Regarding the diet above, which limits your sugar intake to 20 grams a day, what are some potential consequences of starving your body of sugars?
Sounds good in theory (sugar is bad), but it sounds stressful (body starts producing ketones due to suck a lack of sugar, flu like symptoms for a week).
Producing ketones is perfectly normal. The flu-like symptoms can usually be avoided by easing into a low-carb/keto diet and/or ingesting sodium, chicken broth is normally recommended at the early stages.
Potential consequences of reduced carb intake are weight loss. It can be used to treat type 2 diabetes, epilepsy, a wide range of neurological disorders, some cancers (yeah, really), and much more.
I'm not aware of any scientic data that found adverse consequences. You get a lot of resistace from health professionals because for the last decades what you eat on a ketogenic diet has been blamed for heart diseases or high cholesterol, but there never was scientific evidence to back up those claims.
Here's a study that shows that while low-carb diets achieved effects faster (involved more weight loss in the first 6 months), after a year the difference in weight was negligible. Low carb diets led to higher levels of LDL cholesterol, which is generally considered to be bad, though were also correlated with better levels of HDL cholesterol, which are considered to be good. http://www.ceb-institute.org/fileadmin/upload/refman/arch_in...
Here is a a long term study that shows that low carbohydrate, high protein diets were correlated with higher mortality rates. It's an observational, not a controlled study, so the usual caveats apply, but it's definitely some evidence that there's no automatic win for low-carb, high protein diets: http://folk.ntnu.no/lyngbakk/artikler/trichopoulou.pdf
I'm pretty sure I've seen another study that linked long-term use of low-carb, high protein diets with increased incidence of cancer, but I can't find that study at the moment.
Thanks for those links. Yes, I should have been more specific, the diet I was talking about is low carb high fat (LCHF), not low carb high protein. Increased protein intake can indeed be a problem and seems to be common with low carb eaters.
Please don't promote "observational" studies. They are not worth the electrons it cost to display them on my screen let alone transmit them across the 'net.
You can find an 'observational' study to promote nearly any point of view. If it's not a properly controlled peer reviewed study it's not worth anyone's time except the shills who got paid to write it up by whatever corporate group commissioned it.
Wow, you definitely sound a bit too defensive. A bit like my sister, in fact. She also followed the ketogenic diet for four months and was very, very adamant about how it was healthy because she was finally losing weight. But then reality hit her hard. She had her blood samples taken before she started the diet and after the four month period. What the lab results showed clearly was dangerously elevated levels of LDL (from all the fried pig skins and bacon jerky she was munching on, no doubt). She finally realized that, despite what you read on the Internet, nothing beats the hard results you see on a lab report. She returned to a normal diet afterward.
Controlled studies about lifelong effects of fairly fundamental parts of your life such as diet are quite difficult to do, especially with large enough populations to be statistically significant and without being overly affected by their dropout rate.
Observational studies have significant problems, as I explicitly pointed out in my comment about the study. However, they have some advantages in that they are a lot easier to do for larger populations over a longer time period.
Both of these are valid scientific techniques, to inform us about what is most likely to be a healthy way to eat. There are, of course, other valid techniques, such as studying immediate metabolic effects of ingesting certain foods, and linking those to known risk factors for a variety of conditions. Science is not a single, infallible technique, it is a set of techniques which taken together are intended to give us the best approximation of the truth, though every method can fail in certain ways.
Diet is an especially difficult topic. Human bodies, human behavior, and differences between different people are quite complex. There are a lot of people who are afraid of diseases of affluence or degenerative diseases that you see coming up more often simply due to our longer lifespan. Lots of people are interested in solving these problems, and I think that a lot of people jump to over-simplifying conclusions on these topics. We've seen this played out in the past; a huge over-emphasis on low-fat diets, that seems to have left us unhealthier than ever. Warnings about dietary cholesterol, when it turns out that the cholesterol in our blood stream has very little correlation to cholesterol consumed.
Every time I hear about some new extreme diet that is supposed to work wonders, I get concerned. Low fat, low sodium, low carb, no carb, paleo, high protein, high fat, vegan, raw, gluten free, dairy free and so on. Most of these things seem to focus on some single source of evil, and claim to offer amazing benefits if you follow them. Most of those benefits don't actually play out; despite the huge push for low-fat diets over the 80s and 90s, obesity continued rising at an alarming rate. Despite the huge popularity of Atkins, "paleo", and other low carb diets over the past decade, it has continued to rise.
People keep searching for a silver bullet, and in diets, like much of life, there is no silver bullet. Eat less, exercise more, eat healthier foods like fruits, vegetables, nuts, and whole grains while reducing the amount of sugars and fats, avoiding too much processed food and so on is not some amazing new diet plan that you'll be able to sell some fancy book about, but it's pretty much the actual advice you need to follow if you want to stay healthier.
Anyhow, I see this over and over again, and then I hear from eager people who want to tell me that low-carb, no fasting, no gluten free, no lactose free diets will help them lose weight, prevent cancer, prevent heart disease, prevent Alzheimers, prevent autism or ADHD, do all of the above and more, and there's no risk, they're so healthy, why would anyone not do this? And then I read the literature, and I find that actually, this new diet has quicker effects in the first six months but is about as effective as the last fad diet was after a year, and actually it does have certain dangers, and so on.
Eat less, exercise more, keep it healthy. Beyond that, don't worry too much, and do everything in moderation. Take all dietary science with a grain of salt, since it's a tough field to study the real, long term effects of (20 year studies are considered to be long term studies, but that's only a fraction of a life, meaning that many real long term effects get very little study). Take industrial food with an even larger grain of salt, as it's more likely optimized for shelf life, profitability, or narrow nutrition claims to be able to put some particular label on it, rather than flavor and health. Don't drink soda; I don't care if it's regular or diet, or whether the sugar is corn syrup or cane sugar. Soda is always extra calories that you don't need, or extra sweetness sans calories that confuses your body. And don't drink venti mochafrappucaremelates, or whatever the hell they're called. Don't eat salty snacks on a regular basis, but don't be afraid to put a pinch of salt in your food to make it taste good. Don't have dessert with every meal, but don't be afraid to have a slice of cake at a birthday party.
Anyhow, rant over. I just get upset when I see people getting religious over some new diet fad, which in 10 years will be the diet that the people selling a new diet fad will be talking about in their "you've been lied to for all of these years. Learn how to really stay healthy and lean!"
> I didn't really see anybody getting religious, but why is it you get so emotional about this?
It's just that there have been one too many threads of people promoting some particular fad diet idea (gluten is poison! sugar is poison! soylent is the food of the future!) and I'm getting kind of sick of them. I've been hearing these fad diet ideas for years, it's just different things which are claimed to be the poison or different combinations of things or combination of restrictions which are claimed to be the be-all cure.
This thread hasn't been particularly bad, though you were a bit overly pushy about ketogenic diets and dismissive of criticisms of them earlier: "I'm not aware of any scientic data that found adverse consequences. You get a lot of resistace from health professionals because for the last decades what you eat on a ketogenic diet has been blamed for heart diseases or high cholesterol, but there never was scientific evidence to back up those claims."
> So eating above one's caloric requirement and a lack of energy are always problems of willpower?
No, there is not always a problem of lack of willpower. Metabolism plays a role, though diet and behavior play a big role too. There are certain circumstances for which ketogenic diets are appropriate, just like there are certain circumstances for which gluten free diets are appropriate; likewise, just because they are appropriate and effective in certain cases doesn't mean they are appropriate or effective for every case.
I think that for a lot of people, however, the problem is willpower. There are a lot of people who just want an easy excuse or an easy answer, when there really is an easy answer that just takes a bit more willpower.
I do believe that the low-carb, paleo, ketogenic, and likewise diet fads have at least helped combat the harmful emphasis on low-fat above all else. I recall at the height of the low-fat craze finding lots of fat free and low-fat foods that were stuffed with tons of sugar to compensate.
> I think everybody can get behind this, it's like thinking of the children.
No, I don't think everyone can get behind it. There are a lot of people who take the "you can eat whatever you want as long as it's not carbs" idea and eat way too much bacon, pork rinds, and the like.
Fresh fruits and vegetables are healthy. Eating pork rinds instead of a banana because the banana is fairly carb rich and the pork rinds are not is not healthy.
> So grains healthy, fat bad? As you don't mention meat that's probably also bad? Well, it's the details that get interesting, what are healthy foods.
I don't think dividing it into "this entire category of food is healthy, this food is not" is a good way to approach your diet. So no, I'm not claiming "grains healthy, fat bad". Both grains and fats are good for you, in moderation. Likewise meat. All of these things can be bad for you when taken to excess; eating too much meat can give you cancer (and some meats are fattier, leading to the problems with too much fat), too much fat can raise your cholesterol leading to heart disease, too much grains (especially highly refined grains) can lead to spikes in blood glucose and harm your insulin response.
What I'm saying is favor fruits and vegetables over grains, favor whole grains over refined, treat meat as a supplement, flavoring, or occasional treat rather than the central part of every meal, favor unsaturated fats (generally vegetable oils and fish) over saturated fats (generally from other animal sources), and keep refined sugar consumption very low. If you need to lose weight, eat a little less, and try to fill up a little more on things without much caloric value like greens (but don't go spending all of your time eating salads, as they generally come with dressings that consist mostly of fat and sugar, defeating the whole point).
Personally, I follow this by eating meat (of any form, fish, poultry or red meat) only about 3 times a week. I never drink soda (can't stand the stuff now that I'm not used to it any more). I generally use unsalted nuts or fruit as a snack if I need something to tide me over between meals (but don't snack often). I usually buy whole grain bread. But I cook with butter plenty (as well as with olive oil, I love sauteing food in a combination of the two), I put cream in my coffee, I enjoy the occasional juicy steak, I eat a lot of cheese (my one main vice), and I have the occasional dessert.
Now, I don't claim that my diet would work for everyone. That's why I'm not out selling it; it's just what happens to work for me. But I do think that it's good to employ an approach of moderation and avoiding thinking about food in black and white terms, unless there's a very good reason why a food should be completely banned (like if you have celiac disease, a nut allergy, or a moral objection to consuming animals).
> though you were a bit overly pushy about ketogenic diets and dismissive of criticisms of them earlier
Seriously, you keep calling LCHF keto a "fad diet" and accuse people who talk about it of "selling books", calling it the "be-all cure" or eating "way too much bacon, pork rinds, and the like". Your underlying tone is really ad hominem, you seem to think all ketoers are stupid, uneducated or in it for a quick buck.
"Of note, in intervention trials that have shown protective effects of reducing saturated fat, ie, the Veteran Affairs (19), Oslo Diet Heart (20), and Finnish Mental Hospital (21) studies, the calculated P:S ratios ranged from 1.4 to 2.4—values that are much higher than the threshold of 0.49 above which CHD risk has been reported to be reduced (44). Relatively high P:S ratios (1.25–1.5) were also observed in the Anti-Coronary Club Study, an early trial that showed beneficial effects of a lower fat diet (30–32% of total energy) (45). The presumed beneficial effects of diets with reduced saturated fat on CVD risk may therefore be dependent on a significant increase in polyunsaturated fat in the diet. Existing epidemiologic studies and clinical trials support that substituting polyunsaturated fat for saturated fat is more beneficial for CHD risk than exchanging carbohydrates for saturated fat in the diet, as described further elsewhere (46)."
Exactly as I said, favoring unsaturated fat in diets over saturated fats seems to have benefits as far as cardiovascular disease, while replacing fats with carbohydrates leads to poor results.
> Polyunsaturated and monounsaturated oils have to be balanced. Too much omega-6 rich polyunsaturated vegetable oil like from soybean or corn may actually increase risk of heart diseases
Sure. I wasn't trying to lay out every possible dietary guideline, just a few rough ones. And I really mean them as rough, and meant to be broken. I don't believe that we know enough about dietary science at the time to make strong judgements; making drastic dietary changes on the basis of poorly understood science can be a bad idea.
One rough metric for whether a diet is good to eat is whether it a similar diet has been eaten over the past few hundred years by agricultural societies; that gives at least some evidence that it works over a large population for a long period of time. It's not perfect, and modern scientific understanding can help us understand and improve it, but it gives you a good baseline.
I don't really buy the paleo idea that we evolved for the hunter gatherer diet, and then evolution stopped; after all, Europeans evolved white skin as a result of agriculture, so I find it a lot more plausible that our digestive system has likewise adapted to agriculture, though it's too quick for it to have adapted to modern industrial agriculture and food processing.
Given that we've been eating butter, olive oil, and lard for centuries, while corn and soybean oil are inventions of modern agriculture, I tend to favor the former over the latter.
> Seriously, you keep calling LCHF keto a "fad diet" and accuse people who talk about it of "selling books", calling it the "be-all cure" or eating "way too much bacon, pork rinds, and the like". Your underlying tone is really ad hominem, you seem to think all ketoers are stupid, uneducated or in it for a quick buck.
I do think that there's a LCHF/keto fad. I've seen a lot of fad diets over the years, and it has all the trappings of one. I don't think that all ketoers are stupid, uneducated or in it for a quick buck, but I do think that lots of well meaning, smart people can get caught up in fad diets, just like the low-fat fad that was popular for so long (and still has plenty of vestiges in nutrition advice and policy today).
That doesn't mean that that there aren't valid uses for a keto diet. That has been demonstrated in a variety of studies, and a classic example is in epilepsy. What I don't think has been demonstrated is the long-term efficacy of keto diets over normal calorie restricted diets. Keto tends to get results quicker (at the expense of some unpleasant side effects) but the advantage tapers off after a year.
On the other hand, low-fat diets are useful for specific therapeutic purposes as well, such as people having gallbladder problems. We've all seen the damage that over-emphasis on low-fat diets for the general population has done. Look at all the trans-fats people have consumed while avoiding saturated fats; and all the sugars that have been substituted for fats in foods to try to make bland processed food taste better.
From the evidence I've seen, I think that low-carb is likely to be a bit safer than low-fat as it's easier to wind up consuming more calories in carbs when eliminating fat than vice versa, but I do worry that too many people deciding to jump on the low-carb high-fat or low-carb high-protein bandwagon may wind up doing themselves harm; possibly from causes that we already know, and possibly from things that we don't know.
By the way, I think you've mistaken what ad-hominem is. An ad-hominem attack is one in which you attack a person rather than their ideas. That's not really what I've done; I've just been fairly dismissive about the idea. Perhaps I've been unduly dismissive, but having recently been in a thread discussing gluten free diets, I'm feeling a bit uncharitable towards the tendency for people to latch onto a dietary idea that is a very effective treatment for a very specific problem, and decide that it's the solution for everybody and must be evangelized far and wide.
> From the referenced study: "associations of harmful factors, including intake of trans–fatty acids and foods with a high glycemic index or load"
> You seem to have missed the other half of that statement.
What the actual frack? No, I can read, and we weren't talking about trans-fatty acids at all, how on earth could I have missed something we're not talking about? Or did I promote eating processed foods?
Anyway, this doesn't seem to lead anywhere, you have made up your mind.
One of the possibly side effects is decreased kidney function from the rapid increase of proteins in the diet (which don't metabolize very cleanly compared to fasts or carbohydrates). People with kidney issues or possible problems should avoid these diets. Kidney stones are much more common IIR.
Another is lower bowel problems as these diets frequently don't have enough fiber in them to keep things moving.
I lost a ton of weight (about 60 pounds) but I also had some weird problems that made me give it up:
- I felt unbelievably hungry all the time. Even after eating a huge meal. This is supposed to go away after a few weeks, but months into the diet I still felt like this.
- I felt like grease was oozing out of me at all times. I just felt icky and couldn't ever feel completely clean.
- My hair and fingernails grew at astonishing rates. I was cutting my nails every 3 or 4 days at one point.
- I had wretched B.O.
- I was constipated all the time. Low-carb fiber supplements solved this.
Good things:
- My mental clarity was unbelievable. You don't get drowsy in the middle of the day, and you don't really need anything to help wake up.
- I was doing lots of sports then and injuries healed so fast I felt like Wolverine. I never bruised during this time and I was doing full contact kickboxing.
- I was easily the strongest I've ever been.
- Weight loss was pretty constant till I hit a nice comfortable plateau at a good weight for me (a little under 160).
I've also done vegetarian diets and for a brief spell vegan diets. It's hard to compare how much better I felt overall on the first diet than the vegetable based ones though.
"One of the possibly side effects is decreased kidney function from the rapid increase of proteins in the diet (which don't metabolize very cleanly compared to fasts or carbohydrates). People with kidney issues or possible problems should avoid these diets." You are confused and incorrect on this point at least, I recommend anyone considering this to go to some legitimate sources of information. There is a liver condition that is unrelated to ketogenic diets which people confuse mightily.
I've gone on keto 3 times, for different periods of time, and after being off of them for a month or so, I've developed kidney stones.
I have no idea if they're related, but I am the only one in my family that gets them (no medical history) and it's the only 'abnormality' in my normal, generally healthy, life.
Nope, I'm definitely correct on this point. There's an unbelievable amount of bullshit in ketogenic diet circles about it - to the point an absurd reverse of well researched results. It's one of the very well researched downsides of any low-carb, high protein diets. The trick is to eat low-carb and low-protein as high-protein diets simply aren't good on kidneys. But then you're basically just eating fats and that gets boring. It's very hard to get dietary fats without one or the other though.
"By restricting carbohydrates drastically to a mere fraction of that found in the typical American diet, the body goes into a different metabolic state called ketosis, whereby it burns its own fat for fuel. Normally the body burns carbohydrates for fuel -- this is the main source of fuel for your brain, heart ,and many other organs. A person in ketosis is getting energy from ketones, little carbon fragments that are the fuel created by the breakdown of fat stores. When the body is in ketosis, you tend to feel less hungry, and thus you're likely to eat less than you might otherwise. However, ketosis can also cause health problems, such as kidney failure (see below)."
"What Are the Risks Linked to High Protein, Low-Carb Diets?
High protein, low-carb diets can cause a number of health problems, including:
Kidney failure. Consuming too much protein puts a strain on the kidneys, which can make a person susceptible to kidney disease.
High cholesterol . It is well known that high-protein diets (consisting of red meat, whole dairy products, and other high fat foods) are linked to high cholesterol. Studies have linked high cholesterol levels to an increased risk of developing heart disease, stroke, and cancer.
Osteoporosis and kidney stones. High-protein diets have also been shown to cause people to excrete a large amount of calcium in their urine. Over a prolonged period of time, this can increase a person's risk of osteoporosis and kidney stones. A diet that increases protein at the expense of a very restrictive intake of plant carbohydrates may be bad for bones, but not necessarily a high-protein intake alone.
Cancer. One of the reasons high-protein diets increase the risks of certain health problems is because of the avoidance of carbohydrate-containing foods and the vitamins, minerals, fiber, and antioxidants they contain. It is therefore important to obtain your protein from a diet rich in whole grains, fruits, and vegetables. Not only are your needs for protein being met, but you are also helping to reduce your risk of developing cancer.
Unhealthy metabolic state (ketosis). Low-carb diets can cause your body to go into a dangerous metabolic state called ketosis since your body burns fat instead of glucose for energy. During ketosis, the body forms substances known as ketones, which can cause organs to fail and result in gout, kidney stones, or kidney failure. Ketones can also dull a person's appetite, cause nausea and bad breath. Ketosis can be prevented by eating at least 100 grams of carbohydrates a day."
There's tons more. But I can't be bothered right now.
That's with respect to high protein diets, and not necessary to keto, which is typically a medium protein, high fat diet. I'm also not certain an uncited webmd link is the best nutritional reference.
Seriously, if webMD is getting canned as a fringe site these days with inaccurate medical information and nothing to counter their medically accurate information, then there's literally nothing you can trust on the internet.
It's literally the accredited health care information site.
I'm not saying that their information is free from being wrong, just that given a standup between webMD and some random keto blog, I'll go with webMD.
Regardless of the source of dietary calories, a diet that triggers ketone production, which is the point of a ketogenic diet, introduces ketones into the bloodstream, which are processed in the kidneys.
Because there appears to be at least 2 people on HN who don't know about ketones (a family of organic compounds that includes acetone), but know about ketogenic diets, a well known and researched diet intended as a medical aid for epilepsy in children with a wealth of academic research on the effects of the diet both positive and negative. But it's also used widely to treat type 1 diabetes. Since diabetics often have reduced kidney function, ketone management can become critically important.
We know that ketogenic diets stress kidneys. This is basic information known to medicine. It's about as basic anatomy.
Other well known side effects include bone demineralization, constipation (which increases risk for colorectal cancer and other lower digestive complications), menstrual irregularities in women, increased colestrerol (up to 30%!), kidney stones are recorded at rates as high as 1 in 20, acidosis and all that includes.
It's considered as a diet that you should only go on under doctor supervision and constant blood tests.
The liver produces all the glucose that your body needs, which is mostly used by the brain. The likely consequence is that you might need to eat more protein to replace the amino acids scavenged for this purpose.
In practice, you cannot contract a dietary deficiency disease from eliminating sugar unless you have a genetic defect affecting liver function. Even if you also eat no protein, your body will self-cannibalize muscle tissue to keep the brain alive.
It appears as though the evolutionary pressures on humans have produced support for two different energy metabolisms. In times of feast, where sugars and starches are consumed in excess, the body operates on glucose and glycogen, and stores fat. In times of famine, the body operates on ketones produced from its own body fat, and the brain operates on a combination of lactic acid and sugars scavenged from the body's protein stores.
The potential consequence of this is that if you ever do start eating significant quantities of sugar, your body will chemically signal that famine is over, and prioritize the restoration of your body fat stores. In other words, you can never go off the diet if you want to maintain your weight, as your body will want to turn every last scrap of excess sugar into fat as fast as possible.
This seriously sucks, because the brain is hardwired to love sweeter foods--foods that surround us constantly. It's like Lou Wu from Niven's Ringworld resisting the urge to eat the magic sweet potato that turns Pak breeders into protectors. Your limbic center wants that doughnut, no matter what that prudish frontal lobe says. So low-carb dieters have to consistently maintain a high level of sheer willpower for their entire lives. That may not be physically stressful in the cortisol-producing sense, but it is stressful mentally.
Sugar is a rather broad term, I'm assuming you mean white refined sugar (sucrose, a disaccharide).
You absolutely don't need to to eat any sugar at all. Simply put, glucose (a monosaccharide) is what normally power our cells. Glucose can be produced from hydrolyzing longer carbohydrates, or even from fat and proteins via gluconeogenesis.
> what are some potential consequences of starving your body of sugars
If you look at history we've never had so much sugar in our diet at any point in human history, not to mention the fact that most sugar isn't actually sugar but things like HFCS which has a higher glycemic index.
The keto flu may sound bad, but it happens because your body isn't used to producing ketones since you've never been in ketosis before. I've been on and off keto for the last two years, and I don't get a keto flu since the first time I went into ketosis.
People assume that's a bad thing, but that's not a trivial assumption. Yes, it's not convenient - but e.g. fever - while indicative of a disease, is most of the time a good thing (unless it is life threatening, taking down the fever with Tylenol or Advil is likely to prolong the disease). Those flu- like symptoms might be a good, if uncomfortable, process.
I don't know myself - I'm just pointing out that it is not necessarily an indication that keto is bad for you.
Sounds good in theory (sugar is bad), but it sounds stressful (body starts producing ketones due to suck a lack of sugar, flu like symptoms for a week).