Ketogenic diet - very bad side effects

@qe5rt @bulkbiker - in the interests of balance and opposing views, here are some links that counter the Ballantyne/Minger stuff above:

https://docmuscles.com/2015/05/10/m...-are-the-adverse-effects-really-that-adverse/

http://mariamindbodyhealth.com/8-common-misconceptions-about-ketogenic-diets/

Podcast response by McNally & Moore:
http://ketotalk.com/2016/06/23-resp...allantynes-claims-against-the-ketogenic-diet/

Not to mention all the benefits of the diet outlined by every speaker on the Metabolic Therapeutics conference (which is current research/diet practice rather than historical):
https://www.youtube.com/channel/UCkUl8S70DCT66YJ30w75d6A

Indy51 said:

@qe5rt @bulkbiker - in the interests of balance and opposing views, here are some links that counter the Ballantyne/Minger stuff above:

https://docmuscles.com/2015/05/10/m...-are-the-adverse-effects-really-that-adverse/

http://mariamindbodyhealth.com/8-common-misconceptions-about-ketogenic-diets/

Podcast response by McNally & Moore:
http://ketotalk.com/2016/06/23-resp...allantynes-claims-against-the-ketogenic-diet/

Not to mention all the benefits of the diet outlined by every speaker on the Metabolic Therapeutics conference (which is current research/diet practice rather than historical):
https://www.youtube.com/channel/UCkUl8S70DCT66YJ30w75d6A

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Thanks as always @Indy51 much appreciated.
I am just interested to read as much as I can but am unlikely to change my WoE..it works... (for me)

Listen to @AtkinsMo
It is typically a lack of adequate salt in the diet when following keto which can give the GI effects often experienced. Have a cup of broth per day, up the salt and water. You excrete more salt on a low carb diet.

Also 300g fat is a lot - that is 2700kcal from fat alone. Diving straight into that amount may be challenging.

Personally I would for the first 2 weeks reduce gym intensity (3x a week), start on lower kcals, increase water and salt for sure, then slowly increase exercise and kcal from week 3-4.

I agree with those posters who have suggested to up your salts intake. I'd recommend reading "The Art and Science of Low Carbohydrate Living" by Stephen D. Phinney and Jeff S. Volek which covers the reasons for this.

zoozle said:

I agree with those posters who have suggested to up your salts intake. I'd recommend reading "The Art and Science of Low Carbohydrate Living" by Stephen D. Phinney and Jeff S. Volek which covers the reasons for this.

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From the experts themselves:

bhk said:

Thanks for your reply! I might or not be the case, I know the urine strips aren't as accurate but they were around 1.5 and 4.

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Here is a fairly detailed explanation of what I was trying to say
http://ketopia.com/why-you-need-to-stop-worrying-about-the-color-of-your-ketostix/

@Indy51 docmuscles perfectly illustrates why i have issues with ketogenic diets. I'll try to explain as best as i can:

In nutritional science it's hard to prove anything because of several reasons (in both directions). But you'll be hard pressed to find anything that without a doubt can say that the positive (or negative) effects come from the ketogenic part and not just what's been eaten. If you take your group of people with horrible diet and put them on any diet all their relevant values will most likely be effected in a positive sense. Figuring out if those people would have similar effects on another diet is difficult. Some positive effects (or negative) can probably be attributed to the ketogenic state but maybe not only to that.

In his article he often mentions his own patients but let's face it you don't go to a physician unless there is something wrong. Since KD is an effective diet you can be sure that they'll get better values when tested after a while but since he only seems to be using a keto diet you can't really say that it's better than another diet. It's kinda like saying i mow my lawn with a gas powered lawnmower, haven't tried the rest so it's the best there is because i got results. I'm not in doubt about the validity of his claims or that KD is very effective in weight loss (if not even the best) but the reasoning he's using is not entirely correct.

Furthermore a lot of his arguments are also the most common arguments used to counter the positive effects (population, test methods, assumptions, ...). Which for some reason everyone takes at face value and forgoes the possibility of negative results. In which i would think a KD is the first diet to not have a single negative effect on a single human being. To add to this someone in this topic mentioned that since he doesn't have any of the adverse effects it must be bogus. Adverse effects are things that could happen but might as well not happen at all, it's not because someone doesn't have it that it doesn't happen at all. They're like the side effects from medication, they could happen but are not all likely to happen.

Lastly and maybe my biggest issue with keto as it's portrayed: The man is a physician who sees his patients and can test them regularly. He even goes on to say:

Cardiomyopathy – Prolonged QT intervals have been associated with cardiomyopathy and the former can stimulate the later. Any diet that has the potential to prolong a QT interval has the potential to cause cardiomyopathy. Hence the need for regular EKG monitoring on any diet (Acquired Long QT Syndrome. Berul C et al. www.uptodate.com, May 2015).

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Which shows that drastically changing your diet can have health effects. While none of us here have any medical qualifications there seems to be no qualm about suggesting a diet that changes your metabolic function while not knowing how it will effect the person. On top of this none of us know the person who is asking (like other health conditions, ...). More so nobody bothered to ask the exact goals of the person asking the question, most just assumed that KD is the way to go and i think the one thing we can all agree on is that there is no one diet fits all needs. And while most agreed that he wasn't doing KD with 50 grams of carbs, he still mentioned his BS were nice so you could build on that suggesting a moderate LCHF diet. I know he asked for specifics on a KD diet, and the salt reasoning is dead on i think, but a diet should fit the needs of the person and it might not be the diet he wants. I'm really just saying that when suggesting any diet a word of caution can go a long way instead of disregarding even the remote possibility of an adverse effect.

Kristin251 said:

True that on the carbs! Wondering if 100 G protein is too much too?

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Depends on your weight, but most of us are advised to keep protein down to 80 g or less. Protein converts to carbs in the body, so more protein does not help going keto/ As said by others, most need to drop carbs to 20 g or so/ The ketones you were measuring probably came from your exercise, not diet. Nausea probably due to fat intake, which seems a little high too.

There are other ketogenic diets you could try. Atkins was the main one and there is much info that reads across from that diet to LCHF et al.

@qe5rt you are correct that anecdotal and/or individual stories are not very helpful. That is why you need larger cohorts and this is difficult in human nutrition but in particular to control well for specifics, such as keto.

Volek and Phinney have a lot of papers out there that do this and the data is positive.

The counter to your argument however about the negative aspects (and I agree you cannot say something has no adverse effects in all people!) is that you are assuming we have some sort of established standard that has little/no averse effects. I contend that, and I think the obesity epidemic and general health of individuals in Western societies emphasise that point.

We say that the "keto diet is not for everyone" and the unsaid sort of assumption people subconsciously make is that a "regular" recommended Western diet (300g+ carbs per day) is a diet that could work for everyone. How often do you hear someone in the West say "a normal (western) diet is not for everyone"? We don't, because it has been engrained that the current advice (from a decision made in the 1950s/60s and supported by billion $ industries) is the default best case scenario. I think the evidence is starting to come to light that there is no default best, and actually every single diet, depending on your genetic predispositions, may have some merits in some people and disadvantages in others.

Another way to illustrate this is that conventional western diets are far worse for children with epilepsy in general than a ketogenic diet. That is an interesting observation.

Another interesting thing to consider is newborns and breast milk. If you look at the compostion of a purely breast-fed baby (arguably the best option for a developing child) then the RDV's will mean that any baby on the breast will be exceeding their RDV of fat or not getting enough carbs. The ratio is completely different to our RDVs. Now I appreciate that this is a completely different scenario as it is a developing and fast growing child with different needs to an adult, but why is it because the government says this is your RDV of fat, carb and protein does this default this as being a "safe" diet? When actually it will highly depend on the individual diet and there is good evidence that a carb-centric diet may not be best in a large proportion of the western population!!

Just some food for thought (forgive the pun)...

Interesting discussion.

My input is a simple observation that most of us think we eat ok. Balanced, healthy, etc. But really? Take off the personal tunnel-vision spectacles with which we view our own plates...

Likewise, anybody thinking that feeding growing children (with epilepsy) a processed diet of liquified egg isn't going to have consequences, is delusional. Claiming that keto isn't a good idea because of the badly designed, outdated diet in those studies is like saying that we shouldn't eat green smoothies because cucumber causes indigestion.

Edited to add (because I hit the 'publish' button by accident):

Plus, it is worth remembering that this thread was started by a T1.
I think T2s and T1s react differently to ketosis, physically and emotionally.

T2s (the most vocal keto supporters on the forum) don't have the same fear/wariness to ketosis that T1s do.
And
T2s are (often) not at liberty to medicate to compensate for carbs.

This can result in very different perspectives.

As a keto T2, no meds plus other health issues, I only feel well when my carbs are low. I wouldn't be keto if there were alternatives. I like bread and pasta and mash as much as anyone. Why deprive yourself if you can feel well (steady blood glucose, good energy levels, no brain fog) eating carbs? If I were T1, would have to have brittle D, or need to apply Bernstein's Law of Small Numbers before I went keto.

I would low carb of course (i don't think high carb is good for ANYONE)

But keto? Unlikely. And if I did, I would research the whoopsies out of it before i started: cold turkey, or step downs? salt? minerals? carb tolerances? veg options? enough variety? good fat choices? Bernstein. Voleck and Phinney...

I wouldn't just wake up and think 'today is my first very low carb day'.

We are currently staying with our son and dil. I am the dreaded mother in law, so I try to have an opinion on nothing, but I observe. My grand-children start their day with raisin bran, or Cheerios, and skimmed milk. It totally horrifies me. Their snacks are raisins (80% carbs) breakfast biscuits, biscuits and cakes, some fruit. Their meals are carb-centric, their desserts are often 'children's yogurts' - loaded with sugar. We give them (often in addition) omelettes, scrambled eggs, raw veggies, plenty of butter, meat (they will try most things).

Our son and dil are intelligent, educated people. They believe that they are doing the best for their children. With our family history of diabetes, I really fear for their future. I am 62. As a child I did not eat all this carby ****. It was usually a boiled egg and soldiers for breakfast, a school dinner that consisted of meat, vegetables and potatoes for lunch and a dinner that was protein, veg and potatoes, and not a lot of snacks. By the standards of modern society, my grandchildren's diets are quite moderate - they do at least eat some 'real food'. But I really fear for their future. Turning around this 40+ year dogma of every meal being based on carbohydrates is a huge task - I can't see it being achieved in my lifetime, especially when a huge percentage of medical professionals will not even consider alternatives to the established norms.

Sometimes I feel very positive and up-beat about the future, the tide is finally turning, common sense will prevail. And sometimes, like reading this thread, I just despair! If the people most effected by this carb addiction cannot start to see the light, what hope is there for the wider population?

jddukes said:

@qe5rt

The counter to your argument however about the negative aspects (and I agree you cannot say something has no adverse effects in all people!) is that you are assuming we have some sort of established standard that has little/no averse effects. I contend that, and I think the obesity epidemic and general health of individuals in Western societies emphasise that point.

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This is a very good point. Though it might be cultural i don't feel like i've been imprinted with a standard diet growing up in Belgium. Food education still was embarrassingly low overall, i can only vaguely remember a couple of lessons in elementary. I do wholeheartedly agree that the "standard" eating habits in Western society are appalling and that the negative effects of doing nothing far outreach doing something ... anything really.

Do remember that a lot of the positive results about KD (when it's not about seizures or other neurological things) is about weight loss on obese and overweight people. There are more than a few nutritionist (in all their variety) that do not advice a KD diet for a generally healthy person (granted all of us have some form of diabetes) or to be done without the supervision by some medical personal. In this case the OP weighs 75 kg so i doubt he's going to be overweight in the least bit. First and foremost getting his BS under control is the most important though you will achieve that with KD there are other options that don't involve an adjustment period or a, let's face it, VERY strict diet.

Personally i know it doesn't suit me the least bit i've tried it went through the adjustment period and lost strength (about 10% on my max lifts) which is consistent with most KD research on high intensity workouts (where intensity in this case is percentage of a lift). And to be honest i felts like i was fixing something that didn't need fixing, me BS was fine, steady and consistent strength and muscle gains, good recovery, sleep, active life, ... so for me personally there was no need to change anything.


And i like puns


EDIT:

AtkinsMo said:

Sometimes I feel very positive and up-beat about the future, the tide is finally turning, common sense will prevail. And sometimes, like reading this thread, I just despair! If the people most effected by this carb addiction cannot start to see the light, what hope is there for the wider population?

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I don't think you'll find anyone in this topic saying you need high carbs. But there is an amount between high and ketogenic.

@bhk what are your goals with exercising? Do you want to lose, gain or stay the same weight? I'm currently trying to bulk without raising my carbs too much and having a hard time too, need to consume about 3500-4000 calls a day and eating the amount of high fat meals is making me a bit nauseous too. I upped my carbs a bit since that's where i felt i had some leeway left.

I personally feel that getting your BS under control is important since you mentioned fluctuations. Getting a routine in eating and workouts makes this a lot easier.

What benefits are you talking about from the sports? You might find that reducing physical activity might not necessarily mean reduced physical performance when tweaking your workout regime properly.

Edit: i should mention that i'm in no way doing ketogenic and with the recent addition of some carbs not even LCHF (well the second part maybe ). When cutting i probably am considered (moderate) low carb high fat.