Is the horse I’m beating dead, yet?
Well, get it while it’s hot, I guess. Dogpile!
So yesterday’s installment was about how difficult it is to source a lot of fat from animals in the wild, most places. Duck added a supplemental comment as well.
And, what with Chris Kresser (Is a Low-Carb Diet Ruining Your Health?) and Tom Naughton (Reactions To Arguments About Ketosis) displaying increasing skepticism over the healthfulness of very low carbohydrate and/or ketogenic diets in perpetuity, let’s just keep putting fuel on the fire, shall we?
I’ve been lightly participating in both comment threads linked above; rather politely, too. There was a comment by “Damocles” this morning I found interesting and to me, offered a clue as to why so many defend ketosis in spite of what it does to glucose tolerance (See Inuit and Stefansson).
From an evolutionary perspective, it makes perfect sense for the body to increase insulin resistance during ketosis.
Its a signal for the body that carbs are very scarce at the moment. So by increasing insulin resistance, cells wich can well burn lipits and ketons refuse to snatch the glucose from the blood, – leaving more for the most important organ: the brain.
As the brain needs (even in ketosis) a certain amount of glucose to funtion.
The insulin resistance in ketosis is a smart allocation of glucose (to the brain), when carbs are coming available, and to not have to rely on gluconeogenesis from proteins.
When carbs come available again regularily, the insulin resistance can be reduced, so all the other cells can uptake this fuel.
Physiologically, he’s correct. But here’s the problem.
“From an evolutionary perspective, it makes perfect sense for the body to increase insulin resistance during ketosis.”
Yes, this is all very well known and understood, including the fact that some textbooks (I used to have a handy reference) indicate that after a time of adaptation, the brain’s absolute glucose requirement goes down (like from 120-130g per day to ~60).
Here’s your blind spot, though, in my view. This is not an adaptation to ketosis. It’s an adaptation to STARVATION. ketosis itself is a physiological adaptation to starvation. So-called nutritional ketosis is really a hack designed to get a person into ketosis by means other than fasting or chronic starvation, and in a very odd way: restriction of not just carbohydrate to near nil, but restriction of protein as well. Stop and think about it. How does that even pass anyone’s smell test as a desirable daily state?
I concede that long-term ketosis likely has some therapeutic value, as do a number of pharmaceuticals and other therapies when properly prescribed by a clinician with LOTS OF EXPERIENCE. I also concede, in fact strongly support, the notion that episodic ketosis is likely very beneficial. Autophagy. It’s called fasting and just about every religious tradition includes it in some way for good reasons having nothing to do with pleasing doG.
But, chronic starvation is a bad idea, a priori. I suspect chronic ketosis to model a starvation state through restriction of both carbohydrate and protein at the same time, requiring upwards of 80% fat—that’s pretty vapid in terms of micronutrients—to be an equally bad idea for the vast majority of people the vast majority of the time.
This really falls under the “extraordinary claims” clause. As ought anything so unnatural on its face.
By total happenstance, I got an email from Duck a while later. A link to a review paper from 2003: Low-carbohydrate diets: what are the potential short- and long-term health implications? (Shane A Bilsborough MSc (Nutrition) and Timothy C Crowe PhD; School of Health Sciences, Deakin University, Burwood, Australia).
I found the section Potential short-term health implications - Ketosis on page 398 quite interesting and posted this follow-up comment (still in Tom’s moderation queue at the time of this drafting).
Duck emailed a paper earlier and guess what I happened upon (emphasis mine)?
http://apjcn.nhri.org.tw/server/APJCN/12/4/396.pdf (pg 398)
Studies examining the long-term safety of ketogenic diets are few in number with most of the available data coming from the application of ketogenic diets in the treatment of paediatric epilepsy.18 The diet used in this patient group is a high-fat, adequate protein, low- carbohydrate diet designed to mimic the biochemical changes that occur during starvation. Studies of children who have followed a ketogenic diet for management of epilepsy found that about 50% of children will continue on the diet for at least a year.18 Reasons for discontinuing the ketogenic diet were due to either a lack of efficacy or due to the restrictive nature of food choices. Common adverse events attributed to the diet included dehydration, gastrointestinal symptoms, hypoglycaemia, as well as carnitine and vitamin deficiencies. Cognitive effects, hyperlipidaemia, impaired neutrophil function, urolithiasis, optic neuropathy, and osteoporosis have also been reported to occur in some patients following ketogenic diets.19 In addition, elevation of blood uric acid levels is a well-recognised side effect of prolonged ketosis.7
Extraordinary claims demand extraordinary evidence. Can everyone agree that remaining in perpetual ketosis by means of restricting BOTH carbohydrate AND protein in order to “mimic the biochemical changes that occur during starvation” is:
1. A-priori unnatural, since the biochemistry in a state of starvation is not a NORMAL physiological state.
2. An extraordinary claim, when asserted as some sort of optimal diet for long term health or weight maintenance.
…Thus, requiring very extraordinary evidence, up to a standard that ought to be absolute proof. Otherwise, everyone out there doing this “nutritional” ketosis nonsense in perpetuity is conducting a massive experiment with zero basis in natural reality.
Just the word itself is a complete scam. “Nutritional.” Let’s see, restrict both macronutrients with the most vitamins, minerals, phytonutrients, and replace it with the macronutrient with the very least by far of all those things. Call it “nutritional.”
…Alright, now I’m getting angry.
And so, it ought to be renamed so that it’ll at least possess the virtue of honesty: “Nutritional Starvation.” Taking applications now. 50% off until Labor Day.
Here’s one thing to wrap your mind around, in addition to the above. What else goes haywire in a biochemical, metabolic state of starvation besides the glucose tolerance (physiological insulin resistance) that I’ve hammered on over and over (See Inuit and Stefansson)?
We understand why we get insulin resistance on VLC and/or ketogenic. Preserve glucose for the brain. Why? because it’s an absolute requirement and to put it bluntly, our metabolism has evolved to fuck you up in the short-term in order to preserve your long-term survival chances. What else is it willing to fuck you over with in the short term? Speculating, but how about:
- Stress hormones. Keeping you alert and on edge, ready to exploit the most meager source of food?
- Restorative sleep. Good, restful sleep is for the well fed?
That’s just two, but they’re biggies if it turns out to be true. Why? Rapid aging, that’s why. In the very short term, none of this is a problem, it would make you better prepared for survival, etc. Perfect evolutionary sense.
Another commenter (retired doc) suggested that physiological insulin resistance is no big whoop, and you can just cheat on the test.
…The Inuit failing a glucose tolerance test is a normal finding for someone who’s been in dietary ketosis. This is the cause of the carb-induced brain fog. It’s physiological (i.e. a harmless adaptation). If you’re going to have a GTT and are on a ketogenic diet, you should up your carbs to 150g per day for three days. Otherwise, you are going to appear diabetic when you’re not.
That’s a piece of info I picked up on my reading.
Another thing is that someone on a ketogenic diet may have a slightly higher fasting glucose than he did have. Again, a physiological adaptation.
So, instead of jumping to conclusions, as many of the “anointed” do, look this stuff up.
Well, I happen to have very smart, well-studied, laser-sharp commenters who do look stuff up. But, sometimes, they just call BS when they see it. Here’s a regular commenter here, Bret.
To supplement Tom’s reply, it was really Richard’s point that the Inuit were not in ketosis regularly. My point here is that ketosis does not necessarily result in universally excellent biomarkers, the way many unconditional ketosis trumpeters imply. People considering going into chronic ketosis deserve to know the full facts, not just the one-sided view many people give.
On to your retort: So your answer to a post-ketosis BG in the 300s is that the literature says you should up your carbs to 150 g/day for three days? First, I don’t care what any literature says I “should” do. That’s a silly appeal to authority to begin with. Secondly, What is the purpose of a GTT if you are going to modify your normal diet beforehand, other than to pass an insurance physical? Sounds like you’re defending ketosis for the sake of defending ketosis. By the way, what do you think is happening to your BG over those three days, as you prepare for your GTT? If your reaction is like the Inuit’s, then it is hitting the 300s. All to get a good GTT result… Doesn’t sound too smart to me.
Care to elaborate on your point about a higher fasting BG being a physiological adaptation? Much like your previous point, that tells us absolutely nothing useful. Tom’s BG in the 190s was a physiological adaptation of his eating those potatoes. Getting fat from overconsuming refined carbs is a physiological adaptation. Red, inflamed skin from scrubbing yourself with a steel brush is a physiological adaptation. Calling a phenomenon whose cause nobody disputes a physiological adaptation tells us nothing in a debate about the pros and cons of conflicting dietary philosophies. A higher BG is a higher BG in my book, and is not a flattering point in favor of ketosis.
I do not appreciate one bit your suggestion that I have jumped to conclusions, displayed the same attitude as ‘the anointed’, and failed to look this stuff up. Those are all three assumptions, and quite wrong ones, at that.
Of course, in the end it’s always about how it works for you, so here’s how it worked for Kris.
…I had the same exact high blood glucose reactions as you after adding a little too much starch to my diet. Since I was suffering a few side effects of low-carbing, I figured I was destined for diabetes and possibly even insulin injections because I felt I couldn’t stick to it any longer. At first I started experimenting with eating starches such as potatoes or oatmeal for breakfast, but with minimal fat if any at all, and no protein. I found that I was getting lower and more controlled BG readings… in fact lower than when I was on the LC diet. When the negative side effects of low carb began to disappear, I became more and more relaxed about the carb issue. I must admit, I do feel best when keeping wheat to a minimum and getting most of my carbs from fruits and vegetables, although I will eat some sugar on occasion if I feel like it. Now, whenever I test my BG it is consistently normal. When low-carbing my fasting readings were anywhere from 118-125. Now they are 90ish. I am not meaning to encourage you to make any changes if you feel that what you are doing works for you. I just want to let you know the BG readings may be temporary and perfectly normal for a body that is just not used to eating starches and sugar any longer.
How many times have I heard this same story? It’s in the hundreds, now, and it includes literally every friend and family I know that has done LC for a long time and bothered to measure fasting and post-prandial blood glucose. Here’s my reply.
“Now, whenever I test my BG it is consistently normal. When low-carbing my fasting readings were anywhere from 118-125. Now they are 90ish.”
This was my experience, my wife’s…other family members. Essentially everyone I know.
In fact, there is a confirmation bias going on in the LC community and I believe it’s used a bit nefariously by some to promote LC diets.
Suppose you’re a couch potato, overweight, completely out of shape, etc. Suppose further that you’re a member of a group that dub themselves VLE – Very Low Exercise. The aim of this group is to consistently keep your heart rate under 100 so as to avoid becoming a “Palpitator.” Any kind of spike is taken very seriously.
Then one day, the elevator is broken, so you get up off your electric scooter and take the stairs. After several flights you note that your heart is racing, so you get out your meter, insert a testing strip (har har! 🙂 and low & behold THEY WERE RIGHT! 250 bpm. YOU’RE PRE-PALPITATOR IF NOT FULL-BLOWN PALPITATOR TYPE 2!
YOU CAN NOT TOLERATE EXERCISE AT ALL!
Alright. Keep pounding nails into this Nutritional Starvation coffin, or just bury it alive?
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“Is good, restful sleep for the well fed?”
A new study was published looking at the association between better sleep and high GI foods: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0105198 — rice topped out bread and noodles. Other studies have established the link between eating carbs and resting well.
An article about this on The Independent Online (http://www.iol.co.za/lifestyle/family/sleep/rice-might-help-you-sleep-1.1742407) states:
“High GI foods increase levels of a protein called tryptophan that is used by the body to make the brain chemical serotonin, which is known to induce sleep.”
How does that work?
“When eating a high-carb diet, glucose levels in the blood increase, leading to insulin secretion. Insulin promotes the transport of the other large neutral amino acids to muscle and fat cells, but not tryptophan. In circulating blood, tryptophan binds loosely to albumin. Albumin-bound tryptophan is transported to the brain, but not to muscle or fat cells. Hence high-carb diets can increase the availability of tryptophan to the brain, thereby boosting the level of serotonin.” (http://www.gbhealthwatch.com/Did-you-know-High-Carb-Low-Protein-Diets-Stress-Relief.php)
I believe high seratonin levels also increase cortisol levels, and there’s likely a general and individual u-curve at play.
Other questions worth pondering with regards to chronic ketosis considering there is no natural human (or even mammalian) example of such to study:
How does chronic ketosis affect happiness, libido, reproduction, pregnancy, stress, socialization, creativity, motivation, longevity, etc. etc.? Insufficient data. What % of the general population will react poorly to chronic ketosis? Unknown.
If I had epilepsy, certain cancers, or other serious medical conditions where chronic ketosis has been shown to be beneficial, I’d likely give it a try. Not much to lose in that scenario, and there’s a big potential upside. But short of that, no thanks. Promises of no mind fog and becoming a fat burning machine aren’t enough for me.
Want to burn fat? Take a walk. It doesn’t matter if you’re in ketosis or not, you’ll burn fat at a brisk dog-walking pace. Got hills? Even better. Hiking trails? Get to know them.
Cycling in and out of ketosis is supported by most studies, and there are natural examples galore. But, chronic ketosis and a diet informed by evolution seem incompatible.
How does Red Pill taste? 🙂
Red pill, or mainstream nutritional theory. Either one. Although, the latter might not find the evolutionary reasoning as stimulating.
It’s as good to be evolutionary as it is to be King.
– Mel Brooks
Excellent points, Angelo.
Anecdotally, I noticed while I was in ‘nutritional ketosis’ that I frequently (though not always) had some difficulty sleeping. Also had some brain fog and energy issues. I knew I wasn’t “doing it wrong,” so obviously, this ketosis thing was not the state of perfection that some were making it out to be.
I complete agree with your reasoning about hypothetical cases of epilepsy and cancer. I think it’s certainly reasonable to surmise, based on the available evidence, that glucose feeds cancer cells. I suspect I would continue to eat lots and lots of plants, just significantly less starch. Extrapolating on your point a bit, even better would be to avoid the processed junk that promotes the formulation and spread of cancer to begin with. It is my hope that the cure for cancer will be a preventive one: something along the lines of “don’t eat processed crap, and don’t smoke cigarettes,” certainly not more than occasionally (on both counts).
I would only add to your comment about walking off fat stores that one likely ought to be eating a whole-foods diet to enable the exercise-induced weight loss. I know this was implicit in your remark, but I feel it is worth emphasizing, because many people, maybe most, cannot burn their fat if enormous insulin levels resulting from 400 grams of largely refined carbohydrates are keeping their fatty acids locked away in storage.
Thanks for the clarifications, Bret. All noteworthy.
Nice use of the word “vapid.” :o)
Vapid, like juxtaposition and fucktard, are some of my favorite words.
Lately, I have a kick with “dingy.” I’ll have to use it in a post soon.
You’ve made “fucktard” my husband’s favorite word. He even has a ditty he sings upon encountering one.
One mind at a time.
Best to hubby. Thanks for the soul tank top off.
I can relate, Regina. The word now occurs to me with such frequency that I must tip my hat to Richard for his continued use of it. It really is the perfect description of many people. 🙂
Guess what else mimics starvation…
I suppose there comes a time when I might just have to admit it isn’t working for me. I’ve been VLC/Ketogenic for about 2 years now and there are things I like about it. First, I’ve managed to maintain my weight (for 2 years) at about 15 pounds under where I had been for years. Second, I enjoy the cognitive effects I feel from ketosis. I really wanted this to work long term for me because I don’t want to gain back the weight and I need the extra cognitive help because I’m getting ready to change careers and go to medical school at 46 years old.
But if nothing else, I’ve learned that science is about following the data, even if it takes you somewhere you didn’t want to go. So while I still think a ketogenic diet can be healthy long term for some, it doesn’t appear to work for me. My fasting blood sugar levels are now usually in the low 100’s when I go to bed at night (4-5 hours after my last bite to eat) but still in the mid to upper 90’s when I wake up, seem to have moments now where my heart rate will seem to speed up for no apparent reason when I’m just sitting around (cortisol? adrenal glands overtaxed? who knows…), and now I’ve been getting horrible cramps in my legs at night and even during the day. I’ve had all the normal blood work done and it all comes back normal. So the only conclusion I’m left with is that it’s time to change the diet and ditch the keto diet and see how it affects me.
So thanks in large part to Richard and come of the commenters on this site, I’m going to add RS into my diet (but slowly because potato starch gives me heartburn if I take more than a tablespoon) and transition to more a Paul Jaminet style of diet by incorporating safe starches into my evening meals.
My n=1 continues, even though it’s not where I thought it would take me.
Future Dr. Allen,
Your willingness to question both what you have been told and what you have embraced makes you a stand-up guy in my book. I can think of no better attitude for a physician to have than yours, which seems ripe with humility and wisdom.
Best through med school, and I would consider it an honor to be your patient, if I ever had the opportunity. I cannot say the same of many current doctors, including many who advocate VLC.
but one can still get mental clarity from short term ketosis (fasting), yes?
Sure. Just to add a remark, there’s nothing wrong with ketosis as a physiological mechanism. The wrong thing is to believe it is an ideal state that one should be in ALL the time.
Ketosis just happens when cal intake is low for some time. That’s all there is to it. As soon as you eat a good amount of cal (provided that it is not the distorted diet called high fat-low-non-fat, which to me, a French that likes to cook! is a culinary absurdity), you get out of it. And that’s great, a good big meal full of fresh produce, nicely prepared, including everything, will make you warm and nice! You’ll sleep well and have plenty of energy to get going. Who wouldn’t want that ???
i meant the future Dr. Allen can still achieve the mental clarity by IF (short term of course,
then feast like a king!)
(i do agree that chronic ketosis is not a desirable state for most; the diet is probably pretty boring too)
What’s the percentage of people actually eating LC or VLC longterm? I’d imagine worldwide it would be a very, very small percentage.
I have no data to reference, but based on the number of eyebrows that are raised at me whenever I do reveal to folks that I keep the carbs down (I can recall only one person reacting as though they agreed it was a good idea, in nearly two and a half years), I suspect you are right in thinking the proportion is miniscule.
But still, these topics are worth emphasizing. Low-carb advocates borrow the authority of air-tight science to promulgate their ideas. And they make many good points–the narrative against Ancel Keys being a great example–so inquisitive people are bound to listen. It is certainly not possible for me to shut these people up (wouldn’t even if I could), but I can compete with them.
If even one person reconsiders his or her dietary choices due in part to my comments, then I consider it a success. Even if no one does (or I never find out anyone does), I still enjoy discussing and dissecting this. If nothing else, it is amusing to watch figuratively blind VLC advocates hypocritically embody the very sorts of confirmation bias and groupthink they accuse the low-fat gurus of.
so, I have trouble following all of the science and acronyms, etc. however, I think I understand what you’re saying based on my experience on a VLC diet. I was probably in a constant state of ketosis for many months at a time, through a period of 2-3 years, and I found that when I ate carbs, sugars, I would go nuts, craving more, and would become totally out of control. Physically I felt horrible and that something had gone really wrong. I’ve been eating carbs now for the past 6 weeks and am still trying to moderate them. I have gut intuition that I need to be eating some carbs now. I have not checked my blood sugar levels, but I am still having trouble regulating carb intake. One bite leads to 20 bites. So what I’m understanding is that my during that time in ketosis, I produced less insulin or became insulin resistant so that what little sugar I did take in could get to my brain for its very survival. Now, when I introduce higher carb foods, including fruits, my pancreas is not releasing insulin like it used to because it’s insulin resistant, which then sends my sugar levels sky high after eating sugars, to diabetic levels, and then I become out of control. right? I like the idea of slowly adding carbs but what discipline that takes, discipline that I don’t seem to have.
As a massive sugar and junk food eater for a long time, a couple of suggestions.
Try resistance training and eating carbs after lifting weights. Sets of high reputations on some compound movements can prime your body to take the glucose out of blood circulation and into muscle.
Place the carb part of your meal at the end. So eat a lot of fibrous veges along with your meats first, then add the carbs (higher GI foods may be less appealing on a full stomach).
I feel for you man! But you have to be careful when you say “insulin resistant”:
– you can be IR when your cells don’t respond to insulin very much. In this case your pancrease has to produce more insulin than usual to force the “message” (eat that glucose you idiotic cells!). This leads to a temporary high blood glucose level because the cells are refusing to take it with just a little insulin to tell them to do so.
– you can be “IR” because you don’t produce ENOUGH insulin, in which case this is not like being insulin resistant, but insulin DEFICIENT. This is typical of type I diabetes, and people in that case need an insulin pump / injections.
If you are in the first case (more like type II diabetes), this is reversible via diet tweaks, meal timing, sleep, respect for circadian rhythm, little stress, and proper physical activity like resistant training.
Alright, Richard. I’ve had to come to a point of acceptance: I’m getting older, and my weight mightn’t stabilize at all. I’m not getting fatter, thankfully, but I’m not getting thinner, either. At least Himself is happy to keep making us both happy, despite my Rubenesqeue appearance.
I just cannot maintain any sort of clarity of thought, nor any happiness, nor restful sleep, nor sense of order of things in life without carbs in my diet. I may have to accept that I am just a matronly crone who, after several children, just has that motherly look about her.
But, what? Are we all trying to live forever, to be young and sexy like 20 year olds until we’re in our 80s or 90s? Would be great, but its the eternal conceit of man. For the obese, I think a VLC diet is a good START, but not the be all, and the end all, as in the idee fixe meaning, and not the perfection of an ideal. And I know that you recognize the therapeutic benefits of a VLC diet for certain populations. But, c’mon already! Breastmilk supports ketosis – yes, we know, but why? To spare glucose for the growing brain, arguably the organ which defines us as human. Brains need fat, no one argues this (except Obama’s bitch and her USRDA/FDA/School Lunch Rx’ing sycophants).
I’m a bit younger than you, Richard. My maternal grandparents were born in the early 20s and lived dirt poor with their respective Czech/Polish immigrant families. My grandfather (Bless His Soul) remembered hunting and fishing in Wisconsin (home to large settlements of Central Europeans) as early as five or six, and bringing home beaver and rabbit, pike, walleye, and crappie for food. His future wife, my maternal grandmother, remembers catching pigeons on the streets of Newark, NJ, for food, with her older brother. But always, rice or potatoes or bread or porridge was the heart of the plate. Yes, peasant food. Maybe it has such derision because it allowed “peasants” like me and mine to survive. But they were more or less happy.
I’m more concerned about happy, lately. It doesn’t come from pastry and pie, but from looking at my small half-acre well tended, and from my children smiling at me and bringing in squash and potatoes from the field, and in having peace.
Free The Animal. Yes, free him from the worst of what civilization brings us: status whoring, overt displays of wealth, rampant trampling upon the ground that gives us our sustenance…but at some point, NOT living like an animal can be a prison too.
I know, you’ve long abandoned religion. But please, if you would, give a reading to the Books of Job, Sirach, Ecclesiastes, and Wisdom? Only four books, perhaps a few weeknights of your life. It’s all been addressed, and the light is full and true, but the aperture through which we view it tends to skew perception. Not to bring you back to Christianity, but to say, hey, this has all been hashed out before, why do we continue to reinvent the wheel?
Nothing new under the sun, and to everything a season, etc.
Most literate people who are in their fifties read all or most of the bible in the 1970’s.
In the 70’s, when I was in a private Christian school, it was common practice to read a chapter per night before bed. Gets you through a reading once per year.
I did it a few times.
I don’t deny there are some valuable, literary passages here & there. But I prefer modern literature.
My experience with post menopause and ‘healthy’paleo fats. I got the shock of a lifetime when my LDL hit 285 (measured), as did my doctor who said I should seriously consider statins – I said no of course. As a nutritionist – I just don’t see the evidence that high LDL is safe – even if it is almost all large fluffy. After all those with familial hypercholesterolaemia have large fluffy – and they die early from heart attacks. (And I know you are thinking – I am safe because I have low TG and high HDL – the truth is we don’t really know if very high LDL is safe in this context)
I have hashimotos too – well controlled, however this tends to downregulate LDL receptor activity – and if LDL is high with Hashimotos it tends to be oxidised.
I’m not purposely low carb – but when I did the sums I was eating only 50g a day.
I was determined to get my cholesterol down – and immediately cut out all coconut cream and oil, butter and obviously fatty meat. Added at least a cup of starchy root veg to two meals and had a berry and kiwi smoothie for BF. I alaso added supplements as recommended by Paul Jaminet. (google – perfect health diet problems with zero carb diets)
To counter the extra carbs – I decreased added fat and ate leaner meat, more seafood. Not only has my weight remained stable – but I feel really great and have better appetite control, I dont need to snack at all. The good news is that in a few weeks my LDL has come down to 171, much to my doctors amazement. Still on the high side but not so concerning.
As a number of people have noticed Bullet proof coffee has profoundly affected LDL levels in some people. My observation is that post menopause makes this worse – I get regular emails from older women on low carb, high sat fat paleo whose LDL has skyrocketed. Dr Dayspring also noted that in one of his case studies.
It should of come as no surprise. Saturated fat raises LDL. Some people can get away with liberal servings of butter and coconut oil, but if you browse the paleo forums you’ll see so many that cannot. What’s worse is the denial that this is a major problem. In the majority of cases, people with high or borderline high LDL have a high LDL particle count. It may not be much of an issue for young active people but it’s pretty worrisome seeing older people who probably already have atherosclerosis being told that they should ignore this problem.
Nice to hear from you. I wonder what Jamie thinks of all this. 😉
Hell yes, it is. But keep beating it!!
Since you actually get to the heart of the matter, instead of spouting silly one-liners to defend your bias, I hope you continue to kill that horse over, and over, and over again.
Speaking of one-liners, my comment to that effect over at Fat Head contained one huge error that I discovered in hindsight…something about me not disputing a piece of vegan propaganda–in fact, I meant I would not agree with it. I figured I would leave it unadjusted, and let the abrupt, contextual contradiction speak for itself. 🙂
Back on ketosis, I feel that bloggers like you and commenters like me and others would not have to beat this dead horse if the relentless ketosis proponents among the low-carb experts, who seem to carry much more influence at the moment than we, would actually acknowledge these undesirable effects and caveat their advice accordingly. Instead, they’re telling themselves it isn’t happening, or that people are “doing it wrong,” and advocating for ketosis, like lawyers. Somebody has to tell the other side of the story. Otherwise, a lot of naive, desperate people will unwittingly develop a severe insulin resistance and glucose intolerance that they did not sign up for.
“keep beating it!!”
I beg your pardon, but you’re getting a little personal right there.
Sorry. I’ll be less presumptuous henceforth and try not to forget my boundaries.
“Somebody has to tell the other side of the story. ”