Dr. Sarah Ballantyne doubles down against ketogenic diets

science
(Ken) #63

That was essentially my pattern, but I’m not sure why people think the 60/35/5% Paleo macro is somehow not ketogenic. The 5% Carb macro is certainly low enough for sustained lipolysis, and therefore ketosis. Even now that pattern is still my baseline, with the exception of some HWC and the occasional Carb intake for metabolic reasons. The problem is the original, true Paleo guidelines have been corrupted by so many gurus that they are really no longer Paleo. They are Fauxpaleo.

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #64

Of course Rosedale’s timeline is designed so he can talk about flatworms, rapamyacin, cancer, TOR, mammalTOR, and the need for less protein.

Never mind that Dr. Mike Eades burned Rosedale’s thought house to the ground and then burned his insurance check, as well. AMPK vs mTOR in fasting and carb restriction. Game set match.

Yes, humanity’s existence on the scale of the evolutionary history of life on earth is a shallow breath. So of course Paleo is a blink. But I don’t feel particularly like a flat worm, so I don’t find that portion interesting.

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #65

That’s basically my macro, as much as I sweat that. It’s the Protein Power macro, of course the Eades and Dr. Cordain were in a mutual admiration society.

(Ken) #66

His argument from that aspect didn’t make sense to me. Evolution is a fact, as species evolve to fill specific ecological niches. In the context of humanity, a five to seven million year stretch of Evolution is certainly relevant, with special emphasis on how our current specie evolved. Due to the increases of brain size due to eating meat and fat, we were able to evolve into an Apex Predator, although our biochemistry still enables us to be omniverous.

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #67

I was bothered by Rosedale’s presentation because I like the protein.

Dr. Eades made a comment during a Q&A that got me researching.

The TL:DR is that fasting reduces mTOR. And carb restriction does, largely through the same mechanism.
https://www.ketogenicforums.com/t/lechefs-midlife-crisis-a-turnaround-project/32600/77?u=lecheffre

#68

Re protein, I was vegan for 7 years, and I lost muscle and gained weight and always had swollen ankles. I’ve come back full circle to keto which makes me feel very well as long as I get enough veggies, edema gone, and weight dropped off, only the 10 pounds was all I needed. The best book I have read that explains the science behind keto is “Tripping Over the Truth”. It’s written by a doctor and very well referenced. I was going to skip the chapter on weight loss, because that wasn’t my motivation; however, I found the chapter fascinating in explaining why other diets don’t work. If you want to read a scientific argument for keto, read that book.

(Wendy) #69

I found that title on Audible. I may take a listen. Have you read/listened to Good Calories, Bad Calories? I just finished that one and really enjoyed it, and learned so much.

#70

Someone is paying her a lot of money!

(Wendy) #71

I thought I hit respond to this but I guess I didn’t. :smile:

#72

Interesting. I agree that Dr. Ballantyne writes and speaks well.

She certainly took some exuberance out of Jimmy Moore’s evangelical early keto enthusiasm, and I think Jimmy has matured his presentation approach a lot since their few encounters. In following that interaction a few years ago, I appreciated Dr. Ballantyne’s questioning and in doing so exposing the unavoidable cognitive dissonance that comes along with a way of eating that provides many with almost instant improvement in health.

But keto WOE is maturing, like Jimmy Moore’s enthusiasm. Some of us are discovering the adverse effects of which Dr. Ballantye warns and can follow the cause roots back to choosing to eat keto.

Atrial fibrillation and a kidney stone are two adverse effects of my personal experience while eating LCHF and being in nutritional ketosis. They also appear in Dr. Ballantyne’s 2015 article.

This is awesome as I can now review her literature review, and review the reviews of that review to track down the best resources to continue the scientific detective work into the devilish details of sustainable LCHF eating and health maintenance.

(Karen Parrott) #73

I totally respect Dr. Ballentyne for her work in AIP and those who she’s helped in that space. I suspect that as a post Hashimoto’s person, I need a few more carbs 27-47 per day than a lot of my <20 grams of carbs Keto buddies.

I think that we all congregate in spaces where we fit genetically, post disease, and to our goals. I congregate in a long term weight maintainer after 40 years of obesity, post auto-immune, with a T2D high risk space. That means I eat low carb (not super low carb), I eat some colorful carbs (like Terry Wahls and Sarah) but more like Robb Wolf for outcome and finally, I’m Keto like a bandit because 18:6 keeps me really Keto and really lean. YO! So that’s why I’m here in the Ketogenic forums. I don’t really fit in here- into the <20 grams of carbs, but I’m going to be Keto because I fast.

Let’s all hold space for multiple views I suspect like @FrankoBear that kidney stones are high risk for me. More auto-immune diseases are also high risk. I would urge us all to leave pathways for folks like me who need to have one foot in LCHF, one foot in Keto and please hold room for us. Hold a space for us not to get bashed. Please.

We will move Keto forward by leaps and bounds. I only take one thyroid meds, it could be fasting and some colorful veggies that keep me from getting really sick. The last time I took my ketones, they were 0.9. Good enough. To stay lean, to keep other auto-immune diseases in remission, to keep migraines away.

I’ve sustained a mild Keto diet for 7+ years now, weight maintenance 6+ years. We are all very smart, if strict Keto works great for you with super lean mass results, weight maintenance, mood, good thyroid ballace great!!! I love to celebrate with you. I hope you’ll celebrate with me. Leave room for us. The keto folks that are LCHF with mild ketones need to have a place to go. The whole Keto movement needs to go forward- with all of us.

I’ve interfaced with Dr. Ballentyne, Mickie Trescott, and Angie Alt. They all say their AIP folks need a little bit more carbs. So does Robb Wolf for performance and he teaches Keto Master Class. All four people have had great health outcomes. There is something to learn here.

(Karen Parrott) #74

I’ve found mild ketosis (0.5 to 1.5 or so) works much better for me than a higher ketone levels. To get higher ketone levels, I gain weight due to too much dietary fat.

7 years in mild ketosis. Keeping 70 pounds off.

(E.O.) #75

Yes–in fact just today I read a Paleo website blog post today that suggested Paleo can be altered for either Keto or IF for those who eat that way.

(Bacon is a many-splendoured thing) #76

Personally, I’d like to see what mechanism she posits for this “too little” insulin. Protein stimulates insulin at half the rate of carbohydrate, so there is always going to be insulin produced—so long as the beta cells of the pancreas are healthy, and they are going to be much healthier on a ketogenic diet. Granted, the brain cannot function without insulin, and we need insulin to keep our ketone production in check, but ketoacidosis is not a threat even if the pancreas is making only a small amount of insulin.

What this sounds like to me is someone who’d really prefer for us to eat all carbs, but who has given up and is saying, “Well, for heaven’s sake, guys, won’t you eat at least a few carbs?” And of course we do: very few, lol!

(Todd Gamel) #77

First, I think she misses the point in her article and way overgeneralizes the ketogenic diet.

"Low-carb diets do promote weight loss (and achieving a healthy weight reduces risk of diabetes, cardiovascular disease, etc.). This fact has led to their increased popularity and the push towards ever lower carbohydrate intake, including the current ketogenic diet fad.”

Wow, keto is a fad diet, I have never heard this one before (rolling of the eyes). I am not sure how it is any more of a fad diet than the paleo diet which she advocates. Essentially, keto and paleo follow the same basic dietary guidelines except that keto has a higher dietary restriction of carbohydrates which are replaced with fat, and paleo restricts dairy. In his book ‘The Paleo Diet’ (p.11), Loren Cordain lists the following comparison:

The Paleo Diet: Protein:19-35%, Carbohydrates: 22-40%, Fat: 28-47%
Low Carb *Fad Diet: Protein 18-23%, Carbohydrates 4-26%, Fat: 51-78%

*Note: He uses the word “Fad” diet in his description, not me.

Now there are many areas in which these two diets overlap, and I know some people who do a form of paleo in which they eat on the lower end of carbohydrates, and eat slightly more fat making it ketogenic. So I am not sure why one way of eating is considered a “fad” while the other is not. As for weight loss, carbohydrate restriction is the ONLY way that I know of that a type 2 diabetic like myself can control their blood glucose levels via diet. The weight loss is a bonus, as a type 2 diabetic, blood sugar control is my goal. I could not do this on a paleo diet as proposed by her because it contains to much starch and or sugar. Yes, I could modify the paleo diet to better suit my diabetes, but the I would be left with a ketogenic diet…DUH…

“However, rigorous and well-controlled metabolic ward studies have confirmed that low-carb and ketogenic diets don’t turn us into “fat-burning machines” with increased energy expenditure and preferential fat mass loss.”

My own results as well as those of many others on these forums disprove this statement. Are our results scientific? Well, in a true sense maybe not, but to use an old adage “if it walks like a duck, looks like a duck, and sounds like a duck, then it must be a duck.” My current blood ketones are 2.1, my last Hgb A1C was 5.3, I have been ketogenic since September 2016, and I have lost about 80 pounds, and have kept if off for almost two years. I will eat this way for the rest of my life, this is definitely not a fad diet. And if my results are not good enough, she needs to speak with Dr. Jason Fung, and Dr. Erik Wiessman about the amazing results they have had for years treating thousands of patients with type 2 diabetes and obesiety in their clinics.

“The truth might actually be the opposite. These 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. While weight loss is certainly more complicated than calories in versus calories out, a caloric deficit is still a necessary condition for weight loss.”

Funny thing is the same diet that she promotes also focuses on more satiating foods, in the case for paleo as we have seen higher levels of protein (19-35%) are touted as causing satiation. Here is another quote from the book ‘The Paleo Diet’ (p.21). “Also more than fats, more than carbohydrates, protein has the highest “satiating value” - that is, it does the best job of making us feel full”. So how does being satiated from higher levels or protein differ any from being satiated from higher levels of fat? Would not both lead to a decrease in overall caloric consumption? Well no, the difference is that fat contains more calories than protein so eating a higher fat (9 kcal per gram) ketogenic diet in general provides a more caloric dense diet than one of higher protein (4 kcal per gram) as proposed by the paleo diet advocates.

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

Yes, caloric restriction can lead to a lower basal metabolic rate (BMR), but the ketogenic diet is not about lower caloric restriction, in fact, I do not count my calories, I eat until I am satiated. The focus of the low carbohydrate diet however, is about restricting carbohydrates and eating a moderate amount of protein and higher amount of fat. We eat to satiation, the same concept that Loren Cordain talks about in his book ‘The Paleo Diet’. How this concept of satiation is perfectly safe for one way of eating and not another amazes me.

As for muscle wasting, this is simply another falsehood. The ketogenic diet is not a starvation diet. Even extended fasting in which you eat no foods for 3, 5, 7 or more days does not promote muscle wasting. Do not take my word for it, although I have put on muscle and lift weight 3 – 4 times a week while on keto and while fasting. There are many other keto weight lifters that have impressive results that are keto fanatics. And of course when it comes to fasting, no one knows more about it than Dr. Fung and if it caused muscle wasting do you think that as a medical professional he would recommend a ketogenic diet to his patients? Of course not! Btw, did I mention I have maintained my weight loss for almost two years? The ketogenic way of eating is not a “fad diet” it is a lifestyle, and because it is a lifestyle I will never have trouble maintaining my weight or regulating my blood sugars for the rest of my life.

This of course is just my take on her article…But this is just one keto man’s perspective. I may be totally wrong, but if so, so is the science that backs me up. Stay strong and keto on!

(Doug) #78

Right on, Todd. Doctor Ballantyne made what is essentially just a blog post with several nebulous and overly-general falsehoods. A good bit of her theme seems to be, “You need insulin, you don’t want to have too little insulin.” Outside of Type 1 diabetes, is this much of a concern, at all?

Even if it is, for some people, I have to think that the group with some combination of insulin resistance, obesity, metabolic syndrome, pre-diabetes or Type 2 diabetes, is vastly, overwhelmingly larger, and the doctor’s advice is bad, on balance, for them.

(Joe Mercadante) #79

Agreed. I do both.

(Beth) #80

Just wondering whether these adverse effects resolved and what strategies you employed.

#81

Hi Beth. I dug into my medical biomarker data. Found, like many ketogenic eaters, I may have had a problem with maintenance electrolytes. The biomarker tests suggested too low a magnesium level, despite the magnesium test being low normal. Magnesium citrate supplementation sorted out the atrial fibrillation heart beat irregularities. However, supplementing minerals and not drinking enough water may have induced the ‘one off’ calcium oxalate kidney stone. That was some pain I don’t want to experience again. So I’ve become aware of high oxalate containing keto foods and manage those with cooking and adding dairy, and maintaining hydration. No kidney stone recurrence. But the two months of stress and pain set back my general health gains. Now back on to my modified and supplemented LCHF keto way of eating.

(Splotchy) #82

I suspect this is what many Keto-ers tend to do: go Keto, lose weight, feel great, slip into relaxing things a bit and the less-bad carbs creeping in, see weight creeping up, go back to Keto. If not very overweight/insulin resistant, it’s probably a reasonable approach for long term.