Morning Dump

JohnEGreen

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Low carb doesn't mean no carbs just keep them in the range you have allowed your self.
 
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Zab

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Hi, everyone! I am over in Canada, but come check out this site sometimes because there is a lot of useful information and today, while reading this post, I realise that *maybe* I can help some of you.
I also suffered from a morning time liver dump, or Dawn Phenomenon. Most morning reading were between 8-11. What happens is basically this: as a diabetic you need to eat fairly regularly. At least every 5-6 hours through the day and timing your meals to be around the exact same time daily can be quite helpful in controlling your numbers, especially if you are on oral medication. When we sleep, most often we are going too long without eating, so our livers kick on and start supply our body's with glucose. For most of us, it makes far too much. Because we sort of suck. So, I started incorporating a bedtime snack of about 15 grams of carbs + added protein (think apples slices with nut butter, crackers with tuna, maybe a low carb protein bar). This helps a lot because your liver will not kick in so early on you and start producing crazy morning numbers. I saw results almost immediately and now have been doing it for two months. Now most mornings I wake up with values in the 4s and low 5s. Interestingly, when I take in half a cup of spinach, with a few other added veggies, in addition to my bedtime snack, my numbers are always in the 4s. I hope that helps some of you. I had to join just to leave this post LOL
Take care!
 
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ickihun

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I have to agree with @Zab .
It's all about the liver and stored glucogen from mostly carbs eaten previously.
The liver keeps us alive in times of famine.
If your body thinks its fasting it releases glucose into the blood stream.
I also have a protein nibble before bed. Nuts or cheese.
I also have a slerp of double cream out of the fridge as I wake up properly or a coffee and cream.
Coffee and cream is very good for stamping on liver dump due to no breakfast.
I'm not a breakfast lover, only on special occasions.

Protein nibbles are good for staving off hypos too. Only if hypo doesn't need treating with glucose.

I've observed many members reduce their fasting bgs with a lchf diet then these tips.
Carbs fill the liver with glucogen which has to go somewhere, maybe turn to fatty liver eh?
 

Zab

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Thanks, ickihun. I would just like to point out that nuts are fairly carby themselves.
I find the LCHF diets rather fascinating and I am lucky to be a member of the libraries of my past college and universities, so I have spent a lot of time researching the studies done over the last one hundred years or so, and I have to say: a lot of the stuff I have read is pretty disturbing and I have concerns for those who have long-term adherence to these particular diets. Long-term would be classified as 4 years or more. I find it especially disturbing to read mainstream articles now because so many hype the benefits...there are tremendous benefits....but so few actually talk about the risks and there are many. I urge people on this diet to keep up with the doctors appointments and try to gain access to real studies done. Media and hypers will often latch on one sentence from a study, but if you go and read it, almost always the next line says: However.... Of course, when side effects are mentioned, you hear of the typical raise in cholesterols. about 1/3 in any given study to drop out because of extremely high elevations to bad cholesterol and bad triglyceride readings (A better indication of heart disease than the cholesterol alone). Everyone should know, that diets like the Keto were first developed for epileptic children. It helped reduce their amount of seizures vastly. If you read studies, you will find in every one that some children died. Thise who adhered to the diet for more than 4 years at time were suddenly having cardiac arrest. For a long time, they thought this had something to do with medications given, but then some children were taken off the pills and were prescribed the diet alone, while other children were just prescribed the diet. Children kept dying. They started a new study in 2014 with adults who had one other known condition. Things like Alzheimers and diabetes. Long-term adherence produced the same results. Apparently, somewhere around that 4 year mark, people begin to lose their selenium levels, even if they eat a diet rich in selenium. The people dying of sudden cardiac arrest sometimes have selenium levels so low, they cannot be detected through standard testing. Researchers are trying to figure out why because the diet does have so much to offer. Other seldom mentioned things that popped up heavily in all of these studies were a lot more broken bones that would not heal properly, decline in cognitive power, kidney stones in 5 year olds and with the children, a whole slew of them just stopped growing, with many never hitting puberty. This kind of information should be on every LCHF website so you can make the most informed decision about your health and to ensure you are having the proper tests done through your medical team.
Personally, I do low-carb, but not to the point of 50 grams or under a day (I sit more in the 90-100 range) and I do frequents the LCHF sites for ideas on deserts, though I do modify recipes because I think things like no cake needs 6 eggs :) I opt more for a Mediterranean diet modified to fit my needs and I too have normal blood glucose levels ranging typically from 4-6 on *most* given days. Birthdays and the sort do see me rising higher. :p
 
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AndBreathe

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@Zab and @ickihun , I'm afraid I take a very different view on Dawn Phenomenon (DP). I see it as "just one of those things". I think to think in very simple terms about these things, although I have done quite a bit of reading, for obvious reasons.

My thoughts on DP is it's our body making us ready for the increased activity of the day, as opposed to the fast of the night time. Yes, it is energy released by our livers, but that's just (in the most simplistic way I can) is a bit like running down a rechargeable battery at bit. By that I mean, by having DP (running down the battery down a bit), there is room to replenish it as soon as we eat or drink. The first thing our bodies will do is try to top up the liver (recharge the battery), and it focuses on that when we first eat. That to my simplistic expression is why for those with romping DP, their after breakfast test is often lower than their pre breakfast reading, even though that may have eaten a few carbs. See what I'm getting at?

Like all things in dealing with diabetes, the extent or the extremity of how we experience this is very personal. Personally, I've never had much of an issue with DP, and in fact once I'd got a handle on things, I'd have said I didn't suffer with it at all. Using the Libre informed me I do evidence DP, but in a very minor way.

@Zab - As far as the longer term sustainability of a lower carb diet, I've now been consciously eating this way for almost 3 years and I'm extremely healthy. I take no medications, and I mean no medications whatsoever. I'm keen to stay that way.

There are several people on this forum who have eaten a lower carb diet for years and years. I'm thinking of @Brunneria (T2) and @tim2000s (T1) , @donnellysdogs , just for starters.

@Zab , I would suggest that modern thinking, is moving towards a better understanding of the actions and reactions of carbs and fats, without the interference of Ancel Keys and his flawed "findings" and conclusions.

I intend to be rudely healthy for a long time, given half a chance!
 
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Brunneria

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Yup, i have been low carbing for decades. Literally.

Started reducing carbs in my late teens, and have been working my way down to current levels since then. I am currently 49.

@Zab could you please provide the references for these studies where 'children kept dying'? I think I need some more specifics than you have given so far. :)
 
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fene48

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Ok, I'll stand up and say it - I am not managing my levels brilliantly. I spend a lot of time in the 7s and 8s and also have a reading of 9 or thereabouts at least once a day. Usually about 2 hours after breakfast as I get a high reading first thing and then it rises until mid morning, then starts dropping. So 2 hours after breakfast is peak. I have tried skipping breakfast, and trying different things for breakfast, but the readings just climb on regardless.
I am doing low carb, have lost 1st one 2lbs since diagnosis (8 weeks ago) and exercise every day. I can't do any more to bring my levels down
Good on you Jennifer for your honesty. I was in the same boat as you. Now I just have cheese and a glass of red before bed - and my readings are a lot lower in the morning. A win-win situation.
 

ickihun

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@AndBreathe
Do you think the more insulin resistant you are the bigger the dump?
Have you seen your dump reduce in time or do you think it's been consistant?

Mine has only been significant since coming off metformin and more insulin resistant.
In pregnancy (3yrs ago) I used metformin and insulin and the dump was significant too. Only nibbling kept my sugars down. Nuts and sometimes carbby breakfast biscuit. (Only 1)
Of course pregnancy uses up more energy but experts say not by much.

I'll be observing my levels now on metformin but to be honest I'm not sure to what extent metformin clears the glucogen by the liver.
Whilst I wasn't on metformin I tried to mimic its liver assistance. Sometimes I achieved it, some days I didn't.
Isn't metformin for the intestines?
A liver dump assistant thou.
 

Zab

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@AndBreathe, Hi. First, I am not trying to dissuade anyone from their diet. That is a personal choice. Nor do I think there are not benefits to this diet. It is just not something I would pick for me because of other risk factors and conditions present in my own life. My only points were that there are some flaws in this diet and for some, it can become extremely dangerous, so I was just pointing out some factors you can take with you to have your doctors check in on.
I went through about 100 years of research, comparing statistics and the like. It took a long time to wade through it all. I want to put it together in a more comprehensive way, but I think you would find a good start yourself by searching out studies done with epileptic children and going over the research and making your own conclusions. Most of my readings did come from university and college libraries and you may have a better go gaining access to one of these data bases or visiting a local library. These will not necessarily be focused on the Keto diet, but on other things, especially the ones up until about 1980, but there will be mentions of the diet (and of how they kept modifying it hoping for better outcomes) and effects and growing speculations found within the studies that has led up to some of the newer research finally being done. You might also keep in mind that more recently parents of epileptic children are looking towards other ways of treating their children, specifically with certain strains of marijuana. This is happening for a reason. Mainly because of how current treatments effect their children.
 
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Brunneria

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@AndBreathe, Hi. First, I am not trying to dissuade anyone from their diet. That is a personal choice. Nor do I think there are not benefits to this diet. It is just not something I would pick for me because of other risk factors and conditions present in my own life. My only points were that there are some flaws in this diet and for some, it can become extremely dangerous, so I was just pointing out some factors you can take with you to have your doctors check in on.
I went through about 100 years of research, comparing statistics and the like. It took a long time to wade through it all. I want to put it together in a more comprehensive way, but I think you would find a good start yourself by searching out studies done with epileptic children and going over the research and making your own conclusions. Most of my readings did come from university and college libraries and you may have a better go gaining access to one of these data bases or visiting a local library. These will not necessarily be focused on the Keto diet, but on other things, especially the ones up until about 1980, but there will be mentions of the diet (and of how they kept modifying it hoping for better outcomes) and effects and growing speculations found within the studies that has led up to some of the newer research finally being done. You might also keep in mind that more recently parents of epileptic children are looking towards other ways of treating their children, specifically with certain strains of marijuana. This is happening for a reason. Mainly because of how current treatments effect their children.

If you are unable, or unwilling, to provide references for your claims, and if those claims are based on studies that are decades old, then can I ask you to be more circumspect in presenting your theories on the forum?

Basically stating that eating ketogenically kills children without providing backup references, strikes me as scaremongering. Especially in view of the increasing amount of research in the last couple of decades on low carb and ketogenic eating, which has not (as far as I have seen) thrown up any correlations with infant death.

If you are interested in more up to date research, then I heartily recommend Voleck and Phinney's works, which amount to over 20 years of low carb research, including work with obese patients and endurance athletes. They have written some texts on the subject which are current publications, and which do not support your theories. One of the key points they make, over and over again, is that a well formulated low carb diet is vital, but then the same can be said for any sustainable way of eating.
 

Zab

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I really do not have the time to go back through dozens of studies today, in fact, it would take a few days. As I have said, most are not actually focused on the Keto diet, you have to start going through them all to find the trends, etc. and to find the two lines of at first speculation inside some of them. It is really best if you look into it yourself. And is something you should have done to begin with because this diet was never designed with diabetics in mind, but for a different condition all together. Any books, websites, articles that only hype benefits, without sharing risks, is not really research.
I am not trying to scaremonger anyone. Ultimately, why would I care what diet you are on? It effects my life 0. All I have basically said is if you are on this diet long-term, you may want to have your selenium levels checked regularly by your doctor. Big deal. You are already getting blood taken for various other things being a diabetic. That's just a helpful hint. As for the other stuff mentioned, like children not hitting puberty and not growing, you can easily find that just by typing it into any search engine. While we might be adults we should still question what that means for us.
I advocate low-carbing, not to the point of a Keto diet, but I still agree with the premise. I am not trying to freak-out people. Just provide some additional information that may help you out in the long-term.
 
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OceansEdge

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.. another liver dump victim here.... and yeah frustrating and disappointing, especially at first

@Neverbloobloo - like you I don't really 'count carbs' so much as read packets carefully, watch my numbers, adjust accordingly and keep a rather lovely spreadsheet of food intake, medications and BG numbers. It does help identify patterns which is especially useful to me as it's a bit of a trick getting/keeping my life routinized.
@Zab - another Canuck here, east coast, sounds like we're taking a very similar approach - I too worry about the long term effects of extreme LCHF, but find some of the information useful in reducing carbs. I do try keeping to somewhere in the 20-40 gr of carbs per meal (2 per day) and under 20 for snacks (1 or 2 day depending). I do find a bedtime snack - (low or no carb) helpful - my fasting morning number is still usually my highest of the day, but it still (in general - 18/20 times) within my target range of 5.5 - 7.5.
One of the reasons tracking was so important to me especially when I started out was that routines here are - well a bit fluid. I work night shifts 3 nights a week, so while there is a routine - it needs tracking over weeks - not days. Interesting thing: I still keep my meal times consistent, but when I'm working nights, I need a snack around 3am - usually a sugar free low carb yogurt (love my Yoplait Source for an interesting variety of flavours) and a Kellogg Pastry Crisps (19gr carbs/6 gr sugar - per two bars) - this keeps my morning numbers within 0.1 of my post dinner reading. When I'm off shift and sleeping through the night, a snack at bedtime, (usually something sweet: a sugar free jello/yogurt or homemade sugar free ice cream, or a protein powder in milk for 'dessert') and my morning reading will be 1.0 above my post dinner number. If I don't have a snack, it'll be 1.5 to 2.0 higher at my pre-breakfast reading. However if I'm sleeping through the day (when I'm working nights), I don't see that fasting dump phenomenon. So I'm inclined to think it may be also related to circadian rhythms, but that's just an observational guess, not data. However, so long as I keep everything within the 5.0-7.5 range ... I'm happy my doctor is thrilled and we shrug and say "Uh that's how my disease is working for me." and I'm learning to let go of the annoyance and frustration with it.

and I'm another person who could stand to lose half my body mass, but that IS coming slowly but surely - on average 1.5 lbs per week considering the latest diet research and issues of rebounding etc, I'm really just as happy to keep the progress SLOW but steady on that front. I'm down 65 lbs from my highest weight (Dec 2014 - 325 lbs), and 15 lbs from my diagnosis weight (Apr 23/2016 - 275 lbs), and if it continues at the rate it's going my target weight (150 lbs) will be within spitting distance next summer.

@srobertson06 - @JenniferW - yeah carbs my bane, I love my carbs - they're what landed me in this mess in the first place - I love baking, breads, rolls, pizza, bagels, pitas, croissants .... yeah I know I'll stop now. I've cut them out *almost* entirely - and consider them a 'treat' when my numbers are on the low end. However, I've also come across a source for low carb real flour (nope no clue how they do that) I know some people have some concerns about the chemicals (!!) in how 'carbalose' is made, (but then a lot of people have concerns about sucralose - me I'll keep taking my splenda in my coffee) but if I can have croissants or pancakes or waffles for breakfast again one day a week, I'm willing to give it a try.
 
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Brunneria

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@Zab

Many of us here on the forum have done extensive research on diabetes, its treatment, management and dietary options. We discuss it widely, share information and references, swap ideas and sometimes even use ourselves as guinea pigs in n=1 experiments.

So asking for references, providing links, and debating them is pretty standard round here.

No one wants to jump out of the diabetes fire and into another one. But for exactly that reason, it makes sense to give more info than 'it was in a study I once read in a university library, you can find it too, if you look hard enough.'
 

Kristin251

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I have been eating a keto diet for more than 25 years and I am far from dead. Other than diabetes I am in great health.

I do find 1/4 hot dog with mustard and a small glass of red wine before bed lowers my fasting.
 
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Zab

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Here. I spent a few minutes seeing what I can access on the internet, as opposed to the my university and college libraries. This person, a proponent of the paleo diet put this together, and I recognise several of the studies she explores and she gives you some of the outcomes. These are by no means all the studies I read. There are some in there I am pretty sure I did not read. But she gives you some graphs and stuff taken from the studies. My suggestion is to google the studies and see which ones you may be able to access yourself and again, weigh your own risks and benefits. The nice thing about the things she has compiled here is that she includes studies done that focus on benefits, studies that showed no real outcomes and the ones that showed adverse effects.
Enjoy your day, everyone.

http://www.thepaleomom.com/wp-content/uploads/2015/05/Ketogenic-Diet-Literature-Review.pdf
 
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AndBreathe

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@AndBreathe
Do you think the more insulin resistant you are the bigger the dump?
Have you seen your dump reduce in time or do you think it's been consistant?

Mine has only been significant since coming off metformin and more insulin resistant.
In pregnancy (3yrs ago) I used metformin and insulin and the dump was significant too. Only nibbling kept my sugars down. Nuts and sometimes carbby breakfast biscuit. (Only 1)
Of course pregnancy uses up more energy but experts say not by much.

I'll be observing my levels now on metformin but to be honest I'm not sure to what extent metformin clears the glucogen by the liver.
Whilst I wasn't on metformin I tried to mimic its liver assistance. Sometimes I achieved it, some days I didn't.
Isn't metformin for the intestines?
A liver dump assistant thou.

To be honest, Ickihun, I have no idea, because I've never had much and as I got on with taking control my numbers came down across the board, so I concluded I didn't have DP. Only when I started using the Libre (not full time, I might add) did I see evidence I have a very small amount, but even then it still has my fasting range is 3.5-4.5.

If I'm utterly honest, the only time I would be concerned about DP is if it meant my fasting score was consistently stratospheric, or it started very, very early on, or it didn't start moderating until lunchtime, thus impacting my longer term average numbers. If it helps cycle my naturally stored liver stores, I'm perfectly OK with it - especially as it seems to be particularly difficult to result. I know some on pumps set profiles to increase their insulin dosing to help moderate their DP, but of course, that's not available to us.

I think you would learn a massive heap if you could manage to fund the odd Libre, but I do appreciate it's a chink of money. Now that the LibreLink is an option, it does away with the absolute need to buy an Abbott reader, so saving £50, as long as you use an Andoid phone with NFC technology.
 

AndBreathe

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@AndBreathe, Hi. First, I am not trying to dissuade anyone from their diet. That is a personal choice. Nor do I think there are not benefits to this diet. It is just not something I would pick for me because of other risk factors and conditions present in my own life. My only points were that there are some flaws in this diet and for some, it can become extremely dangerous, so I was just pointing out some factors you can take with you to have your doctors check in on.
I went through about 100 years of research, comparing statistics and the like. It took a long time to wade through it all. I want to put it together in a more comprehensive way, but I think you would find a good start yourself by searching out studies done with epileptic children and going over the research and making your own conclusions. Most of my readings did come from university and college libraries and you may have a better go gaining access to one of these data bases or visiting a local library. These will not necessarily be focused on the Keto diet, but on other things, especially the ones up until about 1980, but there will be mentions of the diet (and of how they kept modifying it hoping for better outcomes) and effects and growing speculations found within the studies that has led up to some of the newer research finally being done. You might also keep in mind that more recently parents of epileptic children are looking towards other ways of treating their children, specifically with certain strains of marijuana. This is happening for a reason. Mainly because of how current treatments effect their children.

Zab, thank you for voicing your concerns, but I'm afraid you have nothing to deflect my commitment to my way of life.

I am a highly trained former HCP. I gave up practising some years ago due to my, then concerns for the future of our NHS. I was not wrong in my misgivings, and although it is an immense shame it cost a huge amount to train me, I am sure my life is better and probably my health too, because I found commerce and corporate life to be much less stressful than working in an environment curtailed in the way it was and even morerso today.

As someone scientifically trained, I would ask you to trust me when I tell you I have done my own thorough research, although I preferred to focus more on the near recent years and up to date studies. I am not interested in managing my life as they did many years ago. If I have something to address, I want to be up to date and utilising as much of the available current knowledge and technology as I can. Frankly, if I needed my appendix out, I would never invest much time in exploring how that could be achieved many moos ago. I would prefer to explore keyhole and minimally invasive options, rather than exploring full laparotomy and all the additional trauma and recovery time that involves.

Thus far, I am extremely fit and healthy, with no metabolic markers or other medical conditions. And I mean none. I take no medication for diabetes or anything else, and I have never taken any medication for the longer term in the past. Thus far, I don't think I'm doing too badly.

I have taken responsibility for my health and well-being, and should anything go horribly wrong with it, I will accept the consequences as I have made my decisions based on my own personal research and my decisions are informed.

Your choices are your own and I respect the choices you have made, even if they differ from my own. I do wish you well, but would urge you to not become too wedded to significantly historical research.
 

Zab

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Tablets (oral)
@AndBreathe Again, I have no intentions of swaying people from their diets. Again, I advocate for low-carbing to control this condition, I do it myself, just not to the extent some do. I firmly believe I would not be where |I am today had I not drastically changed the way I ate. I started this disease with an A1C of 18. Three months later I was down to a 6.2, my next test is in August and I know it will be much lower if my meter readings are any indication. I sit in the 4s and the 5s almost always lately (except those few times I tried those darn no sugar added ice creams and experimented with the dreaded oatmeal) by researching and learning a few tricks that help lower blood sugars quite well after meal time. Ultimately, I do think people should make informed decisions and be aware of things to look out for. While I read a body of research from the last 100 years that does not mean I hinged my conclusions on it. I know how to look for patterns and recognise concerns that came up over and over again. The actual information that I presented about selenium being the root concern is based on new studies. Scientists made the connection, same as I did, and actually I was quite surprised as I came up through the studies independently to find myself reaching some of their concerns that they are now currently looking into more, you know, to ensure this diet is safe for people because right now, it isn't for everyone.
While I think people should think about all the good and bad that may come from this diet, again, all I was saying is that people on a very low carb diet should have their selenium levels monitored as well, so that if a problem starts cropping up, it can be dealt with. I very much want to see people to be able to get a handle on their condition and the battles that come with it. As a proponent of the diet, I am sure you would like to help as many people as you can with it and part of that should be telling them what to look for and advocating for more research, so that the problems that have been identified find solutions so that good health remains for all. Turning a blind eye is actually detrimental to your cause.
 
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Brunneria

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@Zab

I've had a look at your link and the relevant studies it contains, and I am still puzzled by your comments.

Two studies mention selenium deficiencies on a ketogenic diet. No mention of what those keto diets actually involve. Since the foods that contain the most amounts of selenium are all keto friendly, I can only assume the diets used in the studies were not well formulated. Without details on menus and portions, concluding that keto diets result in selenium deficiency is a big stretch.
https://draxe.com/top-10-foods-high-selenium/

Ditto the comments about growth and skeletal density.
Any well formulated keto diet is recommended to include bone broth containing the necessary minerals, and a good range of foods will provide more.

I completely agree that we bear individual responsibility to research and inform ourselves. We also bear responsibility to ensure that our diets contain a healthy range of foods, vitamins and minerals - but the same applies to ANY way of eating. It is simply a matter of ensuring adequate nutrition - just as any vegan bears the responsibility to get enough B12.