Get Low, Get Low, Get Low

Hey, guys! Before I get down to business, I’d like to give you a little insight into how much this post has grown and evolved since the idea first sparked in my brain. Here’s a little history: A while back, I started listening to some Jimmy Moore podcasts – he’s a pretty radd dude in the low-carb/Paleo “scene”, so be sure to check him out if you haven’t already. Jimmy has been doing a little experiment with “nutritional ketosis”, which sounded kind of familiar… I was pretty sure Mark Sisson had said something about that in The Primal Blueprint. Right?

The more I listened, the more curious I got about this idea. I heard wildly differing opinions: it’s great, it’s shit, it’s only great if XYZ… All I knew was that Jimmy was reportedly getting fabulous results, in terms of weight loss and health markers, but it sounded a bit too cuckoo and difficult for me. Still, my inner nerd wouldn’t rest until I learned a bit more about it.

Simultaneously, on a different train of thought, I was getting pretty curious about trialling a sugar-free lifestyle. When I eventually decided to take the plunge with my program (I’m just about finished!), I decided to also start tracking my macronutrient ratios (how much carbohydrate, fat and protein I was eating). And that’s where things got interesting. It would seem, from the self-observation data I’ve collected, that this whole “nutritional ketosis” thing is a lot closer to home than I thought. This lit a fire under me, and I started digging.

Photo Credit: independentaustralia.net

Photo Credit: independentaustralia.net

And I dug up a lot.

So, all of those factors conspired to bring you the post you’re currently reading. (And, I’d wager, a few more to come.) See, when I got the idea to decode “nutritional ketosis” for you all, I didn’t realise how big a topic I was actually taking on. I’m also mindful of the fact that many of you aren’t anywhere near as nerdy as I am, nor as familiar with the scary hairy world of nutrition, so I can’t just blather on without taking a moment to explain, and letting those explanations marinate.

In the immortal words of the lovely Julie Andrews, then, let’s start at the very beginning. I’m going to explain what “low carb” actually means, how it relates to ketosis, and give you a bit of background. In future posts, I’ll be delving a bit deeper into how it all works and how it all relates to where I’m at, but I think this will do us for now. Onwards!

What Does “Low Carb” Really Mean?

I’m fairly certain that, even if you’re completely uninitiated in the world of nutrition, you’ve heard of “low carb” diets before. You might have heard of Atkins. You might have seen someone pass on the bread at dinner because they’re “cutting carbs”. There are as many low-carbohydrate approaches as there are low-fat approaches (and almost all of them posit that all the others are completely wrong).

Essentially, low carbohydrate diets restrict or minimise sources of carbohydrate in the diet, and include proportionately more of the other macronutrients (protein and fat). If we’re looking at this in relation to ketosis, we’re focusing on “LCHF” = low carb, high fat.

f1assistance.comSee? Really not as complicated as it sounds. Eat fewer carbs, eat more fat to compensate. Ta da!

The basics: eat meat, fish, eggs, dairy, oils, and vegetables that grew above the ground. Avoid sugar, starch (including grains), fruit and alcohol. Eat until you are satisfied – this is not an exercise in withstanding hunger, but rather in being selective about where you get your fuel.

This approach is believed to stabilise blood sugar (because it is carbohydrate that pumps up your blood glucose after eating), which leads to decreased insulin production, which leads to less fat storage (insulin being the “storage hormone”), and so forth.

If you want to get more technical, as per LCHF theory, excess consumption of carbohydrate means that your glycogen (sugar) stores in the body are chronically over-filled. Your body has to handle that somehow, so the extra carbs are converted into fat in the liver (a process called “de novo lipogenesis”). When this occurs, fat utilisation is blocked, and any dietary fat that is consumed is stored straight away. So, eating too much carbohydrate, and not using enough of it through movement, stops your body being able to burn fat.

Adherents to a LCHF lifestyle also claim that it improves blood pressure, cholesterol profile, stomach ailments, mood and mental health… the less carbohydrates consumed, the more pronounced the effect. There have been several studies demonstrating that low-carb diets are the most effective for weight loss; of course, we could argue about the methodological strengths and weaknesses of such studies for days, but I’d really rather not (just thought they were worth mentioning).

Photo Credit: bsig.co

Photo Credit: bsig.co

Anyway, the adherents I mentioned – of which there are many – have formed a worldwide community, with its own offshoots and branches and sub-sections. And in an ever-expanding subsection, there is an almost Paleo-esque emphasis on food quality, as well as macronutrient breakdown. It’s not just carbs and fats, it’s where you get them from that matters – for instance, seed oils and margarine are being eschewed in favour of fats like butter, olive oil, and coconut oil. Obviously, I’m not going to argue with that! The lack of attention to food quality has always been my biggest concern about any “low carb” approach. “Low carb energy bars”, with their palm oil and sugar alcohols and what not, are out – healthy, fresh, real food is in. Yay! Indeed, there are quite a few parallels between these communities, and a lot of crossover between them – Jimmy Moore, who I mentioned at the start of this post, being a prime example.

So, that’s LCHF in a nutshell. Note that this isn’t the type of low-carbohydrate diet you’d typically see touted in a fitness magazine, or whatever – those sources often emphasise what is more of a moderate-carb/high-protein approach, but they label it “low carb” just the same (technically, it does involve decreasing carbohydrate a little below the “standard” intake, but not to the extent of LCHF). To be honest, it really kind of gets my goat when people bandy about terms like “low carb”, without actually understanding what they’re talking about or what that means. That “low carb bread” you’re eating? It might be lower in carbohydrates than WonderWhite, but you’re kind of missing the point. (Swedish advocate of LCHF, Dr Andreas Eenfeldt, refers to these foods as “low carb fairytales”, which I think is absolute gold!)

Anyway, acknowledgement and awareness of LCHF is spreading. Which brings us to…

What’s This “Ketosis” Thing?

Right, so: nutritional ketosis is a type of metabolism, a way your body breaks down and utilises energy. Specifically, your body will preferentially use fat, and a group of compounds that we refer to as “ketones”, for energy – instead of carbohydrates/sugar/glucose.

A “ketogenic” diet is one that causes these ketones to be generated by your liver, which sifts your body’s metabolism away from using glucose and towards using ketones + fat. Ultimately, the production of ketones is determined by your carbohydrate intake, because it is carbohydrate intake that determines whether your body uses sugar or fat for fuel. So, to induce ketosis, you have to go to the pretty extreme end of a LCHF diet.

With me so far?

The History of Ketosis and Ketogenic Diets

Photo Credit: thedaisygarland.org.uk

Photo Credit: thedaisygarland.org.uk

Ketogenic diets, used to induce ketosis, have been a long-established treatment for epilepsy. It would seem that they increase the ATP/ADP ratio in the brain (in English: they make more energy available for the brain to use, helping it run more efficiently). Ketogenic diets have been prescribed for treatment of childhood epilepsy as far back as the Middle Ages, in various forms, but they fell out of favour with the discovery of new epileptic drugs in the 20th century. They were “rediscovered” in the 90s, and used for difficult-to-treat cases. They are now also being investigated as a possible treatment for Alzheimer’s, and several types of cancer… but most people use ketogenic diets in an effort to lose body fat, while maintaining lean body mass (i.e., bone and muscle).

Ketogenic diets have been used this way for at least a century. Indeed, they became very popular – albeit under a different name – with the popularisation of the “Atkins diet” in the 70s (hello, low carb!). Of course, it fell out of favour when Atkins was criticised harshly by the AMA – and, admittedly, Atkins’ early work wasn’t all that great – but we are now witnessing quite the resurgence.

Nonetheless, ketogenic diets (indeed, any LCHF approach) remain quite on-the-outer when it come to nutritional recommendations, and there are a variety of reasons for that. One of my favourite soap boxes to jump on relates to the economic interests in our continued intake of dense sources of carbohydrates (grains, legumes, sugar), and how these interests have influenced the production of our “official” dietary guidelines. When you look at it from that perspective, a ketogenic diet is quite subversive, a big “eff you!” to Big Agriculture. But that’s not really the point here. The point is this: ketogenic diets are very popular in some circles, but remain much maligned by mainstream nutritionists and authorities. So, if you decide to go down this road, you’ll likely face a bit of resistance on more than one front.

ketosis-kills

So, What Are These “Keto” Folks Eating?

The specific macronutrient breakdown differs for everyone. However, to induce a state of nutritional ketosis – where your body burns fat and ketones for energy, instead of sugar – the bulk of your calories (roughly 65%) should come from fat, a moderate amount (roughly 30%) from protein, and a minimal amount (roughly 5%) from carbohydrates. This is trickier than it sounds. Of course, this breakdown varies greatly depending on your muscle mass, activity level, genetics, etc. As a general rule, though, any diet with a carbohydrate >100g per day cannot be ketogenic.

(Quick cheat sheet: if you’re getting a bit lost in all of this fat/protein/carbohydrate talk, just try to remember that if it grows in the ground it’s a carb, but if it’s from an animal it’s protein + fat. Obviously, this isn’t 100% accurate all of the time, but it’s a good heuristic to remember, just the same.)

To induce a state of nutritional ketosis, you will likely be eating predominantly animal products, oils, and low-carbohydrate vegetables (usually ones that grow above the ground). Fibre doesn’t really “count” as a carb in this situation, either – fibre is mostly cellulose, a type of sugar/carbohydrate that our bodies can’t metabolise (use for energy), so it can’t raise your blood sugar, and consequently won’t affect ketosis. Veggies like spinach, lettuce and broccoli, all quite high in fibre, won’t throw out your macronutrient balance if you’re aiming to induce ketosis.

Photo Credit: tumblr.com

Photo Credit: tumblr.com

The Take-Home Message

“LCHF” is a dietary movement that has been around for a while, but is experiencing a recent resurgence in popularity. It involves eating proportionately less carbohydrate, and proportionately more fat. Many who take this approach go down the route of a “ketogenic diet” (“keto” for short), reducing their carbohydrate intake to such an extent that their body no longer relies on them as a primary fuel source, and instead burns fat and ketone bodies (produced by the liver) for energy. This can be achieved by consuming primarily meat, fish, dairy, eggs, oils, and low-carbohydrate/high-fibre vegetables. Such an approach is often harshly criticised by mainstream nutrition authorities, but is reported to have amazing health benefits, according to its adherents.

I’ll leave it there for now, but I’ve just barely scratched the surface of the world of ketosis – there’s a lot of ground to cover! I’ll be delving a little deeper in future posts, so feel free to get in touch if you have any specific questions or concerns!

Have you ever heard of a ketogenic diet? Have you ever tried it? What do you think – good idea, or bad?

14 thoughts on “Get Low, Get Low, Get Low

      • It says duplicate comment when I try to post something, but it isn’t showing my post and it says nothing about my comment awaiting moderation. It had a few links..is it possible it got auto deleted?

        • Hi Jonathan – it would seem that your post did get “auto deleted” I’m afraid, as WordPress flagged it as spam. I’ve gone back and unchecked it.

          You make some interesting points – I’m really only familiar with the HPA axis from the psychology side of things. Thank you so much for your input!!

  1. I chose LCHF after being diagnosed with T2 diabetes and lost weight (necessary) and got my blood glucose down into the normal, non-diabetic range fairly quickly. Then my weight loss plateaued (as it does) and I followed Jimmy Moore into nutritional ketosis in June last year. I’ve now lost 24kg, stopped taking blood pressure medication, and have more energy than I’ve had for 30 years! I love what I eat and expect to continue happily eating this way for the rest of my life.

    • Holy moly, Ann, that’s such an incredible story!! Truly impressive, congratulations :) It’d be great to get your feedback on the rest of my little “decoding ketosis” series, seeing as you’re a seasoned pro – I’m still not 100% sure where I’ve got it right, where I’ve missed the mark, etc.

  2. Oh, how I want this to work for me. It sounds like it should work like ten bears.

    I am so strict with my diet, and just can’t get above .4 for ketones or get my fasting blood sugars down below the 106-115 range. I have gained SO much weight over the past 5 years–doing low carb all the while–and I just don’t know what’s wrong with me. I’ve got my protein down to 45-60 grams per day, my carbs to 15 grams per day, and even my calories are down to @1100 per day (otherwise I gain weight). So I’m up around 75 – 80% fat. I lift weights, I walk…I still can’t lose a pound. Can someone offer any advise? I must be doing something wrong.

    • Hi BD – I’m SO sorry to hear you’ve had such a rough time of it! This post didn’t really get down to the nitty gritty, but I’ll be detailing how ketosis can go wrong and why it doesn’t always work how we intend in future posts. Being that I’m an amateur, I wouldn’t want to “diagnose” your difficulties.

      However, in my amateur opinion, it would seem that your calories are VERY low (particularly if you’re lifting and working out), and the protein you’re eating may not be enough to support your activity.

      Personally, my instinct would be to take a bit of a “break” from low carb/ketosis – yes, this will probably mean gaining a few pounds and feeling a bit ick for a little while – but you may need to explore some other options, with the help of a medical professional. You’ve been at this for five years, you’re doing all the “right” things (it’s instinctual to blame ourselves and think we’re “doing it wrong”, but I honestly don’t think you are) – and it isn’t working. That’s okay, not everything works for everyone (even Jimmy Moore is very clear on that point). There are many people who have tried ketosis, and it simply hasn’t worked for them, for a variety of reasons – that’s okay! If you try other approaches and they don’t work, then you can always come back to keto. For now, though, it sounds as though you’ve been in quite deep ketosis for quite some time, and your body isn’t handling that well – remember, ketosis essentially mimics a starvation response (so your body could believe you’ve actually been FASTING for five years!). Does any of this resonate for you??

    • Another amateur here…not diagnosing but just sharing what worked for me….

      I too could not lose weight (former borderline anorectic here with decades of yo-yo dieting and way too many years of SAD eating). The rather-magic bullet for me was starting to take Metformin for my blood glucose. I wasn’t technically in the diabetic ranges, but convinced my doc to prescribe it for me because my fasting blood glucose was always in the low 100s no matter how low carb I ate (it was much worse when I ate carbs). I had been doing LC for over 6 months with no weight loss. I was lifting weights, biking, walking, etc. with no impact on my weight loss.

      Metformin made the difference and I SLOWLY started to lose some weight. I started doing a ketogenic diet 6 months after starting Metformin and, while my weight loss didn’t speed up any, it continued to be steady. Since January of 2012 (about 14 months now), I’ve lost 90 lbs. I still take metformin because if I don’t my blood glucose goes back up. I think I was severely insulin resitant and the metformin helped with that.

      The other thing I did in January of 2012 was to get really strict and cut out ALL grains–completely. And no prepared foods of any kind. Cutting the grains helped too, at least it eliminated my cravings (although I missed my low-carb wraps!).

      • Wow, that’s incredible! Excellent work! What I’m taking from your experiences is this: it’s very important to become an expert in your own body, observe everything and find what works. Work collaboratively with a practitioner, and never give up – sometimes it just takes a little more time and a few extra tweaks. Would that be about right?? :) Congrats again, I’m so happy for you!!

    • Perhaps something with the HPA axis? Having a well functioning Hypothalamic Pituitary Axis is important for a good metabolism.

      http://www.stopthethyroidmadness.com/

      http://www.stopthethyroidmadness.com/temperature/

      Depending on your finances you might be interested in some good books on the subject. Iodine by David Brownstein is great. Iodine is necessary for the HPA. The Iodine Crisis is cheaper and has much of the same information, but is a bit less complicated of a read.

      Stop the Thyroid Madness the book is also a very good read and the information overlaps some of the stuff from the other two books, but is a great read if you don’t mind reading books.

      STTM website is a great free resource as is

      http://tinyurl.com/iodine-references

      Another possible problem might be inflammation caused by animal fats. I haven’t read that much about it, but Dr. Steven Gundry mentions that some people may have inflammation caused by animal fats. Its only around 20% but it may be a possibility.

      http://www.askthelowcarbexperts.com/2013/01/35-dr-steven-gundry-high-fat-diets-good-vs-bad/

      An ApoE gene type test with a result of 3/4 or 4/4 would indicate you are in this 20%.

      http://jackkruse.com/brain-gut-6-epi-paleo-rx/

      I really like this eating plan and you might want to try this, but include more fish and seafood and less animal fat if you either do the ApoE test and get a 3/4 or 4/4 result or you could just try it as a trial without doing the test to see if it seems to make a difference.

      I’ve heard of inflammatory responses keeping people from losing weight so perhaps that could be part of it. If your body doesn’t like animal fat or some other kinds of foods that you are eating it could be contributing to the problem.

      Good luck

  3. Pingback: Mmmm, But She Blinded Me With Science | choosingtoeat

  4. Wow, thanks everyone. There are some great ideas here. I appreciate all of your thoughts very much, and it seems like great minds think alike, as you’ll see below.

    I’m already on metformin, but it’s not doing much anymore (it seemed to for a little while, but no so much now). I also just had a break from NK over the past few months, actually, and thought I’d try it again. I kept lowering my calories and protein to see if I could get it to work, but no go. I’ve backed off on the exercise because the calorie and protein level just aren’t supporting it. But anything over 1200 calories seems to cause weight gain. A mad cycle. It’s so damn frustrating…like my body is somehow breaking the laws of physics and biology and I can’t see to stop it. I also tried eating fresh salmon and oysters for 3 weeks to see if that helped (another great suggestion) but it didn’t make any difference.

    I suspect it’s the insulin flooding my system, trying to get my fasting blood sugars down. They’re not horrible, but it seems like something is in the way, and it may be insulin. Or it may be that my normal looking thyroid numbers are disguises a bigger problem, yes. I have dry eyes, nose and throat, too, so maybe there’s something to that.

    I guess it’s back to the doctor yet again for more tests. Thank you all so much for your thoughts and well wishes! I will continue on.

    • Not saying you are wrong..because I just don’t know enough to say that, but when you say you ate Salmon and Oysters for 3 weeks and it didn’t help what exactly does that mean?

      Do you mean you didn’t feel better or were there blood tests that showed that nothing improved? What kind of doctor do you have? You might want to try to search for one on the Paleo Physicians Network. After I started eating better many of my numbers improved, but I didn’t feel all that much better. My best bet is its likely going to take time for things to heal.

      http://www.stopthethyroidmadness.com/temperature/

      Have you tried these temperature tests? It should give you an idea of if your Thyroid/Adrenal systems are working properly.

      If your Thyroid/Adrenals show to be messed up a doctor that is Iodine literate might be a good start.

      http://www.stopthethyroidmadness.com/how-to-find-a-good-doc/

      This has tips on finding a good doc. Iodine Friendly doctors

      http://breastcancerchoices.org/ipractitioners.html

      http://www.stopthethyroidmadness.com/recommended-labwork/

      This list of labs with a good doctor to help you interpret them should help you figure this out. Its not a comprehensive list of everything possible, but it might be a good idea if your Thyroid/Adrenals don’t come up right with the temperature test.

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