Interestingly, right after my last post, I went to a grocery store I don't often frequent (I'm out of town) and there was the largest array of protein bars I've ever seen (I never find myself in that aisle at home). They had 8 or 10 different Quest bars. I bought one to try out of morbid curiousity. I will not have a whole one, but may have a quarter to see what happens.

I will lok forward to any comments you might have on that website, Benay.

While I agree that BG readings in the 300s are high, I am always bothered by the judgement of those who eat different amounts of carbs than we do personally. 100 grams per day is still considered low carb compared with the SAD diet, the diet recommended by the majority of health professionals, diabetes "educators" etc. I applaud that poor woman for stumbling on that site and commenting. To me it shows she's trying to do something to understand her situation, a necessary precursor to change.

Well Liz, I went to the website and read the blog on gluconeogenesis mentioned by Jey. At your request, here is my 'take' on that blog post.

http://www.ketotic.org/2012/08/if-y...es-it-turn.html

– Comment: is 11 days long enough for the body to convert to a stable gluconeogenesis? I don’t know. We do not know the parameters of the keto diet or anything about the sample. Clinical trials/experiments are only generalizable to similar groups and not to everyone on a keto or low carb diet. (Researchers define a low-carb diet differently by amount of carb grams. Do keto researchers have as wide a variation in their definitions of keto diets?)

2nd study Comment: Too little information to judge the validity of the study.

3rd study Comment: Since normal people eat protein rather than take it IV,, are these studies relevant to the discussion? Even people who are tube fed would have to digest their protein and the digestive process may influence the results.
.
The authors conclude:

Liz, I did not find these studies convincing, although the authors of this blog appear convinced. We don’t have the studies themselves from which to judge but what we have I am not convinced.

Gluconeogenesis appears to be relevant only in the face of extremely low or no carbs but even that needs to be defined clearly and given a range that all people will fall into (for example obese versus lean, 20 yr old versus 70 year old, male versus female, metabolic disease or not).

The variability of the current studies in terms of design will affect outcomes. Until we can tease out differences in sample selection, variables and their controls, and length of the study, we just don’t have much solid ground to work from to draw conclusions.

I have accepted the 30% protein guideline without questioning it until Westman et al suggested “hold down the protein, don’t go overboard.” I would need to re-read Volek and Phinney for their definition even if they were just interested in lean hi-performance athletes.

PS What did you think of the Quest bar Liz? Which one did you choose? What did it say on the nutrition label about carbs (total, sugar alcohol, fiber, sugar), protein and fat? Just curious.

Thanks, Benay. I hope I didn't cause you to read it if you weren't already so inclined. However I know you have the background to wade thru the mumbo jumbo. I may have come to the same conclusion but wondered if i missed something relevant.

The whole "adequate, not excessive protein" thing is so poorly defined. One thing I've always thought though is that the amount of protein required to maintain muscle probably depends on amount of lean mass, not percentage of calories. I used to follow Westman Phinney and Volek's recommendations in NANY of 70-145 g proten based on my height and gender, typically eating 90-100 g per day, roughly 25% of my cals. Now I aim for 65-80 grams, ~20% of my cals, feel fine and notice no decline in energy or strength or stamina.

I bought some sort of vanilla quest bar. It seemed to be the lowest carbs of what I found. I'm currently travelling, visiting friends and families and am finding myself with more opportunities than I need to eat. So it sits untouched in my suitcase. However if and when I eat it, I'll report back here.

Liz, one of the things I valued in the original Protein Power (1996) that was left out of the Protein Power Life Plan, was the calculation of "adequate protein intake" based upon height, weight, hip and waist (for women) plus wrist (for men) measurements that were then placed into a formula called "conversion constants" (page 71 chart). Once these factors were given, then you calculated your percentage of body fat, then calculated lean body weight. There was also a calculation for ideal body weight. Then you were given a table for ideal body fat percentages for gender and age.

From this information, you could find your daily protein intake in grams.

For women over 61, they suggested a range of 22-31% body fat based upon all these calculations.

The following chapter is on calculating individual protein requirements. They then give 5 levels from sedentary to athlete which ranges from 0.5 gm/pound to 0.9 gm/pound. Then you calculate your own daily total protein need by multiplying your pounds of lean body mass by your activity number. To get your amount of protein/meal, simply divide your total by the number of your daily meals.

Although I valued all these calculations, most readers seemed to have problems with it. I hope they don't throw them out for the revision. Making me do the math brought it all home -- far more than just looking up values on a table.

On page 154 they have "Protein Equivalency Charts" in which they provide a breakdown of whole protein foods to meet that amount. For example, if the total daily protein intake per day falls within the 81-100 grams -- that would translate to about 34 grams/meal or about 5 ounces/ each of 3 meals. What that looks like in food would be 5 ounces of meat, fish or poultry, or 4 oz of meat plus 1 oz of hard cheese etc.

I found these recommendations for protein consumption in line with the recent Volek & Phinney as well as for Westman et all NAFNY. So, there must be a common source or Q-document for these values somewhere.

Sorry if this is overwhelming you, Liz. I do value the original PP for these calculations alone (among other things as well).

Thanks, Benay. Not at all overwhelming, in fact the most detailed and definitive method for calculating protein that I've seen. I wonder if that's where W, P and V got their wide range for protein.... I've often wondered, under what conditions should I eat 70 grams? Under what conditions would I require 145 (twice as much?). At first I took the middle ground, but that's a compromise on all levels - I want something more definitive. I entered the LC world thru South Beach, where they suggest you just eat to appetite and not count anything. never bought the PP books. I'll try to find the original used at Amazon.

I finally had an opportunity to eat my Quest Bar yesterday - late breakfast, no lunch, late-ish dinner. I din't check glucose beforehand, but it was 156 about an hour after eating it, so I'm sure i went up the same 50 (or 60?) pts that those on the video did. And then i felt a little weird, mildly hypo, something I never feel while eating LC. An hour later it was 121. Still high, but a huge drop. Too much of a roller coaster for me. It didn't taste good enough that I'll ever be tempted again. In fact, I found it downright weird, though the artificial sweetner aftertaste was less pronounced than Atkins bars.

I'd be really interested in the new PP book. I know they were soliciting ideas for topics they'd like to see, but I don't pay much attention to the blogosphere and and I don't know what was suggested. I sure hope the "excess protein/excess BG" issue will be addressed.

It has to be difficult to assess one's true dietary protein needs. I imagine there are many factors that can't really be quantified. How about the immune system? You may not feel sick, but your body could be fighting an infection and your protein requirements go up. Or would they?

How would it change based on your protein preferences? We all seem to have different "go-tos". Someone who eats a ton of fish might have different protein needs from a similar person who eats a ton of chicken or a ton of beef. We could break it down to different amino acid needs and REALLY get obsessive about it.

Liz, I dug out my original PP (1996), went to the calculation page for body fat and LBM based upon weight, height, waist, hip and age and did all the calculations for 2 different heights (I lost 2 inches of height when I had both knees replaced), gave myself an activity factor of 0.6 (next to the lowest), then calculated my daily protein requirement.

Here are my results:
Daily protein requirement based upon calculated Lean Body Weight x 0.6 activity factor = 65 grams daily or about 9.3 ounces total for the day and about 3 ounces per meal.

I, of course, eat more protein than that which might account for my slow weight loss.

The calculations were an eye opener for me and I tried every way I knew how to increase my protein allowance through the calculations. Since I could not do that I just entered what I ate in the Diet Power program and watched my daily weights. Talk about agonizingly slow!

I may be eating 20 gm or less of carbs but I am not eating 3 oz protein/meal. I am lucky when I can get in between 4-5 ounces.

Thanks for making me do this again--always need a heads-up. And taking the time to do the calculations makes it far more real for me. I do hope they keep these calculations in the 2nd edition.

I agree, because I have seen it in myself. I have reached goal more than once, settled into the "I'm 'normal' now, I don't have to be so strict" frame of mind, and let a little bit of this or that sneak by. Only to wake up a year later and 20 or 30 pounds heavier, realizing what an idiot I had been. It's really, REALLY easy to do, particularly when your weight/health isn't the catastrophe it was when you started. Then you have a daily reminder of WHY you have to be so strict.

Good points KDH!

addendum to my previous post: Westman et al in NAFNY on pages 42-43 give their recommended daily protein allowances for men and women based solely on height.

For my two heights the daily protein intake is more liberal than my calculations from PP: 73-152 grams/ day with an average of 16 ounces per day (as compared to 9) and at 2 inches taller: 76-159 grams per day with an average of 17 ounces per day.

So Liz, your protein reduction seems more in line with PP than NAFNY.

I ordered a used copy of PP, to be delivered Tues, and look forward to going thru the calcs. I think my reduced protein is going to be right in line as well. Thanks so much for suggesting it, will report back when I run the numbers.

Can't wait!

Perhaps the question should be "Does a VLC diet eventually make you insulin resistant?"

And if it does, is that a good thing? Even if it does occur within the context of a low glucose diet?

http://eatingacademy.com/personal/e...ogenous-ketones



I saw this in Attia's post on ketone supplementation. Maybe this can mitigate the physiological insulin resistance Peter at Hyperlipid writes about, that's mediated by palmitic acid.

Back when they were doing prolonged starvation studies in obese medical students, there was one study (working from memory here, but this should be close enough) where subjects were fasted for 40 days, and then administered insulin. Very low levels of blood glucose were achieved--I think somewhere in the teens--to the point where a non-fasted person would probably become unconscious, but these people were symptom-free. Blood glucose went way down, but there was a more modest dip in ketones, if memory serves, about 1 millimolar, I forget what the level of ketones was exactly--but after ten days, starvation should give a ketone level around six or seven millimolar--so while blood glucose went way down, there was really only a slight dip in ketones.

These guys would have had a glucose intolerance--caused by a decrease in insulin secretion in response to a glucose load, rather than insulin resistance as such. I think we have to look at very low carb in more than one way, not as a block. I know some people on the forum seem to have difficulty getting into ketosis. High free fatty acids will cause a sort of insulin resistance. Should it be mitigated by some of the actions of the ketones? What if the ketones don't show up?

http://high-fat-nutrition.blogspot....ance-guess.html

Hyperlipid post on physiological insulin resistance and ketones...



The post is about physiological insulin resistance at the point of glucose oxidation--but perhaps increased insulin sensitivity when glycogen repletion is necessary. This makes wonderful sense--and explains why I can do "glycogen depleting" exercise, day after day, without hitting the wall. It needs to be possible to feed the brain ketones, use glycogen for maximal effort, and restore muscle glycogen pretty much at the same time.

I'd also wonder, whether the effect of MCTs on insulin secretion in a glycogen-replete person would be the same as in a keto-adapted, glycogen depleted person.

Personally--glycogen depletion on a ketogenic diet doesn't give me hypoglycemic symptoms, if anything it makes me feel better. But there's so many different things going on, it would be astonishing if everybody had identical results.

Ah yes...I have indeed heard this about palmitic acid. So rather than saying sat-fats de-facto contribute to insulin resistance, we may need a more nuanced view of all the different sat-fatty acids.

Heck, even plant-based diet advocates like David Katz believe stearic acid (chocolate fat) is benign, for instance.

Aware me on palmitic acid...that is most prevalent in dairy fats, right?

If so, that makes sense from a "paleo" point of view, since dairy is not paleo.

I would wonder if those having high morning BG's consume a fair amount of dairy perhaps? I know I do. But am really lowering my intake of it, as I move to more of a "Neanderthin" approach to eating.

But for those unwilling to give up butter...I would speculate that grass-fed butter is LOWER in palmitic acid than corn-fed cow butter.

When mammals synthesize fatty acids, they tend towards palmitic acid, so grain and grass-fed being both fairly low-fat diets, I'd guess there'd still be lots of palmitic acid in the grass-fed dairy. I don't really think palmitic acid is such a bad thing, but maybe for people with blood-sugar issues, upping fat from olive oil or coconut is worth a shot.

I wonder how stored body fat figures into this? We burn some mix of body fat and diet fat, depending on what we've been eating over the years, the free fatty acid mix would be affected. This is a plausible thing that could change over time, and cause us to react differently. We vilify polyunsaturated fat--omega 6's, at least--but there are studies showing lower glucose, higher ketones, on a ketogenic diet with omega 6 vs saturated fats, or a higher fasted ketosis on a diet that contained high omega 6. This is all mostly in rodents, I read it on Peter's blog, so I don't have the references handy. The rodents with greater fasted ketosis due to corn oil or what ever the omega 6 source was, lost more fat than rodents eating a diet with less corn oil, but at the same calorie level. Peter's guess was that they would have been hungrier due to the failure of physiological insulin resistance, and greater tendency to hypoglycemia. Maybe a fair guess, but since the ketones were there to potentially protect from the dip in glucose, I'm not so sure.

Anyways, not advocating guzzling corn oil here--but sometimes I wonder if that first "golden shot" we see written about on the forum with a first venture into Atkins induction is partly due to the body taking the opportunity to run through excessive omega 6 stored during years on the SAD diet, high in various vegetable oils.