Keto – Week 6

You know how sometimes you hear the same thing over and over and then one day it clicks and you just get it?  And you wonder why it didn’t click the first 10 times you heard it or even considered it?  I’m having that experience right now.  Today I read this transcription of a talk given by Ron Rosedale in 2006 for the American Society of Bariatric Physicians (ASBP), entitled “The good, the bad, and the ugly of protein.”  Although much of this information is new to me (and a lot of it I’d have to spend more time with to really understand – leptin, MTOR, IGF-1, for example), the theme that too much protein can cause problems is one that has been recurring for me.  This passage jumped out at me today:

A high protein intake has endocrine effects such as it increases insulin, increases IGF, and we know these hormones increase the rate of aging. Furthermore the metabolic effect of high urea and many amino acids may exceed the kidney and hepatic system’s ability to metabolize and excrete the excess nitrogen.

In other words, when you use protein as a fuel, you take off the excess nitrogen, and then you have to do something with it. Because, it’s a poison. If you take too much, It causes acidosis in the blood and that causes redistribution of calcium and magnesium, and all sorts of things, and what the consequence are for that is manifold.

So what’s high.  Certainly above 1 gram per kilogram of lean mass is probably high.  Most people, I’ll put on .7 or .75 grams per kilogram of lean body mass.  But if I’ve got a diabetic, and I really want to reverse their aging, which means reverse their diabetes, because diabetes is a model of aging, I’ll put them down to .5 or .6 grams per kilogram of lean body mass per day.

A year ago when I was attempting to eat a ketogenic diet (but failing, cuz too much protein, but I didn’t realize it because I wasn’t bothering to test for ketones) my labs were disappointing.  High uric acid, high (bad) lipids, poor BUN/Creatinine ratio, struggling thyroid, high calculated anion gap (which can indicate acidosis).  After 4-5 months I was tired and irritable all the time and quit.  The above passage explains that maybe some of this was because of my high protein intake, which led to sustained high insulin levels and high nitrogen.  Too much protein = high insulin and difficulty eliminating excess nitrogen = metabolic acidosis and feeling shitty.

Rosedale goes on to recommend limiting protein and increasing fat consumption. Starting today I’m using his recommended 0.5 to 0.6 grams of protein per kg of lean body mass.  For me that is somewhere in the neighborhood of 60-70g of protein per day.  I’ve been eating twice that amount.  What do I have to show for it?  Overall good energy and sleep, but very slow fat loss and still relatively high hunger.  I’ll be using Cronometer to track my intake for a while to make sure I’m staying within that range.

Since my last update I’ve gained back a pound or so.  6 weeks of keto and I’ve lost about 4 pounds and a couple inches from my waist.  I’m not complaining….well actually, yes I am complaining.  It’s not easy eating a diet this restrictive and exercising 3x a week with so little to show for it.  I think the amount of protein I’ve been eating is a critical factor.  A possible confounder is that I’ve been eating butter in an otherwise dairy-free diet.  I’ll be eliminating that too for now.  I can always add it back in later to test for problems.

26 thoughts on “Keto – Week 6

  1. Yes! Protein cannot be stored! It is used for structure like enzymes, hair, nails, muscle … you don’t need much (like a home project where you need only one sheet of plywood and you get 12 sheets…what do you do with the excess if you cannot return it? Chop it up and store it for campfires) Excess protein that was broken down into amino acids is deaminated (remove NH2 amino group) which combines with water to form very toxic ammonia (NH3) which the body converts via the Ornathine cycle to less toxic Urea to be excreted by the kidneys in the urine. Deaminated amino acids are converted to glucose OR FAT that is stored in the liver. Ergo Dr.(s) John and Craig McDougall, Neil Barnard, Colin Campbell et. al. all recommend a vegan diet based on unprocessed carbohydrates (fruit, vegetables, legumes, beans… HCLF . Do you get enough protein? YES! The largest and strongest animals are vegetarians and regarding calcium and cows milk…do cows drink milk? No, they get their calcium from grass.
    Just ending 3 mos Dr. Jason Fung’s LCHF + IC and lost 25 lbs and all labs dropped into the good end of recommended (A1C, Fructosamine, Lipid panel, %body fat…) Now trying HCLF + IF to see what happens (LC = vegetables, beans, legumes, fruit; LF = limited “good fat” like butter, coconut, olive oil, nuts, seeds).
    Good luck with your Experiment Lanie…many of us want to exit Big Pharma, Allopathic Western Medicine, Big Ag and the consequences of consuming their products. Recognize that the #3 cause of death in America after Cancer and CHD is the medical health care system (adverse drug reactions from prescribed drugs, hospital infections, iatrogenic (doctor/hospital errors)

  2. That’s scary stuff about the medical system being so lethal! I can’t wait to get off of my prescribed meds. I feel like a slave to a doctor who’s best idea is statin medication. That’s great you’re had good results with fasting – keep me updated on your progress. What are you hoping to accomplish now?

  3. What are my goals? To NOT be in the 99+% of people who lose weight and gain back what they lost and more. Ergo, to alter my life style to not be a bunch of “billable hours, copays and Rx” for the health care/big pharma/big Ag/ boys…I think I will keep My eat dinner 6pm then not eat again until next day lunch forever…I absolutely love the morning feeling of ketosis — alert, focused, NOT HUNGRY, increased strength (at gym). Clinisticks show I am pretty much on ketosis whenever I check even now when I have added HC beans, potatoes, squash, salad, fruit, millet, quioia, rice etc….and keeping my LF restricted to the good ones like butter, coconut, olive oil. Plus I find I eat less at lunch than when I was eating B-fast putting to rest the argument that if you skip B-Fast you will just eat a bigger lunch.
    BTW: I am experiencing the effects of increased HGH … following recommendation to exercise BEFORE lunch not after…Movie stars pay minimum $600/month for anti-aging HGH injections. I get it for FREE.

  4. I cannot post links here, but I’ve been looking at a lot of studies on it. I just put in a google search on Thiamine and ketones. Lots was listed, I haven’t read them all, but the ones I have point directly to glucose metabolism. I would like to send you a few to look at. toni at fairchild-associates dot com

  5. Awesome, John. I would love to be able to skip breakfast. I’m hoping as I reduce protein hunger will drop and I’ll be able to do that.

  6. Not sure why you can’t post links here…feel free to do so. I don’t have any reason to think I’m thiamine deficient. I take a good quality multivitamin with bio-available forms of all of the B vitamins (Wellness Resources) and have been for a year. I also eat liver every so often and get more than enough meat in my diet. I have taken B1 as a supplement and didn’t notice much. If you have any science to share I’d be happy to take a look though – I’m still seeking answers.

  7. IFing …Dinner to next day lunch 18 HR fast: It takes about two weeks to get into the routine of doing other things that you would normally do eating B-fast. Its like quitting smoking…much of what we are addicted to is the ceremony of the addiction rather than the substance itself…quitting pipe smoking a long time ago was about the addiction(s) to: 1. ceremony (habit) of tapping tobacco into the pipe bowl, oral stimulation etc. and 2. nicotine itself. If you get into the 18:6 IF eat/stop eat routine you will find other things to do in the morning than preparing and then cleaning up after B-fast…plus you will be amazed at the $$$ you will save because overall you will find yourself eating a lesser quantity of lesser costly food….So if you want to try IF …. start with “intermittent” intermittent fasting…try just a couple of days a week and see what happens…give yourself about two weeks and see if you can get the hunger suppression effect to kick in. I am predicting it will.
    BTW: This is an AWESOME BLOG!! I have learned a lot from your posts and from the comments…whats up with “SWOT” ?? I miss his/her posts because he/she is a source of really good info.

  8. Still Here. Part of why IF is good (generally you need 16-20 hours), is it shuts off MTOR/IGF-1 reducing aging, increasing BDNF and activates AMPK. That’s aside from decreased insulin, but the MTOR/IGF-1 shutoff is mainly from the lack of protein. I normally fast 16-23h myself during the week (12-16’s on weekend). My C-RP drops from fasting as well, which I think is from less protein.

    Anyway, for fasting entertainment, you can always watch Scott, the Truck Driver —

    He’s been fasting over a year, and added keto to the mix–has some entertaining VLogs if you don’t mind his linguistic style.

  9. Loss of Inches without much weight loss might mean your gaining some LBM from the exercise, so it might be better than you think.

  10. I did a hypothetical calculation on a woman with a BMI of 32ish losing 4lbs and two inches off the waist and it showed 8lbs of fat lost.

  11. I never thought I would be deficient either, but life happens. In Dec I started taking LE brand benfotiamine 100 mg at breakfast, lunch and dinner….then in Jan I took one Ecological Formulas allithiamine 50 mg (can pass BBB) and the next day, I cleaned the whole house, dusted, vacuumed, cleaned 3 bathrooms, laundry, organized the garage, and that had not happened for years. I usually only had energy for 1/4 of that. I have been studying the many benefits since early Jan. It seems everything is leading to mitochondrial issues and thiamine to the rescue. It is mainly the transport enzymes that get deranged, so when you are reading, that pops up a lot. I’ve also read it lowers triglycerides. A person with higher blood glucose uses up thiamine faster than the regular person.
    Here are a some links, but there are plenty more! 24 year FB patient tells her story Antonio Costantini, MD from Italy study on 3 Fibromyalgia patients

    great to have English subtitles—these people were helped by Antonio Costantini, MD good article by Antonio Costantini, MD

  12. Michael Gregor MD posted this today….supports Lustig’s contention that T2 diabetes hyperinsulemia is due to muscle/liver/pancreas fat accumulation that interferes with insulin signalling …
    And blocks leptin (stop eat) receptors in the hypothalamus. Ergo T2 D is not carbs that Taub indicts, it is fat…so my 80:10:10 HCLF + IF expt that I started last week should provide interesting results.
    Really Enjoyed Scott the Truck Driver video…

  13. “Ergo T2 D is not carbs that Taub indicts, it is fat” — I’d say it’s insulin resistance in the abdomin leading to chronic hyperinsulimia caused by excessive fructose, trans-fats, bad w6:w3 ratio (too much w6), excess cortisol induced by lack of sleep, lack of exercise, stress, Vit-D3 deficiency etc.

  14. @John, If+hclf would give you comparable results if your insulin doesn’t stay high after a meal too long…postpranadial hunger would indicate that the insulin spike is too high for too long. I’d still avoid sugar/fructose on it to keep liver insulin sensitivity higher. Wheat can cause really big spikes in some people, including myself. Of course eating once a day from If only gives you one spike to deal with.

  15. @John, See

    This is a guy who dieted down to 10% bodyfat. He’s constantly hungry. I can pretty much guarantee you he has hypoleptinemia (low leptin) from his low bodyfat, and his insulin levels are not very high. The only hacks he could do at this point is try to either lower his insulin further by 1. fasting longer (but no more than 24 hours (and even that might be too much) since absolute leptin levels will continue to drop 2. lower protein and carbs and go more fat. 3. Temporarily raise short term leptin drop by re-feeding primarily on starch (carbs (not sugar/fructose) raise leptin) or 4. Regain some bodyfat to increase leptin levels to shut-off hunger. A lot of the 500 comments are stupid bro-science too.

  16. Fung ignores leptin’s role in energy balance. His long term fasting protocol is a problem, IMO. I don’t have a problem IFing up to 2-3 days MAX. He claims people like Jimmy Moore are insulin resistant. Uh No–when you go from 420lbs to 280lbs, you have shrunken white adipose tissue (WAT)/fat. Shrunken adipose is very insulin sensitive. Jimmy lost 10lbs of Lean tissue and 10lbs of fat doing >3 days fasts per Fung’s “advice” over 30 days totally contradicting Fung’s bologna post that fasting doesn’t cause muscle loss.

    Fung misleads others by quoting short term ADF studies as proof that >3 day fasting is just as good..It isn’t. I’ve heard of anecdotal reports of him blaming patients, especially women quitting for “psychological” reasons and blaming the patient, when it’s well known extreme dieting/fasting changes the biochemistry in the brain making binging a typical rebound effect.

    I do agree heavy fasting can reverse type-2 diabetes by getting the phase 1 insulin burst back by decreasing pancreatic fat. But it doesn’t need to be done with total fasting…a PSMF would be better (and should be medically supervised if done for long stretches)–as it typically takes 8 weeks from the studies. At least a PSMF would reduce lean tissue loss.

    So I tend to agree he’s somewhat of a quack per what Woo said over on her forum.

  17. Great post response – thanks! So whats your take the UFC esque battle between the HCLF MD doctors (McDougalls, Colin Campbell, Greger, Furhman, Bernard, et al) and the LCHF doctors (Hymann, Atkins, Fung et al) ?? They all write books that recommend lifestyle changes that are polar opposites of the other side. Which side went to Donald Trump’s Medical School? I did a LCHF + IF “personal experiment” for 3 months and got great results but I think the good results may have from IFing …18:6 IF 6 days/week and 23:1 If 1 day a week.. So my test is now HCLF + IF (same IF as before) and will do labs again in 3 mos. My daily meter BG test paradox is that post 18 hr and 23 hr fasts always give me high BGs (110-125 mg/dl) . Fung says its because in ketosis HGH and Cortisone levels are high increasing BG which is not a problem. My end of 3 month A1c and Fructosamine tests were normal. Also lost -25 lbs and lipid panel was in the good range of normal. Plus I do like the am before lunch feeling of ketosis … maybe its because I am drinking too much coffee but I can definitely feel sharper and…Not hungry.

  18. All “diets” will, in general, lower insulin to some degree so leptin works better. First, you cut out processed foods. There goes your HFCS/sucrose/fructose bomb clogging up you liver and appetite increase from excess uric acid driving up insulin causing your leptin to be blocked.

    LCHF, tricks you into eating fewer calories since 1. your insulin is lower from the lack of carbs so your leptin works better 2. protein increases satiety from GLP-1/PYY in the gut. For people without T2DM/IR, HCLF works okay too, since their insulin response from starch/glucose doesn’t stay high for too long since their insulin curve is normal. (note I said starch/glucose which goes to every cell in the body, not fructose which slams the liver alone). HCLF can also give “slightly” better results in leaner people especially since carbs do increase leptin better than fat/protein. Anytime you cut calories, your total insulin drops so your leptin works better until the drop in leptin evens out the gain from lack of insulin so you hit a plateau.. I still blame most fat gain from fructose clogging up the liver increasing uric acid, draining ATP, creating ROS in the liver, etc. and creating LR. (Also increased TG from fructose prevents leptin crossing the blood brain barrier).

    If I eat sweets, my appetite goes through the roof the next day and I feel like I have a hangover and get lousy sleep. It’s even worse from thecrappy sleep driving up cortisol which drives up insulin.

    Longer term, avoiding PUFAs (in processed foods), like transfat and too much omega 6, or damaged seed oils from heat light, and oxygen also help since those crap oils cause IR as well driving up insulin.

    Fasting increases uric acid in the blood if you start metabolizing your own purine rich LBM. Ketones also slow the rate kidneys release uric acid. I have to take alopurinol since my uric acid is too high from IFing (8s).. I ordered cherry extract. It’s suppose increase rate of uric acid excretion. I have gout and uric acid kidney stones to thank for it.

    Your high glucose is from the HPA axis not being precise.. Your liver is dumping glucose into the blood from the increased cortisol from lack of carbs. The regulation isn’t very tight. It’s normal during LCHF. I’m usually in the FBG in the 90’s-100 when I LCHF or IF, but if I ate HCLF for a day, I’ll typically be in the low 80s. My A1c was 5.0 after doing a 3 month LCHF stint.

    I don’t LCHF all the time. I do a cyclical pattern. Usually I eat LCHF or a reduced carb during the week, but on weekends I eat whatever I want for one day and typically try to keep sugar down. I find if I eat sugar, it slows or totally stops my fat loss. If I do LCHF or HCLF without sugar i can lose 2lbs of fat a week. If I throw in some IF with it, I can hit 3-3.5lbs. Lately, I’ve been experimenting with dextrose as a sweetener, since it’s just plain glucose.

  19. More good info..thanks! Besides daily meter BG I use a 10 paramater urine clinistic to monitor ketones which always are top of scale … even today after a week into HCLF …. now that you mention uric acid I notice that my pH is remaining end of scale is always low 5.0 (i.e acidic) sp gravity low; leucocytes, nitrite, urobilonogen always positive but slight. In either protocol… I try to avoid sucrose fructose whenever possible (sucrose = 50% glucose + 50% fructose). And it is everywhere if you read labels (“sugar”) … Looks like you bounce LCHF and HCLF frequently…in my “expt” I am going to test my 3 month LCHF + IF data set with the 3 month HCLC + IF data set which ends in June.
    BTW: The Fung’s assertion that short term IF does not result in loss of Lean Body Mass?? I will be saddened if Fung is wrong on this issue…I exercise daily and measure wt/reps and how difficult… effort level is fairly constant so how am I losing LBN muscle?
    Lastly…do you do stevia for sugar (fructose)

  20. 80% of processed foods have added sugar. I generally try to eat only real food, and watch the labels carefully for sugar if I splurge in something processed.

    Fung quotes krista varady’s alternative day fasting as “proof” it doesn’t cause LBM loss. ADF isn’t in the same league as longer fasts. Numerous studies show LBM loss during long fasts. Negative nitrogen balance is typical. Either Fung is really ignorant or deceitful by cherry picking if i had to guess. Jimmy’s DEXA scan also refuted Fung’s claim as well.

    I don’t like stevia, or artificial sweetners, in general.

  21. Thanks, Toni…I’ll check out these links this weekend. An experiment over the last few days has led me to believe my biggest problem has been high insulin, perpetuated by too much protein. Still, I’m open to learning more about B1. In fact, I have a supply of the stuff if it looks like a good thing to try.

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