Now, it is some time I have not followed scientific papers on keto, and trying to read all the posts here is a daunting task.
Might, then, ask what is the current scientific consensus on:
Protein consumption, high or low: I remember Valter Longo and David Sinclair used to argue for low protein consumption, due to mTOR and AMPK issues (at least, from 30 years old to 65, more or less). But here many people are carnivores, so I guess their protein consumption is high (and of the type of protein the ālongevistsā argue is worse, i.e. red meat). Are there results about this issue?
Cycling keto: Mankind has spent most of its existence under the yearly cycles. So I guess our bodies are more or less used to be in keto for autumn and winter, and out of keto in spring and summer. But instead, most people are either on the keto side or on the non-keto side āalwaysā (granted, there are people who do keto cycling, but this is a weekly cycle, not a yearly one). Are there results suggesting a yearly cycle is good/not-good?
Protein consumption is still being argued about. The understanding of mTOR is more nuanced these days, and people donāt seem as concerned about it as they once were, so now the debate is about how much is enough protein, and many people are putting the required intake quite high. Dr. Stephen Phinney expressed some concerns about what he considers high protein intake (over 1.5 g/kg of lean body mass) at Ketofest 2019, though Iām not sure exactly what those concerns are. On the other side of the debate is Prof. Benjamin Bikman, who is concerned about muscle retention later in life, and who feels that we need a high protein intake (2.0 g/kg LBM) all along in order to retain as much muscle as possible when we get older. I suspect that we donāt yet know enough to say what is best.
If anything, Iād say the human race was mostly in ketosis except in autumn, when putting on weight for the winter. It doesnāt seem to be harmful over the long-term, especially since there are enough people who have been on a ketogenic diet for two years or longer for any long-term problems to have shown up. Furthermore, Dr. Phinney has been eating that way for a couple of decades, and I imagine that Dr. Westman has been at it even longer, and they are both in great shape. Vilhjalmur Stefansson, the Arctic explorer, ate a meat-only diet for most of his life, and he was in great shape when he died at age 82. My belief is that we have enough data to suggest that this is a safe way to eat over the long term. I also cannot see any mechanistic reason for fearing ketosis (apart from the risk of ketoacidosis to Type I diabetics, and that has nothing to do with what they eat), so I am willing to take my chances.
Paulās response is far more elegant than mine. All I would add is:
Protein should not be feared (unless you are obsessed by blood ketone numbers). It plays such an important role in the formation of bone and lean tissue. Further, itās best sources (beef and organs) are incredibly rich in essential nutrients. Based on age and activity levels, I would go for the higher range (as per Ben Bikman for instance).
Been debating this on another thread. Ultimately, unless you are willing to test yourself, e.g. using a CGM; fasting insulin; T3 levels; testosterone; maybe HSHBG, all you can do is size up the existing literature. As Paul mentioned, apart from Stefansson, there is no +12 month studies looking at long-term keto.
amwassil
(Michael - When reality fails to meet expectations, the problem is not reality.)
#4
For protein I fall mostly in the āmore is betterā camp - with the caveat that one be self observant and adapt as needed. So Iām also in the ān=1ā camp - Iām eating for myself and no one else. Vice versa. I accept that individual variations are to be expected, within an overall range.
Iāve noted elsewhere - multiple times - my acceptance that ketosis is the normal, healthy metabolic state for humans. We evolved to gestate, grow and live in it. Prior to the Holocene, there is zero evidence that plant-based carbohydrate-rich foods were consumed by our paleolithic ancestors in anything beyond very minuscule amounts. I think the idea of seasonal fat/meat carb ācyclingā is wishful thinking. There is no evidence to support it.
Going back to Stefansson, he lived and studied with the Canadian Inuit (aka āeskimosā). He was not only an adventurer/explorer but also skilled observer. He studied the Inuit when they still ate their traditional diet consisting almost exclusively on fat and meat. He shared that diet with them all the years he spent in the arctic living among them. His Bellevue experiment was conducted on his part to try to get the medical/nutritional āestablishmentā of the time to accept that a diet consisting exclusively of fat and meat was both nutritious and healthy.
Please forgive a minor correction. The Virta Health study, conducted by Sarah Hallberg, is past the two-year mark. They showed a 60% reversal rate of Type II diabetes, as I recall, with no malign effects. And the recent study reported by Jeff Volekās team was done on athletes who had been keto-adapted for two years or more. Now, these are certainly not randomised, controlled studies, but they do show the existence of some data.
And then there are the anecdotal data from people on these forums who have been eating a ketogenic diet for years with no discernible ill effects. Not that can be ascribed to their diet, any way. There are even people who have been eating a carbohydrate-free diet for ten years or longer, who are to all appearances perfectly healthy. Again, itās not real data, but at a certain point a large number of anecdotes all pointing in the same direction start to mean something.
I also think you could eat a relatively higher carb diet, say eating in season fruit, and still stay in ketosis, depending on you, your exercise level, time in ketosis, etc. While I generally donāt eat much fruit, we did go strawberry picking this spring, and I had some strawberries and yogurt. Still was in ketosis (though I only have a breath meter now).
Iāve even heard it said that the doctors conducting the experiment on him and Anderson were quite disappointed that they didnāt develop scurvy. Although they should have known better, since the anti-scorbutic effect of fresh meat had already been known for at least a century, in 1928.
Also, Stefansson maintained his carnivore eating pattern until his death at age 82. It hardly appears that a carbohydrate-free diet can be all that dangerous, if his story is any indication. And how many years did Stanley Owsley eat a carbohydrate-free diet? And so forth.
For anyone interested, there are a couple of television interviews with Stefansson available on YouTube, as well as one with his widow.
Makes no difference what the āScienceā says, because the people providing the science are biased in one direction or the other and their end goals dictate how their āstudiesā are done. āScienceā says fat clogs your arteries and causes CVDā¦ and it DOESā¦ the way those studies were conducted! Somebody that didnāt have a bias and that did studies on people eat low carb or keto will show the opposite, and theyād also be correct. Just like everything context matters, and the context can completely change the outcome.
I believed the low protein thing for years, and lost a ton of muscle over it. All depends on your goals. I was completely unable to keep muscle on with lower protein and never deviating from standard keto, since cranking up protein I was able to put some muscle back on, and since switching to TKD/CKD Iāve been consistently regaining muscle and now have more muscle and lower bodyfat than I have in years, which was my goal.
I could care less what somebody did a couple hundred years ago, I donāt see any point in using the past as a way to decide while Iāll do if thatās not going to get me to my goals. My goals are progressing the way I want, I feel better, my labs are good, my inflammation is remaining low, my A1C is maintainingā¦ Iām good! Donāt get me wrong, Iām all about the science, but Iām not going to override what gets me to my goals because somebody else says to.
In the end, there is a trade off: scientific studies on diet are almost always epidemiological (until we do not have devices in our bodies that track automatically what we eat), so the conclusions have to be taken with a pinch of salt.
Individual experiences, from individuals that know themselves well, are probably more valid.
But anyway, there is always the risk that something that goes well at the beginning, could have bad long term effects on longevity and healthspan.
Interesting, how expectations have changed. When I was young, reaching the age of 82 was considered quite an achievement.
amwassil
(Michael - When reality fails to meet expectations, the problem is not reality.)
#12
The global life expectancy at birth for women is 75 years old and for men, itās 70 years old . However, in America, the average life expectancy for women is 81 years and for men 77 years.
your questions are good but I think you hit on itā¦it is too daunting and too vague for each of us in a way LOL
Meat protein is key in life and fat must be present and that IS ALL the body requires for total physical survival. Not one carb neededā¦soā¦start thereā¦
Your food options now will never be what they were back in life on this planet. The FOOD is not the same so we got a wild gap right there.
Then take in seasonal. Local? GMO or from eons ago as it was on the planet? Nope not the same. One in Maine eating pineapple as their āfruit of the dayā would not and never be a real seasonal anything at all ya knowā¦pineapples are transported to peopleā¦another so?
Our meats. They are in fact the cleanest of all the food out there in a way that our fresh meat is only dealt with animal husbandry for medical issues for herds etc and that has to happen when we āfarm animalsā soā¦ but it has to be seen, all the pesticides to save plant harvests, it is about fertliziers dumped onto plants/trees for production, water issues to make those harvest? GMO changes and way more on crops BUT of course the meat is changing with āselect breedingā and food for those animals and what are they before market? but still way cleaner and meat protein provides all nutrients and vitamins the body requires ever than tree production/veg and fruits that will never ever provide that nutrition and more for health BUT again, we know not one carb required for life to exist so?
We canāt and never should put carnivore against keto at all in that a total animal menu will never equal in any way a āketo planā person for all the debates at all so?
How do we all put it in present day? right now for us? KEY IS FIND you on your eating plan that suits you to a T. Once you find that, go for it and learn thru truths on what foods you put in your mouth on how you change, or get worse, or get great results will always be that ultimate long term lifestyle eating change we can find!
alot of ands and buts in there it wonāt ever be black and white now
Thatās life expectancy from birth, which averages in unfortunate deaths among infants and the young. Itās especially non-comparable when you include developing countries where infant mortality is relatively high.
Among my parents, there are 6 siblings, all born around 1915-1923. All three females lived past 100 (one is still alive at 102). One male lived to 103, the other to 96 and the third died at 62 in a bicycle accident. These are anecdotes, but Iām struck by how many of my friends and acquaintances today also have parents who are into or recently died well into their 90s. So, yeah, I guess my expectations follow accordingly. Interestingly, my mother was anti-sugar from the 1960s though she never truly practiced what she preached.
amwassil
(Michael - When reality fails to meet expectations, the problem is not reality.)
#15
Stefansson was born in 1879. A more useful number would be how many others in his cohort lived 80+ years. Adjusted for infant/child mortality and WWI and WWII of course.
amwassil
(Michael - When reality fails to meet expectations, the problem is not reality.)
#16
@Wendy198 Iām inclined to accept that genetics plays a significant role in our individual lives. I wonāt go so far as to say genetics determines outcomes, but I think genetics certainly determines the probability of outcomes. In your case, having multiple centenarians on both your maternal and paternal families bodes well for you becoming a centenarian as well. In my case, both my parents died at the age of 85 and neither were healthy for most of their adult lives. I am not aware of any family member from either maternal or paternal sides of my family who lived beyond their 80s. So my odds are not nearly as good as yours. This despite my being healthy throughout my own life and continuing to do so as I age. Whether or not it adds time to my life before I die - we will only know after the fact.
I know nothing about Stefanssonās family history, so canāt comment on whether or not his odds of living beyond his actual age of death were good or not. So I think being uneasy because he died of a stroke is not realistic. Lots of things can cause a stroke. We all die of something sooner or later. If people were dropping like flies from eating a carnivore or ketogenic diet, that would indicate a problem. But thatās not happening. We have a world-wide epidemic of obesity, CVD and T2D from folks eating variations of SAD. Thatās a problem.
According to seniorliving.org, it appears the Stefansson beat the average age even for an older person, as it shows that a man who was 65 in 1900 would be expected to live 12 more years to 77 years old. Or if 65 in 1950, to make it to 78 years old. Although the SSA site gives such a man today as likely to make it to 84 years old.
No question genetics plays a role, but hasnāt anyone else noticed how much more common it is these days for people to reach 100? Check out the increase in centenarians here: https://www.pbs.org/fmc/book/1population4.htm
Some causes of death ā like cancer ā are more clearly genetic than others. I think stroke and most CVD causes are (or should be) more controllable, and I believe diet and lifestyle are major risk factors.
I worry about minerals and mineral balance on some keto diet formulations. Animal foods are high in many minerals, but the balance is not always great. Mineral balance is essential for proper functioning of the heart, blood vessels, nerves and muscles. There have been several reports on this forum of people ending up in the ER due to low potassium/electrolytes. No diet should cause that kind of incident. Iāve heard the recommendation to just eat more NaCl, but I have yet to see the science to back up claims that people on keto or carnivore donāt require scientifically estimated requirements for minerals. For example, I canāt see how NaCl would counter the need for potassium. Iād think the opposite was true, since the two elements work together through their concentrations inside and outside cells.
The science behind mineral requirements isnāt perfect, but for example, the calcium requirement is determined by comparing intake with output (in urine and feces ā not much loss in sweat), so it seems pretty obvious that if output is greater than input, you will be losing calcium from somewhere.
For the record, I have been in at least mild ketosis for the past 20 months, so in spite of my questioning, I tend to believe ketosis is the most health-promoting state for me right now, even though I do not have T2D or obesity. However, I am currently tweaking my diet to add potassium-rich fruits and vegetables in small amounts. It doesnāt seem to kick me out of ketosis.
The genetics may be a pre-disposing factor, but the cancer researcher, Dr. Thomas Seyfried, feels strongly that almost all cancers are caused by metabolic disruption, and most of that by excessive carbohydrate in the diet. Which is not to say that a ketogenic diet will cure cancer, but it does mean that cancer is less likely on such a diet.
A couple of points, here. First, the daily allowances were determined mostly from studying a population on the standard high-carb diet. That may or may not mean that the allowances apply to people on a ketogenic or carnivore diet. For example, there is science to show that the requirement for vitamin C is far lower for people on such a diet.
Second, we also know that many vitamins and minerals are available in a much more ābioavailableā form in meat than they are in plants. It is also known, but unexplained, that vitamins seem much more potent when ingested in whole foods, than when taken as supplementsāwhich suggests that there may be other compounds also involved, of which we are as yet unaware.
As far as salt is concerned, it appears that the mechanisms regulating sodium, potassium, magnesium, and calcium are to some extent interlocked, so keeping salt in the proper range tends to keep the others balanced, as well. This may make it possible for some to do without supplementation, who might need it on a low-sodium diet. But salt is the easiest to adjust, since we have known its importance since classical antiquity, if not earlier, and our society is set up to make sure it is available.
Furthermore, while there is no science to explain this, it is clear from many anecdotes that many long-term carnivores find it easy to dispense with added salt in their diet. However much they may need, the amount in their food seems to suffice. This is probably not true for everyone, but many carnivores do seem to find it so.
Also, potassium is very tricky, since both hyperkalaemia and hypokalaemia can be seriously harmful, even fatal. Anything that makes it less necessary to fool around with potassium is probably a good thing.
Cancer and cell change can be environmental alsoā¦massive life diff in people so? just sayinā
live under big electrical lines?
work environment with chemicals?
food supply like fish under oil spills that is natural life but contaminated?
use chems in your lifestyle or more?
local water pollution and more and more and more and thenā¦
and a gazillion more
Cancer and cell change almost canāt be pinpointed unless army people using agent orange or a known asbestos inhaled for lung issues or ? but those can be direct correlation but then think, general people, just people living lives and we never know anything more to change the cells in their environment soā¦
world now is massively polluted thru noise, food gmo and stress levels and crazy we all seeā¦so what science drs do the real study on how cells change now thru current life forces? hmm, it will never be an all in, we will never nail this down, never get it everā¦YET all we focus in on is the pill to fix itā¦ugh
it wonāt ever be black and white now