Just to play Devils Advocate

(Christopher John Howson) #1

We “Ketonians” say THEY are blind!
but sometimes, i can’t help but think… is it us!!?

is it WE, pushing OUR beliefs so much that WE are blind?
that WE are selecting to believe information that suits US?
(and having a total disregard for anything that goes against what WE THINK WE KNOW!!

we all hear about confirmation bias, we all select, read and listen to stuff that confirms our own beliefs. after all, why wouldn’t we? our own unique n=1 experiments have all been correct, so far!
my own n of one has been no exception and am now in the best shape of my life at the tender age of 34!

my question is this…

if the pancreas is overworked in a carbohydrate rich environment and its spewing out enough insulin daily to regulate blood glucose then workload is said to be detrimental to pancreas health.

if the exact same load is transferred to the liver to produce ketones from processing fat in the absence of carbohydrate, is this situation going to put our livers under abnormal strain?

is there a middle ground?

are we adversely affecting the day to day running of the homeostatic machine that is the human body by doing one extreme, or the other?

yes - i am keto till i die!
but thought this would be a good conversation starter and am to be honest, in the dark about it myself.

the keto house

(Cathrine Helle) #2

I think that being open minded is always a good thing :slight_smile:

This is an article I found that discusses the possibility of being too insulin sensitive. Personally I don’t think it applies to me, as I’m not an athlete and have more than enough body fat. But it was an interesting read for sure.


(Cathrine Helle) #4

Let’s hope that’s not the case! We need nuances, and being unwilling to see these are detrimental too our cause. It’s so easy to become almost religious when having the revelations of improved health after having struggled for years, at least that how I felt when I started this WOE in 2010/11. But at the base of science is the willingness to question established truths, and ours shouldn’t be any different. Just my opinion.


There are some indigenous groups that thrive on a high carb diet. The high prevalence of metabolic damage we see in the West comes from an overabundance of readily available, highly processed, sugar-filled junk that puts our blood sugar on a rollercoaster ride that simply wouldn’t occur in nature. I personally think soda and fruit juices are amongst the worst culprits.

The modern diet takes its toll on the liver, too. Fructose has to be processed by the liver, much like alcohol, and a diet high in fructose can lead to fatty liver disease. Ordinary table sugar is half fructose, and processed food products can contain even higher levels as it adds a lotof sweetness.

The liver has work to do regardless of how we fuel our bodies. It turns glucose into glycogen and fat if we eat carbs, and produces ketones if we don’t. I don’t know if ketone production places a greater strain on the liver than any of its other metabolic functions, but it’s a natural state and I don’t expect it would cause problems in the long term as long as you don’t take the mickey with alcohol and meds. Also, it’s not like we’ll develop ketone resistance from eating too much fat! :wink:

I think that for the metabolically healthy, avoiding grains and sugar and replacing vegetable oils with healthy fats is enough to lower inflammation and improve health. A lot of people feel great on paleo and liberal low carb diets, for example. However, once you’ve got insulin resistance the middle ground doesn’t always work. Perhaps over time your body may heal and carb tolerance may improve. Personally, I can feel the difference between being in keto and not, so I aim to stay in keto as much as possible.

(Richard Morris) #6

One way to look at complex biological processes is to consider their evolutionary context.

Our primate ancestors evolved around the tropical equator, in trees eating fruit. We can infer that by the fact we have fingerprints for traction, see the color red (like most fruit eating animals), we also lost the ability to produce vitamin-c unlike almost all other mammals because of our fruit heavy diet. We probably had a much more varied diet like modern tree dwelling primates, but we almost certainly didn’t have a problem with carbohydrates. This is the basis of the pancreas that can produce prodigious amounts of insulin.

Then about 2 million years our ancestors left the trees and the equator and fruit became a seasonal food. But at one time of the year, right before winter we took advantage of the mammalian hibernation reflex to allow us to gorge on ripe fruit and become slightly diabetic as we made body fat reserves to last us through winter. This is something bears and other mammals that hibernate do every fall. Our ancestors who could pack on more fat survived the harshest winters. This is the basis of the metabolism that can become diabetic.

About 200,000 year ago anatomically modern humans appeared, still following that seasonal fast and feast cycle. We took to running down prey and became the greatest daytime persistence hunter on the planet, and we evolved big brains to outwit our prey. And those brains required massive amounts of glucose … but modern agriculture was still around 190,000 years away, and mars bars were around 200,000 years away, so our livers adapted to adequately fuel our brains with made glucose and ketones. This is the basis of a liver that can replace glucose as a fuel for the brain.

If any of those things were not the case, we likely wouldn’t have reached where we are today.

Unfortunately our bodies are not well adapted to cope with perpetual summer, ripe fruit 12 months of the year, and Grains and Sugar every 3 hours, 365 days a year.

For me, a Ketogenic diet is a hack to revert us to a pattern our ancestors evolved with.

But … y’know I’m perfectly willing to be wrong. I just know I prefer to be non-diabetic and in control of my intake and exercising spontaneously, rather than the previous state.

I suspect anatomically modern humans would not have survived the 190,000 years until agriculture was invented if that were true.

It is worth reflecting that this would not be a like-for-like swap, glucose in the pancreas for fat in the liver. Caloric loads in an insulin resistant person eating sugar and starch to satiety are significantly greater. than a ketogenic person eating fat to satiety.

Ketogenic diets are not fat to absurdity (“ad absurdum”) they are fat to satiety (“ad libitum”). Which is something that people who don’t really understand ketogenic diets always get caught up on.

Q: “What you can eat as much bacon as you want?”

A: “Yup - but ‘all you want’ is a lot less than you may think it is”

(ianrobo) #7

great post Richard and just listened to Cate Shananan on a podcast making this same point. I doubt you are wrong at all and all studies and oour won experiences prove this. As Jimmy Moore says the breakthrough will happen once insulin tests at home are produced and people will see the impact of carb eating.

(Nigel Williams) #8

I am LCHF I’ve dropped from 14.5 stone to 13 stone and need to lose another stone (14lbs) I’m not diabetic but before LCHF might have been close.

More conscious than ever of confirmation bias. When I first saw the Tsimane study suggesting carbs were OK I had to try very hard not to just dismiss it then worried that I had been pushing LCHF too hard. Zoey Harcombe explained well for me the Tsimane carbs were guessed not measured.

However, like anything the more deep you go the less clear things get. The things I’ve seen subtle changes on are:

Calories were irrelevant because your metabolism goes up with high fat high but now calories are relevant, even on high fat if you want to reduce body fat.

Too much protein is bad now meat only OK, this was based around protein spiked insulin. But that spiking view I think is slowly shifting.

Atkins was sort of right but later went for high protein not necessarily high fat so was wrong, but as above point that might be changing.

I’ve recently heard Dr. Ted Naimen say losing weight on calorie restriction or LC are both beneficial massive simplification of what he said.

LCHF isn’t Ketogenic for about 6 months after I started I thought they were the same.

In the near future I think there’ll be subtle shifts on Fasting, I’ve done 6 day fast where I had cream coffees twice a day, I think that will change to saying fasting means no calories. Also, I wonder whether the Autophagy thing will weaken.

Cancer, Dr Seyfried says it can reduce tumours others suggest it can help chemo etc work more effectively but Low Carb won’t directly help with cancer. Way too an emotional area to get any clarity. And how do you even do RCTs on this.

I am a massive advocate of LCHF. The N=1 is a way to dismiss the above and is how anti-LCHF can say it doesn’t work for the majority.

When I find people laughing at LCHF/keto I get annoyed my reaction worries me, am I becoming a zealot? Suffering from confirmation bias?

I am generally sceptical about everything. So when I hear all these wonderful things about LCHF I need to say where’s the evidence. Is there evidence of better skin, shinier hair, more energy, clearer thinking, less sleep.

I’ve got in to debates with nutritionists who say weight loss/gain, eating issues are very complex. I did dismiss this attitude but I now agree with them a little more.

My view is LCHF clears away many confounding factors. Then you can add the n=1 factors to tweak, the dudes say hack, your diet to deal with our individual complexities.

Perhaps we’ll see more carbs being allowed or perhaps zero carbs will be the future or maybe we’ve finally cracked it. I’d like to try living only on meat. But I don’t feel I know enough about a meat only diet yet.

So in summary when you personally see all the benefits you really want everyone to do the same. I used to then go in to lecture mode - very bad idea. Worse is when someone on calorie restriction tells you they’ve lost a stone in weight so LCHF is no different. I now smile and say whatever works for you keep doing it.

I used to then ask a month later, how’s it going, which annoyed them because the weight loss had stopped (although to be fair I haven’t lost any weight in a year now despite multiple fasts).

Now I am more open minded and listen better. I ask how did you feel on low calorie what did you eat what other changes did you notice.

I try to find common areas with them, all the time fighting hard to not go back to lecturing them even when they ask more about LCHF or worse tell me LCHF is a fad😤


(ianrobo) #11

of course you get an idea with BS tests but easy for some to see, eat a carb rich meal when T2 and see what happens … QED

(Richard Morris) #12

I am not sure that the underlying data is useful because the subjects were a bunch of uni students that they filtered out with a Glucose Tolerance test - to make sure they didn’t have any diabetics and then expose 3 people to each food candidate and took the average of all three measurements.

The first problem is each candidate sample had a different 3 test subjects … so you’d have to be sure that they all had an insulin response representative of the rest of the population.

We know from Dr Kraft that a lot of people who pass a OGTT fail the Kraft insulin assay, so they will have had some people in that test who had abnormal insulin responses. They’ve never released the data, so did they reject outliers or did they make it back into the data.

Also the university of Sydney glycemic institute, and specifically Alan Barclay and Jennie Brand Miller have done a lot of strategic publishing to exonerate sugar, as well as helping to develop low GI logicane for CSR.

So while it’s useful to see that glucose is not the entire story, I wouldn’t mind seeing the results replicated by a different lab.

(Karen Parrott) #13

Yes, this is an excellent topic. And, wise to both listen to others and see how your own body adapts and performs overtime.

The tools I use now in long term weight maintenance are not the tools I used heading into Paleo/LCHF/Keto. Not changing up, experimenting myself, and looking at the bigger picture can box me in.

I’m only 5+ years into the next 35 years. I’ve got a long, long way to go, adjust, read and tinker as I age. It’s the gift I give to myself. I would have re-gained my 70+ pounds by now if I had not.

Keep up these topics. There’s no one way.

(Mike Glasbrener) #14

I am a n=1 study of two different woe methods…

I lost 90lbs eating a low (zero) simple carb diet moderate protien very low fat diet. I exercise a ton. I got at least 1hr/day cardio and more on the wekends. This was ~8.5 years ago. I lost 90lbs in 9 months. From there I stayed in great shape for about 4 years although I added abut 10lbs. This culminated in a 1/2 iron man. While eating and exercising this way I always managed my diet (hunger). This was SOOOO much better than the SAD diet. My hunger was much more linear. On the SAD diet I would swing from sated to STARVING in ~1-2hrs tops. My hunger would go from detectable to insatiable in 1/2… I HAD TO EAT!!! With the HCLF diet (zero somple carbs) My hunger was much more linear. I would go from detectably hungry tostarving in about 2hrs or so. If I was coaching my kids teams (3-4 nights a week plus weekends) I would eat something like a protein bar to allow me to delay dinner. So it was managable and “worked”. However, I was still managing hunger and was eating complex carbs and some protein ALL THE TIME. I would snack after dinner on raw veggies or a bowl of melons (water/cantalope) nearly every night. While doing endurance things longer than an hours or so I was managing fuel (simple sarb beverages and gels).

I relapsed into bad habits about 4 years ago due to family and job stresses.

Last fall I worked to get back into shape and tore my quad which wasn’t figured out til Jan. this year.

I started eating a my HCLF diet beginning this year and discovered keto in the beginning of Feb…?? Rehab is just about finished and my knee will need arthroscopic surgery in 2.5 weeks. The quad/knee are relevant because My eercise is WAY down compared to previously. However, since switching to dirty keto (I don’t track macros but I’m anal aboutkeeping carbs as low as possible) I moved through PISS and dropped about 3.5lbs/wk for some time while my resting heart rate and blood pressure improved. I had a holiday last week and upon returning I did something I never could have done before… I fasted for 36hrs. I was astounded (only not quite so much because of testimonials here about fasting and reading Fung’s book). It also kick started my resumption of weight loss (or so it seems).

So even though I’m 8+ years older and my exercise is down my health (weight and health markers) is improving at a similar or better rate than before and my hunger is totally manageable. For me this is so much easier to maintain. Also, if I get off track I can always fast to reset.

Oh! BTW I purchased a vitamix and drank green smoothies for a while about 5 or so years ago in the morning. My family didn’t like them unless they had fruit in them so I yeilded and made them for all green with fresh fruit added. I thought it was healthy. However, I couldn’t lose a Frickin’ pound and in fact put some on even though I was eating “healthy”. This woe is SO much better for me. I will continue to experiemnt some and post as I progress.

Lastly, I’m an engineer and read prolifferously about keto now and almost all of the science just fundamentally makes sense and fits well with my n=1 experience. Baby backed ribs for dinner tonight for me.:grin:

(Richard Morris) #16

I know! Right?

we need to get Rory on to “pants” Alan Barclay in yet another forum :smiley:

(Todd Allen) #17

Forum members regularly speak out on the issues they are having such as keto flu during adaptation, not losing weight, constipation or the opposite, dry skin, high LDL, etc. I’d expect if there were any serious long term health risks such as harm to the liver, gall bladder, intestines, etc. these would manifest as a pattern of complaints by a noticeable fraction of members.

Another pattern seems to be that new ketonians report far more issues than longer term ketonians, suggesting more issues are short term/adaptation than long term problems. Not that this is a well formed science experiment, it could be people prone to developing long term problems stop keto and move on to something else. Still I would expect some/many developing long term issues would be hesitant to move on due to other positives such as improved weight control and would stick around discussing developing long term issues looking for solutions. The long term issue that seems to come up most is “help, I’m stalled and I haven’t achieved my dream body yet” and I’ve not seen “help, I need recommendations for liver transplant surgeons”.

(Christopher John Howson) #18

some good info here, thanks so far.

(Christopher John Howson) #19

I agree - open discussion for me is the best way I learn. 2 years in, I still learn new things. you will always get that smart arse though that “knows it all”

best practice is to try and not get offended and assume that the post is meant as no harm intended rather than a malicious listen to me, I’ve been there and done that.

(Christopher John Howson) #20

ive calmed down a lot from how I used to be about it! if people want to try it, they can. and I will help them where I can too. but we cannot make them do it; we can only lead the horse to water…

Bad Science by Ben Goldacre is a good read (if you haven’t already!)

(Christopher John Howson) #21

Just to play DA again, Richard… (haha)
what do we say to those that say “well yeah, but cavemen only lived til they were 40”

(afterthought - these people though on rare occasion may add “and that’s before CHD kicks in”)

(Richard Morris) #22

We have paleolithic skeletons in their 80s so that isn’t really supported by the evidence. We also have recent data directly from paleolithic peoples - for example the Pintupi 9 which were the last paleolithic Australians walked out of the Gibson desert in 1984.

Most humans until roughly the 19th century died in childbirth, or in childhood. The lifespan expectation at birth (LEB) for humans born in 1900 was 31 years.

The LEB for someone in the paleolithic era was 33. But the chance for making it to 15 years of age was 60% and the additional Life expectancy at 15 yo was an additional 39 years - so 54 years.

Our best guess at the LEB for the neolithic when we developed agriculture was more like 20.

According to the WHO in 1950 our LEB was 48 years probably reflecting the invention of antibiotics.

The average LEB for an Australian born today is 82.8 years which probably reflects the quality of our neonatal healthcare.

(Siobhan) #23

I think it is quite important to question what you base your beliefs on.
Read studies that support your idea, try tp find flaws, point them out (to yourself).
Try to figure out if the researcher drew sound conclusions from the data.

Now find a study that contradicts your beliefs. Do the same thing.

That is what I try to do. In every book on nutrition Ill find things I already know, something new (which I then verify), and always something I disagree with.
Plus I use n=1 and follow that

But I also treat learning nutrition like a hobby, and not everyone has the time. Quick thing would be to contradict your own believes, read through thoughts from people who disagree and try to prove them right… or wrong… and draw conclusions. Can take as little as 15 minutes.

Or just start this thread and have some friendly (but not echo chamber) discussion.

Even, eapecially, towards your own beliefs your gut reaction should always be “SHOW ME THE SCIENCE!!” :smile:

(Steve Stephenson) #24

40 is probably some sort of average. There were probably a lot of deaths in childbirth, mother and child. There were probably a lot of deaths by disease, esp. in childhood. There were a lot of deaths by accident and infection. And, back then humans were also prey to some pretty terrible and efficient predators.