Why do we sometimes get thrown out of Ketosis 2

(John Drewett) #1

John Drewett ( it was recommended I start a new topic rather than to have posted where I did so I am copying and pasting ) to admin it is ok to delete

Hello Folks , I’ve been doing a pretty good job on the lipolytic program and gave it a try 4 weeks ago tomorrow ( I learned the term lipolytic here. ) . My question is if Carbs are like pieces of a puzzle and when they add up to more than X pieces of the puzzle that your body ( I guess your liver ) stops making Ketones or if it is not the number of carbs but rather the glucose / insulin response that "kicks you out of Ketosis " . As you must very well understand there are things "newbies , addicts " want to eat that they should not eat even a little of when respecting the 20 grams of net carbs ceiling . With my limited knowledge I have to think it is a glucose / insulin thing rather than a # of carbs thing . And if this is the case couldn’t a guy or girl add more oil onto a salad to put a bunch of bell peppers , eggplants and tomatoes on the salad and wouldn’t a salad with fatty protein be different than a salad with no fatty protein or oil in regards to Ketone production . My plan is to stick to the rules for the net carb rule for 3 months or until my Ketone Meter arrives but I’m a bit curious what "stops Ketone production " more than any other thing . There seems to be a line in the sand that you can not cross . I’m pretty fat but my motivation is one a. I’m locked up in the building for this Covid thing and it is challenging b. I’m 61 years old and have 5 year old twins , they say older folks heads work better on fat than on carbs c. I don’t have any post nasal drip or coughing at night , this way of eating has put an end to that and given me the idea that the reason I would cough at night had to do with some food I was eating d. I swim up to 4k in the ocean 2 or 3 times a week and climb the stair wells now since the gym is closed for my work outs not to mention battle the children , my fatigue is different now , not so sore afterwards . Really what I want to do is to continue to add tomatoes and onion and other to the salads and not freak out or stress over it . All of the information I’ve read here says don’t worry about going into and out of Ketone production and then "out there " I get a lot of no long term evidence and it could be dangerous. Yet here I’ve read some stuff about guys who eat spaghetti all weekend . I don’t know about all of that and my only question was is it the glucose / insulin thing that stops production of Ketones or the number of Carbs thing that stops production of Ketones , I have a lot of questions and I apologize for the run on , thanks John

FatLoss Ken’s Reply

It’s both. Here’s what happens. When you eat any protein or carbs, you have an insulin response. When that happens, Glucagon production halts and therefore Lipolysis. This includes ketone production. Protein intake only causes about 10% of an insulin response as carbs do. Fat causes little or no insulin response. Once the insulin response is over, and dietary carbs are cleared from your system, Lipolysis resumes.

Duration of suspension of Lipolysis is dependent on amount off carbs consumed. Excess carbs are first converted.to Glycogen and shuttled to the muscles. This does not affect Lipolysis as muscular glycogen becomes locked in until burned, so is not available as an energy source to the digestive system. After that, excess carbs are converted to glycogen and stored in the liver. This glycogen must be used by the digestive system before Lipolysis can resume. If you eat enough carbs that the liver is full of glycogen, then the body starts storing body fat. That is Lipogenesis.

In reality, you can avoid fat gain as long as your liver never fills up. This is called Maintenance. It is also why people are able to have carb meals/days, as it takes quite a few carbs to fill up your liver. Usually several days, unless you’re doing it intentionally, like following a CKD.

1 Reply

John Drewett

I can’t tell you how much I appreciate you taking the time to express this in a way that I can think about for a bit and attempt to better understand . One of my take aways is that after my watch estimates I have used 1000kcal + after a long ocean swim would be a good time to push the net carbs number to somewhere near 50 , may I assume that as long as the ketone level stays over .5 I have a green light on that number at least after 1000 kcal expended . Do you have a rough estimate of how many grams of carbs it takes to replenish your glycogen in both your muscle and liver , I want to guess this thing is knowable . Can you feel when your brain is no longer running on ketones , I’m thinking out loud and no need to reply, again thank you for having sharing that with me .

It was recommended I start a new topic and so I will

(John Drewett) #2

Really what I’m after is to add bell peppers and some onion to the green stuff salad, I added 1/4 cup of bell pepper and 1/4 cup of onion to the salad and another 1/4 cup of onion to the guacamole with a couple of table spoons of salsa at 1 carb I showed 2mmols ( ?) at the hospital lab 3 hours after that meal also including 127 grams of ribeye. The Carb Manager app I downloaded via someone’s recommendation here tells me 34 net calories from the data I entered rather than the 20 net grams . The Dexa tells me I’m at 88lbs of fat and 158 lbs of muscle / lean tissue . I’m 61 and interested in understanding Keto because I believe metabolic flexibility is a gift we were born with and we should at least understand what that means , I like the idea of running my body at the upper end of fatty acid metabolism as I can go for a lot longer , it feels good to my brain to run on ketones ( I’m ADD and have had a lot of head injuries from a lot of different activities and the doctor also guesses I’m a controlled BiPolar but haven’t taken the test ) , we have not been allowed to leave the building for 4 months here in the Philippines and so this has been a good challenge for us and I’ve got a couple of 5 year old twins to take care of who depend on me , I’m thinking older folks do better on this type of energy than younger folks and I’m a free diver also , I got a feeling I will have better breath hold times or struggle less on this kind of energy , again excuse the run on .

(Bacon is a many-splendoured thing) #3

The biology of this is as follows: Carbohydrates are glucose molecules combined in various ways. Fibre is constructed in ways that make the molecules indigestible; the other carbohydrates we can digest. The molecules get split up in the digestive tract, and all that glucose enters the blood stream.

Too much glucose is dangerous to the body, so the rising glucose level causes the pancreas to secrete a hormone called insulin, which causes muscle cells to take in some of the glucose and metabolise it, and the rest of the excess glucose is stored as fat in the adipose tissue. This gets it out of the bloodstream, so it can’t cause damage. As long as insulin remains at a high level in the blood, fat is trapped in adipose cells and cannot get out. As long as we keep eating carbohydrate, insulin stays high.

When we drop our carbohydrate intake to ketogenic levels, the pancreas secretes another hormone called glucagon, which stimulates the liver to make whatever small amount of glucose the body might need (we do need some, just not very much) and to start producing ketones for cells to metabolise in place of the glucose we are no longer eating. Everyone has their carb tolerance, and as long as we eat less than our tolerance, glucagon will be high, insulin will be low, and we will be in ketosis. As soon as we eat more than our carb limit, glucagon will drop, and insulin will rise and tell the liver to stop making ketones. As long as insulin stays low, fat can get out of our adipose tissue, and we can use it as fuel; but as soon as insulin rises above a certain level (in response to the extra load of glucose when we eat above our carb limit), the fat is trapped in our fat cells again.

Your carb tolerance may very well be greater than 20 g/day, but that is a good level to start at. Once you become fat-adapted, you can start experimenting to figure out how much carbohydrate your system can actually tolerate, but it is a good idea to get used to eating a ketogenic diet before starting to experiment.

(Michael - When reality fails to meet expectations, the problem is not reality.) #4
(John Drewett) #5

Thank you PaulL

(John Drewett) #6

I figured it out , the Net Carb thing after digesting some of the answers , the 20grams of net carbs is the only practical thing we can measure on a daily basis and is a number that should work initially for most people if not everyone

(Doug) #7

Approximately - we have about 100 grams of glycogen in the liver and 400 grams in muscles when the storage is full. Bigger people will have more. Glycogen is a carbohydrate and has ~4 calories per gram, so that’s around 2000 calories. Those with a lot of muscle mass could have a considerably higher figure.

Things get ‘fuzzy’ pretty fast, I think. Even when eating no carbs, the liver makes some glucose, and I’m wondering if some does not get stored as glycogen. And on the “empty tank” part, I think it really takes a while to get there.

We don’t just use glycogen and then completely shut that off and switch over to burning fat. During prolonged exercise, as glycogen stores get depleted, the body starts burning fat, and that gradually increases as glycogen gets less and less. I don’t know if we get to zero glycogen or how close to it, if not.

Even as those energy sources get mixed somewhat toward the end of glycogen consumption, it’s still common to feel a severe energy decline as the body substantially moves into burning fat. This is the “hitting the wall” phenomenon for marathoners at about mile 20 or 30+ kilometers. If one is well fat-adapted, I’d think this would be lessened, but it’s still an individual thing, and for the given individual, long training sessions while burning only fat usually help - the body gets better at burning fat.

I’ve never felt any changes in my brain or head when going from ketosis back to substantial carbs, but I think some people do. For me more just a general sluggishness and “loaded-down” feeling overall, like I’m struggling once again with high insulin.

Good question. I would think the ultimate would be running entirely on one’s stored fat - that way the body isn’t using any energy at all on digestion. However, if burning fat, either one’s own or from eating it, then there is a built-in disadvantage in that it takes more oxygen to metabolize fats versus carbs, as carbs come with some oxygen built-in.

There have been impressive results with elite athletes who train on a ketogenic basis, all the way to possibly increasing the number of mitochondria (the ‘powerhouses of the cell’) in some of our tissue. To some extent, such adaptations would at least partially offset the advantages of carbs as a fuel.

Since diving is such a special case - using only one load of breath - I think the single biggest thing is to practice holding your breath. There are a few other things described if you search for “how to improve freediving,” etc.

(Bacon is a many-splendoured thing) #8

That’s not exactly how I would express it, since both carbohydrates and fatty acids are combinations of carbon, hydrogen, and oxygen, and both yield equivalent amounts of ATP for the same energy cost of metabolising them. The main difference is that glucose metabolism is faster, and does not need to take place within a mitochondrion. The glycogen store in skeletal muscle is quickly mobilisable, and therefore important for fast-twitch, explosive performance. Fatty acids, as I understand things, take longer to mobilise and metabolise, so they are a better fuel for endurance performance.

I can’t pretend to understand all of Dr. Phinney’s and Prof. Volek’s research, but it is clear that fat-adaptation gives significant performance benefits to athletes, and Volek’s team recently demonstrated that glycogen stores in fat-adapted athletes eventually return to the same level as seen in carb-adapted athletes (though not immediately after fat-adaptation).

As you mention, fatty-acid metabolism depends on the health and number of mitochondria, and exercise is very helpful in promoting both.

(John Drewett) #9

I’m not sure about all of this and it is late on this side of the ocean , what is interesting to me about breath hold is it isn’t really the amount of 02 that limits one’s breath hold rather that urge to breath comes from C02 building up in the body and with practice you can develop a tolerance to C02 . There is another fascinating thing that happens and it is called the Mamailian Dive Reflex ( like it comes from Whales and Dolphins who were Elephant like creatures who wandered back into the ocean eons ago :slight_smile: ) any as you go deeper the 02 moves to the brain and the lungs and away from the limbs with the help of the water pressure . The danger of passing out is when coming up in an too much of an 02 deprived state as the pressure comes off the 02 moves back out an away , the black out always happens as you approach the surface. Regarding the metabolism and stuff to some extent it is addressed in this article ( are we allowed to post links here : https://peterattiamd.com/can-fasting-help-athletes-hold-their-breath-longer/

(John Drewett) #10

What I did learn about fast and slow twitch muscles most recently was from this guy by the name of Inigo San Millan ( I began listening to Peter Attia and that is how I became interested in eating this way ) . Two things I was exposed to that may bear repeating is 1. he is going to argue that the best way to improve fat burning and lactic acid clearance is by spending a lot of time in Zone 2 . He is going to say Zone 1 begins when you move your toes in the morning and Zone 3 will begin when your body begins to request more energy than you can provide than from fatty acid metabolism or to the best way to improve the density and number of the mitochondria is by walking :slight_smile: or at the point before your breath becomes labored , something like that . That you can continue to increase the amount of work you do with fatty acid metabolism alone and measure it in watts . Something about how when the lactic acid begins to spill over into the blood stream that then is when you shifted to the the other gas tank , maybe that is correct. Another interesting point I got from this guy ( he does muscle biopsies and counts and measures their mitochondria and is the Tour de France coach for the USA or something . Anyhow the best way to become fat adapted if I understood this right was to walk fast but not to fast :slight_smile: That only when the demand for exceeds what the mitochondria can provide ( I think lactase ? ) do we begin to burn glucose rather than fatty acid but in the cytoplasm rather than in the mitochondria . The other thing I thought was of interest was that when we think of fast twitch and slow twitch muscle fibers we should not think of how fast they twitch . Rather fast would mean something like how much time they can go before they fire again . That slow twitch muscle cells may be filled with a lot of mitochondria and that fast twitch muscle cells need to burn glucose . I got interested in all of this because I know a lot of people are prediabetic , like half of the US population and this Keto thing or that most people are sick and that fat adaptation is a good way to get healthy again. What I know comes from listening to 3 podcast so I’m not sure exactly what. im talking about nor can I defend it .

(Bunny) #11

Diabetes is an insulin problem not a glucose problem, are you diabetic?

Insulin stops ketone production. Keeps them stabilized and under control.

You don’t want high ketones just like you don’t want high glucose? Insulin is always needed to control ketones but insulin is not always required for glucose uptake, however insulin is required for amino acids.

If you don’t eat 4 or 5 hours before going to sleep your body will naturally go into ketosis and burn it’s own fat lipids even on a higher carb diet like 150 grams of carbohydrates.

Not sure if that is true if you are diabetic because that may be the reason people get diabetes in the first place, is eating too much within a 24 hour period?

If your eating more than you could stuff into a racket ball and your sedentary, then your eating too much?

Active two racket balls?

Lift weights 4 racket balls?

(John Drewett) #12

Thanks Atomic Space Bunny ( I’m gonna call my little girl that in the morning ) I’ll need to take another look at your post but I’m active , I breath hold dive to 20 meters and swim 4 to 6 k and what else I was doing the gym 4 or 5 times a week but now I’m stuck in the stair well which I’ve learned to enjoy I also love the structural stuff with Eric Wong . In any case I figured out the carb thing and came to the conclusion that counting carbs is just a good metric for the glucose and the insulin thing , but they seem to talk a lot about how many carbs and it was/is confusing, that what I’m feeling the answer is now , im not diabetic but I bet I have metabolic disease and weighed 283 on April 4 when the lock down began with a AC1 or is it A1C was 5.9 and I dropped it to 4.9 in just a few weeks and I hit 250 today , I also do boxing but I’m pretty fat . The keto thing has helped my health in a lot of ways and I’m learning .

(Bob M) #13

Ah, what?

I guarantee you can eat as much meat in a 24 hour period as you want and you’ll never get diabetic. (A side issue: what is “eating too much”?)

(Michael - When reality fails to meet expectations, the problem is not reality.) #14

Or fat. Never get diabetic from fat either. So that leaves carbs/glucose as the primary suspect. Diabetes is a disease of disfunctional carb/glucose metabolism. Might even be accurate to call it a disease of carb/glucose poisoning. Of course it involves insulin, which is trying hopelessly to cope with the cascade of failures.

PS: As Bob points out below, it probablymaybe involves a screwed O6/O3 ratio and PUFA overload in conjunction or consequence.

(Bob M) #15

For you, I’d just test it out. If you are new to keto/low carb, and you’re exercising (as you are), it can take a while to transition. I’d guess 4 weeks minimum, but expect even longer.

Try that first.

At some point, you could try a “targeted ketogenic diet” (TKD), which is where you basically eat some carbs sometimes. I did this for a while, eating higher carbs the first meal after a workout. I THINK it might have helped, though the carbs I chose (sweet potato, etc.) tended not to agree with me. On my normal keto diet, I NEVER get acid reflux or the like, but eating these carbs, I did.

I went back to eating keto.

Anyway, I said “I THINK it might have helped”, as I was gaining strength, as gauged by the number of pushups I could do. Having stopped the TKD, I am still gaining strength, so it’s unclear. Maybe I did get faster recovery? Hard to measure that, as I only workout three days a week.

Some people really like TKDs though.

(Bob M) #16

Well, I could see it being a little more complex than that, perhaps PUFAs + carbs (though I got fat drinking beer, eating pizza and ice cream, which I think is low PUFA…), but I see the point. It’s not the meat or fat. Unless you’re vegan, then OF COURSE it’s the meat and fat (and not the carbs/PUFAs).

(Bunny) #17

I’m sure the ancestors were manipulating there dietary intake?

As in modern times us monkeys still can’t figure out that we eat too much?

Oh I have bad genes?

Oh it’s the carbs?

I like the quote from Forrest Gump “Stupid is as stupid does?”

Too many visceral “Ah What’s?” and not enough cerebral stimulation?

(Doug) #18

Cool, Paul. I never dreamed that glycogen would go to the same level.

It still takes a lot more oxygen to use fatty acids, since they only have 2 oxygens, with up to 30+ carbons, while carbs tend much more toward equality. By far, the most common fatty acids in stored triglycerides/human fat have 18 carbons (59+%) or 16 carbons (31+%). So if we give them a percent ‘score’ of oxygen/carbon, they’re at 11 and 13, while glycogen and glucose are at 83 and 100.

Not talking about diving in water here :smile: but oxygen in general is free and unlimited to us, and fat is more energy dense than carbs, so it’s not a straight-up comparison as far as energy production, but when we use a given amount of oxygen to burn fat, less ATP is produced than when we use it to burn glucose or glycogen (oxygen being the limiting factor in human work when burning fat or glycogen).

Well… :slightly_smiling_face:

We’re not talking about oxygen utilization with the very short-term, fast-twitch muscle stuff. We can run on ATP and then CP turned into ATP for a few seconds. Even a 100 meter sprint takes us beyond that, into anaerobic glycolysis. There is a slowdown over the last 20 - 40 meters as this takes effect.

This type of glycolysis can’t go on for very long, either - it builds up lactates fast, and this can be felt after the 100 meter race and certainly at 400 meters. The maximum possible average pace in the 400 is a little less than for the 100.

Then comes the aerobic stuff, using glucose/glycogen and later fat. Exercise long enough and regardless of who the individual is, fat will be almost all that’s being burned. For the given individual, I still question if burning fat can make for the same intensity of exercise, versus burning glycogen, because of oxygen being the limiting factor.

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

The Equations

Oxidation of a carbohydrate molecule:

6 O2 + C6H12O6 → 6 CO2 + 6 H2O + 38 ATP
RER = VCO2/VO2 = 6 CO2/6 O2 = 1.0

Oxidation of a fatty acid molecule:

23 O2 + C16H32O2 → 16 CO2 + 16 H2O + 129 ATP
RER = VCO2/VO2 = 16 CO2/23 O2/ = 0.7

Source

(Doug) #20

Michael, that makes sense to me - a 13% advantage in ATP production for carbohydrates, there. I’ve read 15% in the past (would be explained by the average human fatty acid having a little more than 16 carbons).