Ketosis and Fat Adaptation - A Discussion and Analysis

#14

Thank you for clearing the thread. I was feeling so bad for hijacking someone else’s!

You assume anyone eating carbs, say 60g, produces a lot of insulin to deal with that. But that’s not so. Not everybody is insulin resistant. Many people won’t see any bump in insulin to deal with a small carb load like that. I’m not talking about myself, unfortunately.

You’re also assuming if one is not eating carbs, insulin is low. Now, I’m talking about myself. I can fast 48h, run on day 1, say 1h, mountain bike on day 2, say 4h, before eating. Been there, done that. I measure BG before this start, it could be high, even though I was having very little carbs before the fast, say, below the 20g. After every bout of exercise, my BG goes up. Up! Recently, after fasting for a blood test, my FBG went from high 90s (after over 12h fast), to above 110 mg/do, while still fasting, hours later. My insulin? 61!

So, eating carbs doesn’t mean high insulin for someone (unfortunately not me) with good insulin sensitivity, just like not eating carbs (or anything for that matter), doesn’t mean low insulin for someone (unfortunately, like myself) who has some degree of insulin resistance (not to the level of diabetes).

But when people talk about these issues, they assume everybody is the same. We aren’t!

You also assume (sorry if I’ve misunderstood) that one needs the stored fat from fat cells to function. What about fat eaten? I’m asking to be sure I understand.

Also, eating so and so carbs doesn’t mean one is cutting calories. One can be maintaining weight and only playing with macros.

It’s my case. I’m happy with my weight. I was keeping my weight before, when I was low fat. I am keeping my weight now, that I’m (very) low carb. The amount of calories? About the same. No magic weightloss (and I don’t mind). Why I do it? Low carb food tastes better AND I want to try increase my insulin sensitivity, hoping that’s possible, but not yet convinced it is.

Just for info: I’m asking questions, just because I’m curious and I want to understand. I have no doubts this WOE is better for me (because of insulin sensitivity issue).

(Bob M) #15

This happens to me too, especially in the morning:

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I have months of data that look exactly like this. (Multiply by 18 to get US units.)

My blood sugar also goes up after exercising. I believe (though don’t know) that it’s your body’s way of replacing glycogen and/or preparing for the same.

The insulin number is more concerning. That should be closer to or below 10. How many times have you had your (fasting) insulin checked? What were the results?

Unfortunately, until we have a home insulin meter (even with strips), a lot of these questions/issues can’t be answered. I generally have insulin below 10, but have had as high as 33, for reasons not clear to me.

(Edith) #16

@Corals, I copied this from one of your posts on the previous thread.
You did say you only eat about 1200 calories a day. That is why I mentioned low food intake possibly being a cause of your low energy.

"Protein varies, around 110g/day. Fats, about 130g/day.
110x 4= 440 Kcal
130 x 9 = 1170 Kcal."

#17

I love when you share your data! Love it!

Unfortunately, it was only measured once.
FBG was 106 mg/dL and insulin was 61.4 pmol/L. A1c 5.5 %. I’m so disappointed with my insulin! I hope this is something that can be changed, or at least that won’t get worse if I eat very low carb.

#18

Except if someone is like me. I get unwell if I don’t eat fatty protein after any carbs I eat. If I just include a lots of fat, I may get away with it but alone in the end? Sugar poisoning and hunger. No way I ever eat carbs without fatty protein afterwards again…

And I always find these… separating advices vastly unnatural in most cases. We don’t eat first meat and then bread. We eat things together. I can eat almost anything separately but the people I know eat everything together. Who eats bread alone and why? The bread lovers I know wouldn’t eat it alone, no matter what.
(But I don’t understand people eating the toppings of pizza either, it’s wasteful and makes no sense to me as a hedonist either and still, people do it. Odd.)

(Michael - When reality fails to meet expectations, the problem is not reality.) #19

I don’t disagree other than I wouldn’t describe ‘fat adaptation’ as simply the ability to metabolize fat. My response to that is: so what? Maybe I’m just arguing symantics. But my view is that simply metabolizing fat is not the issue. Anyone can metabolize fat thanks to 3+ million years of hominid evolution. Even obligate herbivores actually metabolize fat - they eat cellulose to feed their gut bacteria which in turn ferment it into short chain fatty acids, which is what the herbivore actually uses for fuel.

I think the issue is one of efficiency. CICO proves you can burn fat at the same time that insulin is trying to stuff glucose into the same fat cells. But to me that sure looks like one of those “what’s wrong with this picture” sort of things. So I don’t describe that as being ‘fat adapted’. When you get insulin out of the way by remaining consistently in ketosis your metabolism utilizes fat much more efficiently and thoroughly simply because it’s not working at cross purposes. I call that fat adapted. While fat adapted by my definition, your metabolism also produces and processes the glucose you need without interfering with fat metabolism. Thus, I conclude that real fat adaptation requires ketosis.

This also bears upon the issue of so-called metabolic flexibility. Eating carbs to the point of stopping ketosis is not flexibility - you just stopped the efficient metabolism of fat. What’s’ ‘flexible’ about that? Ketosis is the actual state of metabolic flexibility because you’re metabolizing both glucose and fat efficiently. And, yes, I know the official definition of metabolic flexibility and think it’s nonsense.

(Bacon is a many-splendoured thing) #20

Actually, insulin goes up whenever we eat. If it didn’t, we would starve to death. Fat raises insulin secretion the minimum necessary for survival.

Protein raises insulin to some degree. In a low-carb setting, the increase in insulin is matched by an increase in glucagon, the insulin/glucagon ratio stays low, and the body remains in ketosis. In a high-carbohydrate setting, insulin goes up, and there is no matching increase in glucagon.

Carbohydrate, being pure glucose, raises insulin the most, because too much glucose in the bloodstream is toxic and must be dealt with.

There is no way to measure your insulin level at home, because it require radioassay equipment unsuitable for an inexpensive home metre.

The question is how much carbohydrate someone can eat without raising their insulin/glucagon ratio to the point where it shuts off ketogenesis in the liver. I don’t know any way to predict this, because everyone’s metabolic situation is different. Given the same amount of carbohydrate, an insulin-sensitive person will have a lower insulin response than an insulin-resistant person. But that amount of carbohydrate, whatever it is, might still be enough to shut down ketogenesis, even in the insulin-sensitive person.

Most of the recurring discussions on these forums, about how much carbohydrate people can get away with eating, sound very much like the sorts of things heard at A.A. meetings from alcoholics who are trying to find a way of staying sober without actually giving up alcohol. Unlike those alcoholics, we are fortunate that our drug of choice, carbohydrate/glucose, can safely be eaten, if the dose is small enough; we are not required to go full-on carnivore in order to get the benefits of ketosis. It is hard to accept, however, that there actually is a limit, and that limit is fairly low.

The alternative to cutting carbohydrate intake and increasing fat intake is the Kempner rice diet, which is extremely high in carbohydrate and extremely low in fat. It does work, and some people on the diet permanently reversed their Type II diabetes, but it is apparently a hellish diet to stick to, and patients (so the story goes) actually begged Dr. Kempner to whip them, so that they could stay on the diet. (Yes, he obliged them.)

I think I’ll stay keto, thank you very much. Bacon, yum!! :bacon::bacon::bacon:

(Bacon is a many-splendoured thing) #21

The problem is that after an extended period of high-carbohydrate, low-fat eating, the mitochondria get damaged enough from the reactive oxygen species generated by glucose metabolism that they no longer function properly. Certain other cellular processes shut down from lack of use. The fat-adaptation period involves both the healing of mitochondria, the birth of new mitochondria, and the reactivation of those shut-down cellular processes. So yes, fat-adaptation is indeed the regaining of the ability to metabolise fatty acids.

The muscle weakness comes from the fact that the muscular mitochondria are not active enough to metabolise fatty acids, they can barely manage ketones, and the muscles’ supply of glucose has been greatly reduced. As the mitochondria heal, as new mitochondria are created, and as the other necessary metabolic pathways in the cells are reactivated, the person regains strength and endurance. Many people find that after the adaptation period is over, their endurance is actually better than it ever was.

Explosive performance takes longer to recover. No one seems to know quite how much longer, but we do know that in endurance athletes who have been eating a ketogenic diet for at least two years, their glycogen levels are indistinguishable from those of carb-adapted athletes. So glycogen levels recover somewhere between a minimum of eight weeks to sometime less than 24 months.

(Michael - When reality fails to meet expectations, the problem is not reality.) #22

I do not assume that at all. I will state this fact: sufficient insulin suppresses ketogenesis. There is some variability between individuals as to the exact threshold amount of insulin required to suppress ketogenesis. There is some variability as to the exact amount of ingested carbs it takes to release enough glucose to raise insulin to that threshold. The variability is in the range of 20-50 grams of carbs more or less. Overall size and body comp, body built and metabolic rate all have effects. There are always outliers, of course, but you don’t base general guidelines on outliers.

Not assuming that at all. If you eat less carbs than raise your insulin to the point of suppressing ketogenesis you remain in ketosis. If you eat more, insulin will suppress ketogenesis. Again, it all depends on what exactly is your ‘threshold’. Your insulin will, in fact, be within the ‘normal range’. When in ketosis and fully fat adapted (by my definition) your daily glucose and insulin plots would look almost straight with only very slight up/down variations during the day. Unfortunately, we don’t yet have a continuous insulin meter to see this, we have to infer from continuous glucose plots instead. Maybe some day.

Now, it’s another issue if in fact you eat no carbs and you are not in ketosis and/or have high insulin. If that’s the case something is amiss. Please don’t misunderstand the following. Amy Berger talks about it as well. You can measure very low or even zero ketones on the various tools we currently have for measuring them but still be in ketosis. Because ketones fluctuate greatly, get synthesized at different rates and in different amounts, get utilized more or less efficiently, don’t get excreted or don’t spend much time in blood transit. You can get very low or nil readings at any time. Unfortunately, we don’t have any device yet to measure ketosis directly - how much fatty acid is actually being diverted into the ketone pathway. Maybe some day.

I totally agree and if I have given the impression that I think we’re all carbon copies of Generic Homo I don’t mean to do so. A very common theme in these forums is the uniqueness of our individual experiences. It’s also one of the most frustrating problems understanding human metabolism.

No, I certainly don’t say that. There’s a limit to just how much onboard fat one can metabolize daily. It’s based in part on how much you’ve got and your metabolic rate. But generally, it’s less than enough to provide all the fuel you need, so you have to eat the rest. Phinney has a nice chart on Virta which I’ve most recently posted here that shows the relationship between the utilization of onboard fat and plate fat over time on a typical weight loss keto diet.

(Michael - When reality fails to meet expectations, the problem is not reality.) #23

Thanks Paul, all excellent points. Again, none of that healing and recovery are going to happen unless you’re consistently in ketosis.

Explosive performance takes longer to recover. No one seems to know quite how much longer, but we do know that in endurance athletes who have been eating a ketogenic diet for at least two years, their glycogen levels are indistinguishable from those of carb-adapted athletes. So glycogen levels recover somewhere between a minimum of eight weeks to sometime less than 24 months.

Interesting that you mention this. Yes, it’s entirely relevant and I have already intended to bring it into the discussion. As a youth and young man I was a competitive middle distance runner (5 miles generally - that’s 5-10K nowadays). Although I never ran distance I was aware of the big issue of how to avoid ‘hitting the wall’. We were discovering lactate as well.

(Michael - When reality fails to meet expectations, the problem is not reality.) #24

:+1::+1::+1::+1:

(Mg ) #25

Keto adaption is great as long as you don’t get stuck.
Plateau right? Stinks especially if you love what you’re used to doing. Creature of habit.
Just like anything else I suppose?
Life is all about change.
Oh, and that darn patience. Yuck
But have to learn that in this lifestyle.

(Bob M) #26

I also think “metabolic flexibility” is bunk, if this means you’re supposed to eat carbs so you have a better blood sugar (and insulin?) response to carbs.

As for athletes, I wish there was more research on lifters. I think if you want to get really big (aka “HUUUUGE”), you most likely need some carbs. But you also likely have a large insulin sink in your muscles, so a carb “hit” isn’t going to be the same for a person with 20, 30, 40+ pounds of muscle versus those with no or low amounts of muscle.

The version of me in my 20s, when I was lifting all the time and my bench and squat and deadlifts were quite high (nowhere near power lifting results though – you need genetics for that), that version of me could probably suck up insulin and carbs.

Today’s version of me, with torn rotator cuffs, back issues, other injuries, much smaller muscle mass, this version of me can’t suck up nearly the insulin and carbs.

But I don’t see any keto studies on lifters. Would a keto lifter have the same glycogen as a higher carb lifter? The same muscle mass? Could I (re)gain more muscle mass if I ate more carbs? I’ve been trying a pseudo-TKD, where I eat some carbs the meal after exercising. It might help mentally, though I can’t figure out whether it helps physically. I also have limited the amount of carbs to only around 20-25 grams after my exercise, and often forget and just eat meat after exercising.

And you’ll see advocates of lower carb lifting, like Shawn Baker. But he was massive before he started low carb/carnivore. That is, he didn’t get his mass by being low carb/carnivore.

So, I’d appreciate someone doing the same Phinney/Volek test they did on cyclists, but for lifters.

(Edith) #27

Too bad we can’t get someone from Keto Gains to weigh in on this. They seem pretty buff over there.

I think I may try to find some podcasts where Luis Villasenor has been interviewed and see what he has to say.

#28

@Paul, if what you said is right, perhaps the fact I feel so weak means I have a mitochondria problem. Perhaps I have some kind of condition that has damaged mitochondria in my muscles and I can’t use ketones as a normal person. And I only find this out now, because before I ate a lot of carbs.

It’s a big if and a lot of guessing, but if that’s the case, I hope it can heal and eventually I’ll have energy again.

Regardless, your posts are nice. I always learn a lot. Thank you!

(Bacon is a many-splendoured thing) #29

As we tell people, it takes generally six to eight weeks for the healing to occur. Some people take longer, but that’s rare. If you keep eating a ketogenic diet, your body will be busy repairing mitochondria and making new ones. Exercise helps this process, if you like doing exercise. Just don’t stress your body too much at this point. It’s got enough to do, recovering its ability to metabolise fat.

(Bob M) #30

One of the issues is the chicken and egg concept. Saw Ted Naiman say that we shouldn’t be worried about whey proteins because if you follow people who are “buff”, you see many of them using whey proteins.

But I think there’s a difference. Take a buff person with 30+ pounds of muscle (say, younger male), and give them whey protein, which causes a very high insulin peak. Where does that insulin go? There’s a large insulin sink in the muscles.

Now, take that same person, make them 30 years older (me, 7 years ago), they’ve lost most or all of that muscle and replaced it with fat, and have another 50 pounds of fat too. Throw in a good amount of “insulin resistance”. Give them whey protein. Where does that insulin go? I can’t see this being a good idea.

I took some time to find studies where they gave obese people whey protein. It did not seem to help with fat loss or really have many benefits than on paper (eg, maybe LDL went down).

Now, I’m in between those two extremes. So, would whey protein (or carbs) help me? It’s tough to say.

And one’s goals also affect this. I’m interested in exercise and getting a bit more muscle mass, but don’t want to be “massive” any more. It’s unclear even to me whether I should be trying carbs, though it happened this also worked well with the “high saturated fat” diet I was trying too: starchy carbs soak up saturated fat like nothing else.

(Bacon is a many-splendoured thing) #31

I’m not sure why you are characterising muscle as an “insulin sink,” since all cells in the body have insulin receptors. And surely, if muscle is a sink for insulin, so too must be adipose tissue, right? Muscle and adipose are both definitely sinks for glucose, as well as the liver, to some degree.

In any case, my understanding was that insulin is sent to the liver for disposal. Did I get it wrong?

(Michael - When reality fails to meet expectations, the problem is not reality.) #32

Protein builds muscle mass, not glucose. Glucose can provide the energy but so can fat. What glucose does that fat doesn’t is convert to glycogen which in turn binds to about 3x it’s weight and volume of water. Folks who pump iron and ‘carb up’ are just inflating their muscles with glycogen and water - not more muscle mass.

(Edith) #33

I know that the glycogen being stored with water is true but @Dread1840 seemed to have a lot more success once he added in carbs.