Ketogenic Diets And Cortisol/adrenaline

[LLight]

If I understand well their experiment, the high protein diet is not low carb enough to be classified as a proper low carb diet: its formulation seems to include 1.8g of carbs per kg of body weight, which for a 70kg person for example, exceeds the 100g of carb per day threshold (which is more like 20g of carbs for keto, depends on the person).

 

[haidut]

Two studies below for those interested. The first one is pretty obvious, but I think it is worth emphasizing once again - i.e. caloric restriction WILL raise cortisol AND will also increase psychological stress. As the conclusion says, fasting/dieting is deleterious and a change in attitude of medical professionals towards dieting is needed. The last link is on a study I already posted, which shows that exhaustive exercise will achieve basically the same effects as the low-carb. Considering that the default medical advice to pretty much EVERYBODY is to "eat less and exercise more", it is little surprise that there is an epidemic in obesity, insulin resistance and diabetes II around the world.

Low Calorie Dieting Increases Cortisol
"...Results: Restricting calories increased the total output of cortisol, and monitoring calories increased perceived stress. Conclusions: Dieting may be deleterious to psychological well-being and biological functioning, and changes in clinical recommendations may be in order."


The second one shows that low-car diets will both increase cortisol synthesis (11b-HSD1) and decrease its degradation (11b-HSD2).
Dietary Macronutrient Content Alters Cortisol Metabolism Independently of Body Weight Changes in Obese Men
"...Conclusions: A low-carbohydrate diet alters cortisol metabolism independently of weight loss. In obese men, this enhances cortisol regeneration by 11β-HSD1 and reduces cortisol inactivation by A-ring reductases in liver without affecting sc adipose 11β-HSD1. Alterations in cortisol metabolism may be a consequence of macronutrient dietary content and may mediate effects of diet on metabolic health."

Third one is from another post. It basically shows that fasting/dieting = exercise when it comes to raising cortisol and decreasing its degradation.
Exercise + Fasting Is Stress, Causes Obesity And IR, And Requires Cortisol Blockade To Reverse

 

[CLASH]

1) raising cholesterol via keto is different than raising cholesterol with nutrients like SAFA, sugar, eating cholesterol rich foods. Raising cholesterol with keto is due to a combination of eating higher fat and cholesterol rich foods with a backlog of cholesterol in the blood because it is not being converted to steroid hormones with the accompaniment of thyroid hormone and sugar at the mitochondria.

2) I dont think the argument was ever that keto will lower your basal metabolism. The argument was that keto will shift your metabolism to run primarily on stress pathways involving adrenaline for lipolysis, cortisol for gluconeogenesis, and glucagon for blood sugar. Many people develop symtpoms on keto after an extended period of time associated with chronically elevated cortisol, and lowered thyroid function. It doesnt seem like a long term strategy as much as it is a possible therapeutic intervertion.

3) There is a massive difference between keto and diabetes. Diabetes is an inability to oxidize sugar most likeyl due to a gut infection with elevated endotoxin. Keto is an absence of sugar leading to less oxidation of it to spare it for the brain and other vital functions. The insulin resistance induced by keto is transitory and can be reversed once adding carbs back in. The insulin resistance of diabetes is pathologic and difficult to reverse. The diabetic has elevated fatty acids, adrenaline, cortisol, blood sugar and insulin, even in the presence of carbs because the carbs cannot be properly oxidized by the cells. The ketotic individual has elevated adrenaline, glucagon, cortisol with low insulin and blood sugar because they are running on fatty acids by avoiding carbohydrate. Somewhat similar profiles but, the devil is in the details.

4) the benefits of keto seem to be clearing up gut infections, atleast in the small intestine using saturated fat and avoiding problematic foods like grains, beans, processed garbage etc. The saturated fats and avoidance of garbage foods help to clear up the endotoxemia thus lowering the high cortisol induced by endotoxin. However, cortisol can still be increased with a sugar deficiency by its upregulation for gluconeogensis to maintain adequate glucose levels via the transformation of amino acids. Cortisol is upregulated for more than one reason. So if someone has a gut issue then increasing MUFA and SAFA, while maintaining adequate protein and dropping garbage foods would be very helpful to clearing up thier gut infection, atleast in the small intestine and thus lowering cortisol (i think this is why you see rapid weight loss with keto besides the glycogen and water weight). However, this doesnt neccesarily mean the diet has to be low carb. It just has to provide easily absorbable sugars that can be digested in the now “clear” small intestine so that nothing is going to colon to ferment. The answer: fruit juice with a 1:1 ratio of glucose to fructose atleast and no fodmaps. I think a you would see a keto persons cortisol, adrenaline, and glucagon levels drop with the addition of the aformentioned juice while thier weight would decrease or at the minimum stay the same. Furthermore, thier thyroid profile would be better and thier steroid hormone profile would be better. Keto is notorious for sh***ing on mens testosterone levels, not sure about womens progesterone levels. A single macronutrient isnt to blame in most cases for dietary issues, its food type and thier specific effects on the body in conjunction with the bacteria present in the gut. The two biggest killers are PUFA and endotoxin, PUFA is easy to avoid but endotoxin is ubiquitous.

 

[Kelj]

Keto diet: Scientists find link to diabetes risk
Keto diet: Scientists find link to diabetes risk

 

[haidut]

Keto diet: Scientists find link to diabetes risk
Keto diet: Scientists find link to diabetes risk

Thanks for finding this!
This should be posted in its own thread. Please do so when you get a chance. Finally, some common sense coming out of mainstream medicine. From the article.

"...Although ketogenic diets are known to be healthy, our findings indicate that there may be an increased risk of insulin resistance with this type of diet that may lead to type 2 diabetes."

I am really shocked as to why the authors include this bizarre statement "ketogenic diets are known to be healthy" when their own study shows the exact opposite!! I guess the fear of losing funding is too big if a scientists goes directly against a popular dietary fad.

 

[Kelj]

Thanks for finding this!
This should be posted in its own thread. Please do so when you get a chance. Finally, some common sense coming out of mainstream medicine. From the article.

"...Although ketogenic diets are known to be healthy, our findings indicate that there may be an increased risk of insulin resistance with this type of diet that may lead to type 2 diabetes."

I am really shocked as to why the authors include this bizarre statement "ketogenic diets are known to be healthy" when their own study shows the exact opposite!! I guess the fear of losing funding is too big if a scientists goes directly against a popular dietary fad.

I noticed that, too. Those kinds of insidious statements are made in everything people read, listen to and say to each other. No wonder everyone's confused.

 

[LLight]

Thanks for finding this!
This should be posted in its own thread. Please do so when you get a chance. Finally, some common sense coming out of mainstream medicine. From the article.

"...Although ketogenic diets are known to be healthy, our findings indicate that there may be an increased risk of insulin resistance with this type of diet that may lead to type 2 diabetes."

I am really shocked as to why the authors include this bizarre statement "ketogenic diets are known to be healthy" when their own study shows the exact opposite!! I guess the fear of losing funding is too big if a scientists goes directly against a popular dietary fad.

I will not spend much more time defending the keto diet as it's not my religion, and particularly on the Ray Peat forum where people are clearly not interested in it, but two points on this study (and a lot of these studies with mice): mice are notoriously bad at entering ketosis (i.e. we should not make direct conclusions for humans based on mice study I believe), the diet is probably full of PUFA (much more than what people here would already consider a high PUFA diet, or much more than what people eating a keto diet from whole foods would have) as a high-fat mouse diet in a scientific study can be.

 

[postman]

Thanks for finding this!
This should be posted in its own thread. Please do so when you get a chance. Finally, some common sense coming out of mainstream medicine. From the article.

"...Although ketogenic diets are known to be healthy, our findings indicate that there may be an increased risk of insulin resistance with this type of diet that may lead to type 2 diabetes."

I am really shocked as to why the authors include this bizarre statement "ketogenic diets are known to be healthy" when their own study shows the exact opposite!! I guess the fear of losing funding is too big if a scientists goes directly against a popular dietary fad.

Did you read the study? Did you read what they ate? Absolutely abysmal diets, and completely unrealistic diets. The keto group got 90% of their calories from crisco and corn oil, and the HFD group got 35% of their food by mass from lard and soybean oil. Surely this must bear relevance to the negative effects? What's more, the study shows that ketosis is protective compared to the HFD in some regards.

"Short‐term obesogenic HFD feeding but not KD causes increases in fasting insulin and HOMA‐IR"

"Interestingly, in our studies, only the HFD animals showed signs of impaired glucose homeostasis when observed in the 6 h fasted state, even though the effect on hepatic glucose output under insulin was stronger in the KD fed group. The key difference between these two diets is that the obesogenic HFD provides significant amounts of calories from both fat and carbohydrate, whereas the non‐obesogenic KD provides calories almost exclusively from fat. It is relevant to note that a low carbohydrate KD does not cause obesity and that muscle insulin sensitivity appears to be entirely preserved in this model even after long periods of feeding, in marked contrast to obesogenic HFD (Jornayvaz et al. 2010; Garbow et al. 2011)."

This idea that keto is promoted by mainstream doctors or the pharmaceutical industry is very very funny. It's a controversial diet and it's not recommended as a first line treatment for any disease, anywhere, by any health authority. Just because it's trendy on the internet doesn't mean that many actual real life MDs support it.

 

[Dino D]

1) raising cholesterol via keto is different than raising cholesterol with nutrients like SAFA, sugar, eating cholesterol rich foods. Raising cholesterol with keto is due to a combination of eating higher fat and cholesterol rich foods with a backlog of cholesterol in the blood because it is not being converted to steroid hormones with the accompaniment of thyroid hormone and sugar at the mitochondria.

2) I dont think the argument was ever that keto will lower your basal metabolism. The argument was that keto will shift your metabolism to run primarily on stress pathways involving adrenaline for lipolysis, cortisol for gluconeogenesis, and glucagon for blood sugar. Many people develop symtpoms on keto after an extended period of time associated with chronically elevated cortisol, and lowered thyroid function. It doesnt seem like a long term strategy as much as it is a possible therapeutic intervertion.

3) There is a massive difference between keto and diabetes. Diabetes is an inability to oxidize sugar most likeyl due to a gut infection with elevated endotoxin. Keto is an absence of sugar leading to less oxidation of it to spare it for the brain and other vital functions. The insulin resistance induced by keto is transitory and can be reversed once adding carbs back in. The insulin resistance of diabetes is pathologic and difficult to reverse. The diabetic has elevated fatty acids, adrenaline, cortisol, blood sugar and insulin, even in the presence of carbs because the carbs cannot be properly oxidized by the cells. The ketotic individual has elevated adrenaline, glucagon, cortisol with low insulin and blood sugar because they are running on fatty acids by avoiding carbohydrate. Somewhat similar profiles but, the devil is in the details.

4) the benefits of keto seem to be clearing up gut infections, atleast in the small intestine using saturated fat and avoiding problematic foods like grains, beans, processed garbage etc. The saturated fats and avoidance of garbage foods help to clear up the endotoxemia thus lowering the high cortisol induced by endotoxin. However, cortisol can still be increased with a sugar deficiency by its upregulation for gluconeogensis to maintain adequate glucose levels via the transformation of amino acids. Cortisol is upregulated for more than one reason. So if someone has a gut issue then increasing MUFA and SAFA, while maintaining adequate protein and dropping garbage foods would be very helpful to clearing up thier gut infection, atleast in the small intestine and thus lowering cortisol (i think this is why you see rapid weight loss with keto besides the glycogen and water weight). However, this doesnt neccesarily mean the diet has to be low carb. It just has to provide easily absorbable sugars that can be digested in the now “clear” small intestine so that nothing is going to colon to ferment. The answer: fruit juice with a 1:1 ratio of glucose to fructose atleast and no fodmaps. I think a you would see a keto persons cortisol, adrenaline, and glucagon levels drop with the addition of the aformentioned juice while thier weight would decrease or at the minimum stay the same. Furthermore, thier thyroid profile would be better and thier steroid hormone profile would be better. Keto is notorious for sh***ing on mens testosterone levels, not sure about womens progesterone levels. A single macronutrient isnt to blame in most cases for dietary issues, its food type and thier specific effects on the body in conjunction with the bacteria present in the gut. The two biggest killers are PUFA and endotoxin, PUFA is easy to avoid but endotoxin is ubiquitous.

Whitch feuit juicea are the best?
Anything other then juices for this aproach?
I dont seam to be that fine with liquids...

 

[Kelj]

Low carbohydrate diets are unsafe and should be avoided

If you didn't like the other study:

"This study prospectively examined the relationship between low carbohydrate diets, all-cause death, and deaths from coronary heart disease, cerebrovascular disease (including stroke), and cancer in a nationally representative sample of 24,825 participants of the US National Health and Nutrition Examination Survey (NHANES) during 1999 to 2010. Compared to participants with the highest carbohydrate consumption, those with the lowest intake had a 32% higher risk of all-cause death over an average 6.4-year follow-up. In addition, risks of death from coronary heart disease, cerebrovascular disease, and cancer were increased by 51%, 50%, and 35%, respectively.

The results were confirmed in a meta-analysis of seven prospective cohort studies with 447,506 participants and an average follow-up 15.6 years, which found 15%, 13%, and 8% increased risks in total, cardiovascular, and cancer mortality with low (compared to high) carbohydrate diets (see figure for total mortality)."

"The researchers also examined the link between all-cause death and low carbohydrate diets for obese (body mass index [BMI] 30 kg/m2 or greater) and non-obese (BMI under 30 kg/m2) participants in two age groups (55 years and older versus under 55) and found that the link was strongest in the non-obese older participants."

The reasons why are a lot of guesswork and highly suspect. The fact of who died is straightforward.

 

[postman]

Low carbohydrate diets are unsafe and should be avoided

If you didn't like the other study:

"This study prospectively examined the relationship between low carbohydrate diets, all-cause death, and deaths from coronary heart disease, cerebrovascular disease (including stroke), and cancer in a nationally representative sample of 24,825 participants of the US National Health and Nutrition Examination Survey (NHANES) during 1999 to 2010. Compared to participants with the highest carbohydrate consumption, those with the lowest intake had a 32% higher risk of all-cause death over an average 6.4-year follow-up. In addition, risks of death from coronary heart disease, cerebrovascular disease, and cancer were increased by 51%, 50%, and 35%, respectively.

The results were confirmed in a meta-analysis of seven prospective cohort studies with 447,506 participants and an average follow-up 15.6 years, which found 15%, 13%, and 8% increased risks in total, cardiovascular, and cancer mortality with low (compared to high) carbohydrate diets (see figure for total mortality)."

"The researchers also examined the link between all-cause death and low carbohydrate diets for obese (body mass index [BMI] 30 kg/m2 or greater) and non-obese (BMI under 30 kg/m2) participants in two age groups (55 years and older versus under 55) and found that the link was strongest in the non-obese older participants."

The reasons why are a lot of guesswork and highly suspect. The fact of who died is straightforward.

These kind of papers are not very interesting as they mix keto dieters with non-keto low carb dieters, or probably doesn't even include keto dieters at all. The health status of someone eating a "low-carb" diet of 150g of carbs per day is not what this thread is about.

 

[JDreamer]

Keto Diet and Diabetes Risk
And THE GLUCOSE FATTY-ACID CYCLE ITS ROLE IN INSULIN SENSITIVITY AND THE METABOLIC DISTURBANCES OF DIABETES MELLITUS - ScienceDirect

The second article is Randle's (the Randle Cycle). These articles show it is the ketogenic diet which causes the high blood sugar of so called diabetes. Without the rise of adrenaline and cortisol, a low carb dieter couldn't survive the carbohydrate deprivation, and a ketogenic diet could not achieve the claims it makes of utilizing ketone bodies and fat stores for energy. As Ray describes: "Eating meat without accompanying carbohydrate will stimulate, first, insulin to dispose of any circulating amino acids and at the same time, lower any circulating glucose and tend to turn it into fat. As glucose goes down, that will drive up your cortisol. A big protein meal will cause a big surge of cortisol and people will become supposedly 'diabetic' or very hyperglycemic because they eat too much meat unaccompanied by sugar or some kind of carbohydrate. The cortisol turns protein into sugar and fat."

I often worry about the damage I did to myself with how often my caloric intake wasn't high enough and my protein/carb balance was wildly out of wack favoring protein (often featured two protein shakes a day). Part of that has also been because of the constant bloating I get from carbs - but then again it's probably the grains and whatnot. It would also explain the struggle I've had with this freakin' stubborn lower ab fat and I'm someone who doesn't eat like sh*t.

Mind you this is something that has gone on for the better part of the last 6-7 years while I've been stressed out at work 24/7 and as I've gotten more dedicated in my heavier compound workouts. Apparently just been driving up cortisol, turning protein into glucose, then glucose into fat - rinse and repeat. Now the question is how do I undo all of this? I know in my heart of hearts it's a major problem.

 

[Kelj]

I often worry about the damage I did to myself with how often my caloric intake wasn't high enough and my protein/carb balance was wildly out of wack favoring protein (often featured two protein shakes a day). Part of that has also been because of the constant bloating I get from carbs - but then again it's probably the grains and whatnot. It would also explain the struggle I've had with this freakin' stubborn lower ab fat and I'm someone who doesn't eat like sh*t.

Mind you this is something that has gone on for the better part of the last 6-7 years while I've been stressed out at work 24/7 and as I've gotten more dedicated in my heavier compound workouts. Apparently just been driving up cortisol, turning protein into glucose, then glucose into fat - rinse and repeat. Now the question is how do I undo all of this? I know in my heart of hearts it's a major problem.

Tummy Troubles

"I am actually going to address the more insidious form of self-identified food allergy, intolerance and sensitivity that actually arise because the patient experiences symptoms when eating certain kinds of foods. In other words, she avoids foods that cause a reaction. The reaction is usually gastrointestinal, but may also involve rashes, headaches or foggy-headedness."

"what is a patient supposed to do if she needs to recover from an eating disorder and yet cannot eat a broad array of foods because they worsen physical symptoms?"

"An intolerance to a food item will mean that the body is unable to produce enough digestive enzymes to handle the food breakdown effectively and the result will be various gastrointestinal symptoms: gas, bloating, pain, sometimes acid reflux, possibly diarrhea and/or constipation, and occasionally skin rashes as well."

"the primary reason for failing to tolerate these foods will be too little energy within the body available to produce adequate amounts of digestive enzymes."

"What is also completely off radar, and yet very likely critical for patients recovering from restrictive eating behaviors, is the fact that the symbiotic (friendly) and commensal (presumably neutral) bacteria in the large intestine are highly involved in the modulation of our immune responses to food. These colonies are decimated during bouts of restriction and excessive energy expenditures."

"Disparate gastrointestinal symptoms (e.g. bloating, distention, flatulence, gas, diarrhea, loose stools, poorly digested foods, constipation, burping…) tend to flare up significantly as you enter a recovery process and that is because not only does your body have to bring back online proper digestive enzyme production and release, but the bacterial colonies have to multiply and start modulating the digestion and immune responses in the ways that they are meant to do as well."

"attempting to support your body’s desperate need for more energy while maintaining a restrictive diet of any kind is problematic to say the least."

"I approach eating disorders through the discipline of triage. Eating disorders are deadly; IBS is not. That is not to say that the symptoms associated with IBS are not phenomenally unpleasant and painful, they are. But there is no question in my mind that re-energizing an energy-depleted body must take precedence over squelching non-life threatening symptoms, to the maximum level to which the patient can manage the impact."

This is how I recovered. Helpful info. here.

"Furthermore, there is plenty of evidence that much of the gastrointestinal distress that is monstrously present for those with active eating disorders, actually resolves with aggressive re-feeding tactics. 25,26,27,28,29"

 

[CLASH]

@Dino D
Low fodmap juices with equal fructose to glucose ratios:
-pomegranate
-orange (can cause issues for people)
-grape
-pineapple

Eating whole fruits is helpful as well.

 

[Julles]

When I was low-carb for 3 years, atempting keto (but never got in ketosis more than 5-6 days in a row), I was most of the time in a fight or flight mode, and shitty sleep, like the brain waves never got down to <delta or something, only woke up refreshed after a full day of carbs... you know, the usual gym wanna be rat, keto and carb refeed, etc i'm pretty sure my cortisol was blowing up and making my hair disappear also.

Sugar is like a big massage in all the cells! ahhhhh...

 

[Rafael Lao Wai]

Did you read the study? Did you read what they ate? Absolutely abysmal diets, and completely unrealistic diets. The keto group got 90% of their calories from crisco and corn oil, and the HFD group got 35% of their food by mass from lard and soybean oil. Surely this must bear relevance to the negative effects? What's more, the study shows that ketosis is protective compared to the HFD in some regards.

"Short‐term obesogenic HFD feeding but not KD causes increases in fasting insulin and HOMA‐IR"

"Interestingly, in our studies, only the HFD animals showed signs of impaired glucose homeostasis when observed in the 6 h fasted state, even though the effect on hepatic glucose output under insulin was stronger in the KD fed group. The key difference between these two diets is that the obesogenic HFD provides significant amounts of calories from both fat and carbohydrate, whereas the non‐obesogenic KD provides calories almost exclusively from fat. It is relevant to note that a low carbohydrate KD does not cause obesity and that muscle insulin sensitivity appears to be entirely preserved in this model even after long periods of feeding, in marked contrast to obesogenic HFD (Jornayvaz et al. 2010; Garbow et al. 2011)."

This idea that keto is promoted by mainstream doctors or the pharmaceutical industry is very very funny. It's a controversial diet and it's not recommended as a first line treatment for any disease, anywhere, by any health authority. Just because it's trendy on the internet doesn't mean that many actual real life MDs support it.

A carnivore diet centered around grass fed beef and beef fat would have vastly different effects, I highly suspect. That's the problem with these studies on high fat diets: they give the rats absurd amount of PUFA. Beef fat is extremely low in PUFA. If one is eating suet as a source of fat, even a 100% fat diet( just an example, I don't think that's a good idea) would only provide 2 or 3% of your calories as PUFA, with tons of stearic and palmitic acid to balance out the PUFA.

The native amercians ate 80% of their calories from bison( and probably more during winter time) and were very healthy( tall, strong, muscular, etc.). I think carbs are good, but I don't think it would be fair to ignore the experience of people who are doing very well on carnivore/ zero carb diets when what they're doing makes a lot of sense( low PUFA, high SFA, high MUFA, quality protein, lots of nutrients, etc.). And SFAs are anti- cortisol, so that should help with the lack of carbs.

 

[Kelj]

Native American foods: History, culture, and influence on modern diets - ScienceDirect

This is a great article on what native Americans ate. Also, there is a video by Chris Masterjohn on how the Inuit are uniquely adapted to their native diet.

 

[methylenewhite]

The native amercians ate 80% of their calories from bison( and probably more during winter time) and were very healthy( tall, strong, muscular, etc.). I think carbs are good, but I don't think it would be fair to ignore the experience of people who are doing very well on carnivore/ zero carb diets when what they're doing makes a lot of sense( low PUFA, high SFA, high MUFA, quality protein, lots of nutrients, etc.). And SFAs are anti- cortisol, so that should help with the lack of carbs.

Surprisingly grass fed bison has 6% more of PUFA comparing to grain finished.

 

[milkbasedvegan]

As much as I love the carnivore rationale, their avoidance of plant toxins, and the fact that we are anatomically very well adapted to eating animal foods, all of those low carb guys tend to forget that it’s saturated fat we are after just like all mammals, NOT hundreds of grams of protein as per Saladino, NOT high phosphorus possibly maybe balanced out with high calcium as per Saladino, NOT high calcium/magnesium ratios (does Saladino talk about magnesium?), and well, we want sugar for our brains. That’s just the easiest way to feed it: liver glycogen supplying sugar.

This is how we run optimally. I don’t think it’s debatable in truly healthy humans with HBA1c around 5% at most? Liver glycogen nice and stable, EZPZ.

In insulin resistant people / T2D - yeah, avoid sugar for a while, I suppose. There’s a lot to undo internally before feeding them sugar.

even then, I’m not convinced their insulin resistance isn’t basically a lack of bio available nutrients per calories.

 

[Rafael Lao Wai]

Surprisingly grass fed bison has 6% more of PUFA comparing to grain finished.

That is surprising, thanks. The grass fed had more saturated fat too, so that help balance the increased PUFA.

I wish they would have measured the fatty acids in the bison suet, since that's one of the most important sources of fat, considering that grass fed/ wild animals have significantly less fat in the muscle meat.