A ‘Well Designed’ Ketogenic Diet?

Four years on, and three hundred pounds lighter, as you might imagine I’ve had a conversation or two (hundred) on the subject of weight loss and dieting with folks.

Invariably I mention a ketogenic diet (LCHF) as what I believe the human body was designed to eat* and just as invariably I receive this response…

“Oh, I did that and it didn’t work for me.”

I literally had this exact conversation with a young weight lifter at work who is convinced that giant sugary shakes, so long as they are filled with fruit, are the ne plus ultra of healthy.  When I mentioned a ketogenic diet he insisted he had done, and doggone it, it just didn’t work for him and to boot he felt awful for weeks.

It has become my custom at this point in the conversation to ask some pointed questions about what they ate and their basic understanding of the keto diet.  As a rule they either ate too many carbs or didn’t eat enough fat.

In his case he did not eat enough fat.  His statement, and I quote was in all it’s glorious indignance, “but I ate steak!”

Ahem

You may note that none of the cuts of beef, steak included rise to eighty percent of calories from fat.  Mind you he had no idea what I was talking about, none.

My simple formulation of a properly formulated ketogenic diet is less than 20 grams of carbs (with ideally zero from highly processed sources) and more than 80% of calories from saturated fats.  Animal fats being preferable.

On the flip side many I speak with try the amazing tactic of essentially trying to smuggle highly processed carbs into their, ahem, ‘well designed’ ketogenic diet as though you could debate the correct number of carbs with your metabolism.

Heh, um no.

The truth is that the human body thrives on a ketogenic diet. That loud noise you hear is the sound of folk protecting their addiction. Don’t worry, it rapidly goes away as they get into ketosis!

 

*Though I do think when you have achieved your weight loss goals it may be possible to transition to something more like standard Paleo or some such.  I do think straight Keto is a medical diet which helps you lose weight and restore your metabolism to proper functioning and you may or may not need to be on it forever.  However I do not think the human body was designed to eat any grains whatsoever.

“Medical Reversals?”

An interesting NYT blog piece on medical reversals

The consequences of medical reversal are complicated. For starters, reversal challenges the notion that medicine is scientific — the premise that a century ago helped doctors to exorcise images of snake oil and hucksterism. But despite impressive progress, faith in medical leadership is currently at its lowest point in 50 years, a decline likely accelerated by a widespread sense that medical dogma often flip-flops.

On a practical level, reversals also mean accomplishing the near impossible: convincing people to abandon strongly-held convictions. Antibiotics have been used for ear infections for so long, and so pervasively, that years after studies showed they do more harm than good, parents and doctors continue to believe.

Anybody who is currently following a low carb high fat diet and has made the mistake of mentioning this salient fact to their physician is all too familiar with this phenomenon. How resistant to new facts M.D.’s can be.

The reasons treatments like antibiotics for ear infections persist are complicated. Patient expectation, patient-doctor communication, cultural norms, time pressures and financial factors all contribute, making solutions fraught. Meanwhile, scientifically-debunked practices remain common, and troubling.

Shall we add ‘lipiphobia‘ to that list? (related)

So how does this happen?

The pattern repeats: A promising new therapy or technology is introduced based on weak data and later, more rigorous studies discredit the practice. When I spoke with Dr. Prasad, he suggested a more staid, scientific approach. “The adoption of practices based on little or no good evidence is our biggest problem,” he said. “If we decide to use new technologies while waiting for definitive studies, they should be labeled ‘experimental,’ and patients should be counseled appropriately.”

Kinda like this?

The great, flaming irony here is that lipophobia is arguably the biggest and most damaging experiment ever conducted on a human population in the history of the world. And though the data is in, unbelievably it is still ongoing

We spend more time sick now than a decade ago
Despite longer life spans, fewer years are disease-free

Original paper: Mortality and Morbidity Trends: Is There Compression of Morbidity? Eileen M. Crimmins and Hiram Beltrán-Sánchez. J Gerontol B Psychol Sci Soc Sci (2010)

A 20-year-old today can expect to live one less healthy year over his or her lifespan than a 20-year-old a decade ago, even though life expectancy has grown. (snip)

The average number of healthy years has decreased since 1998. We spend fewer years of our lives without disease, even though we live longer. (snip)

Functional mobility was defined as the ability to walk up ten steps, walk a quarter mile, stand or sit for 2 hours, and stand, bend or kneel without using special equipment. (snip)

A male 20-year-old today can expect to spend 5.8 years over the rest of his life without basic mobility, compared to 3.8 years a decade ago — an additional two years unable to walk up ten steps or sit for two hours. A female 20-year-old can expect 9.8 years without mobility, compared to 7.3 years a decade ago.

And among serious medical folk the subject of nutrition, other than scolding patients to do low fat/high carb harder, is simply not on their radar in any appreciable way. In fact to bring it up will get you a condescending sneer and a lecture about the dangers of animal fat. We know, when we were improving our health massively by doing the exact opposite of what modern medical science recommends Michelle was seeing multiple Doctors, everyone of whom was running full panel tests on her.

To a one they would enter the examination room marveling at Michelle’s improvement and wonder what she was doing. When we informed them that it was simply LCHF (blank look) Atkins, they would recoil in horror and insist we stop immediately as Atkins was dangerous, everybody knows that!

With the exception of the nephrologist, he was interested until he learned it was a dietary intervention and said “Boy, I wish we could make a Pharma for that.”

To which we replied, “there is a Pharma Doc, food.” As this flew in the face of his received religion he just tuned us out. Here’s what we think, if the average American reversed their diet, eating large amounts of saturated fat preferably from animals and eliminating processed carbs most hospitals could eliminate eighty percent of their current volume.

And perhaps that is why the medical profession always reacts with hostility to this simple idea?

Is Metabolic Syndrome Responsible For Increased Death Rate?

This story has been floating around for a couple of weeks in various forms

Why has the mortality rate for middle age white Americans gone up dramatically since 1999 – even as it has gone down for other groups of Americans and whites in other countries? (snip)

The study released this week by the Proceedings of the National Academy of Sciences found that the surprising rise in middle-age, white mortality in America from 1999 to 2013 was driven by a rise in suicide, drug abuse, and alcoholism. The trends were strongest among those with the least education and in the predominantly red South and West, with the authors suggesting a vicious cycle of physical pain and addiction to painkillers, compounded by fiscal uncertainty.

“[M]any of the baby-boom generation are the first to find, in midlife, that they will not be better off than were their parents,” the authors write.

Meanwhile, data show that the primary red axis of the country, running from Appalachia to the Southern coastal plains, is the epicenter of some of the nation’s greatest stresses. It’s here that the lack of well-paying jobs and large-scale abandonment of the job market are most pronounced, where obesity and health problems are most dire, where Walmart is winning a race to the bottom of what the American consumer can afford amid stagnating wages, and where the rising dependence on disability and Medicare is most pronounced.

Chaser…

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Chart courtesy of gnolls.org

“We spend more time sick now than a decade agoDespite longer life spans, fewer years are disease-free”

A 20-year-old today can expect to live one less healthy year over his or her lifespan than a 20-year-old a decade ago, even though life expectancy has grown. (snip)

The average number of healthy years has decreased since 1998. We spend fewer years of our lives without disease, even though we live longer. (snip)

Functional mobility was defined as the ability to walk up ten steps, walk a quarter mile, stand or sit for 2 hours, and stand, bend or kneel without using special equipment.

A male 20-year-old today can expect to spend 5.8 years over the rest of his life without basic mobility, compared to 3.8 years a decade ago — an additional two years unable to walk up ten steps or sit for two hours. A female 20-year-old can expect 9.8 years without mobility, compared to 7.3 years a decade ago. (snip)

“There is substantial evidence that we have done little to date to eliminate or delay disease while we have prevented death from diseases,” Crimmins explained. “At the same time, there have been substantial increases in the incidences of certain chronic diseases, specifically, diabetes.”

From 1998 to 2006, the prevalence of cardiovascular disease increased among older men, the researchers found. Both older men and women showed an increased prevalence of cancer. Diabetes increased significantly among all adult age groups over age 30.

The proportion of the population with multiple diseases also increased. (snip)

“The growing problem of lifelong obesity and increases in hypertension and high cholesterol are a sign that health may not be improving with each generation,” Crimmins said. “We do not appear to be moving to a world where we die without experiencing significant periods of disease, functioning loss, and disability.”

So, the key thing I want to note here is that all the “diseases” that are returning with such a vengeance are what are known as “diseases of civilization.” These are the very “diseases” that the modern ‘heart-healthy-whole-sugars’ experiment was meant to address.

Why are people finding themselves in pain in middle age, as I did?

Why are people living fewer healthy, pain free years?

Perhaps because we were listening to the gubmint which insisted that we keep on keeping on with the high carb lifestyle and they would find some sort of magic cure. Yeah, right.

Instead we took the ‘radical’ step of eliminating sugars from our diet and, hold onto your hats, our diseases of civilization vanished. No expensive drugs required, no Doctors required whatsoever, and as a matter of fact Doctors fought our leaving the ‘heart-healthy-whole-sugars’ & ‘sell-U-stuff-health-care’ model.

Really, they did.

I can tell you that after seven years of being massively, morbidly obese, being unable to work and in constant, chronic pain I seriously considered killing myself. It wasn’t a life in any way shape or form. I literally praise God that he showed me a way to return to life but I have a sneaking suspicion that my experience mirrors that of the folks who find themselves over medicated and addicted to pain killers.

So, I’m here to tell you that if you find yourself in the place I was, sick fat and nearly dead, to borrow a phrase, there is hope. It can be done.

You have been cynically fed a diet by interests that want you buying cheap to produce food that will hurt your health and leave you addicted, with promises that modern medicine will swoop in to save the day.

But oops!

That hasn’t actually happened, people just keep getting fatter and sicker with no end in sight.

If you find yourself here today read this.

And know that it’s not impossible. Michelle and I both have profoundly changed our health by eliminating sugars and carbs from our diet and increasing saturated fat to at least 80% of calories.

Not only is it not impossible, it’s not even particularly difficult. A big change to be sure but not impossible.

Update: I meant to mention this

Intro to Fasting

Brian & I have long been avid readers of the Diet Doctor website for education and encouragement regarding the LCHF lifestyle. You can still read the blog and view some videos on the site; he has fairly recently added a membership option that makes more content available (particularly video learning) to paying members only.

There you will find a new series all about fasting, with Canadian nephrologist Dr. Jason Fung, Membership is required to view the entire series, but the intro is available on the regular site. Fung gives the basics on what fasting is (i.e. NOT starvation!) and its history across time and various religions of the world.

intro to fasting

CLICK TO GO TO VIDEO

Like many people who switch to a low carb, high fat diet, I find that I need less food and very naturally partake in intermittent fasting simply by eating when I’m hungry, rather than at set meal times. I’ve lost a bunch of weight (still working on further progress in that department!), and went from being a diabetic struggling to control my blood sugar with insulin and oral medication to being pharma-free with fasting blood sugars that run in the 80-85 range!