glucose versus cholesterol optimization

[Ron Put]

On 8/2/2021 at 11:20 AM, Dean Pomerleau said:

Quite amusing. Suffice it to say that you should ignore the study in question.

I agree on the good detective work, although not with the conclusion, or at least not wholeheartedly.

Most of the attacks come from a clearly partisan wing of the keto and high-fat camp and while some of the points of contentions seem valid to an extent, others are just personal attacks. 

Fleming may be a crook, and the study may have methodological shortcomings, but it generally jives with a number of other studies or aspects thereof. Even a broken clock tells the right time twice a day.

I don't care enough, so I only spent a few minutes on this, but much of the arguments focus on Fleming's medical fraud conviction, and on the unlikely randomization and 100% completion among the 120 participants. But "unlikely" does not mean "impossible" and even if there were errors, it doesn't mean that the whole study is worthless.

After all, the reversal of the long-standing medical consensus that public mask-wearing showed no practical benefit during respiratory disease epidemics was reversed based on shoddier research and studies (like a researcher yelling through a funnel in a lab), once the media and the Twitter mobs went on the attack. And we are still living with the repercussions of this madness.

[mccoy]

19 hours ago, Ron Put said:

Also, for what it's worth, according to SelfDecode's blood sugar report based on my genetic data, I am in the 3rd percentile of the population for risk of developing diabetes.

3rd percentile = almost zero. But having a look at the glucose spikes real-time  may give you another perspective...

[Ron Put]

On 8/4/2021 at 12:29 PM, mccoy said:

But having a look at the glucose spikes real-time  may give you another perspective...

Yep, I am definitely curious.

BTW, out of "chicken" curiosity, was it painful in any way attaching the sensor?

[mccoy]

8 hours ago, Ron Put said:

BTW, out of "chicken" curiosity, was it painful in any way attaching the sensor?

No, it was actually a zero-feeling operation. I inserted it on the lower part of the tricep as advised in some youtube videos, instead than on the external part of the triceps as advised on the official videos. I used the location the guy in the video did. The gal used a slightly different position.

The application scene starts at about 7:30 minutes

 

[Ron Put]

Thanks, mccoy. I'll see if I can get one within the next week or two.

[mccoy]

This morning I checked FBG and the result was 97 mg/dL, still higher than expected. With this degree of dietary adherence, based also on a previous experience of mine, I was expecting values in the 80 to 85 range. Adjustments of glucose homeostasis require less time than lipids homeostasis (the latter takes about 3 months). So after over one month there remains an elevation in fasting BG which I don't know how to explain. Maybe gluconeogenesis, since this diet is high in protein. Maybe the counter-regulatory hormones, as hinted previously by todd, are for some reasons elevated. I can not decrease protein though, since that would surely entail significant weight loss (including muscle mass loss, as experienced in the past with a low-carb, low-protein diet).

If the situation remains unchanged, the benefits of such a high fat, high protein, low carb diet is just no glucose spikes and a moderate decrease in fasting glucose. I'm also able not to snack, since there is not much I like to snack upon!

Abdomen adiposity remained the same (no visible six-packs). Relatively less aerobic endurance, which may also be due to the heat. 

One evident advantage for dental health is the absence of cariogenic sugars.

It's still soon to judge the effects on lipidemia.

Edited August 7, 2021 by mccoy

[Dean Pomerleau]

Thanks for the honest updates mccoy. It is a really interesting experiment you are conducting. Have you tested your cholesterol while on low carb? Given the topic of this thread it would seem appropriate to do so.

Have you been successful at maintaining your weight? Do you still plan to go back to eating healthy carbs? Soon, or are you giving low carb more time?

It will be interesting to see whether your ability to metabolize glucose has improved, stayed the same or gotten worse as a result of your low carb period. 

--Dean 

[mccoy]

11 hours ago, Dean Pomerleau said:

Have you been successful at maintaining your weight? Do you still plan to go back to eating healthy carbs? Soon, or are you giving low carb more time?

I have lost only about 1 kg, which is all right. I intend to go on, since medium term is probably more representative. I didn't measure cholesterol yet, but they say it takes pretty long to change substantially after a dietary change (about 3 months).

[Mike41]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4731857/
 

Interesting that it appears sodium is a mixed bag wrt insulin sensitivity. Salt sensitive folks tend to improve and salt resistant folks get worse insulin sensitivity with low sodium diets

[Ron Put]

Interesting point about insulin sensitivity, Mike. On a similar note, I was going to ask mccoy about insulin resistance.

It's good to avoid glucose spikes, but high fat intake can lead to insulin resistance, and I'd be curious about mccoy's HOMA-IR at the end of this experiment.

And the lipids panel, of course.

[Mike41]

16 hours ago, Ron Put said:

Interesting point about insulin sensitivity, Mike. On a similar note, I was going to ask mccoy about insulin resistance.

It's good to avoid glucose spikes, but high fat intake can lead to insulin resistance, and I'd be curious about mccoy's HOMA-IR at the end of this experiment.

And the lipids panel, of course.

Perfect point Ron! 
measuring glucose levels is not the whole gambit. Insulin levels are a better indicator. A diabetic can have great glucose levels after taking a stab of insulin but that ain’t an ideal situation.

[Todd Allen]

New low cost glucose/cholesterol optimization option!

[Todd Allen]

For those still on the fence about the benefits of CGM...

https://www.ispot.tv/ad/OCRh/freestyle-libre-14-day-now-you-know-paul

[mccoy]

Todd, metformin sure is an optimization option I thought about. That way the optimization would be greatly simplified since one variable would become less significant (i.e., worry more about saturated fats, less about carbs).

The other option available to eliminate one variable would be statins or PCSK-9 inhibitors.

Another healthier option would be to take berberine and red rice extract or amla and see if the values of both variables are shifted down.

Edited August 11, 2021 by mccoy

[Ron Put]

12 hours ago, Todd Allen said:

For those still on the fence about the benefits of CGM...

LOL, looking at that ad, "Paul" should in fact be saying "No!" to food much more often... :D

 

11 hours ago, mccoy said:

Another healthier option would be to take berberine and red rice extract or amla and see if the values of both variables are shifted down.

mccoy, be careful with long-term berberine. It really screwed up my numbers and stopping it brought me back to normal. Consider that the sudden flood of berberine studies comes mainly from China. I think it's another Resveratrol.

Why not try cutting fats and go plant-based whole food for three months, and see how your numbers go? 

[mccoy]

8 hours ago, Ron Put said:

Why not try cutting fats and go plant-based whole food for three months, and see how your numbers go? 

I've been plant-based whole food for 1.5 years, but I cannot say that's the optimum for my system. Lipids worsened slightly compared to the previous lacto-ovo regimen and I the continued ingestion of soy products did not stand perfectly with my stomach.

Whereas last year I went lacto-ovo vegetarian moderately lowfat and that made me ripped, but at a lower bodyweight than now. I could repeat that, but not after getting thru with this experiment, which is much less impacting than I expected from the side of adherence and stoicism.

[Ron Put]

On 8/12/2021 at 6:40 AM, mccoy said:

I've been plant-based whole food for 1.5 years, but I cannot say that's the optimum for my system. Lipids worsened slightly compared to the previous lacto-ovo regimen and I the continued ingestion of soy products did not stand perfectly with my stomach.

Perhaps try a different version of "plant-based" for a couple of months and test? Like no oil fat (including EVOO), more yams and whole grains, different legumes, like chickpeas and lentils?

It may or may not work for you at the end, but I don't believe you've tried it, unless I am wrong?

[mccoy]

On 8/15/2021 at 10:55 PM, Ron Put said:

Perhaps try a different version of "plant-based" for a couple of months and test? Like no oil fat (including EVOO), more yams and whole grains, different legumes, like chickpeas and lentils?

It may or may not work for you at the end, but I don't believe you've tried it, unless I am wrong?

Ron, I've not tried it but I probably should do it. It doesn't sound so easy to follow in certain circumstances, like on the road and I'm not attracted much by cereals, but I agree it deserves a try.

[Ron Put]

14 hours ago, mccoy said:

Ron, I've not tried it but I probably should do it. It doesn't sound so easy to follow in certain circumstances, like on the road and I'm not attracted much by cereals, but I agree it deserves a try.

I hope you do, I am curious what your results would be :)

I traveled for just over a month recently and it was actually much easier than I thought. What I did is pack my freshly milled flax, chia, nutritional yeast and other stuff, in ziplock bags. My luggage was hand-examined a couple of times by airport security as all the baggies with powders must have looked strange to the staff, but other than that, it was uneventful. I had my core stuff with me and could just mix it all together when I needed it.

[mccoy]

This morning my fasting glucose was 89 mg/dL, on a decreasing trend after 1.5 months of carbs restriction. This is slightly encouraging. The next move will be to check my lipids profile.

[mccoy]

After 5 days of low-carb FMD, fasting glucose was 79 mg/dL, the lowest I ever measured on myself. Of course, this value is the result of ketosis after a reduced carbs FMD and will probably increase , but I would say that a FG concentration between 80 and 90 mg/dL can be considered optimal for most people, surely that applies to me.

Once this parameter has been reasonably adjusted, I'm going to keep the diet moderate-carbs and proceed with the cholesterol parameter, measuring it and deciding what can be an acceptable strategy.

 

 

 

[Ron Put]

13 hours ago, mccoy said:

After 5 days of low-carb FMD, fasting glucose was 79 mg/dL, the lowest I ever measured on myself. Of course, this value is the result of ketosis after a reduced carbs FMD and will probably increase , but I would say that a FG concentration between 80 and 90 mg/dL can be considered optimal for most people, surely that applies to me.

I am pessimistic about the long-term effects of keto, but of course curious about your results.

Some stuff to ponder (apologies if posted elsewhere):

A high-fat, ketogenic diet causes hepatic insulin resistance in mice, despite increasing energy expenditure and preventing weight gain

and
Short-term feeding of a ketogenic diet induces more severe hepatic insulin resistance than an obesogenic high-fat diet

and
Ketogenic Diets Induced Glucose Intolerance and Lipid Accumulation in Mice with Alterations in Gut Microbiota and Metabolites

and I couldn't resist this personal tale :)

Why I Quit The Keto Diet

 

[Todd Allen]

16 hours ago, Ron Put said:

Some stuff to ponder (apologies if posted elsewhere):

A high-fat, ketogenic diet causes hepatic insulin resistance in mice, despite increasing energy expenditure and preventing weight gain

And the keto macros were....  IDIOTIC!  I didn't see what the diet composition was but most of these studies use highly toxic refined seed oils such as soybean oil for the fat.

95.1% fat, 0.4% carbohydrate, 4.5% protein

[mccoy]

Ron, the temporary ketosis I underwent was due to effects of the modified Longo's Fast-Mimicking-Diet I followed for 5 days. My present regime is not a ketogenic, rather a moderately low carb diet (70 to 100 g per day). In a keto diet the ingestion of carbs is severely limited to usually 20-30 g per day max (a little more with exercise). 

[Todd Allen]

58 minutes ago, mccoy said:

My present regime is not a ketogenic, rather a moderately low carb diet (70 to 100 g per day). In a keto diet the ingestion of carbs is severely limited to usually 20-30 g per day max (a little more with exercise). 

Many define a keto diet as 20 g carbs max daily because that is a level at which nearly everyone even the obese with T2D will attain a significant degree of ketosis.  Others consider 50 g daily a keto diet because that is a level that moderately healthy and active people eating a reasonable amount of protein will be in ketosis.  Zach Bitter despite being slim with modest muscle mass has found on days when he runs 100+ miles that he still is fairly deep in ketosis at 250 g carbs per day.

If one is judging a ketogenic diet by measurement of state of ketosis it raises the questions of how does one measure, when does one measure and what level of ketosis is targeted.  The 3 ketones commonly measured are BHB in blood, AcAc in urine and acetone in breath.  Typically people new to ketogenic diets readily spill AcAc to urine for the first few weeks.   And BHB elevates easily in blood for months.  After years of keto many find breath is the most consistent indicator.  I judge my ketosis by breath before breakfast typically after a morning routine with 10 minutes of strength training and a walk of 20 minutes.  And by that measure I can be very liberal with protein the day before, 150-180 g, if carbs are minimal, less than 10 g.  Or if protein is moderate 75-90 g I can push carbs fairly high, definitely 70 g and probably 100 g, especially if the carbs are from things such as aged kefir and nuts and seeds.  After a day of warm fermentation and a few days refrigerated I think much of the carbohydrate in kefir is lactic acid and alcohol which aren't true carbohydrates and minimally suppress breath acetone.  Many nuts and seeds when eaten whole I only partially digest and in addition to the fiber it seems a non insignificant portion of the protein, fats and even sugars are also passing through undigested.