@lucylocket61 I suspect that if you aren't fat adapted and are still using your brain and body then you are consuming enough carbs.I
From my own personal experience I think that HCPs mainly just don't know or don't want to know about keto.
Some of you might have read my previous post on this.... Sometimes (maybe a year or so) after starting eating a keto diet I had the usual annual review with the DN at my local surgery. She was pleased my Hba1c had gone right down but horrified that I was avoiding carbs and not injecting insulin. She told me keto was so incredibly bad for my brain that I would soon die if I didn't eat carbs because brains need a steady supply of glucose which is only provided by carbs. I asked how long death by keto would take - she thought about it for a moment or two and then decisively said 'three weeks '. I laughed and said i must already be dead then because I've been low carbing for a year.
This told me two things... she hadn't been listening to what I'd been saying and she wasn't up to date on the subject she was supposed to be specialising in.
In the most recent (May 2017) Position Statement “Low-carb diets for people with diabetes” of a diabetes charity, immediately under the heading “The role of carbohydrate in the diet” it says “Most carbohydrates are broken down into glucose which is an essential fuel for the brain” and to give authority to their claim they cite a research paper. Firstly, they have implied that eating carbohydrate is essential, which is not true. Secondly, the research paper doesn't appear to demonstrate that glucose is an essential fuel for the brain, but comprises a discussion of how the brain uses glucose. Also, it begins with the statement “The mammalian brain depends upon glucose as its main source of energy ...”. This claim, which is made twice in the paper without qualification, is only true if glucose is the main source of energy in all circumstances for all types of mammalian brain. Illustrating just one instance where this isn't the case (a counterexample) renders the statement false.
Two human mammal counterexamples: If someone is Keto-adapted, which takes a few weeks after starting a Ketogenic diet, about 75% of their brain uses the ketone β-hydroxybutyrate as fuel, which is why mental clarity improves. Indeed, the remainder of their brain uses glucose, but the liver makes it as required in a process called Gluconeogenesis, so eating carbohydrate isn't essential, but optional. Also, I gather newborn babies being fed only their mother's milk can be sufficiently in ketosis for half their brain to be using β-hydroxybutyrate as fuel. Hence, the mammalian brain doesn't always depend on glucose as its main source of energy.
Oddly, the paper mentions Ketogenic diets and β-hydroxybutyrate, but doesn't see the logical contradiction about brain fuel in the opening line, which is extraordinary. If the paper had said “When on a carbohydrate rich diet the human brain depends upon glucose as its main source of energy” then the qualifications would have made it a correct statement. This logical own-goal might not invalidate everything that follows in the paper, but it doesn't give an impression of credibility and one wonders what other false assumptions have been made. When citing a research paper to support a medical claim in a public document, it is surely good practice if the paper is both credible and demonstrates the claim to be true. Otherwise, the credibility of the message (and even that of the organisation producing the document) becomes questionable.
I also gather the human foetus is in ketosis and many of us seem to get through that with our brains in tact!
