Emerging Science of Carbohydrate Restriction and Nutritional Ketosis: Introductory Remarks

[Vince]

An impressive body of scientific evidence over the last 15 years documents long term benefits of carbohydrate-restricted, especially ketogenic, diets. We now understand molecular mechanisms and why they work. Popular books and articles now challenge the advice ‘carbohydrates are good and fats are bad.’ Circa mid-19th century urinary ketones were identified in diabetics sealing their toxic label for the next 150 years. Despite work four decades ago showing ketones were highly functional metabolites, they are still misidentified as toxic byproducts of fat metabolism. The vilification of fat by regulatory and popular dogma perpetuates this myth. But the nutrition-metabolic landscape is improving dramatically.

A growing number of researchers have contributed to what is now a critical mass of science that provides compelling clinical evidence that ketogenic diets uniquely benefit weight loss, pre-diabetes, and type-2 diabetes. In the last five years, basic scientists have discovered that b-hydroxybutyrate (BHB), the primary circulating ketone, is a potent signaling molecule that decreases inflammation and oxidative stress. BHB has been suggested to be a longevity metabolite, with strong support from recently published mouse studies showing decreased midlife mortality and extended longevity and healthspan. Although type-2 diabetes is often described as a chronic progressive disease, emerging evidence indicates that sustained nutritional ketosis can reverses the disease. There is growing interest in studying potential therapeutic effects of ketosis on cardiovascular diseases, cancer, and neurodegenerative diseases including Alzheimer’s and Parkinson’s. There are even reasons certain athletes may benefit from nutritional ketosis and ketone supplements ─ debunking the long-standing dogma that high carbohydrate intake is required to perform optimally.

With the support of the well-established Ohio State Food Innovation Center, this conference will bring together the top experts in these fields to share what has been achieved and what remains to be done to advance this exciting field of scientific discovery.

Videos From The Inaugural Conference: The Science of Carbohydrate Restriction and Nutritional Ketosis - Blog | Virta Health

 

[Leesto]

Thanks for posting this Vince!

 

[Tad1979]

Interesting and regarding a topic I’m trying to become more educated about. I started a ketogenic diet combined with intermittent fasting on September 27th. Since then I’ve dropped 17 pounds without feeling bad or any noticeable loss of lean mass.

 

[Leesto]

Good for you tad1979!

 

[DragonBits]

I am doing well on my low carb, moderate fat and higher protein diet. Lost about 7% body fat so far, right now it is happening pretty fast.

Vince, Tad and others that are on a real Keto diet, do you use a Keto meter to really make sure you are in Ketosis. It's not easy to really get into a deep state of ketosis.

I don't have a Keto meter and doubt I want to spend the money, the meter and 10 strips is ~$60, but practically speaking it will be about ~$130 for 50 Ketone strips and 50 glucose strips. 10 strips that come with the kit is likely too few and no glucose strips are in the initial kit.

 

[Vince]

No l never had one, I don't know how accurate they are.

 

[Leesto]

I have a Keto meter but rarely use it because of the high cost of strips. What it told me is that it takes very strict adherence to the keto regime for my body to achieve ketosis. I must stay under 20 grams of carbs per day. However I do get benefits from the diet even when I'm not quite that strict.

 

[Tad1979]

My spouse has a Keto meter (finger stick test) and we’ve confirmed that I am in ketosis. I can confirm the strips are costly - I’m not certain it’s worth it as even attempting to reach ketosis “should” provide benefits. I haven’t found it difficult to stay at or below 20 grams of total carbs daily, but I think it helps that I’ve been weight lifting this past year and have gotten used to tracking my macronutrients, since I wanted to make sure I was eating to support my weight lifting. I waited until I was ready to shift into a cutting attempt before going full Keto diet as at that point I was going to be reducing my carb intake anyways.

I decided to do the intermittent fasting alongside my spouse partly out of being supportive, and partly out of an interest in the reported synergy with the ketogenic diet. My fat loss was slow at first but seems to be picking up to a rather brisk pace - I dropped 3.7 pounds in the last ten days. For my spouse (a diabetic) things have been even more remarkable. They’ve been able to come off insulin entirely since starting the intermittent fasting, blood sugars all within normal ranges, and there’s been about a 24 pound weight loss over the past two months.

I should mention that keto is actually high fat, moderate protein, unless you’re weight lifting. I’ve heard the ratio of 70% fat, 20% protein, 10% carbs. I’m not that rigid, ranging from 54-60% fat, 34-45% protein, and rarely more than 20 grams of carbs. But that’s also because I’ve found I require closer to 1.2 grams of protein/pound of lean mass to see muscle gains.

... hopefully my final edit here - ketosis isn’t the end goal of the ketogenic diet - really it’s to become adapted to using fats for fuel vs carbohydrates. There are a number of experts like Dr. Jason Fung who will point out you can bounce in and out of ketosis and yet remain fat adapted, so perhaps the meter really isn’t that important.

 

[DragonBits]

The ketone strips have come down in price, at least that is what people say, but the "cheaper" strips are $1 each.

As I understand Keto diet, if you don't eat enough fat then the excess protein you do eat converts to glucose via gluconeogenesis to supply you with fuel.

If you don't eat enough fat, carbs nor protein, you start to break down muscle as well as fat stores for energy.

You are suppose to limit your protein to 25% of total calories, maybe up to as much as 30% if you work out a lot, fat should be 70% of calories.

I think a lot of people on a lower carb diet can slip in and out of ketosis. Like being on a low carb diet then exercising in the AM after not eating all night. But I think a lot of people only think they are in ketosis.

Since I eat way to much protein and not enough fat, I doubt I very often get into ketosis. Once in a while bike riding it feels like some other energy source kicks in after 90 min.

They say you can only eat 20-30 grams of carbs to get into ketosis, and it can take 1-10 days of doing that to get into ketosis.

 

[Tad1979]

As I’ve said, we’ve tested me multiple occasions and have confirmed I’m in ketosis, despite having a higher amount of protein than what is “generally” recommended. This is a calculator I have found useful when it comes to figuring my macros for the ketogenic diet. For muscle building, you can get by with a higher percentage of protein as that protein is being used up to build/repair from your workouts. It takes some experimentation to find the amount of protein that leads to muscle growth for each individual, but once you have that, it’s fairly predictable, (depending on activity level, as little as 0.6 grams/pound of lean mass to as much as 1.2) with the bulk of the remaining amount of your calories coming from fat content. There’s also some good information on the Ketogains reddit

 

[DragonBits]

As I’ve said, we’ve tested me multiple occasions and have confirmed I’m in ketosis, despite having a higher amount of protein than what is “generally” recommended. This is a calculator I have found useful when it comes to figuring my macros for the ketogenic diet. For muscle building, you can get by with a higher percentage of protein as that protein is being used up to build/repair from your workouts. It takes some experimentation to find the amount of protein that leads to muscle growth for each individual, but once you have that, it’s fairly predictable, (depending on activity level, as little as 0.6 grams/pound of lean mass to as much as 1.2) with the bulk of the remaining amount of your calories coming from fat content. There’s also some good information on the Ketogains reddit

Do you know when you were in Ketosis, what was your typical blood glucose level?

 

[madman]

My spouse has a Keto meter (finger stick test) and we’ve confirmed that I am in ketosis. I can confirm the strips are costly - I’m not certain it’s worth it as even attempting to reach ketosis “should” provide benefits. I haven’t found it difficult to stay at or below 20 grams of total carbs daily, but I think it helps that I’ve been weight lifting this past year and have gotten used to tracking my macronutrients, since I wanted to make sure I was eating to support my weight lifting. I waited until I was ready to shift into a cutting attempt before going full Keto diet as at that point I was going to be reducing my carb intake anyways.

I decided to do the intermittent fasting alongside my spouse partly out of being supportive, and partly out of an interest in the reported synergy with the ketogenic diet. My fat loss was slow at first but seems to be picking up to a rather brisk pace - I dropped 3.7 pounds in the last ten days. For my spouse (a diabetic) things have been even more remarkable. They’ve been able to come off insulin entirely since starting the intermittent fasting, blood sugars all within normal ranges, and there’s been about a 24 pound weight loss over the past two months.

I should mention that keto is actually high fat, moderate protein, unless you’re weight lifting. I’ve heard the ratio of 70% fat, 20% protein, 10% carbs. I’m not that rigid, ranging from 54-60% fat, 34-45% protein, and rarely more than 20 grams of carbs. But that’s also because I’ve found I require closer to 1.2 grams of protein/pound of lean mass to see muscle gains.

... hopefully my final edit here - ketosis isn’t the end goal of the ketogenic diet - really it’s to become adapted to using fats for fuel vs carbohydrates. There are a number of experts like Dr. Jason Fung who will point out you can bounce in and out of ketosis and yet remain fat adapted, so perhaps the meter really isn’t that important.

You will never gain serious muscle mass on 20 grams carbs/day even in a calorie surplus.....sure you can still gain some muscle but do not expect to pack it on!

Do understand that when one first goes low carb most of the immediate weght loss is water weight and some of that water will be intra-cellular water from the muscle cells as muscle stores carbs in the form of glycogen will results in fuller, harder muscles.....hence why most will feel flat (and tend to need to increase sodium to experience a pump) when following low carb.

Almost everyone I see that follows low carb that trains with weights might have that lean solid physique but muscularly they are small and have no size let alone their muscles look flat.....muscles topped up with glycogen will always be bigger/fuller as a muscle cell is roughly 70% water/30% protein.

When one speaks of lean mass it is not only ther protein content actin/myosin but it is also the hydration of the muscle including glycogen stores as for every gram of glycogen stored by the muscle it pulls in roughly 3 grams of water( intra-cellular).

 

[Vince]

Dr. Tim Noakes - Sports Applications of Ketosis and Beyond

 

[madman]

Volek is one of the best in the field regarding keto!

Regardless of all the benefits you are still not packing on muscle mass low carb.

 

[Tad1979]

Madman, I didn’t say I was. I said I was doing keto on a cut. There are folks who claim they do it - I’m just not so sure since insulin is anabolic and even according to a keto/fasting advocate like Dr. Fung, insulin promotes growth. There’s also your personal interpretation of muscular- another keto advocate, Jason Wittrock is what I’d call muscular. Beyond that, there’s a whole other ongoing conversation about “how big” a person can get without chemical help. I plan on trying a “keto bulk” following some of the information I’ve found, but suspect I will need to bump my carb intake again. I’m ok with that, and the attempt doesn’t cost me anything. I’m not a physique competitor and am simply trying to be as healthy as I can and as happy with my appearance as I can.

You’re not really telling me anything I haven’t researched ad nauseam, but I do thank you for the concern.

To answer Dragonbits, I haven’t been bothering checking my blood glucose levels. My spouse is the diabetic, and much less active, so has kept a much lower protein intake of 0.6. It took a combination of keto and intermittent fasting to get there, but very rapidly their BGL readings came down and stayed in the range of 80-110, even off the insulin. My spouse tests about twice a week to see if ketosis is being maintained, and it has been. Actually, ketone levels have recently had a recent bump. We have different goals - weight loss for me, insulin control for my spouse, and are both quite happy with the results we’ve seen.