I have never suggested you not post nor have I ever told you what to do!
I just find some of your claims without merit and anytime someone pushes for more details you get defensive.
I think it is doing newbies a disservice to read an older woman can consume an entire large pizza and remain in ketosis. They wonder why they can’t or what they are doing wrong.
Well in that case I try to explain things in easy understand terms and maybe another person cannot see all the science behind what I may be doing but also my time and posts are a learning curve for me as well and I’m always revising where I might be wrong, I’m a self-experimenter and share things that may or may not work for other people. I take studying human physiology and diet very seriously and you don’t get anywhere without testing the turf or other possibilities when things don’t work out long-term.
@Arbre. seriously ? generalize much? not all vegetarians eat wheat, pasta, sugar and veg oil. there are plenty of vegans who do not eat these foods but eat a plant based nutrition dense clean diet and thrive on it. there are keto peeps who eat no carbs but eat all kinds of processed chemical filled meats, cheap antibiotic filled meat , gobs of dairy and just plain too much food. who do you think is better off down the road?
to me, clean thoughtful eaters in both camps seem to have a LOT in common. they are trying to improve their health and (hopefully) the planet and the lives of other critters. I have little in common with ketos or carnivores who eat dirty food from poorly treated livestock or who eat highly processed foods. they can eat what they want but I don’t feel like we are in the same tribe. i have more affinity for the clean eating vegan.
I suspect the long game will show clean food ,and less of it, is the most important factor in long term health and longevity.
I think Robert Lustig is making some good points and some of the studies he’s referencing in his book can’t be dismissed. One of his main studies is one in which he substitutes fructose for glucose in overweight children and saw metabolic improvements.
Unfortunately this study was criticised because (1) they had no control group and (2) the children lost weight, even if they tried controlling their calories, which means they underestimated their caloric requirements. This is a big problem in any study in which metabolic markers are measured to see the response to an intervention, because weight loss is a big confounder, resulting in improvements across the board.
And also there have been studies in which subjects were overfed fructose. Here’s one in which subjects were overfed 150 grams of fructose per day — note this is a high dose, at least twice what the Americans are normally eating on the junky SAD — and nothing happened, the liver was not affected, they did not gain weight, it was completely benign …
It’s worth mentioning that the subjects were healthy and that they simply adjusted their caloric intake to compensate the excess fructose. This study isn’t of the best quality possible, the subjects were free living, although compliance was easy — they simply had to swallow a bag of fructose every day. And interestingly enough, they did NOT over-consume calories, even if consumption of food was ad libitum and they did not gain weight.
The problem with all hypotheses about sugar or saturated fat or whatever macro is trendy to hate is that the problems tend to happen only when in a chronic caloric surplus … high blood glucose, high blood triglycerides, high ALT/AST, non-alcoholic fatty liver, etc… all of them seem to happen when energy poisoning is involved.
We cheered for example when we saw the Annals of Internal Medicine publishing their red meat reviews, suggesting that people should continue their current consumption of red meat, because all of the evidence we have against the healthfulness of red meat is of low quality on the GRADE system (for assessing the quality of the available evidence). But did you know that they had a similar review for sugar guidelines?
This systematic review takes a look at the available evidence for limiting consumption of sugar and concludes that:
Guidelines on dietary sugar do not meet criteria for trustworthy recommendations and are based on low-quality evidence.
And speaking of the carbohydrate-insulin model, as promoted by Gary Taubes …
This might be an unpopular opinion in keto circles, however people with high levels of insulin don’t seem to gain more weight:
This is a meta review saying that there is no association between insulin levels and future weight gain. By looking at someone’s insulin levels you cannot say if they’ll gain weight or not in the future.
Also the idea that overweight people have suppressed lipolysis (due to insulin) may be unfortunately not true. Overweight people seem to have elevated levels of lipolysis, here’s a study that shows it…
Hyperinsulinemia is indeed problematic, being the cause of many problems, but it’s not necessarily the cause of obesity or diabetes, it may very well be its effect and the evidence against Gary Taubes’ CIM model is pretty damning.
The good news is that low carb / ketogenic diets still work in spite of CIM being wrong (e.g. ketosis does have benefits and low carb is still good for managing blood sugar in diabetics). But the mechanism by which it works or doesn’t, that’s still important to find, because CIM probably leads to wrong advice given to people for which keto / low carb doesn’t work so well.
This is me turning the hose on those of you who are getting personal in your debates, you know who you are.
Interesting thoughts @fishbottle and I very much agree with the general feeling, however something caught my eye…
Do you have references to evidence that CAFO meat (the “poorly treated livestock” you mentioned) is healthier than grass finished, free range meat?
What we know is that grass fed and grass finished beef has slightly more Omega-3 fatty acids and vitamins A and E. However beef in general is a poor source for any of those nutrients.
E.g. if you want Omega-3, eat salmon once a week, or maybe walnuts and that’s all you need. For vitamin A, eat 3 to 5 egg yolks per day, which are also good for the folate and the choline. And vitamin E is actually harmful if you eat too much.
Of course usage of antibiotics is of concern, but how do you know that the meat you buy is antibiotics free? You don’t, unless it’s required by legislature. The EU btw has banned prophylactic use of antibiotics and I foresee Australia and US following next, simply because they can’t export their beef to the EU otherwise (just like how they can’t export eggs due to different rules for handling).
Don’t get me wrong, I many times buy meat from local farmers and the difference in quality is very visible. However local farmers don’t have the resources or the marketing know how for labeling their food “organic”, “free range”, “grass fed” or whatever else is trendy.
Also grass fed meat is expensive and represents less than 2% of the meat available for purchase. CAFOs make meat cheaper (until we’ll start paying a carbon tax, like we should).
What are people supposed to do, given a lack of finances or access to a good source of such meat? Well, in absence of compelling evidence, people should just eat the meat that they can find, since we need a good source of protein and CAFO meat is still a good protein source.
Seriously we don’t have evidence that in a well balanced diet CAFO meat is less healthful than free range, grass finished meat. And it makes sense for why we don’t have evidence … animals are excelent filters for whatever toxins is in the food they eat.
We can have the same discussion for plants as well.
What’s the definition of “clean” anyway?
Yes we know that ultra-processed food is unhealthy, we have actual evidence for it, but if you mean ultra-processed, then say “ultra-processed”, because it has a clear definition, whereas “clean” does not and is in tooth-fairy land.
I agree that we should call a spade a spade, and use the terms “ultra processed”, “processed”, and… “non-food items” even! Because at some point, this stuff is not food, it’s disease-producing filler that is thoroughly unsustainable.
In an industrial agriculture economy that destroys everything in its path - there are so many more facts and nuances than notions of clean/dirty. The root causes are constructed by a land-destroying, profits-motivated industrialism that is like a runaway train. I think we also need to be rigorous in acknowledging this culture’s sick disconnection from the living land and the laws of nature that have nourished traditional farmers, along with indigenous & aboriginal humanity for millions of years.
As you prob already know - industrial food production practices are enmeshed with other massive industries such as the world’s largest, the pharmaceuticals industry (which has profits that outpace oil, gas, and petrochemicals combined!). Livestock antibiotics used by the concentrated, inhumane dairy, chicken, and pig producers are the #1 use case for antibiotics sales, followed by human usage. Then there’s also biotech destroying heirloom seed stocks, positioning itself in a central role for farmers who become dependent on unsustainable practices (with high rates of farmer suicides in India), and dumping carcinogenic Roundup/glyphosate into the land. Monsanto GMO corn is heavily used for pig feed, along with other animal feed in the US, but outlawed in Mexico and the EU I believe.
These are some strange “new” vicious cycles and math influencers affecting global economics and public health since the 1950s, that’s for sure.
Dr. Robert Lustig calls metabolic derangement ‘processed foods disease’ - and I think that, at some point, unnaturally raised livestock and animal products are part of the disease-making due to their own hormonal disease (besides the animals’ devastating depression and distress/madness in concentrated conditions). Though one can go far on just eating fastfood burgers w/o the bun, the fatty acids composition and the slaughtering practices that make for high-adrenaline meat do matter on a grand scale of hormonal health and ancestral traditions. The excess fat in the marbled meat of grain-fed/feedlot animals is extremely high in Omega 6 rather than the Omega 3s of pastured animals, and has created a strange “new” problem. Another quote from Dr. Lustig’s recent book, where he synthesizes his data-driven analyses with connected thinking and just serves up a lot of great elder wisdom:
“Next time you’re at the butcher, have them show you strip steak from grassfed cow and from a corn-fed cow. The grassfed steak is pink, and pretty homogenous throughout. It’s delicious, but when you grill it up it’s a little tough. Now look at the corn-fed steak, see all that marbling? We love it because that’s where the flavor is. And after grilling, it practically cuts with a butter knife. That marbling is fat in the muscle. That’s muscle insulin resistance. That cow had metabolic syndrome; we just happened to slaughter it before it got sick, and now we’re consuming the aftereffects in each and every Big Mac.”
The Hacking Of The American Mind: The Science Behind The Corporate Takeover Of Our Bodies And Brains , pp. 126-127
There’s also the greedy practice of supplementing cow feed with cheap protein pellets which contain… other animal flesh (such as sheep and other cows - and not only that, diseased ones!), forcing an unprecedented-on-the-planet carnivorism upon grass-eating ruminants, and likely the cause of Mad Cow disease/BSE. We’re beyond merely dirty - it’s dystopic and predatory on many levels.
Urban food ghettos where the poorest and most marginalized people live are increasingly the norm, where the only “food” for sale nearby is ultra-processed industrial food at gas stations and fastfood places. Fortunately with LCHF/keto, even marginalized people eating low quality industrial animal products and dangerous processed fats can become able to discover more satiety, nutrient density ( via bunless/potato-free/rice-free/noodle-free/sugar-free fastfood fare) and even spontaneous short fasting. There is serious economic disparity though - which is a huge barrier. In the US, close to 50% of the population lives at or below the poverty line - and those who receive paltry scraps of gov food benefits (food stamps/EBT) can now purchase food from farmer’s markets through innovative access programs, HOWEVER that food is not at any special subsidized price for the farmers or for the shoppers - it’s 3x, 4x more expensive than the big corporations’ foods. Food injustice is real 
Nice post, Fabia. 
On fructose - the increased-fructose study concluded that, “This indicated that young, metabolically healthy subjects can at least temporarily compensate for increased fructose intake.”
I would have certainly thought that beforehand. I’m impressed that they went for 8 weeks, however, rather than for just 3 or 4, i.e. “going cheap”.
On insulin levels, the “The entero-insular axis…” study mentions early on that “Weight gain is also a potent predictor of the development of insulin resistance, irrespective of baseline BMI, both in adults and in children.”
This certainly makes sense to me. It’s come up on this forum before - does insulin resistance cause obesity or it the other way around?
I tend to lean toward that too, although there’s often some pushback in the keto community since that sounds like the old ‘calories in and out’ view. It definitely applies to insulin resistance, as well. I can see a “steady state” where liver glycogen never fills up all the way, is drawn down overnight, partially refilled during the day, and things go along nicely. But maybe that’s oversimplified, and right now I can’t remember all the other stuff that’s going on, too, so… 
I do think that energy balance matters - there will be a reason that things happen, and at the least we shouldn’t neglect it. For example, however one gets to using up stored fat, there needs to be a reason that the body does that.
If the carbohydrate-insulin model of obesity is really “wrong,” then that seems to fly in the face of:
More later - I’ve gotta get going - will read through the studies for real…
Where in the world are you based?
Here in the UK almost all meat is mainly grass fed so…
Maybe not so much ‘wrong’ as not completely right in the investigation of the personal fat threshold idea and the complexities of the other 33 hormones, including glucagon, or so involved in digestive metabolism, satiety etc.
Great points @fabia
I agree with you PeteMarie
Everyone has something good to offer, it doesn’t benefit anyone to publicly attack each other. We can leave that to vegans… Did I say that?… I’m really just kidding.
not going to address all your points since I found many of them valid and astute.
My choice of not eating CAFO meat is not a nutritional or economic choice so your points about that aren’t germane , its based on my belief that the industry is cruel, inhumane and not good for the animals or the environment. I don’t think its great nutrition for people either but thats less clear and harder to prove (or disprove). it depends on who is funding the study, yes?
By not my tribe , I simply meant I often find I have more in common with some segments of the vegetarian crowd than many in the keto crowd. I get a bit weary of the vegetarian bashing and sneering that pops up on the forum. The nature of social media I know…
I don’t make much money and I can’t always buy organic (though where I live the prices for conventional and organic are not far apart. food is very speedy in Seattle. I make do. though , i don’t shop at Walmart. again…ethical choice. ) .but I certainly cannot afford to purchase heritage organic $38 chickens straight off the farm - though they are very tasty. I can try to bargain or barter for imperfect veg from local farmers or raise my own. I have farmed/gardened and raised stock much of my life, and this year purchased 1/2 cow happily pastured and locally and humanly slaughtered by the mobile slaughter house which came in at about $4/.7a0 per lb not bad . the dog and I will make it last most of a year and eat a lot of fish . I also hunt pheasant a d grouse with my dog .
By not by tribe or not by community, I am saying I do not align or identify with people who do not place the treatment of animals and consideration of the environment near the top of their criteria when choosing foods no matter if they eat vegan SAD or keto,
I simply choice not to participate in animal cruelty including CAFO. I don’t believe humans are more valuable/ or important than animals-. I don’t believe humans have them to right to torture another animal in order to eat.
As far as defining clean? Don’t argue semantics. It’s not a legal term. It’s a bit subjective. Pick whatever criteria you want. I meant mostly whole food, as free of additives as possible, and nutrient dense.
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Ethical treatment of animals, while an admirable moral, does change the science of nutrition. Virta’s results speak for themselves w/o big $ vested interests backing them. IMHO They are leading the medical industry in well funded long term closely monitored studies of low carb WOE enhancing people’s health. I’d be happy to look at studies of how this growing WOE will alter agribusinesses. However, that’d be a different thread…
I wish I was one of those people who do well on vegan. I do better on ‘clean’ Vegan (ie sugar free, carb conscious, low process, etc etc) than on SAD . but I unfortunately am better on keto . might be genetics. might be years of SAD . might be just sloppy non attention to my insulin resistance. (formerly called syndrome x?) . oh well. in my next life…
So keto is your consolation prize? Oh well, better luck next time around. 
its ok. I would rather not eat animals. but as much as I like kale…so yes …consolation prize . life is imperfect and I try to minimize the harm I do. ok with it
These are subjects dear to my brain. The philosophical aspects of eating applied to a wider context of living ethics.
Tribalism is rife. The outliers, those slightly different become shunned or exalted. One becomes the eccentric outcast or the respected shaman. Both speak of ideas outside of the norm. Ideas at the edges. Edges of groups, edges of established dogma.
It’s at the edges where diversity exists. Diversity of ideas, diversity of beings. Between the jungle and the plain, between the mainstream and the upper bank. The riparian zone. It’s from diversity ideas are tested and presented, and the adaptability of the tribe, community and self progresses. It’s also a hostile place always threatened by the existing beliefs, the religion and traditions, the plateau of thinking where many will gather and stubbornly refuse to shift perspective.
The evolution of eating to include ethics is led by the vegan community. They hold the high ground. But between the entrenched vegans and the stubborn, uncaring, maybe even selfish, mainstream is the fringe minority: regenerative agriculture, permaculture, earth ships, composting toilets, fossil fuel alternates, a whole milieu of humans trying things that take the best aspects of what already exists and reimagining and reconstructing the components into something new, something new that resembles something old, something seemingly weird if the story of it is not understood. And hopefully something better without losing, or sacrificing, or forgetting the good parts of what came before.
The application of ethics to eating is another level from the ignition point of understanding that eating food is power that carries responsibility. Initially responsibility for one self and self health improvement, and when well trained and skilled, where eating properly is instinctive, then the ideas and benefits expand outward into the close community of family and friends, and one can look up and see the beckoning warm glow of ethics and philosophy in the essential consumption.
@fabia Can’t use this first review article in a PhD thesis as it is 10 years old but it demonstrates the differences between grass fed and grain fed beef. Not exactly CAFO vs pasture but gives an applicable delineation based of feed stuffs. There may be other CAFO inputs such as animals per square metre (crowding), intensity of use of anti microbial treatments to limit disease spread, or to change the ruminant gut biota to produce more carcass weight (growth stimulant effect) etc.
More recent 2019
In conclusion, growing and finishing cattle on pasture improved the carcass yield of retail cuts because of low fat concentration, and improved the nutritional and health value of the beef fatty acid profile.
I wouldn’t say that’s precisely true. The key to reversing Type II diabetes lies in restoring insulin sensitivity. Lustig et al. showed that reducing fructose consumption alone is sufficient to reduce visceral (especially hepatic) fat and produce a marked improvement in liver enzymes. This is important, because fatty liver disease is a highly important part of insulin resistance.
As far as insulin resistance in adipose tissue is concerned, it is the reduction in serum insulin (which is what makes fat loss possible), not the actual loss of fat, that permits the restoration of insulin sensitivity. (Of course, reducing the lipid level plays its part by reducing the need for insulin resistance.) On a well=-formulated ketogenic diet, insulin resistance increases in muscle tissue as glycogen stores drop to normal levels and the liver starts producing ketone bodies. This frees up the glucose produced in the liver (gluconeogenesis) for use by those cells (red blood cells in particular) that cannot metabolise ketone bodies or fatty acids.
Sugar, in particular the fructose component, definitely plays a role. Taubes notes that in the 1960’s, when Japanese sugar consumption per capita was what it had been in the U.S. in the 1860’s, diabetes and obesity rates in Japan were what they had been in the 1860’s in the U.S. It was in the 1860’s, after the end of the Civil War, that the U.S. confectionery industry got started, and the diabetes epidemic in the U.S. began about twenty years later (as noted by Joslin at Massachusetts General Hospital in Boston). Once Japan’s sugar consumption caught up with that of the U.S., Japanese rates of obesity and diabetes rose to be comparable to those in the U.S.
Of course, that is correlation, not causality. The picture is probably more complicated than simply a rise in fructose consumption, since the introduction of seed (“vegetable”) oils into the food supply occurred on a similar timeline. Ω-6 fatty acids are known to cause systemic inflammation, and they form a major percentage of the fatty acids in such oils. There is a food activist (whose name I am forgetting at the moment) who claims that it is seed oils, rather than sugar, that caused the diabetes and obesity epidemics. I can’t say he is wrong, and Dr. Malcolm Kendrick, the noted cholesterol sceptic, gives him a great deal of credence.
However, I suspect that it will probably turn out that the increased consumption of both seed oils and sugar is the cause of our current poor health. I certainly wouldn’t be surprised, at any rate.
