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New study. Keto v low carb v low cal

Discussion in 'Low-carb Diet Forum' started by HSSS, Sep 11, 2020.

  1. HSSS

    HSSS Type 2 · Well-Known Member

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    https://sciforschenonline.org/journals/endocrinology/IJEMD158.php


    Conclusions: 6 × 6 was more effective than LCD or ERD in overweight or obese patients with type 2 diabetes regarding weight loss, remission of type 2 diabetes, HbA1c-levels, and the reduction of diabetes medication.


    6x6 seems to be keto with high protein rather than high fat staged diet.
     
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  2. MrsA2

    MrsA2 Type 2 · Well-Known Member

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    The authors designed and developed the trade marked 6x6 dieet, but still interesting reading and ideas.
    They didnt go into details on how to achieve the strict 6g of carbs 6 times a day. I assume one has to pay to find that out
     
  3. pdmjoker

    pdmjoker Prediabetes · Well-Known Member

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    It says:
    Design: A retrospective three-arm study in dietitian practices to reduce weight; HBA1C; and use of medication in overweight/obese adults with type 2 diabetes on 6 × 6 (VLCKD); a 50-100 grams/day LCD; an energy restricted diabetes diet at 3, 6 and 12 months.​

    I guess VLCKD is Very Low Carb Keto Diet, and I don't think it's surprising how effective it was.

    Would 36g carbs be Keto? Not for everyone, I guess. However, it says:

    There is one restriction. Studies have revealed that humans need 36 grams of carbohydrate as a minimum level of intake in order to avoid a shortage of glucose in the brain. The carbohydrate need of the brain and the erythrocytes is estimated on 36 grams per day average [11], but there are considerable interpersonal differences [9]. The 6 × 6 dieet® is a VLCKD with 36 grams of carbohydrates per day administered in a strict scheme, meaning that the patient eats 6 times per day 6 grams of carbohydrates, preventing insulin release by the pancreas [10,17].​

    [My emphasis]. Does Gluconeogenesis not work for everyone then? Puzzled....
     
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  4. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    The brain requires glucose only for people who have not become fully fat adapted. The studies referred to were probably done on people were not fat adapted. So a bit like comparing apples with oranges. The 6x6 diet starts with 36 grams of carbs a day, which is low. But it reintroduces carb later on, pulling people out of ketosis and losing key benefits. For the full benefits to be achieved and maintained, ketogenic eating, staying in ketosis and remaining fat adapted is the way to go. Short term studies are not a good indicator IMO.
     
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  5. pdmjoker

    pdmjoker Prediabetes · Well-Known Member

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    Thank you for the explanation - that does make sense.

    I gather you are also saying that genuine ketogenic eating has many benefits (I agree!) but here it has been negatively modified and the weaker, modified version has been branded the "6 x 6 Dieet®" (for commercial reasons). How innovative! :banghead:
     
  6. Roggg

    Roggg · Well-Known Member

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    More confirmation that keto outperforms moderately low carb and ERD. This is not surprising. No attempt to compare their version of keto to anyone else's. Maybe I'm a curmudgeon, but this seems like marketing more than science.
     
  7. pdmjoker

    pdmjoker Prediabetes · Well-Known Member

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    I fully agree!
     
  8. lucylocket61

    lucylocket61 Type 2 · Well-Known Member

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    so someone like me, who doesnt do keto, needs some carbs for my brain to work?
     
  9. pdmjoker

    pdmjoker Prediabetes · Well-Known Member

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    What do you eat? I gather if you don't eat carbs (or not many ie Keto) then your body will become "fat adapted" and will produce whatever glucose your brain and red blood cells require... I don't know if anyone needs to eat carbs, but various agencies like to say the brain needs glucose and glucose comes from carbs (inaccurately implying carbs are needed).
     
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  10. lucylocket61

    lucylocket61 Type 2 · Well-Known Member

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    As I said, I don't eat keto. I am not fat adapted, so do I need to eat carbs to feed my brain?
     
  11. bulkbiker

    bulkbiker Type 2 · Oracle

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    Well not really.... that's what gluconeogenesis is for.. but you have zero need to eat the carbs just enough fat and protein.
     
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  12. lucylocket61

    lucylocket61 Type 2 · Well-Known Member

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    As you know, I have complex health issues and keto is not possible for me.

    However, it was stated upthread that carbs are necessary for adequate brain function if one is not keto.

    I want to know the science backing that up. So far, the person I originally asked the question, has not replied with the answer.
     
  13. bulkbiker

    bulkbiker Type 2 · Oracle

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    Screenshot 2020-04-28 at 09.00.15.png
     
  14. pdmjoker

    pdmjoker Prediabetes · Well-Known Member

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    Sorry, I thought I had answered: IF you eat very few carbs (Keto or carnivore), then your body will make what glucose you need.
    IF you eat more carbs (not Keto), then you are eating adequate carbs and your body will get the glucose it needs from those carbs.
    Does that make more sense?
     
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  15. lucylocket61

    lucylocket61 Type 2 · Well-Known Member

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    Thanks.
     
  16. Mrs T 123

    Mrs T 123 Type 2 (in remission!) · Well-Known Member

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    How would I know if I was fully fat or fat adapted or not?
     
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    #16 Mrs T 123, Sep 13, 2020 at 8:32 PM
    Last edited: Sep 13, 2020
  17. Roggg

    Roggg · Well-Known Member

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    I would say it's a moot question. You dont eat keto so you do eat carbs. If you stopped eating carbs you would possibly get mentally foggy while you adapted, but then you would be keto.
     
  18. Robbity

    Robbity Type 2 · Expert

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    @lucylocket61

    It's not carbs, but glucose that some parts of our brain need for essential fuel, and in the absence of carbs our livers will produce sufficient glucose for that requirement.

    And as I understand it the rest of the brain can use either glucose generated from our dietary carbs, or alternatively ketones generated from fats.
     
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  19. Oldvatr

    Oldvatr Type 2 · Expert

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    A perusal of the Krebs (aka Citric Cycle) shows that cells in the body are able to use either glucose or ketones as fuel. We are a true dual fuel machine. Dropping carbs completely from diet will only become a problem if you are unable to create ketones, and to do that you need either carbs(usually) OR protein OR fat since our bodies can turn all of these into useful ketones. What we actually burn in the cells is akin to vinegar (i,e, acetyls).

    The problem with the brain cells is that there is a barrier that allows glucose to filter through, but not much else. Ketones can also pass this barrier, but lipids cannot. So when we say we are fat burning, it is muscles doing that but the brain needs the smaller molecules. Living on zero carbs is difficult to achieve in practice anyway.
     
  20. lucylocket61

    lucylocket61 Type 2 · Well-Known Member

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    my DN (and others) say that I need 130g of dietary carb to achieve sufficient good brain function. If i am not doing keto, are they right that I need 130g a day, hence that being the level considered to be the low carb lowest safe threshold?

    My question is basically - in ketosis people dont need carbs, as they have sufficient glucose to feed my brain. What about those of us not in ketosis? How many carbs do we need for efficient brain function? I dont think this is being addressed. I understand those doing keto can function brain-wise. Is there evidence for those us of on, for example, 60g of carbs a day, not producing ketones, are having enough glucose produced for our brains?

    I hope this question is clear enough. Its difficult for me to explain.
     
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