Saved for future reading. Thank you.
I do wish this forum would have one closed thread (maybe Suggested Reading), that contained these such articles that people could peruse - or not. I would have loved that when I was a newbie and then as I sought to know more about the science of keto. Much of that I’ve gotten from the learned members here from what they’ve said in response to others and articles that they’ve posted from the experts. I think many people seek to understand, and these would be a helpful resource in one place.
We should make additional ones for:
- Cholesterol (my LDL is high!)
- Why am I not losing weight and what can I do?
- Blood sugar
I always thought I’d like to write a primer about how to analyze studies and the like. Never have time for that, though.
Yes. And maybe “How does it work?” I purchased Dr. Fung’s Obesity Code when I started and that helped me understand a lot - but it was a book, not something as succinct as an article.
A true keto diet is 70-90% of calories from fat. For simplicity, fat satiates and you decide that you are not hungry, so you eat/consume fewer overall calories. For example, your resting MR is 2000 calories before starting, and with keto or carnivore or the LCH protocol you now eat 1500 calories, you will lose weight. You have created a deficit. Because your metabolism once required 2000 calories at rest and now only needs 1500 calories, the body will self-adjust over time. I believe this is one of the main reasons why people plateau when using these protocols. Trying to raise this set point can be difficult and time-consuming. I deal with numbers all day long, so I like to measure everything. Blood tests before starting any protocol, and follow-up tests when things have changed. Measure macros in the beginning. Measure blood ketones. DEXA Scan (gold standard) to measure bone density, fat, and muscle mass. A DEXA scan will let you know if the loss is all fat or a combination of muscle and fat. A bathroom scale cannot do that. Maintaining muscle mass is very important as we age. I suppose for a morbidly obese person all weight loss is good. The above is only my experience and some friends and family members with Keto and LCH over the last 10+ years.
I would not phrase things that way. My impression is that a ketogenic diet is one that keeps insulin low enough throughout most of the day to permit the liver to generate ketone bodies. Fat intake has the least effect on insulin secretion, so it is the macro that should be providing the energy that we lose by restricting carbohydrate. Fat should be eaten to satiety, not to some arbitrary percentage of calories.
But given that carbohydrate, because it is simply glucose arranged in various ways, has a significant effect on insulin secretion, it is restricting carbohydrate that lowers insulin sufficiently to permit ketogenesis. As Prof. Ben Bikman likes to say: “Control carbohydrates, prioritise protein, fill in with fat.”
Thank you. I read it yesterday. Very informative; pretty sad.
These were my observations over a 10 year period. I was explaining something for sank of simplicity. I am generally not a proponent of the calories in vs out equation. I do not believe that all calories are equal, even though it may have come across as so. A 1000 calories of potato chips vs 1000 calories of wild salmon are completely different in how they act within the body and how they react differently in individuals. I do think there are too many variables that play a role in weight loss, some of which I don’t think we truly understand. Determining overall calories consumed neatly explains why we plateau.
“Fat should be eaten to satiety, not to some arbitrary percentage of calories.”
You are certainly entitled to your opinion. However, most experts in the field, including Johns Hopkins recommends a percentage of macro calories when doing the Keto protocol. For example, 75% of calories from fat for type 2 diabetes.
Oh, it’s not my opinion; it’s advice from Dr. Stephen Phinney, one of the major researchers in the field. His advice is seconded by Dr. Eric Westman, who worked with Dr. Atkins and studied his patients; Prof. Jeff Volek, who has done quite a bit of research in conjunction with Dr. Phinney and independently; Prof. Benjamin Bikman, a researcher into the physiology of insulin and other related hormones; and Richard Morris, Ph.D., a founder of this site. According to them all, a ketogenic diet consists primarily of a limited amount of carbohydrate (on this site, we recommend less than 20 g/day), a reasonable amount of protein (determined in relation to lean body mass; exact amounts vary from expert to expert), and enough fat to satisfy hunger, whatever that percentage of calories it may turn out to be. A large quantity of fat in the diet will not, of itself, promote ketogenesis or ketosis. As I mentioned in my earlier post, ketogenesis requires the absence of insulin; or, more precisely, it requires a low ratio of insulin to glucagon.
Same machine that’s used to do Vo2 max testing, except instead of cycling or running on a treadmill you’re sitting idle while fasted. Doctors use them, so I assume they’re accurate enough. When my metabolic rate was complete trash going by the numbers I got then got me weight dropping again for the first time in a long time, so good enough for me. I attached what you get from it.
rmrtest.pdf (422.9 KB)
No, keto diet is all about ketosis and we can do that with 50-60% fat just fine, it’s not worse, merely way more suitable for many people… If keto would be only 70+ % fat, I probably wouldn’t even try it!
I have 60-70% days (sometimes 50% but only when I happen to eat leaner protein) on carnivore-ish and I eat quite fatty. I love fat. I am not shy to have it way above 200g sometimes (I would love it all the time but that would be massive overeating for me)… But I love my protein too. Some people even consider <30% protein with their lowish energy intake too little and they may be right. Our need is in grams, being very stubborn about the irrelevant percentages seems a quite bad idea. I don’t care about percentages, mine is only in a smallish range due to my taste and usual energy intake and protein “need” (I tend to be hungry without high protein, not necessarily but it’s easier to keep it high instead of being super careful and not eating what I want, I would fail anyway).
90% fat is fine, even 95% but only for people with a huge energy need, they still can get their protein from the rest. Oh and they need to be able to stomach mostly fat food. When I tried carnivore, I had to be around 60%, now I could go higher but it’s most comfortable around 65. I will go higher when I want to bulk, I can’t afford much fat with my actual needs and goals. If I ate 80% fat, well that probably would be insanely high protein and serious overeating (unless I plan like crazy and give up my comfortable ways)… Certain things are correlated in my life and surely other people have that too.
Certain fat satiates me. Others not at all. It’s super easy to overeat on keto if you ask me and some people found the solution is eating quite high protein (not me, I have my satiating fats and not satiating proteins and I am okay with 2:1 and 1:2 fat:protein ratio alike. it’s way more convenient and enjoyable to stay around 1:1 now though).
Each to their own. No percentages suit everyone.
“Each to their own. No percentages suit everyone.” Agreed. However, generally most studies on Keto for weight loss for the morbidly obese and for the elimination of Type 2 diabetes state a percentage macros range, this includes fat. This is used as a starting point. Fat to satiate means nothing to those who eat too much.
Well if you are doing a study then of course you must set a limit on all macros.
But if you are treating obesity or T2D then it depends on the individual. Some find their satiety signal broken from years on a SAD diet and need limits on fat. There should be no minimum. And sometimes a keto diet fixes that and they can limit their fats based on hunger, not a macro.
I am talking in general terms. I am a numbers person. So I test and then re-test. I have lots of blood tests to see the many different markers. I also have Dexa scans and lots of blood ketone results. I know specifically what works for me and what does not. I can adjust my macros accordingly. I have lots of baselines.
Phinney and others have done studies on ad libitum ketogenic diets. Phinney in particular does not specify macros as percentages, but states the carb limit as an absolute amount. And Phinney is also the one who, so far as I am aware, coined the phrase “fat to satiety.” (I got it from him, at any rate.)
Studies that try to debunk a ketogenic diet are the ones that generally choose a percentage, such as defining “low-carb” to be 35% of calories, and so forth. (I suppose that is low-carb from their point of view.)
The Virta study on reversing Type II diabetes, conducted by Sarah Hallberg, is an interesting one. You might check out their definition of a ketogenic diet, to see how it compares with other studies. (It is not a randomised, controlled trial, but it is interesting nonetheless.)
Gary Taubes, in one of his books, cites an early study on low-carb, ad-libitum eating, in which one of the participants ate 3000 calories and still lost fat at the same rate as the others.
The British nutrition advocate, Sam Feltham, conducted two experiments on himself, a 28-day low-carb, high-fat, 5000-calorie diet, and a 28-day high-carb, low-fat, 5000-calorie diet. He wrote up his experiences and has lectured about them. On the low-carb diet, he lost a bit of fat and gained an equivalent amount of muscle. The results of the high-carb experiment were very different, as we might expect.
There are people on this forum who have mentioned that their hunger signals and satiety signals are messed up or even lacking. I’m sure they would agree that they need to measure and retrain their body’s signals.
And I would say that the word satiety can have different meanings to different people. For example, if I am looking at a recipe and it calls for a large tomato, I get frustrated. What do they mean by a large tomato? Their definition of large tomato could be quite different from mine. I would much rather have them say a quantity such as 1 cup or 100 grams.
So, what does satiety mean? Until I can’t eat another bite? Until the edge of my hunger is gone, but I could still eat a little more if I wanted to?
Like you said, using macros as a starting point can be very important.
For those who experience it, it is remarkable. It is a sense of “I really don’t want to eat another bite,” despite feeling that there is still plenty of room left in the belly. When I first experienced it, it came as a complete surprise in the middle of a meal. These days, when I think of eating when I’m not actually hungry, I almost get queasy at the thought of more food.
This is in contrast to filling up my stomach with pasta to the literal bursting point and still wanting more, which was my usual modus operandi.
I’ve posted this before, but I learned in French class that Americans tend to say, “I’m full,” whereas the French tend to say, “J’en ai eu assez” (I’ve had enough.) For me, that sums up SAD eating and keto eating in a nutshell.
I been neither ‘full’ nor ‘had enough’ nor felt any hunger since Jan 2017. Then again, I’ve not done any multi-days fasts since then either (although I do 3-4 overight IFs each week) - and have no desire to do so. I suspect with my relatively low BF I would get hungry in a few days. I suppose in the interest of science I should do one and report. In the meantime I continue to eat to my macros, maintain both weight and BF% and feel great - lots of energy. Did I mention I have a full-time job at Walmart? And that I’m no couch potato otherwise. Keto works - for me!