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fructose and low carb (ketone) diet
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<blockquote data-quote="Sean_Raymond" data-source="post: 1468889" data-attributes="member: 403497"><p>I see no reason why a ketogenic diet cannot be trialled by someone with type 2 diabetes, low CHO and ketogenic diets are very interesting from a metabolic point of view - colleagues of mine would disagree (as I think you are aware) - however I have seen no evidence of it being dangerous for weight loss or glycaemic control in T2DM. Indeed, I have used quite extreme ketogenic diets for epileptic patients - nothing untoward occurs. I will say that I disagree with the mechanism put forward regarding why ketogenic diets/low CHO diets might work (for weight/fat loss) - namely that it is the fault of insulin. Nonetheless, I accept we do respond differently to nutrients and so I would always explore alternative diets if one I have recommended does not work. My job is simply to ensure the diet will not harm and is nutritionally complete.</p><p></p><p>As for pure fructose - it does not exist in nature in isolation and (off the top of my head) the reason is likely due to its poor absorption - we have no fructose specific transporters that can get it into cells - so fructose tends to hitch a ride with glucose (via glucose transporters) to more readily enter the cell. This is (likely) why fructose is found with glucose in varying ratios. I think a 1:1 ratio is optimal for absorption (don't quote me on that) - it is this poor absorption which implicates fructose with many functional GI issues such as IBS.</p><p></p><p>I know H & B do a 100% fructose powder - I think it is brilliant that you would put yourself forward to trial it - we need more of this to understand diet and its effects. I would not be concerned at all if you did this (if you ingest a not too unreasonable amount that is - I can't cite a specific amount at this point) and would be very interested in your findings. As mentioned, fructose does have potential to have adverse effects beyond the equivalent amount of glucose such as upon blood lipids but the amounts needed to evoke this are very high - and even then a positive energy balance is needed to fully explore these effects. Fructose is not an issue at current levels although I am not advocating its consumption, it is not essential for health and can be omitted entirely with no effect. </p><p></p><p>I will quickly add - a fraction of fructose does get converted to glucose however I understand that conversion is slow meaning glucose clearance is not affected to any noticeable amount. This would explain the lack of a rise in blood sugar however I can't fully elucidate the reason for why the glucose produced from fructose has no bearing on glycaemia - I never pondered this until just this second - I will look into this fr you. However, the literature is clear regarding fructose and blood sugar effects so over to you and your personal trial - if you want to.</p><p></p><p>Many thanks.</p></blockquote><p></p>
[QUOTE="Sean_Raymond, post: 1468889, member: 403497"] I see no reason why a ketogenic diet cannot be trialled by someone with type 2 diabetes, low CHO and ketogenic diets are very interesting from a metabolic point of view - colleagues of mine would disagree (as I think you are aware) - however I have seen no evidence of it being dangerous for weight loss or glycaemic control in T2DM. Indeed, I have used quite extreme ketogenic diets for epileptic patients - nothing untoward occurs. I will say that I disagree with the mechanism put forward regarding why ketogenic diets/low CHO diets might work (for weight/fat loss) - namely that it is the fault of insulin. Nonetheless, I accept we do respond differently to nutrients and so I would always explore alternative diets if one I have recommended does not work. My job is simply to ensure the diet will not harm and is nutritionally complete. As for pure fructose - it does not exist in nature in isolation and (off the top of my head) the reason is likely due to its poor absorption - we have no fructose specific transporters that can get it into cells - so fructose tends to hitch a ride with glucose (via glucose transporters) to more readily enter the cell. This is (likely) why fructose is found with glucose in varying ratios. I think a 1:1 ratio is optimal for absorption (don't quote me on that) - it is this poor absorption which implicates fructose with many functional GI issues such as IBS. I know H & B do a 100% fructose powder - I think it is brilliant that you would put yourself forward to trial it - we need more of this to understand diet and its effects. I would not be concerned at all if you did this (if you ingest a not too unreasonable amount that is - I can't cite a specific amount at this point) and would be very interested in your findings. As mentioned, fructose does have potential to have adverse effects beyond the equivalent amount of glucose such as upon blood lipids but the amounts needed to evoke this are very high - and even then a positive energy balance is needed to fully explore these effects. Fructose is not an issue at current levels although I am not advocating its consumption, it is not essential for health and can be omitted entirely with no effect. I will quickly add - a fraction of fructose does get converted to glucose however I understand that conversion is slow meaning glucose clearance is not affected to any noticeable amount. This would explain the lack of a rise in blood sugar however I can't fully elucidate the reason for why the glucose produced from fructose has no bearing on glycaemia - I never pondered this until just this second - I will look into this fr you. However, the literature is clear regarding fructose and blood sugar effects so over to you and your personal trial - if you want to. Many thanks. [/QUOTE]
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