Dr. Stephen Phinney on the Realities of Sustaining Keto diet

(Denise) #21

Hi Janet! No, I am not bored with my keto diet, and it’s pretty identical except changing out the fish/meat unless I make enough for say, 3 days. I sometimes eat kind of scary low calories but I try to just get 1200 a day. I don’t log unless I get curious how much I am eating, so I just do the “listen to my body”. Eat more if I feel hungry and I’ve maintained my weight so must be ok. I’m 69 now so I know I need fuel but with keto I know what I can eat, and what not to so I don’t buy anything I know is bad for me. I am T2 Diabetic and that is what drove me to find Keto.

I also cut out snacks except for maybe 2 a week which is usually peanuts in the shell. I don’t like the effect they are having on my tummy so not buying them right now.

(May the blessing of bacon be always with you) #22

And not only that, but a couple of studies have actually shown a correlation between higher LDL and better health outcomes (lower all-cause mortality and lower cardiovascular events), particularly in women over 50. Again, this is a correlation, not a demonstration of causality, but it does make one think. :bacon::bacon:

(Denise) #23

I’m listening to the video right now @Keto_Lou and Tro just said reintroducing carbs but I do hope there is going to be more about that as that’s the last thing I want to do in order to bring down my LDL I’ll clip a pic of my latest Lipid profile for those that care to see that and I don’t know that I fit the LMHR. Seems like I looked it up and I didn’t fit it, can’t remember now. I do have a lot of muscle, people are noticing at the gym, but haven’t gained weight at this point:

(May the blessing of bacon be always with you) #24

Given that your ratio of triglycerides is 1.64, I’m not sure what you are worrying about. A ratio of 2.0 or less (0.9 or less, outside the U.S.) is a sign of minimal risk for cardiovascular disease.

I believe there is plenty of evidence to show that cholesterol can’t possibly be the cause of cardiovascular disease, but even the people who believe that cholesterol does cause cardiovascular disease have to admit that a ratio as good as yours is an indication of very low to no risk.

(Denise) #25

Ok I understand that this is what I’ve heard since I started Keto, or after my cholesterol started going up, and I guess why I worry is because doctors freak out about it. I basically told my last cardio to go blow because he wanted to do further tests on me after my arteries were shown to be fine, especially at my age and years of eating wrong, I’d say it’s better than fine.

I do want to know if I am an LMHR? Or, I mean if someone knows whether or not I fit that category :slight_smile: Going back to the video with Berry, Tro, Feldman and Norwitz now. Hopefully find out more on lmhr.

(Denise) #26

Ok, listening to more of the video on LMHR. Sounds like their findings are showing a decrease in high cholesterol when increasing carbs. I know they are saying a bunch of carbs, so I am guessing it’s possible I need a few more carbs in my diet to bring down my cholesterol.

I have not tested to see if I can eat more carbs because I had zero desire to in light of the fact my T2 numbers are so good. Feedback welcome. I haven’t got to the part (if it’s there) that high, ridiculously high cholesterol won’t kill me :grimacing:


if you’ve been LC that long, you’re probably metabolically healthy enough to raise your carbs, then. Most people can eventually. Stay at 40… do 50 for 2 weeks… do 60 for 2 weeks. Keep testing sugar (or get a constant glucose monitor and test various foods, because you learn so much that way), and you’ll figure it out. If you can keep the sugar low raising veggie carbs and drive down the LDL, your doctor will likely feel better and you will feel less nervous and you’ll also get a lot more variety, which may contribute to staying on it for a lifetime. (There are 40-year carnivores out there, but that is pretty darned rare.) So you need to run those n=1 experiments to see how you react. Generalities stop helping us as individuals eventually. Too bad there’s not an easy at-home LDL testing device. That’d sure make life easier for your testing phase!

(Denise) #28

This sounds good, and thanks so much Lou, I have a BG test kit I used religiously when I started, and if I try something else, I test to make sure I’m staying within my limits. I will just basically follow what you said, stay at what I am, and add in a healthy carb, no sugar, but I do know to watch out for some fruits/fructose etc.

I can look into a constant monitor and my doc might be able to prescribe one for me, just for a time to see how it goes. These guys are some of my faves I’m listening to today. They say 50-100 but they aren’t talking to T2 Diabetics as far as I could tell :wink: I also have’t studied up on being metabolically healthy enough to raise my carbs. T2 is my main concern so I’ll watch that, the priority. Weight gain, I don’t know, atleast I am way more active than when I started though :wink:


I did <40g net carbs keto (and probably often 80-100g total but I never could care less about total, never seemed important in my case), it gave me fat adaptation but no noticeable benefits apart from that. Those came when I went way lower when I tried out carnivore. It’s not for everyone but sometimes mere ketosis just isn’t good enough.
Why is it scary? :slight_smile: It was SURREAL to me for months (I went off a lot, I need time with these things) but I had a pretty nice variety and I do it on a budget so luxurious items like ruminants are very occasional and I barely can buy seafood, so little variety here (and most of that is very expensive). I totally use dairy though and lots of eggs. And even with off days, it’s another world than just doing keto. So trying it out may be worth it.

I can relate. I don’t care about my carbs on carnivore, if it’s 20g or more, so be it! It’s individual, I never experienced any problems with a higher number. I like not to go higher than this but only because most dairy easily triggers overeating fat (that’s my usual problem, I eat too much fat too often). I need them but in moderation. But I get a significant amount of carbs from my eggs and liver too and it’s never a problem. But other people aims for just a few carbs a day or less. Each to their own.
Carnivore can be done in various ways and if it’s still not enough, adding some carbs may be perfect for you… There are options and possibilities :slight_smile: I can’t do proper carnivore for long but just doing what I can is way better than my original keto was. And I evolve anyway and that’s good.

I loved basically all vegs except the green ones (and some green ones too like peas).
And at some point I quite suddenly stopped liking them. So I never say never but I wouldn’t have forced them out of my life for sure. I tried out carnivore when I felt ready. I still kept 2 vegs that complimented my meat/egg dishes but I pretty much lost them eventually. The same with mushrooms. My problem area is fruits but I have chances in winter.
But my changes came slow… One big jump per in 4-5 years were enough for me. <20g carbs on my good days, well that took… 8 years from my high-carb times? So I understand you stick your current one. It may be perfect for you long term anyway…

No, I will be SUPER hungry and annoyed and fed up and eat whatever I find in the house… Maybe not now when I am changed but I surely don’t stick to such rules when I am HUNGRY and bored of my food. That is AWFUL, I add carbs if I must in that case.
But if I am really hungry so food boredom has little chance, I easily eat 300g fat from 2 items…
I prefer to eat for pleasure, I am a hedonist. Eating 1000g fatty pork and 10 eggs can be great for pleasure. This level is occasional but eating too much every day? It’s what I do when I do my best not to.

I don’t say it can’t work for some. Or that restrictions on the food items isn’t useful even for me, it totally is. Being shy with dairy and added fat (and very fatty meat) significantly reduces the chance and severity of overeating. But it’s individual. Other people usually say fat satiate them. And some can overeat bacon using unbelievable amounts while I need all my skills to reach 60g. It’s not THAT easy, a few items may be plenty to eat a ton. Some people don’t even get bored.
And anyway, one can eat too much without any joy, appetite and hunger (okay, not having any reduces the chances but it’s not enough). There are some serious urges to eat, the body demands food. Even if it’s a chore and hard to do, it had to be done. Boredom just makes it hellish or slow or one needs 6 meals to do it…
Nope, I want my joy and appetite and the right amount of variety, thank you very much.

But the possibly hinted part where we don’t include tempting treats we can eat any time, I may agree, that should help. My keto days when I was quite generous with chocolate ended up higher-cal (like, 1000 kcal more than usual, I had such a day. no regrets, I needed more fat and freedom here and there but I don’t do such things anymore).

(May the blessing of bacon be always with you) #30

Yes. Triglycerides go up, but LDL and HDL go down. Higher triglycerides, coupled with lower HDL, indicates increased cardiovascular risk.

(Denise) #31

I have to hit this in the a.m. again. I can’t think that much at night, after dinner walk coming up now :wink: See you tomorrow :wink:

Ok, I do remember they were talking more about non-diabetics. It’s a different ballgame for folks that don’t have T2 Diabetes. I can’t just go willy nilly with carbs.

(Denise) #32

I just got my Lipid results in My Chart online. I’m afraid to open it :grimacing: here goes nothing! OH MY GOSH!! I can’t believe it:

(May the blessing of bacon be always with you) #33

Not bad! Your ratio of triglycerides to HDL has increased a bit, but was really good in the five previous tests, so perhaps this is just a glitch. And you are still very close to 2.0, so I wouldn’t worry, just yet. Your total cholesterol and LDL have declined noticeably, however, which has probably made your doctor happy.

(Denise) #34

yes I can see the ratio on trigs/hdl. I hope I don’t have to hope for higher cholesterol in order to keep below the 2.0, 2.1. Not a “damned if you do and damned if you don’t” situation I pray ;(

Well, I don’t know how to change the dang numbers but there must be some ways to keep that ratio right without getting higher cholesterol. It sucks being brainwashed with misinformation :face_with_raised_eyebrow:

(Denise) #35

hey @PaulL& @PrimalBrian, forgot to mention I got my book I ordered by Doctors Phinney & Volek! I ordered it off of Ebay, took a chance, and it’s truly like new thank goodness. “The Art and Science of Low Carbohydrate Living”. Gonna dive into it a bit today if I will just make the time :wink:

I just might have to read Chapter 8 first, lol! Love the first sentence :laughing:

(May the blessing of bacon be always with you) #36

I don’t think that total cholesterol or LDL levels matter, really. Even the people who still believe, despite all the evidence against the idea, that cholesterol causes cardiovascular disease have to admit that the ratio of triglycerides to HDL is the best indicator of cardiovascular risk. Assuming that one isn’t going to do a CAC scan, of course, which is the real assessment of the state of our arteries.

There is a lot of evidence to show that, whatever the connexion between cholesterol and cardiovascular disease might possibly be, it’s not that cholesterol causes it. Saying that is a lot like saying that fire engines cause fires, so we ought to cut back on them, in order to prevent fires. At the very best, cholesterol levels might be an indicator of cardiovascular risk. However, the way to lower that risk is not by manipulating the marker, but by identifying the root cause and dealing with that.

Unfortunately, there is no drug to target insulin-resistance, so people aren’t interested in treating it. And there’s no money to be made by telling people to cut the carbs. That’s too simple, so the medical professions can’t deal with it. Unless you are David and Jen Unwin, or Eric Westman, or Stephen Phinney, of course.

(Denise) #37

I think I will ask, well I will ask, about a CAC scan. I don’t think I’ve had that one, pretty sure. The only one I got was called a Carotoid Artery ultrasound :wink:

(May the blessing of bacon be always with you) #38

A CIMT (carotid intima media thickness) scan is also quite useful. Do you remember the result of yours?

(Denise) #39

is that what I had? Then yes, I think I still have it. What else might that be called Paul? I’m looking for it now.

(Denise) #40

Ok, here is all I got to show for that test??