Where I Part Ways with the Popular Keto Movement | Mark's Daily Apple
Thanks for posting this Brent. The article is an interesting read, and the comments even more so. (Sure makes you appreciate the good nature of the people on this forum).
You’re welcome. While I don’t agree with everything the author says, it made me take a closer and more critical look at my understanding of and goals for keto. Carl and Richard have always stressed that it’s not just about the ketones and that ketone levels after fat adaptation were excess, but the point about metabolic flexibility is a nuanced one. It’s easy to be an absolutist without addressing the wide differences between people, and I thought this might spur some interesting conversation.
I read the article and listened to the LLVLC podcast recently. I can’t help tracking my glucose and ketones, I think it’s fascinating. I guess I’m just obsessed about it. I do agree with Mark Sisson that it is a waste of time and money but I can’t help it. It gives me piece of mind to know I’m managing my WOE towards ketosis. I’m also very analytical and love numbers!
If I were him, I’d probably feel the same way. But I’m not and I don’t.
For those who are metabolically and biologically healthy, Mark’s approach may work. For those trying to treat or prevent a deranged state (ie. diabetes, cognitive impairment, epilepsy, cancer) being in ketosis matters and cannot be managed cavalierly.
I hear you.
I hope to look like Sisson when I’m 64 (15 years from now). Maybe he can look that way with carb cycling; but there’s no way I could.
Again with the carb cycling. Is it just me or doesn’t it seem like this would leave a person feeling not so great much of the time? Like potentially Keto flu-ish on a regular basis? As Mark Sisson put it “to be constantly on the verge of either leaving or entering ketosis”. He’s suggesting eating fewer carbs one day and more the next possibly in the range of 20 to 120 grams. He states that a person will/can drift in and out of ketosis without knowing it and that things get easier living in this “Keto zone”. Maybe for some. But like many others who’ve commented, I tend to question whether this would be possible for people with damaged metabolisms. Even for myself though, with what I think is a fairly ok metabolism, I’m leery of this as a regular practice. Based on personal experience, I don’t enjoy the flopping out and back into ketosis. Granted, I haven’t practiced it regularly in an effort to get used to it. Maybe it does get easier over time. But the times I’ve gone out, I’ve not felt well. I only feel good and normal again once I’m back in and avoiding too many carbs. This is regardless of whether or not I’m in an obsessive period of tracking my ketones, or logging my food… my body has told me that it prefers to be in ketosis. I would be curious to know what affects people doing this experience, if they’ve paid attention and noted the correlations. Seemingly minor discomforts like brain fog, hunger, joint aches, bloating, stomach growling, diarrhea, constipation, wind (from either end), heartburn, acne, etc, all went away for me as soon as I went Keto. On days with extra carbs, many of these return. That was always just the norm before. I didn’t realize how crappy I felt until all that was gone. So personally, if I was talking with a person just starting, I’d recommend full Keto so they could experience for themselves the full benefits that I have prior to playing around with adding carbs back in. That said, I do appreciate Marks relaxed attitude about Keto. I do believe it’s healthy to go easy on ones self, take it a day at a time and not freak out over minor indiscretions.
The article was fine, no red flags in particular but what on EARTH is with the comments section? The further down I read the worse the hate for keto got, and it was blindingly evident that the vast majority of issues folks were talking about were poor electrolyte management or a lack of fat- or excess protein. I say this because I hit all the same skids but found the answers I needed right here in this forum and am now blissfully humming along in daily ketosis.
I need to go have a fat bomb and calm my farm. The comments really got to me.
I didn’t read them cause I knew they’d erk me too much. 
One should always have pre-made fat bombs or bacon.
Sisson doesn’t recommend it for folks with damaged metabolisms. Post transition to ketosis, he has people stay solidly keto for 6 weeks, then discusses the long-term options. The first of those is just staying in ketosis, and he gives a number of reasons that it will be the best choice for many people (and also gives some examples of folks with great metabolisms who thrive that way as well).
He’s basically right. Here’s my opinion. The term “Keto” was chosen by folks like Lyle McDonald primarily as a marketing term. It’s kind’a like labeling fish fat as fish oil. It was more acceptable to focus on ketosis due to the massive, unscientific, anti-fat nonsense going on at the time. The real issue, as it always has been, is Lipolysis, of which ketosis is only one of many components. I’m somewhat disturbed that (including on this board) all the other aspects of lipolysis are basically ignored. It reminds me of typical defenders of a low fat lifestyle, totally ignoring one half of human nutritional biochemistry, that of a lipolytic state based on glucagon secretion.
People also seem not to understand that nutritional benefits and detriments are results of adaptive processes, and the goal is to get to the balanced insulin/glucagon secretion state. Once that is established and fat goals are met and lipostasis is achieved, it’s actually very difficult to regain fat. I’ve never regained an ounce over more than 15 years. I’ve never allowed myself to reestablish a chronic, lipogenic hormonal secretion pattern such as is caused by the NAD.
I’ve found this board to be pretty educational on topics such as lipolyisis. As with everywhere we have people of varying levels of understanding and at different points in their own journey. For someone looking for more scientific conversations I think those can definitely be had here.
Ok, please enlighten us. What are the other aspects of lipolysis? How is a balanced secretion state achieved?
If this is totally off topic, feel free to start a new thread.
OK, let’s review the steps of becoming lipolytic.
Carbohydrate restriction causes a drop in dietary glucose.
Glucagon secretion begins and enables glycogenolysis. Initial weight loss occurs at this time due to glycogen having several water molecules attached. Water weight.
Once glycogen is depleted, lipolysis begins. As each lipid molecule breaks apart, it divides into fatty acids and glycerol.
Fatty acids are used by the vast majority of cells in the body for energy, with the notable exception of the brain.
Glycerol goes back to the liver and is used as the substrate for two processes. First, ketosis, second gluconeogenesis. Both the resultant ketones as well as the limited glucose produced can be used by the brain for fuel.
One of the major benefits of lipolysis, due to glucagon secretion, is the reduction of the detrimental hormonal resistance states that cause weight gain, immunology suppression, etc. Namely, insulin and leptin resistance. This is achieved because glucagon is the antagonistic hormone paired with insulin, so it’s secretion reduces the insulin resistive state. This is what I’m talking about as a balanced secretion pattern, when the body can readily secrete either insulin or glucagon in the absence of any detrimental resistance reactions.
Thank you for the explanation. It makes sense and I understand. Please take this one step further and make this physiology actionable. How is that accomplished/implemented?
Here’s the crazy thing. If you’re doing Keto, as far as macros, you’re there. Keto is actually the misnomer, it’s actually lipolysis/lipolytic rather than ketogenic. Understanding this will enable you to be much more aware about what is actually happening, rather than being focused on ketosis.
Once becoming lipostatic, or “fat adapted” (actually another misnomer, as actually you’ve eliminated lipogenic resistance issues) it’s incredibly easy to prevent fat regain. Fat regain is caused by a chronic, carb based pattern resulting in the rise of leptin resistance and the consequential sustained overcompensation of glycogen. Easy to prevent, especially since a fat based pattern is clearly more healthy. The point is, that Carb consumption is fine in types, amounts, and frequencies that do not cause a lipogenic resistance adaptation. This is mainly determined by genetics, especially if your phenotype expresses a rapid rise in leptin resistance when following a carb based pattern. Myself, I’m of that type. I’ve gone as long as ten days chowing down on carbs, but once eating normally (fat based) and shedding stored glycogen I went back to the same weight. So, enjoy the occasional meal/day/week Carb binge, it’s the long term pattern that counts.
Khara, IMHO you’re experiencing these detrimental effects because you’ve not yet eliminated all your lipogenic resistance issues. It can take a while. For me, it was over two years, but I was very obese at the start.
Here’s a nice primer on dietary hormones. It’s more oriented towards bodybuilders/fitness folks, but it is great for a basic understanding. Make sure you read all three parts.
I don’t think there is a problem with “the numbers.” Unless there were some demonstrably prevalent obsession with ketosis and meter readings, to the detriment of a significant number of people, then what’s the big deal, if any?
Some people do like to track things, and glory in all the data. Nothing wrong with that, and if their diet is working well for them, then fine.
“Eating a low-carb, high-fat diet works because of the low-carb part, not the high-fat part per se.”
Well - yes and no. Agreed that the carbohydrate restriction is massively important, and the prime mover behind some of the benefits. Yet if we do not have the “high fat” part, then we’ll either be restricting calories a lot, or eating more protein than is needed or desirable, many times. Both of those may have bad implications.
Fat is very satisfying, and for a lot of people it’s a very important reason why the diet works. And given the vastly lower insulin response to eating fat, it’s essential for many of us.