Help? One month plateau?! Fat fast? 16:8 Fast?

PaulL · 2019-02-25 01:55:17 UTC

I would like to see the data that back up that assertion. There is plenty of evidence to show that a low-carb, high-fat diet can be effective for weight loss:

Dietary carbohydrate restriction improves insulin sensitivity, blood pressure, microvascular function, and cellular adhesion markers in individuals taking statins.

ncbi.nlm.nih.gov

Paradox of hypercholesterolaemia in highly trained, keto-adapted athletes.

BC Creighton, PN Hyde, CM Maresh, WJ Kraemer, SD Phinney and JS Volek, BMJ open sport & exercise medicine, 2018

A growing number of ultra-endurance athletes have switched to a very low-carbohydrate/high-fat eating pattern. We compared markers of cholesterol and the lipoprotein profile in a group of elite ultra-runners consuming a high-carbohydrate (HC) or low-carbohydrate (LC) diet.Fasting blood was obtained from competitive male ultra-endurance runners habitually consuming a very low-carbohydrate (LC; n=10) or high-carbohydrate (HC; n=10) diet to determine blood cholesterol profile, lipoprotein particle distribution and sterol biomarkers of cholesterol balance.Plasma total cholesterol, low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C) cholesterol were all significantly greater (p<0.000) in the LC group (65%, 83% and 60%, respectively). There were also significant differences in lipoprotein particle distribution as evidenced by a greater size and concentration of large HDL and LDL particles, and total LDL particle concentration was significantly greater in the LC group, but they had significantly fewer small LDL particles.Ultra-endurance athletes habitually consuming a very low-carbohydrate/high-fat diet for over a year showed unique cholesterol profiles characterised by consistently higher plasma LDL-C and HDL-C, less small LDL particles, and lipoprotein profiles consistent with higher insulin sensitivity. There may be a functional purpose to the expansion of the circulating cholesterol pool to meet the heightened demand for lipid transport in highly trained, keto-adapted athletes.

ncbi.nlm.nih.gov

Cardiovascular disease risk factor responses to a type 2 diabetes care model including nutritional ketosis induced by sustained carbohydrate restriction at 1 year: an open label, non-randomized, controlled study.

NH Bhanpuri, SJ Hallberg, PT Williams, AL McKenzie, KD Ballard, WW Campbell, JP McCarter, SD Phinney and JS Volek, Cardiovascular diabetology, 2018 05 01

Cardiovascular disease (CVD) is a leading cause of death among adults with type 2 diabetes mellitus (T2D). We recently reported that glycemic control in patients with T2D can be significantly improved through a continuous care intervention (CCI) including nutritional ketosis. The purpose of this study was to examine CVD risk factors in this cohort.We investigated CVD risk factors in patients with T2D who participated in a 1 year open label, non-randomized, controlled study. The CCI group (n = 262) received treatment from a health coach and medical provider. A usual care (UC) group (n = 87) was independently recruited to track customary T2D progression. Circulating biomarkers of cholesterol metabolism and inflammation, blood pressure (BP), carotid intima media thickness (cIMT), multi-factorial risk scores and medication use were examined. A significance level of P < 0.0019 ensured two-tailed significance at the 5% level when Bonferroni adjusted for multiple comparisons.The CCI group consisted of 262 participants (baseline mean (SD): age 54 (8) year, BMI 40.4 (8.8) kg m-2). Intention-to-treat analysis (% change) revealed the following at 1-year: total LDL-particles (LDL-P) (- 4.9%, P = 0.02), small LDL-P (- 20.8%, P = 1.2 × 10-12), LDL-P size (+ 1.1%, P = 6.0 × 10-10), ApoB (- 1.6%, P = 0.37), ApoA1 (+ 9.8%, P < 10-16), ApoB/ApoA1 ratio (- 9.5%, P = 1.9 × 10-7), triglyceride/HDL-C ratio (- 29.1%, P < 10-16), large VLDL-P (- 38.9%, P = 4.2 × 10-15), and LDL-C (+ 9.9%, P = 4.9 × 10-5). Additional effects were reductions in blood pressure, high sensitivity C-reactive protein, and white blood cell count (all P < 1 × 10-7) while cIMT was unchanged. The 10-year atherosclerotic cardiovascular disease (ASCVD) risk score decreased - 11.9% (P = 4.9 × 10-5). Antihypertensive medication use was discontinued in 11.4% of CCI participants (P = 5.3 × 10-5). The UC group of 87 participants [baseline mean (SD): age 52 (10) year, BMI 36.7 (7.2) kg m-2] showed no significant changes. After adjusting for baseline differences when comparing CCI and UC groups, significant improvements for the CCI group included small LDL-P, ApoA1, triglyceride/HDL-C ratio, HDL-C, hsCRP, and LP-IR score in addition to other biomarkers that were previously reported. The CCI group showed a greater rise in LDL-C.A continuous care treatment including nutritional ketosis in patients with T2D improved most biomarkers of CVD risk after 1 year. The increase in LDL-cholesterol appeared limited to the large LDL subfraction. LDL particle size increased, total LDL-P and ApoB were unchanged, and inflammation and blood pressure decreased. Trial registration Clinicaltrials.gov: NCT02519309. Registered 10 August 2015.

ncbi.nlm.nih.gov

A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes.

AL McKenzie, SJ Hallberg, BC Creighton, BM Volk, TM Link, MK Abner, RM Glon, JP McCarter, JS Volek and SD Phinney, JMIR diabetes, Mar 2017 07

Type 2 diabetes (T2D) is typically managed with a reduced fat diet plus glucose-lowering medications, the latter often promoting weight gain.We evaluated whether individuals with T2D could be taught by either on-site group or remote means to sustain adequate carbohydrate restriction to achieve nutritional ketosis as part of a comprehensive intervention, thereby improving glycemic control, decreasing medication use, and allowing clinically relevant weight loss.This study was a nonrandomized, parallel arm, outpatient intervention. Adults with T2D (N=262; mean age 54, SD 8, years; mean body mass index 41, SD 8, kg·m-2; 66.8% (175/262) women) were enrolled in an outpatient protocol providing intensive nutrition and behavioral counseling, digital coaching and education platform, and physician-guided medication management. A total of 238 participants completed the first 10 weeks. Body weight, capillary blood glucose, and beta-hydroxybutyrate (BOHB) levels were recorded daily using a mobile interface. Hemoglobin A1c (HbA1c) and related biomarkers of T2D were evaluated at baseline and 10-week follow-up.Baseline HbA1c level was 7.6% (SD 1.5%) and only 52/262 (19.8%) participants had an HbA1c level of <6.5%. After 10 weeks, HbA1c level was reduced by 1.0% (SD 1.1%; 95% CI 0.9% to 1.1%, P<.001), and the percentage of individuals with an HbA1c level of <6.5% increased to 56.1% (147/262). The majority of participants (234/262, 89.3%) were taking at least one diabetes medication at baseline. By 10 weeks, 133/234 (56.8%) individuals had one or more diabetes medications reduced or eliminated. At follow-up, 47.7% of participants (125/262) achieved an HbA1c level of <6.5% while taking metformin only (n=86) or no diabetes medications (n=39). Mean body mass reduction was 7.2% (SD 3.7%; 95% CI 5.8% to 7.7%, P<.001) from baseline (117, SD 26, kg). Mean BOHB over 10 weeks was 0.6 (SD 0.6) mmol·L-1 indicating consistent carbohydrate restriction. Post hoc comparison of the remote versus on-site means of education revealed no effect of delivery method on change in HbA1c (F1,260=1.503, P=.22).These initial results indicate that an individualized program delivered and supported remotely that incorporates nutritional ketosis can be highly effective in improving glycemic control and weight loss in adults with T2D while significantly decreasing medication use.

Shortstuff · 2019-02-25 05:50:40 UTC

Yep. Responding to the person who came out with the old “fat will make you fat” silliness but who now seems to have totally vanished so I’m glad other people saw it too…

CrackerJax · 2019-02-25 18:52:09 UTC

Hi Theresa,
I can only tell you my experience. I originally started this ‘diet’ to get ready for a holiday in Australia. I lost well in the beginning and then stalled for a couple of months. However, I continued to feel thinner and realised I could get into clothes easier. My nurses uniform, which is unforgiving and 2 sizes smaller than when I had started, was looser and all the clothes I had optimistically bought for my holiday fitted! Weird but true.
Overall I had lost 3 stone and felt good. Although I am still a ‘work in progress’ with maybe 2 stone more to loose I havent felt so healthy in years (I am 60 years old).
I had a wonderful holiday in Australia. Relaxed my diet a little but not too much. Ate 2 meals a day instead of one. And came home to find that I had lost 4lbs!
So Im thinking that maybe I wasnt eating enough before or maybe my body was just catching up (autophagy?)
Whatever, this ‘diet’ is now a way of life. I think I do better when I relax a little. Its a plan for living after all.
I wish you well in your journey and you will get tremendous support on this site.

theresa525 · 2019-02-26 01:53:57 UTC

Thank you so much Jacqueline! I was wondering if maybe inches we’re coming off or “rearranging” lol, bc I keep having more people coming up to me the past few weeks and asking about my weight loss and ironically I’ve stopped losing I was also questioning if maybe I’m being to strict and not eating enough…it is definitely a way of life for me but I hardly ever “cheat”, maybe I need to treat myself to something and see how my body responds, and not beat myself up if I don’t get the results I want. My clothes are definitely lose, I’ve had to buy new things which is an awesome feeling (and pleasantly frustrated when getting ready for work, I put something and have to take it off bc it’s too big!) . I just wish I could break this plateua, even if by 1/2 lb!, just to know I did it :(. Thanks for the words of encouragement and reenforcing my thoughts of maybe inches coming off and maybe being too strict. Wish me luck!!! And all the best to you as well

cw2001 · 2019-02-26 02:10:08 UTC

How in the world did our grandparents ever know that they were gaining (or losing) a bit too much weight? My opinion on apps and such…if you LOVE using them, get extra joy out of numbers, spreadsheets, and tracking, then go for it. But if you’re doing it just to “force” a weight loss, then you’re focusing on keto just as a means of weight loss…and it really shouldn’t be that. It should be a lifestyle change. It should make you feel better and be something that you gladly stick to for the next umpteen years.

I don’t think we need to (or really even CAN) trick our bodies. I think it’s the other way around…our hormones are driving us but we keep refusing to listen. Ignore the scale for a month, even two. Listen to your satiety signals and when you’re craving protein or fat (then eat it). Just ignore any carb cravings. See how you feel after that month…I bet if you’re not focused on that scale number (that lies anyway), you’ll be more relaxed, won’t fixate so much on what you’re eating (or not eating) and see that a month or two is very little time in the scope of the rest of your life.

theresa525 · 2019-02-26 02:50:14 UTC

Cindy, true, good advice. I do tend to obsess over numbers, I’ve been that way my whole life. I’ve definitely made this a lifestyle change, but old habit’s are hard to break as far as the numbers. I’ll definitely try to listen to my body more and less of the scale ;). Thanks!