Dietician says 130g carb a day. If not, ketones will damage body? - Page 2

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Dietician says 130g carb a day. If not, ketones will damage body? - Page 2


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Old 03-27-2012, 09:10   #11
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Checks for ketones are in case of ketoacidosis. Ketoacidosis happens when insulin is extremely low and blood sugars are high - i.e., the NEED For insulin is high but its levels are very low. In this condition, ketones can reach dangerous levels and skyrocket out of control. When ketones become too high, they acidify the blod and this is very dangerous and can actually lead to death in pretty short order.

This is absolutely unrelated to a controlled (via diet) situation of restricted carbs and protein where ketones are produced. In this situation, blood sugar is NORMAL and while insulin is low, the need for it is at least as low, so it is not in short supply. More or less the "opposite" of the previous condition. In this case, ketones are only present in absolutely safe levels and CANNOT reach the levels seen in ketoacidosis. Blood PH may change very slightly, but nowhere near dangerous levels of acidity.

IMO, low-carbing short of ketosis is a BAD idea, especially for a diabetic. As T2s, most of us have insulin resistance. That means that our cells are not getting enough energy in spite of abundand (TOO abundant in many cases) glucose circulating in our blood. Glucose is a "rude" nutrient and as long as it is coming in from outside every day, it BLOCKS your cells' ability to get energy from anywhere else. So, reducing carbs without ketosis MAY help lower the excess glucose we measure with our meters but will do nothing for our starving cells - in fact it will probably make things worse.

Only by going into ketosis can your cells learn to use ketones for energy along with gluocose. Ketones are not "rude" like glucose. When your cells are in glucose mode, they are incapable of using ketones, BUT when in ketone-mode (ketosis), cells can use either one.

Amazingly, it seems that many medical professionals don't really understand the huge differences between ketoacidosis and dietary ketosis. Understandable, I guess, since before Atkins and others, dieary ketosis could only be observed among Eskimos and a few other places. Nonetheless, our species lived in this state about a million years (over 99% of our existence as a species) and were pretty clearly getting pregnant and having babies all that time!

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Old 03-27-2012, 09:54   #12
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Originally Posted by smorgan View Post
Checks for ketones are in case of ketoacidosis. Ketoacidosis happens when insulin is extremely low and blood sugars are high - i.e., the NEED For insulin is high but its levels are very low. In this condition, ketones can reach dangerous levels and skyrocket out of control. When ketones become too high, they acidify the blod and this is very dangerous and can actually lead to death in pretty short order.

This is absolutely unrelated to a controlled (via diet) situation of restricted carbs and protein where ketones are produced. In this situation, blood sugar is NORMAL and while insulin is low, the need for it is at least as low, so it is not in short supply. More or less the "opposite" of the previous condition. In this case, ketones are only present in absolutely safe levels and CANNOT reach the levels seen in ketoacidosis. Blood PH may change very slightly, but nowhere near dangerous levels of acidity.

IMO, low-carbing short of ketosis is a BAD idea, especially for a diabetic. As T2s, most of us have insulin resistance. That means that our cells are not getting enough energy in spite of abundand (TOO abundant in many cases) glucose circulating in our blood. Glucose is a "rude" nutrient and as long as it is coming in from outside every day, it BLOCKS your cells' ability to get energy from anywhere else. So, reducing carbs without ketosis MAY help lower the excess glucose we measure with our meters but will do nothing for our starving cells - in fact it will probably make things worse.

Only by going into ketosis can your cells learn to use ketones for energy along with gluocose. Ketones are not "rude" like glucose. When your cells are in glucose mode, they are incapable of using ketones, BUT when in ketone-mode (ketosis), cells can use either one.

Amazingly, it seems that many medical professionals don't really understand the huge differences between ketoacidosis and dietary ketosis. Understandable, I guess, since before Atkins and others, dieary ketosis could only be observed among Eskimos and a few other places. Nonetheless, our species lived in this state about a million years (over 99% of our existence as a species) and were pretty clearly getting pregnant and having babies all that time!
Great explanation! Thanks, Salim.

 
Old 03-27-2012, 10:30   #13
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All good answers above already.

Eric C. Westman, MD, MHS wrote this Letter to the Editors of the American Journal of Clinical Nutrition...

Is dietary carbohydrate essential for human nutrition?
In it he discusses the rationale for the often quoted 150g carbs per day minimum recommendation and also states...
Quote:
The currently established human essential nutrients are water, energy, amino acids (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine), essential fatty acids (linoleic and α-linolenic acids), vitamins (ascorbic acid, vitamin A, vitamin D, vitamin E, vitamin K, thiamine, riboflavin, niacin, vitamin B-6, pantothenic acid, folic acid, biotin, and vitamin B-12), minerals (calcium, phosphorus, magnesium, and iron), trace minerals (zinc, copper, manganese, iodine, selenium, molybdenum, and chromium), electrolytes (sodium, potassium, and chloride), and ultratrace minerals. (Note the absence of specific carbohydrates from this list.)
"Essential" in this context means: we have to eat it as our bodies cannot make it

That is NOT a recommendation for a zero carb diet simply an assertion that we can thrive without eating any.

For example look to the Inuit who were free of Western diseases until they started eating a Western diet.

Consider a calorie-restricted diet or even a starvation diet... humans can and do manage for long periods with very little of any food by mouth -- living off our stored energy (of which very little is carbohydrate).


As for pregnancy: I draw your attention to the beautiful bouncing baby recently born to Dr Andrea Eenfeldt and his partner in Sweden. Andreas is a proponent of LCHF.
Expecting our Paleo Baby...

I also understand that breast-fed infants spend a great deal of their time in ketosis (NOT ketoacidosis). Mother's milk may contain some carbs (lactose) but is is definitely high in fat.

Bottom line is that: in this day and age it makes sense for you to read and make up your own mind rather than simply accept the established view without question -- does it hold up to scrutiny and critical thinking? Good Luck and keep asking questions

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Old 03-27-2012, 15:19   #14
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thanks for all the info. I am currently trying to learn as much as I can. It is difficult in that I am not only trying to decide something for myself, but to potentially go against the advice of all my doctors while in the process of getting ready to try for a baby. If I go against what they suggest, then I am basically on my own completely. My fear is that I could choose a path that could have life altering consequences. Therefore I am trying to find out as much as I can prior as possible.

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Old 03-27-2012, 15:20   #15
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Quote:
Originally Posted by annsrum View Post
the part that concerned me was talk of damage from high ketones. if blood sugars etc are good, but i'm damaging my body with ketones, that would be concerning. i had not read anything about ketones on here. hence the request for explanation.
What you're being told is absolutely INCORRECT - no doubt about it. There simply is no danger from a ketogenic diet.

The ketogenic diet has been used since around 1900 for treatment of diabetes, epilepsy and other issues - it's been shown in study after study to be a safe, effective treatment for these issues.
Vining EPG, Freeman JM, Ballaban-Gil K, et al. A multi-center study of the efficacy of the ketogenic diet. Arch Neurol 1998;55: 1433–7.DOI: 10.1001/archneur.55.11.1433

Freeman JM, Vining EPG, Pillas DJ, et al. The efficacy of the ketogenic diet–1998: a prospective evaluation of intervention in 150 children. Pediatrics 1998;102: 1358–63.DOI: 10.1542/peds.102.6.1358
For more information on the ketogenic diet, you can check out this excellent article in Epilepsia Magazine (Ketogenic diets are much-more-common in epilepsy treatment than diabetes treatment - you'll find most research concerning them is found relating to epilepsy...) here: Worldwide Use of the Ketogenic Diet - Kossoff - 2005 - Epilepsia - Wiley Online Library

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Old 03-27-2012, 15:38   #16
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Quote:
Originally Posted by annsrum View Post
... It is difficult in that I am not only trying to decide something for myself, but to potentially go against the advice of all my doctors ...
Educating your dietitian (or dietician depending on where you're from) may be impossible as most are forced to tow their "party line" in regards to carbohydrate (pretty-much EVERY dietitian/nutritionist governing body is sponsored by big-pharma/big-food business, thus they have a conflict of interest) but educating your DOCTOR may not be unreasonable or impossible.

I did it... I printed out studies on very-low-carbohydrate diet effectiveness in treatment of diabetes as well as studies on the safety of ketogenic diets. When I explained my dietary position I offered these studies up as why this diet would be both effective and safe.

The thing is - there really aren't any studies showing it DANGEROUS - the only evidence is linked not to healthy ketogenic diets, but very-low-calorie ketogenic diets (extreme, including studies of people with anorexia nervosa - hardly healthy diets) - and suggesting a ketogenic diet is dangerous simply because a starvation diet is dangerous is simply bad science.

Hope that helps!

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Dx'd T2 Dec 19, 2010 - Fasting BG: 14.8 (267), A1c: 12.1, Wt: 290lb (over 320lbs at my heaviest)

As of Apr 23, 2013: 14-day Avg Fasting BG: 4.7 (85), A1c (Dec21): 5.1%, Stats: 230lb, 6'3" now with 37" waist

Low-Carb (Usually < 45-60g per day on a 3,000+ calories daily diet)

On Metformin only for meds. Exercise 6 days a week.
Supplement only with: Men's Multi-Vitamin, Vitamin D 2000iu/day, Aspirin 81mg, Cinnamon Extract and Fish Oil all 1x per day

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Old 03-27-2012, 16:17   #17
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I very much appreciate the information everyone has been providing. As I am still fairly new to all of this, it is more difficult to give an explanation to a doctor as to why I prefer to stay low-carb and argue against any thing they say when I don't fully understand stuff like ketones etc. And obviously I prefer to know if there are any damaging side effects.

The dietician is pretty much not listening at all. Her solution to the fact that my bg's are not good when I eat 45g carb per meal was, you need to call your endo and tell her that your dosage may need altered. And when I said well I'm taking Janumet with is 50mg Januvia plus 1000mg Metformin twice daily. I am pretty sure that is close to what is the max daily amount. Her response was, well you may need a different medication. The the dietician across the hall butted into the convo and said, "2000mg is not that uncommon" and proceeded to talk like it was no big deal to be on as much meds as maximum possible.

My feeling is, if I can achieve better numbers with low-carb and can keep my mediciation lower than that feels better to me. However, I just wanted a straight answer as to why docs (both primary and dietician) keep telling me there was long term problems with low carb. I think they basically have no clue and just cite whatever pops in their head hoping I will not ask more questions. Regardless I feel like I need to know what they think is long term problems so I can do research and make an educated decision.

My endo on the other hand has not given her opinion about what I should be eating. So I do not know her position on low carb.

The gynecologist asked me how I was doing on my exchanges which I have no idea what exchanges are and told her so. I didn't go into diet discussions with her after that. She told me to come back when my bg's were good and we would discuss pregnancy planning. Also she said that Janumet was not safe for pregnancy and that she only recommended metformin and another drug I cannot remember the name of... I want to say glipizide but not sure. Also she said I would likely have to go on insulin toward the end of the pregnancy. Although books I have read say that insulin is the only official med to be used during any part of the pregnancy.

Unfortunately I have to go back to the dietician for a one hour followup in April. Perhaps I should bring Dr. Bernstein's book with me? LOL

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Old 03-27-2012, 16:48   #18
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You aren't likely to get a straight answer as to why docs (both primary and dietician) keep telling you there are long term problems with low carb . . . at least not from the docs themselves. These are things they were taught in the hallowed halls of medical school - what little nutritional instruction they got at all. And now it's reinforced by the ADA, which has a vested interest in keeping the high carb status quo, because their biggest donors are the food industry, and - by virtue of their overseers at USDA - the agribusiness lobby, PLUS the pharmaceutical industry which gains exponentially when we must continue and increase medications. None of these are interested in interrupting the gravy train with the truth.

If you have to, print out some of the citations provided here, present it to them as Beefy did, and ask if they have the integrity to at least read what true research says about it. Lots of us have done that already. Sometimes it helps.




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Old 03-27-2012, 16:54   #19
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Quote:
Originally Posted by annsrum
My fear is that I could choose a path that could have life altering consequences. Therefore I am trying to find out as much as I can prior as possible.
Don't forget that change is not guaranteed to have any more or any less life altering consequences than doing the same thing or doing nothing.

Sent from my iPhone using Diabetes

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Old 03-27-2012, 17:10   #20
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If you haven't watched this yet, I'd recommend it. Tom Naughton deals directly with the conflicting advice you are getting and why...


I'd also recommend viewing his Fat Head Movie.... and his Science For Smart People video.

---

Dr Andreas Eenfeldt also presents a great primer on LCHF and the story of why we get the diet advice we do...


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