Dr. Sarah Ballantyne doubles down against ketogenic diets

science
#1

I’ve been following the paleo movement for 4 years, getting heavily involved in digging up the science and listening to the science stars in the field. Listening to these folks’ podcasts is how I stumbled into keto a couple years ago.

Robb Wolf’s first book was geared toward helping people lose weight, and while it may have been subtle, it was very clear to me in his book that carbohydrate restriction was a main factor in weight loss.

Fast forward a little bit - Many here have stumbled on Dr. Sarah Ballantyne (ThePaleoMom) and her first blog post Adverse Reactions to Ketogenic Diets: Caution Advised and it’s my understanding that many keto experts have debunked the poor science behind the studies referenced in this article.

Last week, she doubled down against ketogenic diets, and I’m curious if anyone has dissected it and debunked any of her claims. Of course, you’ll have to love the title… The Case for More Carbs

During the meantime, I’m going to keep calm and keto on.

Low carb diet tied to Atrial Fibrillation
(Karen) #2

Paleo makes more sense to me, and I’m wondering if it doesn’t make more sense for females. Ladies, who have lost weight, what is your experience? I buy that “man” dug roots, and ate fruit in season. Bugs too.

K

(Doug) #3

I think she’s a good writer - have to give her that. However, I think she over-generalizes, relies on some stated and unstated assumptions, and truly goes off the logical rails at times.

the now-debunked carbohydrate-insulin hypothesis of obesity

This is such a blanket statement, and it is not true. While some doctors/scientists/researchers hold this opinion, at the most we have some apparently conflicted and inadequate studies; by no means is it so settled as she would have us believe.

Moreover, I have to say that on an anecdotal basis, the importance of insulin levels and carbohydrate intake with respect to obesity appears to be undeniable. I am sure that addressing this is what has made such a beneficial change for me - where nothing else has. That is also true for thousands of people who have posted on and read this forum. There is no rational way that it can be dismissed.

(Ketogenic) diets help us lose weight simply by creating a dietary structure that focuses on more satiating foods so that most individuals naturally achieve a caloric deficit while following these dietary templates.

True for some individuals; I’m not so sure about “most.” Regardless, I think she misses the point that said caloric deficit can be made up by the individual burning their own fat stores, and that this is a large component of many people’s weight loss.

When followed for long periods, ketogenic diets can tank our metabolism and have a muscle-wasting effect, making weight loss maintenance particularly challenging.

Oh come on! For how many people is that actually true?

So, while insulin resistance is clearly damaging, not eating enough carbs to support healthy amounts of insulin secretion can also lead to similar health problems and make long-term weight loss maintenance tougher.

Good for her for making such a positive statement about the problems of insulin resistance, but then she brings up what she assumes is an unhealthy, apparently too-low level of insulin. “Similar health problems” - as if equally bad things may occur if we somehow go “too low” on insulin. This does not make sense - let us address the known, demonstrable effects of insulin resistance without fear of her hypotheticals. If at some later time there is actual evidence of not enough insulin, then that can be addressed.

She goes on to discuss hormones and the evils of “too little insulin” at length. Other than with Type 1 Diabetes, I was not aware of it being a problem. She portrays the effects of ketogenic diets as possibly bad, because of the hormonal changes. This is neglecting the fact that ketogenic diets are successful, quite often, at restoring hormonal balance in the first place. Seems to me that her objections are fairly nebulous - along the lines of “This may happen…” without much if any proof that it is statistically likely that an individual will experience those problems, and without recognizing the fact that even if there are some bad effects along with the good, the good usually will far outweigh the bad.

#4

She is editorialising the fact that people will die when on Keto, people die on Paleo too. Weirdest article I have read in a long while. MOM, MD seems they are all the same: trying to save their businesses.

(Bunny) #5

What kind of insulin are we talk’n bout?

  1. IGF-1: (liver/hepatic) When under an X amount of carbs and sugars are consumed i.e. maintaining ketosis\ketones = glucose sparing; physiologic skeletal muscle insulin resistance?)

  2. Glucagon: (from pancreas when a little amount of protein ONLY is consumed? When over an X amount of protein is consumed gluconegenesis or endogenous glucose at some point in time can or will occur?)

  3. Sucrose/Fructose Reactive Insulin: (from pancreas when high amounts of sugar and carbs are consumed?)

  4. HFCS: Does not initiate an insulin response but the liver turns this type of bacterium processed sugar directly into visceral fat that accumulates around the internal organs and around the torso area of the body…

Notes:

  1. 10 Sneaky Names For Sugar: “…Let’s start with table sugar, one of the most common. The scientific name is sucrose: That’s half glucose (starch) and half fructose (sweetness). You might also know it by “cane sugar,” which is 100% sucrose. …”
  1. Randle cycle: “…The inhibition of glucose oxidation causes fatty acids and ketone bodies to contribute to a glucose-sparing effect, which is an essential survival mechanism for the brain during times of starvation. …”
  1. Keto-adaptation and physiological insulin resistance “…Recap (part speculation): during starvation, muscle starts on ketones but then switches to fatty acids, in part, to prevent wasting and spare ketones for the brain. This is how ketones get so high, and it doesn’t happen when you’re eating [keto]. While on a ketogenic diet, muscle uses ketones and does so increasingly so after ketoadaptation, when mitochondrial capacity is up to snuff <– that’s the speculative bit; but it could explain: 1) why ketones routinely decline in humans & rodents after ‘ketoadaptation;’ and 2) how physical performance is restored (ie, Veech). …”
(Doug) #6

Bunny, I think she means insulin from the pancreas - she is presenting “not eating enough carbs to support healthy amounts of insulin secretion” as just as bad as insulin resistance. To object to keto on this basis seems silly to me.

Even if it’s true that for an individual there will be problems with too little insulin in the future (and again, I’d never heard of this being a thing with regards to keto diets), I’d say let us address insulin resistance and its whole host of problems first, and not worry about too little insulin secretion until when and if it manifests.

#7

I have moved to a little more paleo-style myself, and have found it benefits me. For some reason I’ll never understand, keto did not blunt my appetite like it does for others (diminished, yes. Able to fast for hours and/or days? Definitely not).
Also with strict keto I could not get full on fat like other people suggest. I would eat a hearty breakfast of eggs and bacon, maybe some avocado. That’s a lot of fat there but then I’d be hungry still and have spoonfuls of butter, like go through a brick of kerrygold in one week by my 5’2 113lb self!!And I would still be starving by lunch, where i’d have more ketogenic food and just on and on it went.

I decided to add some sweet potato to the end of my breakfast instead of butter, and BAM, one little piece and total satiety. THen I tried it with green bananas and again, it worked. When I say “bananas” I mean two slices of one that had been frozen. These are not a lot of carbs, but enough to somehow flip the switch for me and signal “done” to my body.

I tend to think keto might be super helpful for metabolically deranged folks, diabetics, epileptics, etc. But I was never any of those and in fact quite small in frame so I think keto did tip things into the “too much” direction for me. I definitely, DEFINITELY do better on low carb, but not that low.

I was sad to not be “keto” anymore, but my blood registers ketones for the most part every morning. Not high and not always and I had to let that go anyway if I was going to be eating carbs, but it was psychological shift that wasn’t easy. The physical shift made my life way easier, but the psychological one was tougher

(Katie) #8

Keto and paleo are not mutually exclusive. Paleo is about food quality–what one is eating; keto is about food quantity–how much of the various nutrients one is eating and switching one’s metabolism to primarily burn fat. I eat Keto quantities of Paleo foods, and it is better for me than when I was low fat, high carbohydrate Paleo.

(Bunny) #9

I would add GLUCOSE TOLERANCE & RATE OF INSULIN CLEARANCE to this, just enough (to be absorbed by cells) sugar and carbs but not too much like we get from processed foods. But how do we do that? I would think from not eating too much of it, type of food is not being discussed with this paleo-mom thing, thinking we can just eat any (CICO) old thing and get the same result long-term is beyond stupid… lol

Clarification: Mixing sugar and protein viz. with fructose from fruit in the same meal (i.e. “paleo”), is a bad idea in my opinion (blocks vitamin K-2 with high fat; increasing CVD risk?), each should be eaten separately at different times (e.g. spiking different types or forms of insulin?)

(Doug) #10

Yes - the article is overly-general in several areas. It’s intentionally broadly anti-ketogenic but seemingly not recognizant of the great range of beneficial effects of keto that are available to many of us long before any problem with “not enough insulin secretion” gets to be a problem, if ever it would.

(icky) #11

A few years ago, I read a newspaper article that the zookeepers at the zoo have to be really careful to not give the monkeys too much “modern” (store-bought) fruit.

Wild fruits have sooooo little sugar content and the fruit humans have bred over the millenia is now a real sugar bomb.

If the zookeepers give the monkeys too much “normal/ modern” fruit, the monkeys develop T2D !! :see_no_evil:

So I think the notion of “humans used to eat roots and berries” needs to be taken in that context…

(Bunny) #12

:speak_no_evil:

(Beth) #13

Fascinating. If you love this topic then you need to read the book, “Eating on the Wild Side” by Jo Robinson. It talks about how over the last 10,000 years that we’ve been selectively breeding our fruits and veggies to have fewer nutrients and much greater sugar content because we are naturally attracted to sweeter tasting things. Here’s a short video that you may find interesting Jo Robinson
Regarding paleo, it makes sense to me too. Paleo concepts focus on the nutrient density of foods. I personally think that we can be both paleo and ketogenic at the same time. It seems perfectly reasonable and natural to cycle in and out of ketosis when properly fat adapted. That’s probably what our bodies did on a daily basis as we foraged, feasted and fasted as hunter gatherers. We are trying to hack our metabolically damaged bodies with the keto approach, but if you aren’t damaged, then maybe keto cycling or a lower carb whole food diet is a perfectly reasonable approach.

I’ve been tracking whether I’m in ketosis for the past 6 months, although I’ve been mostly keto for the last 1 1/2 year. I’ve found that I can have a fairly large volume of leafy dark greens and other veggies along with my fats and stay in ketosis anyway, especially when I’m exercising every day.

Call it keto, call it paleo. . . this is what it looks like to me:

FoodGloriousFood
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(Shayne) #14

Jimmy Moore did a whole Keto Talk episode debunking her claims from a previous article two years ago.

http://ketotalk.com/2016/06/23-responding-to-the-paleo-mom-dr-sarah-ballantynes-claims-against-the-ketogenic-diet/

Having said that, she is the “creator”(?) of the autoimmune protocol and I try to use it in conjunction with keto (yes, it does make it harder) and it seems to help.

(icky) #15

How cute that there are secret-semi-Paleo Ketoers on the forum :smile:

(Alec) #16

I find that a soft version of paleo works beautifully within a keto framework, and with regular fasting thrown in, this seems to me to be the way we are supposed to eat.

Bacon, fast… bacon, long fast… bacon, STAT!!!

(Ken) #17

Original Paleo is lipolytic. It’s based on the 60/35/5% Whole Animal macro. ThePaleoMom is perhaps the best example of how the concept has been corrupted, to the point of being neither healthy nor scientific.

(Brian) #18

To be fair, many of us keto types share quite a lot with many paleo types. Yes, we do disagree on some things. But it seems we agree on an awful lot.

(Karen) #19

Great post. Hadn’t heard that.

K

(Omar) #20

Maybe spies :joy: