How much is ketosis vs just "low carb"

#1

While I am happy enough with my keto results, once upon a time I weighed 260 (6’0" male) and just went on an extended “no bread/potatoes/rice/stuff with added sugar” diet. I ate fruit, corn, beans and am sure I never got near ketosis. Yet I lost 60 pounds in 4 months and kept it off for a year (until I started traveling full time and eating like I used to, that is to say the 2 donuts and a kolache breakfast model).

I had similar improvements in my lipids and triglycerides and felt pretty good.Can you point me to the science of why VERY low carb (driving to ketosis) is much better that just relatively low carb (compared to SAD…) thanks

Excessive Sweat - Smells like Ammonia
#2

Better at what and for who is the key to this question. If low carb works for you and your goals, and you don’t care about ketone levels, then do it. If you find you felt better in ketosis, then you can always go back to it. I think there’s a lot to be said for metabolic flexibility, if you can do it without going down a slippery slope.

(You've tried everything else; why not try bacon?) #3

I don’t believe there is a difference. To me, “keto” and “low-carb” are equivalent terms. A diet low enough in carbohydrate to result in an insulin level low enough to lead to metabolic healing is most likely to lead to gluconeogenesis from lack of dietary glucose and ketogenesis for the same reason.

I am well aware that some people make a big distinction between low-carb and keto, but I’m not sure how real that distincton is. Everyone’s carbohydrate threshold is different; many people can eat a higher amount of carbohydrate than 20 g/day and remain ketotic, whereas some people have so much metabolic damage/insulin resistance that they need to eat even less carbohydrate than 20 g/day.

What is certain is that elevated serum glucose can quickly become damaging to the system; which is why the body works so hard to get it out of the blood and into muscle and adipose tissue. Likewise, the elevated serum insulin required to make this happen is itself damaging, all the more so when insulin resistance drives up the amount of insulin required to remove glucose from the blood. The proper human diet resolves these issues and, over time, can reverse insulin resistance and free excess stored fat from the adipose tissue.

#4

Well that is sort of what I thought but I came back to low carb via some “MCT oil swilling macro counting keto purists” and my indoctrination was more about getting into and staying in ketosis. At my last physical my ketones were 1+ which is of course at the “lower end of awesome” as my purist friends would point out.

I just keep thinking that more beans and maybe some fruit could still keep me low enough carbs to maintain a good weight and be healthy. But there is no way that is keto

#5

It could still be keto for part of the day, depending on how you space your meals, whether or not you exercise a lot, and your own personal threshold for such foods. @atomicspacebunny eats quite a bit of carbs compared to those of us with more metabolic challenges.

Also, if the goal is to be better than SAD you’ve set the bar pretty low. :wink: Just eliminating the worst foods you used to eat goes a long way to feeling better. Some people have issues with beans (legumes) in general because of lectins.

(Michael - When reality fails to meet expectations, the problem is not reality.) #6
(Barbara Schibly) #7

Low carb and keto really aren’t equivalent terms. To be keto, your diet needs to put you in a state of nutritional ketosis with measurable ketones in blood (also will be in urine and on breath) To do this most people will need to limit protein as well as carbs, although incorporating ketogenic fats like MCT can help. If you want to know if your diet is putting you into nutritional ketosis or not, you need to be measuring ketones.

That’s not to say that low carb isn’t beneficial (It’s certainly far superior to the SAD diet!) - and for some people may be a better choice than keto. But ketosis has some serious metabolic advantages beyond just weight loss - so I think it pays to at least go into ketosis for a month or so on an intermittent basis. Then you can shift out to a low carb but not keto diet.

#8

I’d agree that there’s not much difference between popular keto and low carb (by which most people mean very low carb). Medically ketogenic is a different thing. However, there are plenty of people who are able to lose weight easily on moderate carb diets like the one you describe, @Fracmeister. South Beach, The Zone, Paleo, and Whole 30 are all versions of these. They’re all probably somewhere between 75g and 150g of carbs per day. Not what most low-carb diets are near, but much, much lower than the 300g+ of the standard diet.

If it works for you to meet your goals, moderate carb is a really healthy way to eat, especially long term. Some people–including the majority of people on these forums–have more significant health issues that they’re trying to address and that gets done with very low carb, sometimes staying there permanently. Others may just struggle to lose weight on moderate carb and need something more, but will do great on moderate carb for maintenance.

(Ken) #9

This thread illustrates the fact that so many people have a fundamental lack of understanding of Lipolysis. Ketogenesis is a part of Lipolysis. You cannot really separate the two. The reason people are able to lose fat when eating low carb, but higher carb levels than preached in keto dogma is that they are dipping in and out of Lipolysis because their glycogen levels are low.

You eat carbs, glucagon stops, insulin takes over. Once the carbs are processed, glucagon restarts and Lipolysis starts again. It can easily be an intermittent process, with no danger of regaining fat unless glycogen levels are full.

(You've tried everything else; why not try bacon?) #10

I believe this was the point I was making in my earlier post. Any carbohydrate intake low enough to permit ketogenesis counts as keto in my book, whether that amount is higher or lower than 20 g/day.

For what reason is it necessary to limit protein? I haven’t heard that before. The process of gluconeogenesis is more limited by the body’s need for glucose than it is promoted by the supply of amino acids.

It is possible to register serum β-hydroxybutyrate by ingesting exogenous ketone on a high-carbohydrate diet, but that is not what I mean by the term “nutritional ketosis,” sorry.

Lipolysis is the separation of triglycerides into three fatty acids + glycerol. The fatty acids can then pass through the wall of the adipocyte into the bloodstream where they are again packaged into a triglyceride for transport to the liver. This process takes place only when serum insulin drops low enought to permit it. In the liver, triglycerides are again separated into their components, and the fatty acids go through a process known as “fatty acid metabolism,” which is halted about halfway through to produce ketone bodies (ketogenesis). In fat-adapted muscle cells, fatty acid metabolism proceeds all the way to the end, generating adenosine tri-phosphate (ATP, which the muscle cell then uses to perform work), carbon dioxide, and water (which are excreted, primarily in the breath).

(mole person) #11

Because the body can store endless fat but extremely limited amounts of protein. Its capacity for protein storage is even less than its capacity for carbohydrate storage.

This whole point about gluconeogenesis being demand driven has always ignored the fact that excess amino acids, once deaminated, can enter the Krebs cycle at multiple other points and be used as fuel. If the body is getting its energy from protein then it’s storing fat just like it is when it’s getting it’s energy from carbohydrates since it has unlimited ability to store fat but must use the protein immediately.

#12

Beyond just a substrate disposal issue, some amino acids like alanine and aspartate stimulate the replenishment of OAA in the liver and halt ketogenesis while fats are oxidized to glucose instead. GNG is happening all the time in ketosis and the problem lies mostly with an imbalance in the hormones that control it, insulin and glucagon. Diabetics are more likely to see a hyper- or hypo- glycemic reponse to the same amount of protein, while experiencing lower ketones levels.

Also, the glucose could be stored as fat or in muscle glycogen depending on context.

Added a picture to illustrate what goes where.

GNGinputs

(bulkbiker) #13

Which is surely fat? de novo lipogenesis… how else do we store carbs… ?
Excess protein can be excreted as well you know…

(Michael - When reality fails to meet expectations, the problem is not reality.) #14

@Ilana_Rose Thanks for that clarification. My own personal observation:

I use Bikman’s protein recommendation of approx 1.5(+/-) grams of protein per pound of total body weight (in kilograms). My current numbers are: total body weight = 144 pounds (65.45 Kg); protein req = 1.38 grams per kilogram - 90 grams per day.

From experience I know that more than about 120 grams of protein has an effect on ketosis for me. So that is my upper limit currently. Although, I’m nowhere near that and likely never will be again unless I start pumping iron, which is unlikely. I’ve since changed my method for determining macros that keeps my protein intake inline with Bikman’s recommendations while enabling me to modify total calories by changing fat intake only.

(Bob M) #15

As a non-diabetic, I have basically zero blood sugar response to protein. As a person who lifts weights and exercises, I also like increased protein. I am still continuing to lose weight, while eating protein levels that are well beyond what’s recommended here.

Moreover, can anyone cite an RCT of increased protein versus decreased protein where the decreased protein had a benefit? I know of not one.

This is from studies of overfeeding:

" Protein is a special macronutrient. The body does not necessarily gain fat when overfeeding protein."

In other words, if you overeat protein, you will not gain as much body mass as if you eat carbs or fat (where the fat is likely also carb related).

Another one:

"However, recent evidence suggests that there is a quantitative difference in protein versus carbohydrate and/or fat overfeeding as it relates to body composition. Protein overfeeding or the consumption of a high protein diet may not result in a gain in body weight or fat mass despite consuming calories that exceed one’s normal or habitual intake. "

Another one:

“We found that protein intake was the major factor influencing changes in metabolism among those who were overfed. What this means is that, while overeating is unhealthy and leads to a host of health problems, having a high protein diet when overeating may keep metabolism higher and therefore, in the long term, overall weight lower than overeating with different kinds of diets.”

https://nutrition.gmu.edu/news/513601

These were all over eating, but there are many that are normal (though, sadly, keto RCTs are few if any).

And let’s assume for sake of argument that increased protein somehow lowers your ketones. Can anyone tell me what that is bad?

#16

The nitrogen from the deamination is excreted, but the backbone is most likely used for fuel or converted to an easily stored form (glucose or fat). High amounts of ammonia excretion guarantee the kidneys are also engaged in GNG due to anaplerosis. http://m.jbc.org/content/277/34/30409.full.pdf

added this since I couldn’t remember the numbers

In healthy adults, urinary protein excretion averages about 40 mg per day and the upper limit of normal is 150 mg per day. Urine protein concentration may increase to 300 mg/24 hours in healthy adults following vigorous exercise. http://www.clinlabnavigator.com/protein-urine-quantitative.html

#17

It’s only bad in the context where a lack of ketones upsets the balance of fuel available to the brain. If the brain is relying on those ketones to supplement glucose availability, then decreasing ketones will cause an increase in production of glucose to compensate. If you’re not sensitive to switching between fuels then it shouldn’t be a problem to shut down ketosis for short periods of time.

It would be interesting to see those studies replicated in a keto context with persons of varying metabolic health.

(Ken) #18

None of which occurs unless glycogen levels are depleted.

It can easily occur if your daily carbohydrate intake is above 20 g.

Above 20g per day it will simply occur more intermittently, depending upon amounts of carbohydrate consumed, as.well as being impacted if hyperinsulinemia is present.

You have to be able to apply the Science, rather than just repeating something you’ve read or heard.

#19

Unless liver glycogen is depleted. You can shuffle glucose into muscle glycogen all you want. But more accurately, what needs to happen for ketosis is that the amount of free fatty acids (FFA) coming from adipose tissue is sufficient to allow Acetyl-CoA to overwhelm the availabilty of oxaloacetate (OAA) in the liver. This diverts beta oxidation to the production of ketones instead of glucose. GNG is one thing that acts to use up the OAA, and it doesn’t kick in until liver glycogen levels are insufficient to provide adequate glucose [ideally, not in T1 or T2 where it is not well controlled]. There are many rate-limiting steps in this chain of events, but yes, insulin levels and the I:G ratio are the primary forces involved.

added another diagram, 'cause I like diagrams

KetoneGeneration

(Ken) #20

Yes, you are correct. It’s the Liver. Since so few are even aware of muscle glycogen and recompensation protocols I usually don’t go into it.