I was roughly surfing sugar highs for 39 years.
Would highly recommend looking into this if you are a sugar/carb addict like I was.
(Keto communities deal with this by preaching an anti-science, cholesterol-denialist dogma, but that dogma has always been driven by wishful thinking).
Dataset needed
Positives:
- PDF is available!
- Nice formatting
- Very well written, very clear what they did
Negatives:
- Not an experiment. An observational study.
- If I'm reading correctly, they classified someone's diet mostly based on 1 single prior 24 hour food questionnaire. This is a bit...weak.
- The LCHF cohort has significant pre-existing conditions (which they do correct for, but their headline is about the non-corrected number)
- They define LCHF diets as being <100g of carbs a day, and define VLC diets as being <50g a day, but do NOT publish any results for the VLC cohort. Why not?
- They then do NOT publish their data!
- BUT if you dig into their supplementary tables, they DO report that VLCs have lower rates of ASCVD than LCHF.
- They have conflicts of interest: "Dr Brunham has served on advisory boards for Amgen, Novartis, HLS Therapeutics, and Ultragenyx. Dr Iatan has served on advisory boards for Novartis and HLS Therapeutics and receiving honoraria from Novartis and Sanofi. "
Anyway, I give that one a C-. Well executed, but looks like their hands are tied. I would not bet on its associations to reproduce in an experiment.
Were I you I would get my ApoB checked. If it’s low, then great! Keep doing what you’re doing! But don’t give yourself a heart attack following the latest fad diet.
I definitely do _not_ understand the first thing about cholesterol and adverse cardiovascular events.
Certainly high on my list of things to be able to model by the end of the year.
I have spent a fair amount of time in the lab (mostly dry, with a little bit of wet lab), so have good foundations, just that's an area I haven't had time to deep dive in yet.
"In pricinple" or actually measured cholesterol levels? Because the latter doesn't happen.
I found it was just such a pain in the as for other as much as it was for me. Every meal at someone elses house I had to make my specific nutritional requirements available to the host, which then puts them out.
Experimenting with Mounjaro right now + intermittent fasting. So far so good, but only one week into it. I am hoping to use it as a guardrail in case of any accidental deviation.
Except if by "one deviation" you mean a month or more going without IF...
You feel a little hungry. Big deal.
I lost my weight over a decade ago, before "keto" was a buzzword. I've become less strict, because I know that if my weight starts going up, I don't have a problem going very-low-carb to drop it again. It's still calories in, calories out, at the end of the day - but for me, it's a very sustainable diet. I like cookies, but if you offered me the choice between a sweet dessert and another steak, I would have taken the steak even when I was a junk-guzzling fatty.
I never asked anyone to do any special stuff for me after the first few weeks. Someone serves you pasta alfredo? Eat it; one meal isn't the end of the world. Unless your social schedule is very different from most, you're not going to eat at someone else's house more than once a week, and restaurants (at least in the US) can be counted on to have a chicken Caesar salad if nothing else.
Every time I've come off keto, I've always had the intention of staying "lowish-carb" afterwards. It never works. Your body just gets used to whatever it has, gives you cravings before you really need more food, and so you have a bit more and a bit more, and before you know it, you're a full on sugar monster again.
I also think it's worth keeping a food journal. Not even for counting calories or grams of carbs, more that the act of writing it down makes you think "did I really eat that much today?" and gives you a prompt to be more careful.
The rest was just my experience of after I'd got to my goal weight on keto, of trying to stop keto and do something midway between keto and not keto. For me, that never works - some carbs each day, leads to more carbs, leads to lots of carbs. That was never an issue while on keto - I'd just go back to my highly restrictive diet, just that I never found re-introducing carbs easy to moderate. FWIW it's worth, I'm starting keto for the 4th time now. The first 2 times were effective, until I stopped. The third time I tried to be less restrictive than the previous two times, and I didn't really achieve any weight loss.
The "you" in that paragraph about sugar monsters was actually me, but I used the "you" form because I though it could probably generalise to whoever was reading, not specifically you in particular. Sorry for the confusion.
Until you deplete the sugar stores. So like fast 24h and you're back in.
Fat adaptation is about shifting your hormonal balance and response to retrain your body to maintain a lower level of glucose, and to retrain your cravings and hunger.
When there isn't enough glycogen, the chemical balances in the mitochondria change and the liver mitochondria will produce glucose from whatever they have. This isn't a "decision" just the relative amounts of the chemicals change leading to one chemical pathway becoming more likely compared to another. This is all mediated by the random collisions of molecules in your cells. If you have a lot less of one molecule compared to another, the frequency that molecules find each other to do one thing v/s the other will change leading to different chemical pathways becoming more or less active.
There are many routes for your body to produce glucose. It is "easier" for your body to produce it from gluconegenic amino acids (not all amino acids can be used to produce glucose) than it is from fatty acids. It's the process of converting fatty acids into glucose that generates ketones. So when you have excess amino acids that can be turned into glucose, the chemistry will prefer this pathway over breaking down fat into glucose and this will lead to lower ketone production overall and kick you out of ketosis.
(I think I've gotten the gist of this right but any biochem experts feel free to correct me)
This only works because athletes tend to have pretty insane protein (and calorie!) demands.
If you as a regular, non-athlete person load up on protein (while neglecting to consume sufficient fat), your body will be forced to convert the protein into glucose, and you'll fall right out of ketosis