Thursday, May 24, 2018

Keto confusion: When people suck at math. And Thinking.

Hey folks!!

The interwebz. Source of nearly infinite information and incubator for folks who have difficulty with logic/reason/math and a host of other skills, to exist, sometimes even thrive. Bad information…stuff that let’s folks continue to make mistakes which negatively impact not only their lives but the lives of others, unfortunately, flourishes alongside “stuff that works.”  What on earth am I talking about?

I posted this picture on instagram:

I know, I know…I should not BE on social media. Unfortunately, even if I escape to that coconut farm someday I will likely need to hawk my goods online. If you follow the link and read my piece you will see that I make the case that chasing ketones can get folks into trouble. We are all different…the 0.6mm reading is from Nicki after eating 75g of carbs (mixed meal, protein and fruit) while my “measly” 0.4mm is after 6 months of strict, Ketogains macros. The point I make is largely the following:

1-I feel good and am happy with my performance and body-composition.

2-If I were to tweak my approach to increase my ketone levels the main options I have include fasting and adding lots more fat to my diet.

Now, I’m fine with a bit of time restricted eating, but given my relative leanness, propensity to be sympathetic dominant (wound tight!) and activity level, I just don’t push that too hard. 14-16 hrs overnight fast here and there is great. I don’t see the upside for ME to do an extended fast. I’d lose training time, muscle and fitness. For someone else, in a different situation, an extended fast might be just the thing. I’m working on a video piece regarding fasting, hoping to get that up next week. Ok, so fasting is not a good option for me, what about adding a lot of fat? Ketosis only works with a lot of fat, right?

NO.

Only the die-hards hold to the Pure Insulin Hypothesis saying you need to eat fat to burn fat and that fat calories don’t matter. No credible researcher makes this claim…not Phinney/Volek, not Dom D’agastino…no one.

Again, read that whole post if you like but this gives you a sense of what case I made. We are all different, chasing ketones has only very limited application, there may be serious downsides to chasing ketones for ketones sake. I had some great comments, some solid back and forth with folks. Then I received this comment from Jason Volstad:

I’m generally pretty cordial with folks, even those with a dissenting view, but Jason jumped in head first. Deleting the comment would be easy, but I actually DO like to engage with folks who have differing opinions. I’m not going to post all of the back and forth, but multiple times I asked Jason a very simple question:

What would you change about what I’m doing to improve my life?

He never answered this, only re-engaged with more insults. I’m not sure if you caught this in the first photo, but Jason is doing something new, but VERY popular to the keto scene: fit-shaming. Disagree with someone? Have lack-luster results? Clearly it’s not YOUR fault…you need to knock someone down who has this stuff dialed in. So, the back and forth progressed to this:

Again, the fit shaming.

But, we will let that slide for now, there are better low-carb fish to fry. Jason backs away trying to make a case that he is going to go hang out with the “real science” of Phinney and Volek. I love those guys, they do great work. In fact, their work is virtually indistinguishable from what the Ketogains recommendations are…and this is really at the crux of the “state of the union of keto.”

A whole host of Keto-zealots are either flat out dumb, or woefully ignorant of the actual science.

Here is a protein recommendation graphic from page 67 of Phinney and Volek’s book The Art and Science of Low Carbohydrate Performance:

With me so far? Ok, now lets look at what the Ketogains Macronutrient Calculator recommends for the same 200lb male (top line) who is 15% body fat:

Now, let’s see what the protein recommendations are at the bottom, middle and top end of the KG recommendations:

Lower Protein Recs: 0.8g/Kg LBM

 

Middle Protein Rec’s 1.0g/kg LBM

Upper Protein Rec’s: 1.2g/Kg LBM

The Phinney/Volek rec’s are between 102-170g for a 200lb male who is 15% body fat.

The ketogains protein rec’s are 136g at the low end, 170g medium, and 200g at the upper suggested range.

Jason Volstad and a whole gaggle of folks like him on the interwebz are pissing and moaning, fit-shaming and suggesting folks mainline butter to maintain “optimal ketone levels” over a difference in 30g of protein at the respective upper and lower bounds.

The difference in a can of sardines eaten over the course of a day is really enough to get panty-twisted and insult people?

No, of course this is not the case, this delta in 30g of protein is not the driver of this behavior. Wanton, painful ignorance of the facts is the driver. If that delta IS the driver, then these people are beyond redemption. These are the same people claiming to have “Healing Crisis” as part of their remarkable weight gain while doing keto.

I thought the only place I’d ever here a dismissal of dietary failure on a “healing crisis” would be veganism. Apparently, I was wrong.

Let’s unpack/head-off-at-the-pass a few things:

1-If you are eating at the lower end of ANY protein recommendations and you are crushing things, awesome, keep it up.

2-If you have tinkered with keto and been afraid of protein because of “gluconeogenesis.” If you have found yourself hungry, over-eating fat and  gaining weight, I’m going to make a crazy suggestion: go back to that KetoGains calculator, redo your macros, up your protein, and critically assess your results. Report your results. If things are still not working we can dig in deeper, but for crying out loud, don’t just keep doing what is not working!

3-Ketone levels are a highly individual thing and chasing them can set one up for problems. The folks doing good work in this area have noted that people TEND to see a downward trend in ketone levels with time. Even the recent Virta research showed this. If you are going to cite Phinney and Volek as the source for your “keto truth” at least know what the hell that material is and what it says.

There is not a one-size-fits-all way to do this stuff. There are great beginning guidelines but then a lot of nuance and detail from there. Before I close this I’ll share an example of this need for customization:

One of the commenters in this instagram post related that she had reached goal weight but when she was running ketone levels over 1.0mm she felt really good. She now hovers in the 0.5 range and although she feels pretty good, she does NOT have that same cognitive snap as when she ran higher. Jason and his ilk would tell this woman to reduce protein, up fat and run from there. What I see time and again on this scenario is folks lose muscle mass, see reduced performance and often begin gaining weight due to excessive fat intake.

Here is what I recommended:

Delete about 20g of fat from each of her standard meals (3 per day) and add in 20g of C-8 enriched MCT oil. She has not reported back yet, but I’ve used this approach with a number of folks and it has worked well. We keep protein at levels that promote satiety and body composition, while stacking the deck in our favor with regards to ketone production. Even in a mixed, low-glycemic diet for epileptics, the addition of MCT can produce therapeutic ketone levels! With this approach we maintain everything we want, while goosing the ketones that are necessary for THIS situation.

So, although I recommend against generally “chasing ketones” I know enough about this topic to not just tell this woman to keep failing, I gave her an actionable recommendation we can immediately assess for efficacy. I did not need to invoke mystical healing crisis, nor did I need to shame her for needing help. Perhaps most importantly, I will hold myself accountable to making sure this woman finds a solution.

I’m not sure of an elegant way to wrap this up, but I will say the following: If you seek out a plumber to fix a leaky faucet, it’s on you if you call the person back 4 times to fix the same issue and it is never addressed. If, upon inspection, the plumber says “we’ve got more than a leaky pipe here” he/she should be able to tell you what is going to happen, what timeline, cost etc, and if they have ethics, they will hold THEMSELVES accountable for delivering the goods.

Low-carb noodle on that.

Oh! One more thing. I asked Jason to provide an analysis of the difference between KetoGains and the Phinney/Volek recommendations. As of this writing, no response.

 

 

Via Health & Wellness http://www.rssmix.com/

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