Eating 5-6 small meals/snacks instead of 2-3 large meals

HSSS said:

Why wouldn’t it be safe for a person? Presumably not currently for you because of your as yet uncontrolled hypos and treatment issues for 3c. But there are type 1 that do very successfully use it out there. It’s much more frequently used as a successful and supported by science tool for type 2. Different conditions different approaches

Dipping in and out of ketosis has been the norm for much of human existence. It challenges the low fat mantra (which has even less evidence for it’s fundamental principles) of the last 50 yrs and that causes waves and ruffles feathers when you rock the status quo.

Not sure why you think there’s few studies supporting it. It’s probably true there aren’t a huge number of studies overall, rather than them mostly being against it as you suggest. Supporting it for what?

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It's not safe for me because of insulin. It's not safe for me because of potentially high fat and the effect that has on my pancreas. But, as said, this is is general thread and it might be safe for many (or even most) other people. The reason I say there is lack of evidence is because if you look on pubmed there are very, very few studies on it except for those that concentrate on epilepsy. I knew it would cause a debate which is why I almost didn't even comment on it, but recommending a keto diet without evidence is... I dunno. I do concede that many, many people have great success with the diet though and that's great. I do not believe that carbs are the enemy. I believe that excess carbs are the enemy. That's my stance and if I don't say it I'll be forever worrying about it, so I've said it

plantae said:

I may as well say it. I do not believe in the keto diet. Even without high blood sugar you can develop DKA (google it). The keto diet works for you and that's great, but I think it's potentially dangerous and should not be done without medical supervision. Good on you for sticking with it though... I doubt I could eat less than 20 g of carbs a day even though I don't like them

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Euglycemic dka is pretty rare and usually associated with specific medications, or very specific situations. In contrast high blood glucose and insulin levels as opposed to normal levels this way of eating achieves are well documented and undisputed to cause a lot of harm. Not to mention it typically massively improves triglycerides and cholesterol ratios and things like visceral fat and blood pressure.

Many of the things you read in the media are ill informed about exactly how ketosis works and how to do it safely. And that includes by medical people who were never trained in it nor have studied it beyond the same media hype. They quote ridiculous fear stories grossly exaggerating side effects. Eg keto flu (a temporary situation usually caused by a lack of electrolytes and very simply rectified) bad breath (a temporary situation that disappears in days), hunger caused by not replacing the carbs with anything else, hair loss (telogen effluvium which can be cause by any big change in diet good or bad and is also temporary and avoidable by a slow adjustment) and the biggie of the fears of eating fats despite the big improvements seen when you dig deeper that pointless total cholesterol levels into ratios particle size and actual arterial damage.

The tooth fairy and Father Christmas are things you can choose to believe in or not. The scientific evidence is there or not.

Not every diet will suit every person either for medical comorbidities or preferential personal reasons. Any diet done in ignorance or badly can cause harm.

plantae said:

It's not safe for me because of insulin. It's not safe for me because of potentially high fat and the effect that has on my pancreas. But, as said, this is is general thread and it might be safe for many (or even most) other people. The reason I say there is lack of evidence is because if you look on pubmed there are very, very few studies on it except for those that concentrate on epilepsy. I knew it would cause a debate which is why I almost didn't even comment on it, but recommending a keto diet without evidence is... I dunno. I do concede that many, many people have great success with the diet though

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Yes your case is probably not a good candidate. That’s quite different to calling it an unsupported fad as your earlier posts did.

I’ve certainly read a fair few studies (outside of epilepsy but even they sometimes have relevance) that involve ketosis. There very definitely is evidence for it despite your claims otherwise. There aren’t so many dealing with the origins of fat being bad for you (inherently not in specific cases like your pancreatitis). Most start with that assumption being a fact and work from there but its a house of cards with a very shaky base.

HSSS said:

Yes your case is probably not a good candidate. That’s quite different to calling it an unsupported fad as your earlier posts did.

I’ve certainly read a fair few studies (outside of epilepsy but even they sometimes have relevance) that involve ketosis. There very definitely is evidence for it despite your claims otherwise. There aren’t so many dealing with the origins of fat being bad for you (inherently not in specific cases like your pancreatitis). Most start with that assumption being a fact and work from there but its a house of cards with a very shaky base.

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Well, you're right. Most diet studies are inherently flawed because it would be unethical to do double blind studies. So just about all of them are observational studies. That's why I said that if the keto diet worked for some people then that's great. I don't think we should be promoting it though

I really really wish there was a sad or disagree response button. It seems rude to laugh at comments you consider inaccurate or plain daft but there isn’t any other to use. Perhaps calling it creative is the best there is.

plantae said:

Well, you're right. Most diet studies are inherently flawed because it would be unethical to do double blind studies. So just about all of them are observational studies. That's why I said that if the keto diet worked for some people then that's great. I don't think we should be promoting it though

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Have a look at the virta studies bulkbiker refers to. Good quality evidence of the type you say doesn’t exist. And there’s a lot of anecdotal evidence from the many type 2 that achieve remission via this route. Whatever is chosen people should do it with knowledge. A lot of drs wouldn’t have a clue about it, good or bad, and thus cannot advise on it.

What do you think we should promote instead for type 2? Type 1 and 3c are different animals with regards to carbs/excess carbs as they generally are not insulin resistant nor typically have excess insulin levels. This is very important to remember. Type 2 hit “excess” a lot lot fast as a result.

plantae said:

It's not safe for me because of insulin. It's not safe for me because of potentially high fat and the effect that has on my pancreas. But, as said, this is is general thread and it might be safe for many (or even most) other people. The reason I say there is lack of evidence is because if you look on pubmed there are very, very few studies on it except for those that concentrate on epilepsy. I knew it would cause a debate which is why I almost didn't even comment on it, but recommending a keto diet without evidence is... I dunno. I do concede that many, many people have great success with the diet though and that's great. I do not believe that carbs are the enemy. I believe that excess carbs are the enemy. That's my stance and if I don't say it I'll be forever worrying about it, so I've said it

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Bearing in mind your tricky pancreas, and fixed dose insulin regime, I don’t think any big dietary changes would be a great idea, until you are confident in insulin dosing to match what you eat and drink. Thereafter, you probably have lots of options.

In terms of individuals‘ eating patterns, my Endo, whom officially I see for my thyroid, but who is interested in my T2 status, wholly supports low carb diets. I have no idea if he recommends them to patients, but he is very happy to see the results it has achieved for me, over 9 years.

In terms of medics walking the walk, there are quite a few who low carb or keto. I’m thinking here of Dr Ian Lake from Gloucestershire, who has also undertaken ultra distance running on it. He is a decades in T1. He uses a CGM, but feels he has no need for a pump. This is his website: https://type1keto.com/

There is also Dr David Unwin (and his wife Dr Jen) who eat low carb His GP practise has a markedly lower spend on medications for T2, which he attributes, mainly, to the number of his T2 patients who have adopted low carb lifestyles.

There are plenty more just like those out there.

When it comes to diet, we all make our choices. Mine are low carb, but if others choose differently, that’s absolutely fine, provided, like me, they do their own reading and decide for themselves.

AndBreathe said:

When it comes to diet, we all make our choices. Mine are low carb, but if others choose differently, that’s absolutely fine, provided, like me, they do their own reading and decide for themselves.

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Yes, deciding for ourselves

plantae said:

I called it a fad because there is no evidence. None.

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So you haven't looked at the Virta health site I sent you a link to?

Please don't make statements that are simply untrue.

plantae said:

Also, this thread is not about people with T2. It's for people with diabetes... "Food and Nutrition". Suggesting a keto diet just isn't right

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Its actually in the fasting section. Why anyone would think having 5-6 meals a day is fasting is also strange. But I refrained from commenting there too.

bulkbiker said:

So you haven't looked at the Virta health site I sent you a link to?

Please don't make statements that are simply untrue.

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Yes I did read it. I don't agree with it

plantae said:

Yes I did read it. I don't agree with it

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So you don't like real world evidence?
These are real people gaining remission using a ketogenic diet.
They have also published papers in various journals and Phinney and Volek are very well respected scientists in their field.
Dr Sarah Hallberg was also very well respected before she died.

So I'm not sure you have really "read" it.
Do you have any real evidence why you don't agree with it?

Try this part

I'm sorry I just do not believe it. They have 9 references. I'm not going to read all 9, but 9 is very few

Two of their citations are to their own studies! I'm not going to read the rest

Ok, I've read it all. It's an advertisement

plantae said:

Also, this thread is not about people with T2. It's for people with diabetes... "Food and Nutrition". Suggesting a keto diet just isn't right

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The thread has gone off at a tangent but the keto discussion was prompted by a question from the OP about very low carb.

Plenty of people with diabetes of all types follow a keto way of eating, it’s not just a type 2 thing. It might not be for you and no one can tell you what to eat, but please don’t tell others what they can talk about on a public forum.

Should probably leave it at that as I’m derailing even further.

plantae said:

I'm talking about it because it's dangerous

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You are making unsubstantiated statements about something you appear to know little about.
Please stop.

bulkbiker said:

You are making unsubstantiated statements about something you appear to know little about.
Please stop.

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I've stopped. My apologies

plantae said:

I've stopped. My apologies

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Thanks.