F*CK your "diabetic" eye check!

(Richard Morris) #9

#trueDat

Not that we care about measuring ketones, 'cos measuring ketones leads to protein restriction :wink:

(Jim Russell) #10

And protein restriction leads to hate and hate leads to the dark side.

(8 year Ketogenic Veteran) #11

Screenshot_20170825-013121

#12

Dang y’all are totally cracking me up!!! :rofl:

ps. I love this place. Can I just move in here forever?

(What The Fast?!) #13

Is restricting protein to 1.5g per KG of LBM no longer recommended?

(Richard Morris) #14

It was just a smartass comment because I have noticed a distinct correlation between people who like eating protein and telling everyone around them to do the same, and people who heap mockery upon ketone measurements.

The TLDR version is; I’m still eating between 1g and 1.5g / kg LBM.

But since I’m going down this rabbit hole :slight_smile:

There is no real evidence that more than 1.5g/kg LBM has any benefit. And there is adequate evidence that less than 1g could be inadequate - hence the range that I personally try to stay within is 1-1.5g/kg LBM, and it’s what I suggest at the top of each of our podcasts.

But there are plenty of opinions on the internet that more protein is better, and even some that there is no effective limit for protein, and you will generally find among people who hold that view also believe that measuring ketones is somehow ridiculous.

Why would the 2 things be linked? Well many people who measure ketones find their ketones go down when they eat a lot of protein, and there is a biochemical reason why that happens (amino acids replete oxaloacetate).but the net effect of fewer ketones is that we have to make more glucose to fuel our brains - and that means we need to use more protein to make glucose … and that means we need to eat more protein.

For the record I don’t track my ketosis. I don’t eat carbs so I’m in ketosis. But protein requirements can be a slippery slope once you stop burning fat, so I like to stay below that point as much as I can and get my energy from fat (either on my body or on my plate).

As I mentioned there are opinions that there is no effective limit to protein, on the internet from physicians with inadequate body fat to hide their abdominal muscles … by way of their bone fides of course.

The truth is that too much protein killed a 25 year old student paramedic in Perth, Australia a few weeks ago. She was on a protein sparing modified fast cutting for a body building competition and although she didn’t know it she had a semi-rare (1:8000) genetic mutation that meant she couldn’t make enough of an important enzyme that helps our livers convert the waste product from protein (AMMONIA) into something we can filter into urine and get rid of (UREA). Most people with her condition are identified as children, so she must have had a very mild form to have remained undiagnosed until it killed her.

Not everyone has this woman’s genetic deficiency. People who want to eat more protein are welcome to experiment, and I would suggest doing so under the guidance of a doctor who is willing to schedule you for regular circulating ammonia tests to make sure that that is not building up in your body.

For reference the amount of Nitrogen taken in as protein that saturates most peoples ability to synthesize urea is roughly 0.53 g/kg LBM - which works out to be roughly 3.3g of Protein/kg LBM.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC333026/

Any experts on the internet telling you that 3.5g to 4.4g seems to be optimum are giving out dangerous advice unless they are telling you to track circulating ammonia with a regular blood test. You might be a mutant who can handle those kinds of loads of ammonia.

Shouldn't My Dog be Keto?
Macros - am I supposed to hit all numbers?
(ianrobo) #15

3.5g is what some suggest, WOW …

However are these the people on Keto Gains ? I ask because if you are into exercise (either aerobic or muscle) then yes you will need more protein (or more accurately you can eat more with a lower sugar response).

I prob eat about 2g now (though stopped tracking) but as you know Richard I am heavily into cycling so that for example this week is 11 and half hours and this allows more room for protein. For Mr and Mrs average exercise person then the limit you suggest is bang on, though Steve Phinney recommends slightly lower ?

(Sjur Gjøstein Karevoll) #16

Since you obviously know a lot about this there are some questions I would like some insight into.

First, why is increased gluconeogenesis something you are worried about? It makes more glucose, sure, but as it seems to be a demand driven process it would only be made in response to higher glucose consumption so actual blood glucose wouldn’t increase and neither would insulin. As the liver is pretty good at making glucose when it’s needed high fasting glucose is a result of the regulatory hormones.

The second question is why would decreased ketosis be something you are worried about? Ketosis itself does have benefits, but for most people who use keto to combat obesity, t2d etc. the real benefit comes from the lack of carbohydrates. It’s why exogenous ketones aren’t helpful unless you have a specific need.

Proteins do cause an insulin response so I see why that might be a reason to restrict them when you’re trying to lose weight, but unlike carbs they don’t increase blood glucose. I curious, do you know if an insulin response in the absence of increased blood glucose has the same ability to negatively affect IR? What about insulin in the absence of any calories at all, like some sweeteners?

I’m one of the people who don’t care to much about ketosis. As long as I have the energy and mental clarity I got when I switched diets I’m happy with how I eat, and if I could have that without ketosis I wouldn’t really care either way. I’m with you that there isn’t any real point in going over 1.5g and I’m well below that myself, but the only reason I can think of why you would worry about it is because the insulin response could hinder fat loss.

Maybe it would be best to just make a new topic…

(What The Fast?!) #17

@Richard I LOVE when you go down rabbit holes. :slight_smile:
FWIW, I did 40 days of ZC and have monitored ketosis the whole time. Even eating 3g of protein per LBM, I maintained low grade ketosis. (.04-.08, and higher when I did long bike rides).
I know most ZCers don’t care about ketosis but I wanted to try and stay in it.

I’m going to try add back some regular keto foods now and reduce protein again, but I’ll probably stick around 2g per kg of LBM (95g for me) because of my workouts and also because I find staying under 70g to be difficult and I tend to be hard on myself.

I’m going to do a DEXA another scan and we’ll see if all that protein increased my LBM or not. :slight_smile:

Also - in case you’re interested in an update. 5 months since I started keto (with last 40 days ZC) and still no weight loss (31.5% BF)…all tests look normal…I think I figured out that I have low (close to no) stomach acid. I’m trying to get in to this keto gastro doctor I found to see what I can do about it…but I think that may be a big part of the picture. (Fingers crossed.)

(Mike Glasbrener) #18

I love this! It’s one of those benchmarks to remind you how far you’ve come! Congrats! You’re rockin’ it!

(Doug) #19

It sure plays into the mindset of many people though, especially in the body building community. The “more is better” deal ca be hard to resist.

(Richard Morris) #20

I could be wrong about this. That’s why I am going back as often as I can to studies.

I’ve heard good arguments for and against GNG being demand generated … but let’s assume it is and that an increase of gluconeogenic substrates don’t increase output, and that the only thing rate limiting the production of new glucose is demand for glucose signaled by a drop in circulation.

Eating protein can increase demand. And increasing GNG demand can result in lean tissue loss.

Consider a normal man such as George Cahill’s starvation subject in his first 24 hours of starvation. He needs 144g of glucose and is going to use 75g of protein a day to make that. He needs that because his brain isn’t about yet to use ketones for energy,

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Now consider a fully fat fueled man, like George Cahill’s 5 week starved man. His brain is deriving it’s energy from 47g of ketones and 44g of glucose - made from only 20g of protein. It turns out to be 70% of his brains energy coming from ketones, and only 30% from glucose made from those 20g of protein.

He is saving 55g of protein consumption by burning fat.

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Why is that relevant? Well if for any reason you limit ketones the brain requires more glucose. That increases the demand for new glucose production, and consumption of protein.

It turns out that we make ketones when the kreb cycle that turns fuel into energy runs low in a critical molecule - oxaloacetate. Making new glucose uses up some of that molecule. Glucose and one specific amino acid (aspartate contained in many sources of protein) increase the amount of that chemical. This is why we don’t make many ketones when we digest glucose or protein, because we don’t run out of oxaloacetate. And as we’ve seen when we reduce ketone production we have to use more protein to make glucose to fill the shortfall in energy for the brain.

Eating enough protein to inhibit ketosis could increase the demand on protein to make new glucose from 20g a day to 75g a day. This leads to the logic defying situation where eating a little more protein in context could result in more lean tissue being scavenged to make more brain glucose, and eating more fat in context could result in the preservation of more lean tissue.

This is all distinct from the effect on insulin. If you are insulin sensitive and in response to protein you make a small blip of insulin - I say go for it and eat as much as you want (subject to your personal urea synthesis rate maximum). And the evidence shows that some people thrive on a high protein diet.

For those of us who make a lot of insulin for a long time at the slightest challenge … more protein than we strictly need means higher insulin for longer. Insulin also inhibits the production of ketones through malonyl CoA … and that leads back to less for the brain and more demand for glucose … and more protein used to make energy … when what we SHOULD be doing is using protein to make our bodies.

Fewer ketones mean more demand for new glucose which means more protein used up for energy.

I have a lot of problems with Exogenous ketones but I can imagine a context where supplementing for Endogenous ketones (by eating short and medium chained fatty acids) may also be protein sparing for the same reason - ketones lower demand for using protein to make glucose.

BTW: I don’t myself track BHB unless I am doing an experiment in fuel partitioning. I don’t eat carbs, I make ketones -> my body uses them, how many I have left in the tank is something I don’t much care about. But I know that experts in Ketogenic diets (ie: Phinney and Volek and their Virta app) track ketones to ensure people are conforming to the diet.

But I just found it funny that people who want to need to eat more protein appear to have a knee jerk reaction to ketone testing. It’s also faintly ridiculous that low carb people appear to be their own worse enemies as they feud over a side issue like essential vs excess protein.

Low(er) fat keto?
(Richard Morris) #21

I believe there is a special case for Zero carb … or diets approaching zero carbs, where you get to use more protein to make glucose. Normally we need to make 80g of glucose and we can make that from 20g of protein.

Someone eating 20g of carbs a day, only need to make another 60g so their requirement of protein drops to 15g.

Someone eating 40g of carbs a day, only need to make another 40g so their requirement of protein drops to 10g.

Of course that’s just protein to make glucose, you’d still need your minimum required for protein turnover - but at 3g you are probably OK there :slight_smile:

(What The Fast?!) #22

Thanks for that explanation. I’m going to start adding some non ZC things in and test how I feel with different foods.

@Brenda where’s the thread where you tested all those foods after your steak challenge? I wanted to see how you tested each food.

(8 year Ketogenic Veteran) #23

Sadly I didn’t do the food testing for long, as 30 days of only beef steak made me insane. Lol. I needed to stop the severe restriction. The idea to test everything was a great plan in theory, but psychologically proved difficult.

I believe I tested a few things. I don’t remember.

(Jessika Nilsson) #24

There are supposed to be natural ways of increasing stomach acid and supplements which are ketogenic friendly :slight_smile:
http://www.shawnmynar.com/could-low-stomach-acid-be-to-blame/

(What The Fast?!) #25

Thanks. I’m doing all those things! I started a couple weeks ago. I’m up to a ridiculously high number of HCL pills.

(Jessika Nilsson) #26

I was just happy to have recently read something I thought could help, especially as it said that the supplements and the ACV was supposed to help support the body, and that after a while you would be able to start dialling them down because the body would get used to producing the required acid itself.
Sorry that I wasn’t able to provide any new ideas for you and I really hope that you will find out what’s causing the low stomach acid :crossed_fingers:

(What The Fast?!) #27

Thanks girl!!! The confirmation helps, believe me!

(What The Fast?!) #28

@brenda - what do you consider a significant spike in BG? I had bacon and eggs this morning and wanted to test olive oil. My BG was 83, T:30 99, T60 106, T120 98.