From the original post it sounds like @Greg_Spletzer’s friends are asking him (admittedly pointed) questions about ketogenic eating and that Greg’s looking for answers to give them. So it sounds like they’re quite open to hearing what Greg has to say.
Friends Concerned with Long Term Effects of Keto
larry
(Larry Lustig)
#24
Would be nice to have a section somewhere “Answers To Nutritional Nay-Sayers”. Honestly, I’ve wondered myself about the issue of GNG stressing the liver in some way. . .
Greg_Spletzer
(Greg Spletzer)
#26
To give people an idea of what I was looking for I think I may have found a great reference list of most things keto here: http://www.ketogenic-diet-resource.com/site-map.html
To more address that specifically, they have a section on gluconeogenesis: http://www.ketogenic-diet-resource.com/gluconeogenesis.html
It doesn’t quite cover the long-term effects specifically, but it sounds like your liver really only is working overtime during the transition onto a ketogenic diet.
Donna
(Meeping up the Science!)
#27
The body requires glucose to function, yes. Certain cells cannot utilize ketones for energy; for instance, some are in the brain, the kidneys, and one other (I can’t remember). However, the body can create glucose via a process called gluconeogenesis. This occurs in the liver. How does it “tax the liver”? That’s a perplexing statement. Ask them to quantify it with information. Gluconeogenesis does not tax the liver. Alcohol consumption, toxic chemicals being ingested, very high carbohydrate diets, high serum insulin - these things tax the liver.
Also, you use gluconeogenesis whenever you can’t eat. I.e., when you sleep, you use it (and often ketones) for instance. So.
Ketoacidosis is probably one of the most misunderstood concepts in medicine. While it’s a state in which ketone levels are excessively high, it can only occur when you do not make enough insulin. I cannot overstate this: ketoacidosis only occurs when there is a lack of insulin. It does not occur as a result of too many ketones! Saying ketones cause ketoacidosis is like saying a cough causes pneumonia.
Ketoacidosis is a metabolic state that only occurs in situations with impaired liver function. There are only three instances I recall where this happens: alcoholic ketoacidosis from chronic alcoholism (tell your college friends to quit binge drinking), diabetic ketoacidosis when glucose is high and cannot be controlled by the body, and liver damage (for instance, damage from chemicals or other such things).
trekkin1
(Jo Lo)
#29
An interesting way to look at the body’s energy function is like a storage battery. You are meant to run off fat (that’s your big fuel reservoir). But now and then you eat food to top off the fuel source.
Running off carbs would be like hooking up your alternator straight to your car’s electric system and bypassing the storage battery. Now that would work, but not very well… it would be easy to run low on power. Sort of like it doesn’t work very well to run your body primarily off carbs.
-General analogy courtesy of Ted Naiman (twitter). I hope I related it correctly.
Jessica_A
(Jessica A)
#30
I think it’s nice your friends worry about you, but if it were me personally I’d have to tell them to back off and do some of their own research. If you’re not concerned about your long term health then that’s all that matters. If they’re going to judge you for your food choices, then I’d reconsider friendship. Worrying about what OTHER people eat on a regular basis is such a waste of time and energy because it’s only a very small piece of the health puzzle. Unless they want to analyze your blood test results and are qualified to give you some kind of professional opinion, they have no place, IMO.
However, having said all that, it is most certainly helpful to have a arsenal of answers to back up your own conviction so that conversation isn’t completely shut down on the topic. But if they come from a place of deeply ingrained antequated belief of what “true” health really is then it may not matter what answers you have for them. They’ve already made up their minds and are merely trying to change yours.
Good luck, and KCKO 
Regina
(Empress of the Unexpected)
#31
I just re-read the diet section of Dr. Spock’s updated (1997) Baby and Child Care. He said there was absolutely no need for any starches or grains in the diets of children of any age. My family doctor says the same thing for adults.