% Carbs or Total Carbs?

food
(Michael - When reality fails to meet expectations, the problem is not reality.) #41

Different lenses. :sunglasses: :nerd_face:

And I say this as someone who eats high fat 2:1 fat:protein (2100 kcals per day fat) and very low carb, sub-15 grams per day. I tell folks it works for me. I also tell folks that you don’t need any carbs to have a healthy, long and happy life so why bother. But I do not tell anyone else what to eat or not eat.

Finally, I am skeptical of anyone who claims to remain in ketosis above 50 or maybe 60 grams of carbs per day and would want to see some data to back up the claim. Not sayso. I also have a high metabolic rate and it’s not from eating carbs.

#42

Similarly, as I mentioned, I remember reading where someone said they were eating 100-150g & still staying in Ketosis. :face_with_raised_eyebrow::lying_face::zipper_mouth_face: Now this person isn’t here any longer, but I will still not name them, but I honestly don’t know if this is even possible, or was just a line being tossed in to check for nibblers. :fishing_pole_and_fish: … Be nice if it was, but I’ve also read too many times when folks get into maintenance and say just upping carbs slightly caused weight gain to start?

As to folks saying to add more fat… yeah, I’ve heard it mentioned, but it usually had other information to go along with that statement, which may have influenced that suggestion? To me, the adding of fat would probably be more useful to help one stay satiated, but I would also think adding too much would eliminate the body from burning what you have stored, when it has newly introduced fat to use first. … But do not recall every hearing or reading anyone ever stating “eating fat alongside sugar will actually reduce an insulin response” as the OP had stated. And as it’s already been pointed out, the eating 20g or less has always been a suggested starting point for anyone just switching over to this WOE to help them get started. And it should be noted, as I try to do myself, is that it is just a starting point and not a set in stone (works for all) number. There are too many variable in each of us to have a ‘magic’ number that will work for all. (No more than the ‘One Size Fits All’ products that are made. If they said ‘One Size Fits Most’ I’d say it would be a better wording for it…

And not to throw in another wrench to what seems like a fully stocked mechanic shop. :crazy_face: Though I’ve mentioned that I myself do not crunch numbers, do not test data constantly, etc. I still think that some folks can simply get used to that 20g a day limit, where the body itself will adjust to a point, where it may stop showing results. … I know, there is so much talk as to what can cause one to stall, I’ve never read anything definitive on it overall. So I just think this can be one of the possibilities. Again, this is just my personal ‘possible’ insight as to one of them, and I have not looked into or researched this to try and verify if this could be. Just a thought of my own, knowing how amazingly the body can adjust to change.

(Bacon is a many-splendoured thing) #43

Dr. Phinney claims he never said it, but I distinctly remember his saying, in some of the early LCDU videos, that a low-carb diet of 100-125 g/day would result in ketosis. I suppose this could actually be true, for people who are not insulin-resistant.

I find I can consume more than the Dudes’ recommendation of 20 g/day and remain in ketosis, but even while still ketotic, there is a point where I start to get side effects back, such as joint pain, acne, and liver spots, so I have an incentive to stay away from the carbs.

(Butter Withaspoon) #44

In real life, i find with many women in particular with a history of occasional or regular dieting and a habit of low fat beliefs, that I really do have to shout More fat! More fat! To many of my friends, high fat is a modest spoon of olive oil in salad dressing while still eating instagram worthy lite meals. The response needs to be the right one for the person. Eating meat that comes with fat is a useful message because it’s approximately the right amount to get started.

Of course some people are outliers. I eat fat by the spoonful, and (I believe) well above the carb suggestion of 20g because I’ve learned what’s right for me. If only I tracked numbers, I could tell you whether a > 50g of carbs person could be in ketosis for part of every day. I feel like I am :crazy_face:
But maybe that doesn’t count because I slip in and out :woman_shrugging:

What I commit to though, is to recommend under 20g carbs and to add fat to begin keto, because this is what most sicker people need. I have no reason to think people should eat how I eat just because of my personal experience. If I sense that a person doesn’t have so much metabolic damage then I might suggest 50g, or just eat unprocessed carbs after your fatty meat.

#45

I don’t see such blind things from the members of this forum either… Sometimes much salt is encouraged but it really solves many people’s problems and it matters who get this advice. I saw many times that salt should be right, not too little, not too much…
I see that some people push their own beliefs and what works for them but not as in some other forums where something extremely specific “should be” followed according to some people.
We are far from perfect here but we are many so I don’t see that someone would get pushed into some possibly quite wrong direction often…
I always focus on differences :smiley: Fat chance to get something very specific from me though it’s possible my positive experiences due to carnivore-ish shows a bit too much sometimes, I am not very tolerant about using stupid keto processed things galore…
But what works for someone? How could I know?

I only say more fat if it seems that’s the problem, that’s not often. I have to LOWER my fat intake and just adding fat doesn’t make me any more satiated, it may result in nausea too so I wouldn’t advise that personally. But it’s understandable that it’s a common advice when one stops getting zillion calories from carbs. Though it seems to me that so many people overeat fat on high-carb (as many popular food has both galore and many people eat massive amounts of such things), they don’t need to raise it. But it’s individual and anyway, lowering carbs may lower fat intake too. I don’t like this eat less or more thing, eat right, no matter how it was before (it matters a bit, too drastic changes aren’t for everyone).

It’s too individual, that’s why I dislike saying general specific things. They barely ever are right.

But I can buy meat from 0 to 80% fat… People often use too lean meat, I saw that zillion times. It’s fine if they like that but they should get some fat elsewhere then. I feel so lucky I like leaner and fattier meats alike, my taste still keeps my fat percentage in a smallish range but I have some ways to subtly change it if the need arises. Theoretically. I like to eat whatever I want. But if I like two things similarly, I can choose the better one.

50g doesn’t seem so much. I always ate around 30-40g net carbs (usually making sure it’s 40g, I wanted as much vegetables as I could, it was sadly tiny anyway) until fat adaptation and things went smoothly. I never measured anything but I don’t care about others, I proved for myself that my ketosis carb limit is pretty high even when I am a sedentary, short, not muscular but somewhat fat woman. But it doesn’t matter so much as just like @PaulL, I get my benefits (very different benefits but that’s not the point) being sticter, ketosis alone isn’t enough. Fat adaptation is great but still not enough. But I suspect it’s not just about carbs for me. As long as the vast majority of my food is carnivore, it seems to be fine even if my carb intake isn’t very low. But eating a bigger amount of vegetables or nuts messes up things. I am not fully sure but strongly suspect this as my experiences hint at it.

I felt healthy and I was on low-carb since years but 50g was definitely too much for me. I barely felt going into ketosis or not at all but my water weight changes were still with me in the first years (and sometimes other hints helped as well). Now I can’t tell when I am ketosis at all, everything stays the same. Good thing I don’t care, I just want to feel right and stay healthy (and I suppose I am in ketosis on carnivore-ish anyway ;)).

I saw this from multiple people here. Why this? I must eat fatty protein (it’s usually meat for me, that feels the best) after my carbs especially sugar or else I won’t feel right.

(Robin) #46

That’s a good description of how a keto journey can morph over time into what suits each of us physically and emotionally. I seem to be slowly eliminating foods, as I can now tell who the culprit is… so I can quickly see/feel the results of dropping something. For me, veggies must be cooked to mush (no thanks) and dairy now makes me tired. So I am slipping slipping slipping into the future of carnivoreland. Didn’t plan on going there, but here I am. My guide was my own body. Shocking! I’m surprised it’s still talking to me after years of abuse.

(Joey) #47

@A_b: Welcome to the forum! As a biomedical scientist, there’s much you could likely teach many of us about. E.g., I’d never previously heard of the egg white + egg yolk combined = muting effect on insulin … thanks.

As a biomedical professional, you wisely note that as individuals we’re all n=1 subjects offering unique variations on a theme. As such, your comment below caught my interest:

It sounds to me like you have some hunger signals that aren’t serving you well. I won’t get into insulin, leptic, ghrelin, et al, inasmuch as you could probably teach the course. But your own personal experience and sense of hunger - or lack thereof - is something you might want to attempt to re-train and reset to a more functional range of reactions.

While you’re trying to find the “sweet spot” in terms of carb eating, adding this opportunity to reset your habits and reactions to stimuli couldn’t hurt either.

:vulcan_salute:

(Gregory - You can teach an old dog new tricks.) #48

Since 60 grams of carbs would only account for about 360 calories, what would be the metabolic pathway for energy needs beyond that?

I don’t claim to know, but would be interested in the possibilities.

(Bacon is a many-splendoured thing) #49

Fatty acid metabolism, no? Or in a pinch, proteins can be scavenged for amino acids to be turned into glucose and fatty acids.

Or did I miss your point?

#50

And to briefly be contrary, I am very grateful for the posts I read when I was first lurking the forum that suggested consuming more salt - because I thought I was consuming the correct electrolytes, but some symptoms I was having were due to low salt. Once I put two and two together and significantly increased my salt intake, I’ve been a lot better.

Sometimes it might sound like it’s the same advice being given over and over, but we’re in a world where the mantra has been ‘low fat, more fruit and vegetables, little salt’. If keto isn’t your first overhaul of an eating plan (and for many it isn’t, as most try other - more often recommended - routes first), then ‘more fat, less fruit and moderate above ground vegetables, lots of salt’ is an important message to share, because those old SAD rules need to be forgotten and it’s hard to shake them. How many people do you know who attempted keto and piled their plate high with vegetables ‘to be healthy’, perhaps pushing themselves well over 50g of carbs without realising it?

There are broad rules which work for most of us, and then there are cases which are a bit more unique to the individual. Covering all of those points in a newbie topic might be overwhelming - if you’re new, how do you make an informed decision about who is right and who is wrong?

So it makes sense that people tend to make basic recommendations and then suggest adjustments once the new person is a bit further in. Maybe it’s a helpful reminder that we should all be checking in as we get further in on plan to make sure we’re not inadvertently fasting too much or eating too little etc.

(Gregory - You can teach an old dog new tricks.) #51

ammwassill was suggesting one could not eat 60g carbs and still have ketosis.

I was asking in a round about way if the 60g carbs did not meet your energy needs, would the liver (metabolism) ‘prefer’ to produce glucose instead of ketones?

(Michael - When reality fails to meet expectations, the problem is not reality.) #52

One does not require ketosis to burn fat. Folks on non-keto CICO diets do it. My point is ketosis brings many healthful benefits that do not otherwise happen. Staying consistently in ketosis maximizes those benefits as well as fat adaptation.

#53

I think you need to define: (1) what is ketosis; and (2) what are the consequences of transient departures from a ketogenic state.

On (1), this is an unfortunate obsession. I appreciate Phinney and Volek set quite a high bar when they talk about 1.5 mmol (+) being optimal (although I personally remain to be convinced of the science behind this). I have been as high as +3.0 mmol and have experienced no additional (or noticeable) benefit. I think Paul Mason makes a good case for anything around 0.5 - 0.6 mmol. Obviously, you would get away with more carbs if the latter was your ketone goal.

On (2), perennial ketosis will paradoxically impair your glucose tolerance. This lends weight to the metabolic flexibility argument, where you should strategically aim to dip in and out of ketosis. Again, this approach would suit higher carb intakes at certain times.

(Jane) #54

That would be me in Jan 2018 when I had just started Atkins (Dec 2017) and discovered keto. I was horrified at the thought of eating more fat and was convinced those first 15-20 lbs I had lost on very low carb would come roaring back.

Guess what - they didn’t and my meals were no longer so boring. I continued to lose weight. When I stalled out I did cut back a bit on the fat. I was 9 months into keto so fat-adapted and didn’t need as much to get me to my next meal.

(Bacon is a many-splendoured thing) #55

Ketogenesis and gluconeogenesis are twin processes, stimulated by glucagon (in the absence of glucose/carbohydrate in the diet) and inhibited by insulin (which is secreted in response to a high carbohydrate intake).

The idea is that when serum glucose is high from high carbohydrate intake, insulin takes over and forces the excess into muscle for metabolising or storing as glycogen, and into adipose for storing as fat (triglycerides). There is no need to manufacture glucose, since it is abundant in the diet. When serum glucose is low, glucagon stimulates the liver to manufacture what small amount of glucose the body actually requires, and to manufacture an abundant supply ketone bodies (by partially metabolising fatty acids) to fuel the tissues that can use them.

So either the body has abundant glucose from dietary intake of carbohydrate, or liver is making a small amount of glucose and abundant ketones. And of course, the reason it can now make ketones is that there are plenty of fatty acids to metabolise, because when serum insulin drops sufficiently, triglycerides become free to exit the adipose.

There are complications I left out, but this is the basic outline. I hope it answers your question.

(Bacon is a many-splendoured thing) #56

Phinney and Volek would agree. In fact, Dr. Phinney stated at Ketofest 2019 that he and Prof. Volek settled on 0.5 mmol of β-hydroxybutyrate/litre as the beginning of what they call “nutritional ketosis,” because that is the level at which they begin see the clinical benefits. He further stated that while 1.0 might provide a bit more additional benefit, levels above 1.0 appeared to make to further difference.

Dr. Phinney and Prof. Volek both admit that 0.5 mmol/L is an arbitrary criterion. Nutritional ketosis tends to be in the range of 0.5 to 3 or 4, fasting ketosis from 3 or 4 to around 8, and ketoacidosis becomes a worry when β-hydroxybutyrate reaches 10.0. On the other hand, the fat-adapted athletes they studied tended to have readings around 0.2, though they were clearly in ketosis.

I’m not sure where this idea comes from. Is there a study you can link to? The only thing I can think of that might be the basis of this idea is adaptative glucose sparing, in which fat-adapted skeletal muscles refuse glucose and ketones in preference to fatty acids, sparing the glucose and ketone bodies for organs that need them more.

Of course, this might be a reflection of the fact that the body on a ketogenic diet tends over time to become more sensitive to the effects of insulin. I suppose this could be considered “impaired glucose tolerance,” because the serum glucose does tend to drop as the body requires less insulin to produce a greater effect. (Remember that hyperglycaemia is damaging and possibly even fatal.)

So far as I know, no cell in the body ever “forgets” how to metabolise glucose. The fatty-acid metabolic machinery, on the other hand, can become damaged and deactivated after too long on a high-carbohydrate diet. My suspicion is that “metabolic flexibility” is a straw-man notion, designed to scare people away from eating too much meat. People on a ketogenic diet who return to a high-carbohydrate diet have no trouble metabolising the glucose from their dietary carbohydrate.

(Michael - When reality fails to meet expectations, the problem is not reality.) #57

Ketosis is a normal and healthy metabolic state. The many benefits include primarily long term health and well-being, not necessarily short term things you might notice. In fact, I think a very strong evolutionary argument could be made that it is the normal metabolic state for humans to live in. Our Pleistocene ancestors spently arguably 90+ per cent of their lives in ketosis. All humans develop and live in ketosis in utero and when fed breast milk after birth. I don’t think it obsessive to say so and eat to maintain it consistently. Or to view ketosis as our natural and most healthy state. It’s simply acknowledging a fact.

I’m not saying that falling out of ketosis for a day or two once in awhile is going to cause any great distress or harm. But eating glucose in the form of carbs serves no useful purpose. We do not need to and suffer no loss from not doing so.

This is a misconception. So-called ‘metabolic flexibility’ does not mean what you put in your mouth. It means how efficiently your cells can utilize glucose or fats/ketones for energy. Cells never lose the ability to utilize glucose because it is very easily/simply oxidized. It is rather the consistent use of glucose as cellular fuel that prevents the flexibility of utilizing fats and ketones efficiently.

Some cells lack mitochondria and must have glucose for fuel. As Paul noted, gluconeogenesis and ketosis act together to provide sufficient fuel for those cells that lack mitochondria, while providing ample energy in the form of ketones and/or fatty acids for the majority of cells that have them. Eating glucose upsets this balance.


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(bulkbiker) #58

Agree 100% that bloody graphic is a major bugbear of mine… so far as I am aware if you register blood ketones you have to be “in ketosis” otherwise they wouldn’t be there in the first place.

(bulkbiker) #59

But could they not be in “starvation ketosis” i.e. in ketosis because their CICO diet has limited carbs enough that they are indeed in a ketogenic state without following a “keto diet” to get there.

Interesting thread on it here if anyone is interested.

The OP is an advocate for ultra low calorie diets bringing about remission from T2 as per the DiRECT study and is extremely dogmatic about it but some of the other comments are interesting.

#60

As far as I’m aware, persistent physiological insulin resistance from ketogenic dies is fairly well-established in the literature.

A more recent study looked at this phenomenon in athletes and the findings were replicated:

Reduced Glucose Tolerance and Skeletal Muscle GLUT4 and IRS1 Content in Cyclists Habituated to a Long-Term Low-Carbohydrate, High-Fat Diet in: International Journal of Sport Nutrition and Exercise Metabolism Volume 30 Issue 3 (2020) (humankinetics.com)

Amongst other measures taken, subjects underwent the Kraft test. Here are the results graphed:

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The conclusion notes: ‘that chronic exposure to the LCHF diet may result in a downregulation of the insulin signaling pathway, which could partially explain the impaired glucose tolerance that is commonly observed after adaptation to the LCHF diet.’ It also suggests: ‘A possible mechanism for the lower glucose tolerance is that chronic exposure to the LCHF diet reduces insulin secretion and circulating insulin concentrations, resulting in reduced insulin receptor activation and decreased expression of GLUT4 and IRS1 proteins.’