The gauntlet has been thrown!


#21

It seems like part of the problem for his response has to do with citing T2D to begin with, and the fact that a lot of people here are familiar with T2D research. He didn’t seem to ask for anything about “normal, healthy people” in the beginning (and we have to define those terms anyway), so research wasn’t given on that.

On the other hand, there is a lot of research on that kind of group, or really on elite athletes. As I understand, that was the primary group Drs. Phinney and Volek were working with (particularly with endurance athletes) for much of their research (maybe they still do), and I believe that’s also Tim Noakes main field. I believe they show the benefits for that group in their improved endurance performance (setting records for super-marathons, etc.).

Of course, it sounds like once you present their information, he might just say, “but you aren’t a super endurance runner either”.

The research otherwise may be out there for exactly what is sought, but I’ll put things this way: the reason I started a nutritional ketogenic diet was that the research convinced me it was not likely to do any harm, at any rate, and it appeared to be the easiest and most enjoyable way to avoid things that research convinced me would do harm (sugar in the forms of sucrose and fructose specifically). It just appeared to be a practical choice, even if there were alternative methods (and indeed, I’m still open to the idea that alternative, drastically different methods are equally or even more effective, at least for certain populations).

On the vegan note though, when I looked into that research, they claimed nearly identical results, but had a hell of a lot more doubtful evidence and less convincing arguments in their favor. But, hey, maybe they work to certain degrees too? There does seem to be indications that the Standard American Diet at least is simply the worst route, and switching to nearly anything else is better.


#22

Nora Gedgaudas addresses the appearance that vegans seem to do better, but it is only in the short term and appears to be related to the things they eliminate from their diet, and in the end so many vegans abandon that lifestyle because of all the problems it creates after months or years through deficiencies.

Lierre Keith is another former vegan who wrote the book, “The Vegetarian Myth” and explains how she eventually abandoned it because of declining health.


#23

Indeed, I’ve heard similar stories, though I’ve also heard from some that have maintained it in supposedly good health for decades.

One of the sources I like for advice related to nutritional ketosis and other matters had a similar story though (Primal Edge Health), where the couple had gone vegan (maybe raw vegan) for many years, and were kinda fine, but eventually changed to a ketogenic diet after their very young daughter developed clear deficiencies (teeth chipping easily at 2 years old). They’ll tell you they still don’t recommend a nutritional ketogenic diet for everyone they consult, and can explain some of the benefits that do exist with vegan diets (with caveats which make them not recommend it in general), but a nutritional ketogenic diet seems pretty clearly good for a majority of people (adults anyway, healthy children may have slightly different needs), until some better evidence and understanding comes along.


(Jeff) #24

You can eat carbs again, just follow Dr Ted Naiman’s rules. There are three times that you can eat carbs:

-before exercise
-during exercise
-after exercise


(mcebis) #25

Tell him this story. When I met my wife she was low carb. I laughed and said all the things he probably said. Ten years later after a low low fat diet with lean meat and healthy fruit and veg I have type 2 diabetes and high CVD risk. 3 months low carb and my diabetes reverses and CVD health normalise. A1C drops from 9.0 to 6.0% and off all medications. My doc said only one other patient did that in his 40 years!

Then get him to watch this video with you from 12 Feb. Salim Yusuf is the President of the World Heart Federation.

Then if he still doesn’t believe you ask him to talk to me!


(Richard Morris) #26

I would add to that … If you have low fasting insulin.

If you are producing non glucose stimulated insulin secretion - and there are plenty of us with high basal insulin who exercise - better to make that glucose yourself slowly and drag insulin out of circulation to replete glycogen instead of eating it to quickly fill up your glycogen.


(Meeping up the Science!) #27

Cognitive dissonance doesn’t care about science, sadly, and for him to admit you are right he must admit he has made medical decisions which have done harm, potentially.

Live well, get blood tests, and laugh when he is perplexed.


(Barbara Greenwood) #28

I have this lovely image of those pesky insulin molecules being dragged inexorably out of the bloodstream…

But seriously… is it that we are producing non glucose stimulated insulin… or that we are inappropriately releasing glucose from the liver (due to liver insulin resistance), and the pancreas is secreting more insulin to try to keep a lid on it? Which comes first - the insulin, or the glucose?


#29

Spot on - cognitive dissonance is a big barrier to keto for people in general and even more of an issue for a medical doctor.

I would focus on the testimonials from medical doctors who’ve had their epiphanies and gone keto, or at least LCHF, for themselves and their patients since that’s a cohort he can probably relate to.


(Michelle) #30

Exactly @Donna and @BillJay . I think that’s a big part of it. For one, he’s a man (no offense to any men here), but men can be a bit stubborn about admitting mistakes. And two, he’s a doctor, who has been classically educated in western medicine. Comes from a dad that was a doc and mom was a nurse. So, he’s hesitant to go against his “roots” so to speak. With anything that he invests in - he does tons of research. Like more than anyone I’ve seen - whether it be a camera, an appliance, etc. He does his homework.

What I can do is keep throwing study after study to him, and keep chipping away. Real medical studies from people he respects and trusts. I asked for his support with my keto lifestyle and I know he will. Just don’t know if it will turn his head in the right direction. Time will tell!!

At the bare minimum maybe I can get him to stop eating cereal or pop tarts for breakfast…


#31

From the sounds of it, I think people may actually be too harsh on him here. He might be a bit like me, where he’s willing to accept new, counter ideas, but will pick them apart from every angle possible first to see how well they stand up to scrutiny. If you can show that it does stand up to scrutiny, he’ll likely become a huge proponent of the new concept, and feel secure that he is well equipped to answer any questions or challenges from others as he’s already investigated those avenues himself and has found answers. There is, of course, also a possibility of finding somewhere in between as being the believed case, but not as a way of compromise so much as a similar belief shift to what seems the most convincing or reasonable.

This is another way of learning (and avoiding deception), it’s not necessarily a bad thing or a willful stubbornness.


(Richard Morris) #32

Ever hear of the parable of the blind men describing an elephant, that’s what the story of type 2 Diabetes seems like sometimes.

So if we’re going to go down this rabbit hole there are 3 major axes of dysfunction involved in type 2 Diabetes. The Pancreas, the Liver and the Fat cell.

It’s reasonable to observe a pancreas unable to keep up with demand, that seems to happen because of increasing insulin resistance causing more and more insulin to be needed to control high glucose. Most of the glucose used in the body is used by skeletal muscles, it appears that high insulin causes insulin resistance in skeletal muscle cells, and a high carbohydrate diet in certain people appears to cause chronic high insulin. When glucose can’t be cleared into skeletal cells it is sequestered by fat cells. For these people changing the diet (or fasting) to reduce exposure to insulin fixes the problem - I would say that Dr Fung is very much in this camp.

It’s also reasonable to observe that insulin resistance in pancreatic alpha cells is failing to inhibit glucagon which over drives the liver to produce more and more glucose, which causes greater secretion of insulin which drives ectopic fat into pancreatic cells making the insulin resistance worse. Again excess glucose if converted into fat and stored. prof Tim Noakes and prof Roy Taylor are probably more in this camp.

And finally you can make a great argument that insulin resistance in fat is the start of the cascade. Fat cells are supposed to sequester energy when insulin is about. If fat cells become resistant to insulin they release free fatty acids into circulation. At the pancreas free fatty acids amplify the glucose stimulated secretion. So there is another vicious reinforcing cycle - and I think it’s probably the simplest that requires only the well documented behaviour of both organs. Eventually the fat cell becomes so insulin resistant that no amount of insulin can hold back the overflow of free fatty acids and having FFA AND Insulin means that muscle cells take up the lipids but can’t burn them (insulin inhibiting mitochondrial transport of fats) causing build up of intramyocellular lipids that will inhibit glucose coming in - and without it’s primary sink glucose rises. There is another mechanism where an overflow of FFA reaching the liver causes glucose overproduction but I’m not as well across that mechanism. Anyway Gabor @erdoke and Ivor are in this camp.

Any of these could cause most of the observations of the progression of Diabetes, I suspect all of them are occurring in most type 2 diabetics. The root cause in all three is exposure to chronic high insulin. Normally we cycle through high insulin when eating and low insulin when fasting. But one common feature of type 2 diabetics is we make insulin even when we don’t have secretagogues (glucose, alanine in the presence of leucine).

Barbara Corkey has a novel hypothesis of a mechanism that causes non glucose stimulated insulin secretion that ties all of these together that she talks about in her Banting Lecture, and on the IAS video

Dr Corkey may just be another blind person describing an elephant. But the important thing for me is that that production of basal insulin is my remaining problem (now that keto has fixed my glucose excursions). So I am very interested in her hypothesis.


(Barbara Greenwood) #33

That’s very helpful, Richard, thank you.

To corrupt the metaphor… interesting as it is to discuss the shape of the elephant, at the end of the day I’m more concerned with training it not to crush me to death. Whichever is the fundamental mechanism (if there is only one… there could be several), the keto diet helps.

Keeping calm and ketoing on…


(David) #34

Personally, I would stop trying to convince him. Keep bookmarking things to give him, but keep hold of them, don’t pass them over. Just keep everything you learn about this WoE to yourself (for now). I’m sure curiosity will get the better of him, and he’ll come asking for these references when he notices you are benefitting.

Have you ever tried to get the attention of a kid to look at something you want to show them, but they obstinately refuse to pay attention. UNTIL you treat it like a secret that you don’t want them to know about, and then all of a sudden they are there “show me, show me”?

I don’t think men are much different :wink:

Men grow older, but they don’t grow up.


(Michelle) #35

haha!! made me laugh. and yes, I will keep calm and keto on and he can stew for a while.


(eat more) #36

this works with animals too! :joy:


(Karen Parrott) #37

Waste zero time on linking up studies-IMO. Spend a lot of time eating Keto - out, at home, buying keto at the grocery. Wearing Keto revenge clothes, showing BF your great bio-markers post blood draws.

It’s a great dating test- IMO. No need to prove anything. For every study you find, he will find an opposite study. So time wasted.

Looking to see how he adapts to you and your opinions respectful vs low emotional intelligence tells a lot about how things will go in the future. Hopefully he’s a great guy and will go a long on your Keto ride. LOL. Onward and here’s to Ketoing on by your own examples. Keto tastes good, so I think many would go along with that.


(Barbara Greenwood) #38

Yes! Love it!


(jketoscribe) #39

https://www.amazon.com/Principia-Ketogenica-Compendium-Literature-Carbohydrate/dp/1500969591/ref=sr_1_1?ie=UTF8&qid=1487358595&sr=8-1&keywords=principia+ketogenica

Compendium of science literature on the health benefits of low carbohydrate high fat ketogenic diets, and carbohydrate restriction and ketosis in general. With hundreds of research papers and scholarly journal articles from the past century, addressing 15 major health and fitness topics covering hundreds of general subjects, this is the most comprehensive scientific coverage of the myriad health outcomes of ketosis, high fat consumption, and carbohydrate restriction. A must have for anyone who wants all the evidence from the last century in their pocket. Papers are presented chronologically in each section. Chapters: - Very Low Carbohydrate and Ketogenic Diet Research Papers - General Ketosis and Significant Carbohydrate Restriction - Low to Moderate Carbohydrate Restriction - Animal Studies - Heart Disease, Metabolic Disorders, Blood Lipids, Cholesterol - Diabetes - Weight Loss - Exercise and Performance - The Brain, Neurodegenerative Disease, Epilepsy, Cognition, Depression - Hunger and Appetite Regulation - Muscles, Bones, and Body Composition - Cancer - Organs - Hormones - Carbohydrates Role In Human Nutrition - References

There are some less expensive used copies available, and I have the kindle version.


(Jeff) #40

Excellent point, Richard.