they sort of travel together.
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  #6   ^
Old Mon, Jul-09-18, 13:25
Ms Arielle's Avatar
Ms Arielle Ms Arielle is offline
Senior Member
Posts: 9,187
 
Plan: atkins
Stats: 247/217/153 Female 5'8"
BF:
Progress: 32%
Location: Massachusetts
Default

Overall, I am hopeful that this another person in the medical field that will stand up for keto, in whatever fashion.
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  #7   ^
Old Mon, Jul-09-18, 13:33
teaser's Avatar
teaser teaser is online now
Senior Member
Posts: 13,078
 
Plan: mostly milkfat
Stats: 190/152.4/154 Male 67inches
BF:
Progress: 104%
Location: Ontario
Default

That's what I get, he's fighting the good fight, I just thought it might start an interesting conversation.
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  #8   ^
Old Mon, Jul-09-18, 15:43
GRB5111's Avatar
GRB5111 GRB5111 is offline
Posts: 2,448
 
Plan: Ketogenic (LCHFKD)
Stats: 227/186/185 Male 6' 0"
BF:
Progress: 98%
Location: Herndon, VA
Default

Quote:
Originally Posted by teaser

At any rate, ketosis not being important is just a contention--certainly non-ketogenic diets can be therapeutic, but anecdotally and clinically there are a lot of people out there who for instance only get seizure relief when their diet is a higher fat ratio ketogenic diet and their ketones are high. That still doesn't mean that the ketones are responsible for the therapeutic effect, I do better when I increase the fat ratio of my diet to a certain point, better mood, better energy, better workouts. But I haven't isolated ketosis as a cause, any of the things I do to increase ketosis might have some other effect.

I think there's a place for a looser approach--even if it were less effective, greater adherence might make for more benefits in a given population. I'm not up for making the toolbox smaller and turning people like me who need a slightly different approach away.

Very important distinction in your statement that I put in bold. Ketones are present, but the overall impact is complex and has many actors involved. Ketones are just one and their overall role/ impact/ influence is still in the process of being understood. I look at the presence of ketones as a marker that happens to be associated with my increased energy, feelings of well being, and alertness.
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