Ketosis good or bad ?

[Andy12345]

Hi forgive me if this is dumb, I am following a 30-40g carbs a day diet, I thought ketosis was a good thing but reading this article it doesn't sound all that good, have I got the wrong end of the stick? Thanks

Below is what I read not me saying it


Our body produces energy from the glucose we get from the consumed carbohydrates. But when glucose is not available, the liver produces ketone bodies to provide the body with the required energy. Although ketones are always present in the body, their levels can rise during a period of prolonged fasting. This condition is called ketosis.

The most common cause of ketosis is following a low-carb diet. When one switches over from a high-glycemic diet to a low-glycemic diet, their body enters into a stage of ketosis. The body does not immediately start producing ketones, but if carbohydrates are not included in the diet for a long time, say two days or more, the body starts utilizing the energy from its fat stores. The glucose is thus preserved only for dire conditions like preventing protein and muscle breakdown.

The initial stage of ketosis is considered relatively harmless. In fact, ketosis has also been deliberately induced through a ketogenic diet to treat epilepsy. However, prolonged ketosis is harmful for the body and is highly discouraged.

Symptoms
The most common symptoms of ketosis include:
Note: Ketosis and its symptoms are often confused with diabetic ketoacidosis. However, diabetic ketoacidosis is a life-threatening condition, where a severe deficiency of insulin, leads to a toxic buildup of blood glucose, accompanied by excessive breakdown of fat and muscle tissues. However, such alarming levels of ketone bodies are not usually seen in healthy individuals.
Fatigue
Dizziness
Headache
Excessive thirst
Nausea accompanied by abdominal pain
Problems with sleeping
Bad breath
Cold hands and feet
Metallic, sweet, or fruity taste in the mouth
Strong smelling urine
Loss of appetite
Temporary sense of euphoria
Diagnosis
A confirmatory urine test can be done to see whether the body is in a state of ketosis. One can purchase ketosis strips that are easily available in the market. The strip changes color if ketone bodies are present in the urine.

Side Effects
A prolonged state of ketosis can cause major health problems like:
Calcium deficiency
Osteoporosis
Gout
Kidney stones
Liver damage
Controversy Surrounding Ketosis and its Symptoms
Most people claim that going into ketosis and exhibiting its symptoms is no reason for alarm, and simply denotes a different and specific phase of metabolism that the body is going through. This is the main reason that people still strongly advocate going in for low-carb diets, and even go to the extent of claiming that certain organs function better during the state of ketosis. However, research says that ketone bodies are acidic compounds, and their accumulation in the blood could lead to toxicity. It is an aggravation of symptoms that lead to the potentially life-threatening condition called ketoacidosis.

Doing Away With Ketosis
The easiest way of reversing ketosis is by including carbohydrates in the diet. One has to make sure that they do not start consuming carbohydrates suddenly, but increase the intake gradually, after consulting a health professional. Eating smaller and frequent meals help mitigate the symptoms to a large extent. Another important thing is to keep the body hydrated to help dilute the urine and, in turn, flush out the ketone bodies.

To avoid conditions like ketosis and other medical complications, it is always advisable that you consult a health professional before making any extreme changes in your diet. He/she would best know what is suitable for you and guide you accordingly.

 

[Claire87]

It could just be me, but that sounds like an advert from a bread company. But then I've seen a lot of conflicting information on the internet about lots of things. There was massive slush campaign on soya when it first came out because the meat production industry feared soya products taking over and putting them out of business.

From my personal experience: I went through Ketosis. The only feeling I had was tiredness while it was happening for a couple of days, then I felt amazing. I managed to avoid getting insulin tablets because my blood sugar and weight loss in two weeks was such a big change, and the only thing I can credit that to is a low carb diet and going through ketosis. Ketosis saved me from a life of medication and made me feel great. I'm an advocate of it.

But I'm not an expert on the low carb diet, so I asked my nutritionist friend. She'll know the answer. She always does. I'll post it up when she gets back to me.

 

[Andy12345]

Thankyou, I have been trying to get lower and this week I managed 30g by cutting out bread altogether ,I used to have a sandwich for lunch but now salads with ham egg etc. I have no idea if I have been through or am going through ketosis, I've been on or under 100g for the last couple of months, a month at about 150g before that, I have my 3 month since diag anniversary on Thursday and I've lost 2 stone 10lb and am getting fit, going to the gym all the time, is there a sign that I'm in ketosis and is it a permanent state or do you pass through it, if so how do you know?
Thanks
Andy

 

[Ambersilva]

... From my personal experience: I went through Ketosis. The only feeling I had was tiredness while it was happening for a couple of days, then I felt amazing. I managed to avoid getting insulin tablets because my blood sugar and weight loss in two weeks was such a big change, and the only thing I can credit that to is a low carb diet and going through ketosis. Ketosis saved me from a life of medication and made me feel great. I'm an advocate of it.

Insulin tablets? That's new to me. I didn't know that such things were available!

 

[Sketcher]

There's no such thing as insulin tablets; or, at least, if there were, they would be pointless because insulin cannot survive our stomach acids. That's why we have to inject insulin.


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[hanadr]

Taking the thread off topic,
Of course there are no insulin tablets, because insulin is a protein and would be digested. it's not actually the effect of stomach acids!
However, there ARE many oral blood sugar lowering medications.
Getting back on thread though with ketosis
the article that was reproduced here, clearly says that ketosis shouldn't be confused with the life-threatehing condition "Diabetic Ketoacidosis"
There are some people who believe that ketosis is the normal state of body chemistry and it's only our excessive consumption of carbs, which prevents it. The same theory suggests that glucose is only meant to be a "Quick Burst" fuel and that most of the time we SHOULD run on KETONES.
Certainly we do fine on ketones after a shot period of adaptation away from glucose as fuel.
In general, presence of ketones associated with low blood glucose and no symptoms of illness is not a harmful state and there is no need to fear it.
Hana

 

[Sid Bonkers]

Well there you have it all sides of the argumant in a couple of posts.

The medical profession frowns on ketosis and diets that produce it, many diet gurus, cranks and quacks say it is fine and dandy and is the way we are designed to run which is absolute rubbish, tosh and nonsense.

Other more sensible people claim it is OK and there is certainly evidence that in the short term at least it seems to be harmless but its weight reduction properties do seem to stop being effective after 6 to 12 months and most low carbers weight loss stalls around this sort of time period or they simply give up which you will see if you read forums like this one for any length of time. There are a few who manage to maintain a low carb life style and seem to prosper on it, lose weight and maintain their weight loss, but they are few and far between.

There have been no long term studies on low carb diets and most short term studies that have been undertaken mainly state that more studies need to be done regardless of their findings. The last one that I reported here last week was completed I think at the end of last year made findings that suggests that they may be dangerous to health in the long term but again called for more research.

So you read all the evidence you can which mainly says that ketosis diets should be avoided or used only for short periods or you read all the internet talk and listen to some low carbers who will tell you that they are safe and all the research that says other wise is flawed and wont hear a word said against low carb diets regardless of who carries out the research which seems a very blinked view to me. And you make up your own mind

Personally I wouldnt like to say one way or the other so I tend not to low carb although I did for around 12 months when I was first diagnosed. I certainly wouldnt want to low carb for the rest of my life but you might, the choice is yours, but dont be swayed by hearsay, personal anecdotes and garbage written by daft diet gurus and quacks of which there are many.

 

[Yorksman]

Hi forgive me if this is dumb, I am following a 30-40g carbs a day diet, I thought ketosis was a good thing but reading this article it doesn't sound all that good, have I got the wrong end of the stick?

Mrs Yorks and I tried a zero carb diet around 1980. It was not very pleasant and certainly not a lifestyle choice and some carbs are necessary. The question of how low can you go and still be OK is probably answered by genetics. Inuit for example, famously exist on very high quantities of meat, fat and fish, there simply are not many carbs around but the Norse settlers in Greenland could not exist on an Inuit diet and farmed crops and cattle. When the climate changed from the medieval warm period to the Little Ice Age, they couldn't grow crops, couldn't grow fodder for their cattle and were starved out of existence despite the fact that their neighbours, the Inuit, weren't suffereing and despite the fact that the Norse were excellent sea farers and hunters. But they couldn't adapt.

A prediction for an experiment with a european eating an inuit diet is that scurvy should result, because there is no vitamin C. However in such an experiment, the icelander Vilhjalmur Stefansson did not suffer from scurvy one year after starting but, he ate a true inuit, not a part inuit, diet, including raw brain and raw liver as well as other offal. Raw liver is high in vitamin C. Prolonged exposure to this diet however lowers the platelet count and internal haemoraging becomes an increased risk.

All the diets that one reads about assume that, genetically, all humans are the same, yet there are alcohol tolerant and alcohol intolerant populations, the same with lactose tolerance/intolerance and even those who produce the lactase enzyme in adulthood, there are different genes involved in different populations. There is no one diet fits all. That's how selective evolutionary advantage works.

In the Vinland Sagas the Norse settlers traded some milk with the Skraelings, their term for the native americans, in return for furs. The Skraelings dranks the milk but fell ill, because they were lactose intolerant, thought the Norse had poisonned them and attacked them. The Norse didn't know why these people, with whom they had just traded, turned against them and assumed that they were now trying to take back by force their furs. Hostilities resulted. And all because of one carbohydrate called lactose.

 

[Andy12345]

Thanks very much for the replies.....so if I planned to be low carb for say 6 months or until I reach my ideal weight, then modify things a little and become moderate carb with portion control to maintain the weight and (please god) keep bg to an acceptable level, I keep both camps happy and can't be doing wrong?

 

[Patch]

so if I planned to be low carb for say 6 months or until I reach my ideal weight, then modify things a little and become moderate carb with portion control to maintain the weight and (please god) keep bg to an acceptable level, I keep both camps happy and can't be doing wrong?

You only have to keep YOU happy.

I simply CANNOT believe that ketosis is bad. I know from personal experience, that ketosis is simply AWESOME.

My brain works better, I feel more healthy, more motivated - life is just better in ketosis.

You have to find your own personal level for carbohydrate consumption. That may be 200g, or it might be 20g. There's only one way to find out.

 

[Yorksman]

Thanks very much for the replies.....so if I planned to be low carb for say 6 months or until I reach my ideal weight, then modify things a little and become moderate carb with portion control to maintain the weight and (please god) keep bg to an acceptable level, I keep both camps happy and can't be doing wrong?

You have to find out what works for you. People are different. They cluster together in genetic groups but clusters can be quite different. For example, this is a map of european populations which looks at a specific batch of 600,000 genes. As you can see, although there are overlaps between populations there is a considerable variation between them. In fact, europe has a very high genetic diversity.

If we look at the UK, we see the genetic variation within the British Isles. Again, this is autosomal dna and this is a sample of 500,000 genes. The donors involved all had to live within 20 miles of where all four grandparents were born, so it excludes recent immigration. You can see the considerable autosomal genetic variation within the UK:

Look at just one gene, 13910 C/T which is a specific gene which controls our ability to digest one carbohydrate, lactose. To digest lactose, you need to be producing an enzyme called lactase. We all produce it as children but it gets switched off in our teens. However, in northern europe, many have a genetic mutation which allows the digestive enzyme to continue to be produced. 13910 C means production is switched off, 13910 T means production is switched on. This map shows how the C version, ie where production is switched off varies and is higher in the south than it is on the north:

Just because we live in the same country doesn't mean to say we are all genetically adapted to be able to eat the same foods. Broadly we can but, some things work for one person, but not another.

 

[Andy12345]

Thanks very interesting, the problem is as far as I can see with doing what works for me is I could for example stay on low carb forever and be doing damage I'm unaware of.....or not, I at the moment feel as though I prolly could stick with it forever it just gets easier as more time passes, but I don't want to do bad for trying to do the right thing, I suppose I will just see what happens and cross the bridges as I come to them, learning all the time though so its all good thanks again

 

[Yorksman]

I at the moment feel as though I prolly could stick with it forever

I'm not sure that would be possible because at some point you lose enough body fat and then where do you get your energy from? You'd have to eat fat or carbs. If you didn't, you'd start to starve or at least start with some eating disorders. When you've lost enough weight, you'll probably start to increase your carbs somewhat or start on an alternative type of diet such as a mediterranean diet. Most likely you'll settle into something beforehand. I had a 'fish week' and I got my consistently lowest BG readings during this time. I'm going to have another go but, to avoid the expense of wild smoked salmon and Arbroath Smokies, I'm going to try tins of fish, sardines, pilchards, mackerel, herring, tuna, salmon and try things like olives, cheeses, some brown rice and wholegrain pasta and some rye bread, and also big salads. I suspect I'll get another week of very low readings.

I'm certainly starting to think along the lines that, when I am at my target weight, I'll have two fish days per week and one vegetable curry day, gram beans, pulses, that sort of thing. I'll be having carbs in porridge for breakfast or toasted rye bread with eggs and bacon. Whilst watching the type of carbs is important, not eating too many carbs is too, I have a feeling that I must avoid eating too much red or processed meat or fats from them. I'll have to limit those and think more in terms of chicken for meats.

 

[Andy12345]

but i have read so much of people being on 20g of carbs a day for 15 years etc... you are saying it has to be temporary?..... that's ok I like the way your thinking although I don't like fish I can plan other ways of carefully upping the carbs....but its only been like 2 and a half months so for now im going to carry on with the weight loss, its about a stone a month at the moment, in another stone I will want to stop losing it, can a moderate carb intake say 100g a day be sustainable indefinitely, I would like to be able to eat a slice or bread occasionally with scrambled eggs for example

 

[Yorksman]

but i have read so much of people being on 20g of carbs a day for 15 years etc... you are saying it has to be temporary?.....

No but when you have achieved your weight loss you are going to have to supplement your low carb diet with something and people on such diets usually start eating more fats, the typically high-fat, low-carbohydrate, adequate-protein diet. You are probably better off eating more vegetable fats on this or the softer animals fats.

Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies; Fung et al 2010:
"A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates."

Low-carbohydrate diet scores and risk of type 2 diabetes in men; de Koning et al 2011:
"A score representing a low-carbohydrate diet high in animal protein and fat was positively associated with the risk of T2D in men. Low-carbohydrate diets should obtain protein and fat from foods other than red and processed meat."

It's one thing saying that Inuit go out and hunt wild seal and eat their livers raw but you are probably going to go out and buy a commerically reared pig and eat belly pork. It's a completely different food and you have a different genetic make up to the Inuit. You'd be wise to vary the diet and if you want to stick to high fats, have fish oils and things like olive oil in the diet. Even chicken fat is better, although it does rather depend on how the chicken was reared. Anyway, you probably won't get cardio vascular disease but you may get some strain of super flu.

The ketogenic diets have been used as part of epilepsy therapy but there have been studies which suggest the possibility of adverse effects in children:

Sudden cardiac death in association with the ketogenic diet; Bank et al 2008:
"In case 1, the child who died of complications related to torsade de pointes, with documented QT prolongation; post mortem examination revealed selenium-deficiency cardiomyopathy. In case 2, a child experienced QT prolongation while on the ketogenic diet and later died suddenly at home. Both children exhibited selenium deficiency. These two cases suggest that patients on the ketogenic diet require monitoring of the QT interval by electrocardiography, myocardial function by echocardiography, and selenium levels before and during the ketogenic diet."

Selenium deficiency associated with cardiomyopathy: a complication of the ketogenic diet; Bergqvist et al 2003:
"The nutrient adequacy of the currently used KD has not been fully evaluated. The nutrient content of KD with usual supplements may not meet Recommended Dietary Allowances (RDA) for selenium and may not provide other trace minerals in adequate amounts. At our center, selenium deficiency was found in 20% of the patients evaluated. Screening for selenium deficiency is suggested if the patient KD regimen does not meet > or =75% of the RDA or if the child is symptomatic. Nutrient supplementation should provide adequate trace elements for children treated with the KD. The KD requires close monitoring of the overall nutritional status."

Now, these are to do with children and the importance of certain trace elements, because the children are growing. It doesn't follow that the same is true for adults.

If you want to persue a low carb diet after you have achieved your weight loss, read this paper which contains some experimental diets:

Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets, Johnston et al
"KLC and NLC diets were equally effective in reducing body weight and insulin resistance, but the KLC diet was associated with several adverse metabolic and emotional effects. The use of ketogenic diets for weight loss is not warranted."
http://ajcn.nutrition.org/content/83/5/1055.full.pdf

 

[Andy12345]

thankyou yorksman, I really appreciate everything you have said, I understand about half of it, theres a reason I left school at 14 and no one cared lol, im much better with sentences containing 20 words or less I did try to read the article but my brain started dripping out of my left ear, ok I think at the moment im thinking the sensible approach sounds like very low carb to get to the ideal weight then re introduce a little more carb to a level of definatly not being in ketosis then I get the best of both worlds (I hope) unless I completed got the wrong end of the stick, I will now stop telling my wife her and the kids should low carb, in fact I tell everyone to do it, but it seems it isn't quite as clean cut as I thought, but it is working unbelievably well for me I have to continue on it for now

 

[Yorksman]

Ahh, if you're thinking of the wife and kids, then moving onto brown rice and whole grains, wholegrain pasta and stuff like that, fresh fruit and veg and meats with softer fats like chicken that and fats in things like cheeses etc would be one route. Another would be the so called Mediterranean diet or yuo can just keep things varied and do more as a family.

I'd go foraging for shellfish but I'd probably end up with a dicky oyster and poison myself, or forage for mushrooms and get an iffy toadstool. Life's a bit of a gamble

 

[Sketcher]

I'm on LCHF, not to lose weight (DSN told me not to lose any more weight), but to keep my BG levels in the normal range. Every time my progressively lower-carb diet achieved an improvement, the doctor reduced my dose of Gliclazide; so I had to go even lower-carb to maintain it; now I'm off medication and can only keep good BG levels by staying below 50g carbs per day. If I wanted to eat more carbs (which I don't particularly) I would have to ask to go back on meds. So I'm staying put for the moment, and making sure that my diet includes lots of fibre and salad stuff; I have lots of oily fish, avocado, nuts, cheese and so on, but probably also too much red meat.....can't be perfect.....


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[Claire87]

There's no such thing as insulin tablets; or, at least, if there were, they would be pointless because insulin cannot survive our stomach acids. That's why we have to inject insulin.


Sent from the Diabetes Forum App

Third week of being diabetic, sorry I'm not an expert in insulin yet. Well, actually, no I'm not. I don't plan to ever have it. I plan to reverse the diabetes if I can. The doctor tore up a prescription for something they were going to give me for my blood sugar because of my diet working. So whatever it was, I avoided it via a low carb diet.