Carl Franklin @carl and Richard Morris @richard cite and discuss a handful of the science they’ve found that supports the ketogenic diet as a safe and effective therapy for reversing Type 2 Diabetes and obesity.
Episode #69 - Show me the Science!
Jo-Bob
(Tom Cox Jr)
#3
So I listened to #69 today and Richard discussed red blood cell life expectancy and the possible relationship to a higher A1c with older red blood cells. So I decided to check my A1c with a home test. I have been keto for 11 months testing with precision xtra having stable BG usually under 100, never higher than 110 and ketones above .5. Since going keto I’ve also home tested A1c every 3 months with a result of 5.2 but today it was 5.9. About 2 years ago I gave blood and they told me I was a candidate for giving double red blood cells. As far as FULL keto is concerned I do drink miller lite regularly but testing shows I pause after drinking but I’m back above .5. by morning. I don’t know if any of this is relevant but it sure does make me think.
tdseest
(Tom Seest)
#7
It may or may not make a difference as we are all individuals.
I’ve eaten fermented foods regularly since beginning Keto 2.5 years ago.
I like Dr David Perlmutter’s Brain Maker which discusses this topic in detail, and I follow him closely as he seems to stay on top of this.
I’m not sure what really is working, but it all works for me.
Jo-Bob
(Tom Cox Jr)
#8
I have thought frequently about this concept. After reading the book missing microbes along with a lot of Dr google research I’ve had MANY ponderings of the effects of microbes on our bodies and minds.
siobhan
(Siobhan)
#10
I’d agree with this, pretty much every culture has some type of fermented food, and I think there is likely a reason for that.
My fermentation of choice is kombucha, I need to make a new batch sometime.
Or saurkraut… need to get around to trying to find a recipe and making some. Don’t think you’re allowed to sell it if it has live cultures in the US
richard
(Richard Morris)
#12
A little culture is a good thing. I would love to talk to a real expert on the subject
I have one of those stupid expensive Pete Evans fermenting kits, and almost always have a batch of Kimchi or Sauerkraut “brewing” in the cupboard. We make our own yogurt too
Also as you may know Jules is a cheese maker. And I usually try to start my gut after a long fast with a little juice from a Kimchi or Sauerkraut. So I guess you could say that lactobaccilis gets a role in pre-gut digestion at my place.
I am not entirely convinced that these cultures make it passed the low pH in the stomach. But if they do they are good at converting carbohydrates that make it to our large intestine into lactic acid which we can easily make into glucose (Cori cycle).
As far as their impact on protein goes, lactobaccilis doesn’t metabolize protein directly and besides in normal people not a lot of protein makes it past our small intestines to be available for bacteria to digest - because we are quite good at doing that. Not my area of expertise tho. Hopefully one of our experts in gut absorption disorders may also venture an opinion.
But there is an indirect effect. The lactic acid they create can be a substrate for on-demand glucose generation, so that would be specifically protein sparing to someone eating a low carbohydrate diet and relying on endogenous glucose. Lactate appears to be a signalling molecule that you are exercising … so there may be other benefits. Having these critters in your gut is probably a good thing.
Lactobaccilis is just one of millions of different human gut bacteria. We just don’t know what is going on in there, we are only speculating at possible mechanisms of action but that doesn’t stop medical documentarians like Dr Michael Mosely projecting well beyond what we actually know. IMO we’re only at a “cargo cult” state of knowledge about gut biota.
We know we can kill off most of your biota with antibiotics and then re-inoculate you with another individuals colony to overtake what is left of your own biota and some things about how your body works may change - that could be worse could be better. It is a giant crap shoot - literally and figuratively.
Personally I think exogenous ketones are safer than a 2nd party poo enema, and I think exogenous ketones are sketchy as. Oh and the kits on the internet you can buy where you make frozen faecal gelatine capsules to inoculate the other end of your gut … no f*****g way.
That is in my opinion like those Melanesian who thought if they made coconut palm representations of the planes that delivered supplies in the 2nd world war that the gods will bring them more containers of food.
Brenda
(8 year Ketogenic Veteran)
#14
This is why I love you @richard
LMFAO over here @2nd party poo enema!!!
Bahrutile
(Dustin Cade)
#15
I really do enjoy this board… Looking forward to listening to this new podcast…
Brenda
(8 year Ketogenic Veteran)
#16
Natural foods stores sell it, and I have an excellent (simple!) recipe for homemade kraut.
Brenda
(8 year Ketogenic Veteran)
#18
Here’s a bit more @CanKeto so @richard won’t have to repeat himself so much 
A 2KetoDudes podcast all about exogenous ketones 
Duncan_K
(Duncan Kerridge)
#20
If you’re interested in seeing what your microbiome actually looks like this code might still get you a free test:
I just got mine and sent it back. Might be interesting to compare the results of people who eat fermented foods and those who don’t on a keto diet.
Brenda
(8 year Ketogenic Veteran)
#21
Yes, but also this:
“Plus ketones made in a vat are both left and right handed - we only use the right handed ones for energy. No-one knows what a caloric amount of the left handed ones for several decades will do to your cells. No-one.”
Sheesh. Amazing the risk some will take for abz. Health is more important to me.
Keeps me away from them.
richard
(Richard Morris)
#22
So I’m sure you know that biological molecules perform a lot of their function based on their shapes. It determines how they are catalyzed by enzymes and how they fit into mechanical engines made of proteins. Two molecules with exactly the same elements can have totally different behaviors depending on their shape - Glucose and Fructose are a good example, both are C6 H12 O6 yet they both have different roles in the body.
betahydroxybutyrate actually comes in two shapes, both isomers are mirror images of each other. You can think of it like the L isoform in Tetris, one known as D-betahydroxybutyrate fits into all our biological processes
and the other known as L-betahydroxybutyrate doesn’t
We have roughly 3 billion years experience making and using D-betahydroxybutyrate as a “shelf stable” storage form of acetoacetate. We have 2-3 years of experience metabolizing L-betahydroxybutyrate.
Most commercial exogenous ketones are racemic which means they are 50%:50% mixes of D and L-betahydroxybutyrate known as DL-betahydroxybutyrate or just betahydroxybutyrate.
We have a tracer study in mice that shows the tagged carbons in 3 micrograms of L-BOHB is eventually exhaled, which mean it eventually makes it’s way to be burned. We don’t know exactly how L-BOHB makes it’s way to acetyl-CoA. The enzyme that converts the D isomer to AcAc is D- specific. How L-BOHB is metabolized and what processes and transports it would compete for access to has not as far as I am aware been described.
So we don’t really know if a human can handle caloric amounts of L-BOHB for decades safely.
I believe the only commercial product that is just the physiological isomer is TdeltaS from Dr Keiron Clarke’s lab in the UK and that supply appears to be fully bought out by team sky and the British Olympic rowing team. Or so the scuttlebutt goes.
The other consideration is that our conversion of AcAc to BOHB and back again affects (and can be used to diagnose) our NAD+/NADH ratio. Dumping a lot of already converted D-BOHB into the system will likely pervert that balance.
As a podcaster I’ve been offered free samples. But all my requests for details on their benefit and side effects for weight loss and treating diabetes have been ignored.
I know of Dom D’Agostino and I have a lot of respect for his work in this area. I have heard his arguments about Brunnengrabers tracer studies. I don’t believe showing that a mouse can exhale the carbons in a small specimen is adequate to recommend humans stuff their mitochondria with a caloric amount of them for several decades.
There are people with competing patents on both sides of this argument. And the US FDA has certified exogenous ketones as GRAS based on the fact that a human body makes them … but it doesn’t make the L-isoform and I think allowing them into the market unregulated was a mistake.
So that’s what I mean by sketchy. Personally if I need ketones or energy in the context of high insulin (sometimes this is an issue in keto adaptation ) I would rather eat some coconut oil and make the physiological form in the correct context.
Daisy
#24
I watched an interesting programme on UK tv a week ago. IDK where you are or if you can access it - Doctor in the House S02E03.
It focussed on a young boy (11 I think) who was gaining weight but they didn’t know why. When the Doctor investigated, he found his diet to be not great but reasonable. He was good at eating his veg and reasonably well rounded. Yes, he ate too many carbs but likely the same if not better a diet than his peers. He was active also at school and at home.
Testing revealed high BMI, high BG, high insulin and low amounts of good stuff in his micro biome.
Diet changed to be LCHF more moderate than keto but still a huge change, basically cutting out all the starches and processed crap.
Outcome - insulin down from 30 to I think 11 (forget the exact figure), BG down, weight down. They didn’t retest gut stuff I don’t think but one could infer an improvement I think.
Now which was chicken and which was egg? IDK. But, as I have discovered working on my depression and migraines, a multi angled approach works well and it doesn’t always matter which one is the most effective just that the approaches as a whole start working. Considering that IR has been proved time and time again to be improved or reversed with keto, I think that would be my chosen path over poo implants! The studies though are fascinating, I agree, and the fact that micro biome is being regarded as an important factor can be nothing but beneficial.
Daisy
#26
I doubt very much that it is as easy as a “fresh start” but I would be willing to bet you can change your gut micro biome for the better over time.