
Study: Low Carb Diet May Prevent, Reverse Age-Related Effects Within the Brain - rajnathani
https://news.stonybrook.edu/newsroom/study-shows-low-carb-diet-may-prevent-reverse-age-related-effects-within-the-brain/
======
throwaway_tech
The title is terrible, it should read ketosis/ketones may prevent, reverse
age-related effects within the brain.

"Low carb" as the title currently reads does not necessarily result in ketosis
and your body/brain running on ketones, which appears to be the scope of this
study. There is more to dietary ketosis than low carb, just as an example
carnivore or paleo diets are low carb, but those will generally not result in
ketosis, in protein rich diets your body will convert the protein to glucose
which will continue to be the primary fuel for the cells in the brain/body.

If you have never entered ketosis and experienced your brain running on
ketones, I would suggest you experiment for yourself. I would say a minimum
2-3 months which should be enough time for your microbiome to change and your
body/brain to adapt primarily running on ketones.

~~~
bad_user
> _If you have never entered ketosis and experienced your brain running on
> ketones, I would suggest you experiment for yourself. I would say a minimum
> 2-3 months which should be enough time for your microbiome to change and
> your body /brain to adapt primarily running on ketones. _

I've been on Keto for about 8 months (before giving up), measuring my blood
ketones and being in deep ketosis between meals (over 2 mmol/L). I've also
seen values going over 4 mmol/L.

In spite of popular belief, nothing happens, there's no magic at the end of
that rainbow for most people. If you felt anything different, there's a high
likelihood it was just self suggestion, aka placebo.

Also most people are in ketosis before eating breakfast in the morning,
because the liver's glycogen is partially depleted overnight, enough for the
liver to produce significant ketones. And nothing will make you enter ketosis
faster like skipping a meal or two (aka starvation ketosis). People with a
healthy metabolism cycle in and out of ketosis all the time.

Also the idea that your microbiome has to change and your body/brain to adapt
for you to feel any better and that it takes months ... is a complete myth.
Your body takes only mere days to adjust to any dietary strategy. Also the
dreaded keto flu is just dehydration from all the lost glycogen, which pulls a
lot of water on its way out.

~~~
hcurtiss
I actually agree with most all of your posts. The one big difference, though,
in my opinion, is that when adapted to a very low carbohydrate diet, it's
actually easier for me to not eat. That's it. To me, it's the lone advantage.
It's not about the palatability of the low-carb meals. It's that I just seem
to be less hungry. I can skip a meal and it's no big deal. When I'm higher
carb, missing a meal takes a way bigger toll.

One other thing I'd offer -- for long endurance activities at higher heart
rates (e.g., cycling in zone 4 for more than an hour), you absolutely have to
supplement with carbs. You can go a long time in Zone 3 on a low carb diet,
but as exertion increases, you burn through those sugar stores and bonk. I've
tested this repeatedly. In case it's helpful to others, you can consume quite
a bit of sugar on a hard ride and be right back in ketosis hours later as your
muscles take up the glucose first.

~~~
windexh8er
When you state "very low carbohydrate diet" \- what do you mean? Do you mean
you're actively avoiding fruits and vegetables, oats, nuts, etc? Or are you
avoiding processed foods and the carbs that go along with that? The "carbs are
the devil" argument is a huge misconception with people.

You mentioned that it's easier for you to not eat on a very low carbohydrate
diet. My main eating regimen is two feeding periods that are generally between
12:00P and 8:00P. My diet is mainly plant based, so very high in unprocessed
carbohydrates - and I do still eat fish and am also not opposed to eggs from
time to time. I have no problem not eating. If I don't eat at all until the
early evening I am generally never hungry.

So I'm genuinely interested in what you mean by "high carb". Processed carbs
and satiety don't go hand in hand, but a "high carb" intake of whole foods is
not remotely the same.

~~~
hcurtiss
By "high carb," I only mean to suggest easily-digestible high-glycemic index
carbohydrates. I really do think there's something to the blood glucose spike
and crash cycle and its relationship to satiety. I suspect you agree with
that. However, whether through plants or other foods, I think it's the fat
that most effectively satiates. You can get those fats through nuts and plant
oils, but I find it's easier and tastier to get it through butter, eggs, and
red meat.

~~~
windexh8er
With regard to agreement, not exactly. There's a lot of research around high
fiber intake being one of the most prominent indicators of satiety [0]. Keep
in mind most all meats are densely loaded with calories compared to whole
plants. Fats are less satiating than fiber in many studies [1]. Hence it's far
easier to overconsume fats via meats because no meat contains fiber and,
again, is more dense per gram with regard to fat.

[0]
[https://www.nature.com/articles/s41430-018-0295-7](https://www.nature.com/articles/s41430-018-0295-7)

[1]
[https://www.ncbi.nlm.nih.gov/books/NBK53550/](https://www.ncbi.nlm.nih.gov/books/NBK53550/)

~~~
hcurtiss
I don't actually read either of your linked studies to support what you say.
But be that as it may, I think fiber is also satiating. It's just difficult to
hit my macros when eating all broccoli. Broccoli, butter, and steak, on the
other hand, is a nearly perfect meal. I get the sense you're invested in a
plant-based diet. Good for you! I'm sure there are way to engineer the
outcomes you want with plants.

------
blakesterz
Here's the actual study, I'm always skeptical of University PR reports on
studies:

[https://www.pnas.org/content/early/2020/03/02/1913042117](https://www.pnas.org/content/early/2020/03/02/1913042117)

"Together, our results suggest that brain network destabilization may reflect
early signs of hypometabolism, associated with dementia. Dietary interventions
resulting in ketone utilization increase available energy and thus may show
potential in protecting the aging brain."

~~~
technoplato
Definitely skeptical here as well, but the article seems to echo these
sentiments fairly accurately. I’ll have to head the study though to say for
sure.

------
ropiwqefjnpoa
Sugar, not fat is the killer. Incredible how for decades bad research and the
likes of Ancel Keys and Phil Sokolof put the health of millions at risk.

~~~
collyw
Is this definite and scientific consensus?

Nutrition research seems to change as often as JavaScript framework of the
month. I saw one Ted talk that essentially said "everyone is different and no
rules apply to everyone".

~~~
nscalf
The real issue is that nutrition science is bad and everyone has a book. Maybe
1 in 20 studies don't have obvious confounding factors that cause us to have
no real base facts, but we can find a lot of correlation. Unfortunately, this
is kind of the nature of the beast, nutrition science isn't bad because
nutrition scientists are bad, but rather because it's so complicated it's
tough to have very clean data.

Demonizing fats in favor of sugar as a country has allowed one of the biggest
and longest population studies of its kind, and it's pretty obvious from the
health of the population that very high calorie, sugar rich diets are overall
bad for you (notice the wide strokes we have to make here).

Everyone is different, and no rules apply uniformly to everyone, but general
rules do apply to everyone. Fructose in a caloric surplus is more damaging
than glucose, for instance, but different bodies are more or less effective at
mitigating this. Most people have some inflammation response to gluten, but
for the vast majority of people, it's minor. Most things are a sliding scale,
on one end is no measurable result, on the other end is acute response.

NOTE: I'm not interested in arguing about what the research says here. I know
the pro-gluten party will come out in force, and I've made an enemy with the
bread baker's union. I'm not a researcher, I'm just a nutrition hobbyist.
There are much smarter people doing much more comprehensive breakdowns and
having much more meaningful debates than I can, so go listen to them. Read the
research yourself with a skeptical eye. Take all dietary advice with a grain
of salt, and check the opposite side of the research, nutrition and biology is
WEIRD.

Also, we're still learning very basic things that have massive impacts. No one
was talking about "gut health" unless you had a chronic disease roughly 10
years ago. Microbiome didn't have much place in the conversation about health
and nutrition, no crossfit people knew about resistant starches, etc.

~~~
cageface
The government may have been advocating low fat diets but of course people
don't follow nutrition advice. If you look at what people were actually eating
in the time you describe they started eating more of everything. Consumption
of chicken and cheese in particular exploded.

Sugar consumption has actually been in decline for years now and obesity keeps
climbing. Yes sugar is bad for you but blaming modern health problems just on
sugar is not accurate.

~~~
nscalf
Yeah maybe I should be clear here, I'm not talking about putting granulated
sugar in your coffee. I'm talking about the explosion of dumping high fructose
corn syrup into everything that occurred during these years. And teaching
children that they need to eat foods based off the food pyramid was directly
opposite to what was actually good for you. Of course everyone doesn't listen
to the government recommendations, but it's naive to say it doesn't have an
impact.

In addition to that, eating a bagel for breakfast, a sandwich for lunch, and
having bread on the side with dinner is pumping carbohydrates for you body to
break down into sugars 24/7\. These things are higher in calories.

To reinforce what you're suggesting, I'd need to see trends of added sugars to
food going down and the obesity rate increasing. At the end of the day, it's
calories in vs calories out, but pumping things with fructose increases the
calories and the palatability of food, increasing how much you eat. There are
a number of negative health side affects, but sugar likely causes obesity by
secondary affect.

------
chriselles
I’ve been on a keto diet almost exclusively for over 2 years now.

Results have been very impressive for me.

Not just in weight management, but also for fitness/performance.

Anecdotally, cognitive performance/output feels like I’ve moved the needle in
the right direction.

Not sure if related, but multiple tests on telomere measurement(associated
with cellular ageing) show “genetic age” well below my chronological age.

Despite all of this, I really don’t know.

The low carb and no sugar diet really seems to work for me.

If I had to guess, I’d say there is no single overwhelming factor to
increasing longevity.

I think brain health is a mix of:

Healthy nutrition Hydration Fitness/activity level Sufficient sleep Low
stress(but not no stress) Purpose People in your life Traumatic brain injury
prevention Life long education Reading as a hobby No smoking

But in terms of mental agility(if not brain aging), I have a feeling that some
low level of hunger is a positive indicator of short term mental agility.

I reckon there’s a high performance zone for brain health/performance for both
short-term and long-term.

I look forward to more quantifiable research in this space.

Just my amateur 0.02c

------
Munky-Necan
I think the prevailing theory will eventually be that a diet rich in
monosaccharides is detrimental to health. It's been demonstrated that low
carb, high meat diets are not the optimal diet, in that most adults will eat
red meat or some type of processed meat and little fiber. Both add to the
numerator when looking at myocardial infarction, stroke, and colorectal
cancer. When one is in kidney failure it is recommended by the American
Society of Nephrologists to attenuate protein derived from animal products.

Essentially, balance is what the current recommendations say, but also to stay
completely away from sugar.

All my sources shamelessly stolen from Uptodate:

> U.S. Department of Health and Human Services and U.S. Department of
> Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition.
> December 2015. Available at
> [http://health.gov/dietaryguidelines/2015/guidelines/](http://health.gov/dietaryguidelines/2015/guidelines/)

>Carbohydrate quality and human health: a series of systematic reviews and
meta-analyses. Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga.
Lancet.

>Changes in diet and lifestyle and long-term weight gain in women and men.
Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. N Engl J Med.

>Meta-analysis of the association between whole grain intake and coronary
heart disease risk. Tang G, Wang D, Long J, Yang F, Si L. Am J Cardiol.
2015;115(5):625. Epub 2014 Dec 18.

~~~
cloverich
I miss my up to date access. Tangential -- I do not think people realize a
resource like UpToDate exists. Well written up to date summaries of various
medical topics based on the latest research. Were something like this to be
publicly accessible it would do wonders. If anyone is working on or wants to
work on this type of problem please let me know, I'd love to help out
(programmer, former MD).

------
hoka-one-one
Is it too much to ask that anyone promoting low-carb based on personal
experience post bloodwork? I think it's pretty clear no one on here is well-
versed in nutrition as we're all programmers, so maybe it'd be good to have
some intellectual integrity.

I'm interested in prolactin, thyroid, liver, cholesterol, CO2.

~~~
lhl
I've gone through several thousand papers the past year or two so I feel like
I'm more well-versed in nutrition than most nutritionists/dieticians at this
point, certainly in my understanding the recent clinical/research literature.
I rarely post any nutritional/health related statements without citations to
peer-reviewed work (see:
[https://news.ycombinator.com/threads?id=lhl](https://news.ycombinator.com/threads?id=lhl)
)

I think most people don't publish labs because they view it as personal, but I
did a write-up last year, which includes (IMO) basically all my relevant
markers: [https://randomfoo.net/2019/09/17/1-year-personal-health-
inte...](https://randomfoo.net/2019/09/17/1-year-personal-health-intervention-
summary)

A very strange set of lab markers you're interested in btw - prolactin has
very little clinical value for men (and is almost never tested), but I tested
my testosterone at the one year mark (it's fine, 772ng/dL, I have not
sequential tests). I had a thyroid panel last year as well and TSH, FT3, and
FT4 were all in range. My CO2 has stayed the same regardless of diet - I don't
know why that would be relevant at all.

For people looking to track their metabolic health, the bloodwork I think is
most useful to track over time: CMP, CBC w/ diff, basic lipid panel (fasted
12h), A1c, fasting insulin, Vitamin D, hsCRP. I also was getting a full iron
panel, and it was interesting to see my ferritin remained elevated last year
(but is within range now - likely a marker of resolving MetS).

The thing that almost no one gets measured that is almost criminal IMO is
fasting insulin - while it's highly mobile, it's also dirt cheap ($8 more than
FBG+A1c direct-to-consumer price), allows calculating the best IR indices, and
is a 10-15y leading indicator for chronic metabolic disease.

At home, waist circumference to height ratio (WHtR, WSR) is the best simple
marker for tracking metabolic health.

Ashwell, Margaret, and Sigrid Gibson. “Waist-to-Height Ratio as an Indicator
of ‘Early Health Risk’: Simpler and More Predictive than Using a ‘Matrix’
Based on BMI and Waist Circumference.” BMJ Open 6, no. 3 (March 14, 2016).
[https://doi.org/10.1136/bmjopen-2015-010159](https://doi.org/10.1136/bmjopen-2015-010159).

~~~
hoka-one-one
This is really cool and I think you're doing more due diligence than any HN
user I've ever seen. The confounding variable is that you lost a lot of
weight, of course, and I think many people who lose weight will be healthier
at least in the short term. A question I've had in my head for a while is
whether someone who has to stay on a ketogenic diet to be a healthy weight has
"healed" or has just masked the underlying issue.

Would be interested to see your thyroid numbers as you continue on your
ketogenic/fasting diet. "In range" does not necessarily mean optimal, and in
general I'd be worried about T3 uptake going from 33 to 23 even though both
are in range. The liver converts T4 to T3 in response to glucose availability
-- this happens in many tissues, but they all depend on a liver enzyme, and
most of the conversion occurs in the liver.

Low CO2 is a sign of kidney stress and acidosis. I also believe it's a marker
of a low metabolic rate, much like thyroid.

Prolactin is a longer discussion I don't want to get into here (much like you
on your LDL-C :)) but I'll definitely be following your posts as I think
you're doing your part and have done more research than I have so maybe I'll
comment on your blog sometime. Put very briefly I believe high prolactin in
men can be a sign of chronic stress and calcium deficiency. It's been linked
to gynecomastia, for example, which makes a lot of sense. In general I like to
look for tests that show whether something's wrong, rather than what's
specifically wrong. Someone might have alright D but still have issues
properly metabolizing calcium.

~~~
lhl
I'd argue that weight loss _isn 't_ a confounding variable, as resolving
dyslipidemia and MetS is actually one of the main points of the intervention.
As for "masking the underlying issue" \- let's face it, if you go back to
regularly eating a terrible diet, yes, you'll become unhealthy again, but the
same would go be true for any chronic insult.

Personally, I'm a believer in metabolic flexibility and I do take time off
(vacations, parties and special events, or just when I feel like it) to
indulge. The difference now is that I am more acutely paying attention to how
the food is making me feel (turns out for example when I have excess
bread/sugar, I end up getting a pimple or two that I had originally never
connected to being driven by dietary excesses), having a framework to think
about how the food will affect my health (what do I think my liver glycogen
levels are at?), and much pickier in general about how much I'll eat (my
"worth it" taste bar is much higher - if it doesn't taste good I can now just
stop). I also feel like I now have effective tools to pull various metabolic
levers, whereas before I didn't.

Regarding thyroid numbers, IMO taking about what is "optimal" is actually much
trickier than "in range" (which are just standard deviations) because they
need to be taken in the context of how you actually feel and if you present
any symptoms (for hypothyroidism that would be fatigue, increased sensitivity
to cold, weight gain, muscle weakness, etc) - which may be another reason
people don't post numbers. Surrogate markers are most useful 1) sequentially
per individual and 2) need to be considered with whether those numbers
actually correlate with symptoms/reflect pathophysiology. Some are pretty
obvious, but thyroid numbers seem to be one of those that requires a lot of
careful nuance, but seems not worth the trouble (tracking TSH, T3, T4, rT3,
rT4, TPO, Tg) unless you're presenting.

For kidney issues, eGFR is something you'd look at, you'd want to take a look
if any of your CMP numbers are out of wack, but I personally wouldn't be
worried about acidosis - it's almost never a problem for non T1Ds (would be a
sign of a major insulin:glucagon issue at least) but you'd definitely know
(and need to know) if it were an issue well outside of regular bloodwork.

If metabolic rate is a concern, I think RMR and DXA are a much better combo
for tracking, btw.

As for prolactin, if that's something you want to track and can use as a long
term marker that is actionable for you, great, more power to you. It looks
like it's only $60 out of pocket, so not terrible, but just recognize that if
you throw it out there as something that a number that people should know or
care about, or that you want to compare with, it simply won't be.

For chronic stress, I'd suggest 24h cortisol, and maybe some inflammatory
markers (I use hsCRP as my one catch all canary, but other common ones include
ESR, IL6, TNFa), but for most people, you'd probably get more value day to day
from mood and sleep tracking (especially ones that can track HRV or CNS values
like the EMFIT).

Calcium is measured via the CMP and deficiencies would I suppose show up in a
DXA as well (eg if your bone density Z-score was quite low), but again, I
think that's a thing where you'd only be worried about it if you were
presenting symptoms (extreme fatigue, hair and nail issues, sleep issues,
etc).

I do think that if you are trying to track down nonspecific issues (eg
"fatigue") you're going to have to do a bunch of detective work, which may
involve more and more esoteric labs, but I'd also posit that most of those
could probably also be addressed by relatively simple lifestyle interventions,
starting with an appropriate/nutrient-dense diet and the most basic
mood/energy tracking (eg:1-5 phone app like MySymptoms or Daylio correlated
with interventions), and an engineering mindset.

~~~
hoka-one-one
I think a lot of people are aware of prolactin because a lot of overweight men
have manboobs and don't want them. But up to you, at least you're testing
liver and cholesterol -- not everyone can say that. I listed it first because
if someone would only agree to test one thing and nothing else, I think it
should be prolactin.

Well the suggestion wasn't for me personally, it was for people doing keto. My
contention is that if any of those numbers are off, they're probably wrong or
missing something about keto.

Interesting pts on the thyroid stuff, I'll have to think about it

~~~
lhl
OK, so I haven't done much research on this particular issue, but lets say you
have an issue with gynecomastia - this presents itself as a fairly obvious
physical symptom. Does prolactin measurement change either your diagnosis or
the intervention - eg, does it tell you anything you don't know beforehand or
change how you would correct the issue?

Personally, if we're talking about single markers, I think fasting insulin is
the one I would pick because it does fulfill those criteria - it gives you a
10y+ lens before other markers do on diabetic pathophysiology (which now
affects 80%+ of American adults) and also give you guidance on how to
treat/how effective your interventions are. The negative is that there is no
home test (yet, this is being worked on by some people), so it's not as good
as something that can be measured more often/continously.

Everyone who gets an annual physical/bloodwork should be getting their liver
numbers (at least AST/ALT, although in the US GGT is not standard) with their
CMP, although most people (clinicians too) don't really understand what they
mean. I like this presentation on liver markers btw: A/Prof. Ken Sikaris -
"Fatty Liver & Chemical Pathology."
[https://www.youtube.com/watch?v=2c_QYbCxC6g](https://www.youtube.com/watch?v=2c_QYbCxC6g).

It's also important to get these sequentially to see what the actually
progression is (the time frames are usually not captured since people tend to
get these tests once a year at most).

A basic lipid panel is cheap and is somewhat useful for diagnosing gross
dyslipidemia but it's worth noting that it's also much more mobile than most
clinicians believe:

Grant, Azure D., and Gary I. Wolf. “Free-Living Humans Cross Cardiovascular
Disease Risk Categories Due to Daily Rhythms in Cholesterol and
Triglycerides.” Journal of Circadian Rhythms 17, no. 1 (April 24, 2019): 3.
[https://doi.org/10.5334/jcr.178](https://doi.org/10.5334/jcr.178).

------
jaybeeayyy
Not sure if I believe all the hype about these wild benefits low carb/keto
diets have but I will say I've felt so much better on it...I rarely feel tired
anymore and have been weirdly healthy the last 2 years. My doctor was
surprised with my blood tests and weight loss when she heard what I eat lol.
I'd never go back to the amount of carbs I was eating.

~~~
thekingofh
How do you start? I can't seem to find a consistent diet plan that isn't
insanely difficult to get into.

~~~
cgh
Drop all starchy carbs and replace with meat, eggs and vegetables. It’s not
rocket science.

~~~
riku_iki
You need to add some butter, oil and heavy cream, or chances are you are not
in ketosis: 80% of you calories intake should come from fat to guarantee
ketosis.

~~~
tokamak-teapot
This is a popular misconception. Please check the [1] keto FAQ on Reddit.

[1]
[https://www.reddit.com/r/keto/wiki/faq#wiki_how_do_i_start_a...](https://www.reddit.com/r/keto/wiki/faq#wiki_how_do_i_start_and_what_can_i_eat.3F)

~~~
riku_iki
Reading that FAQ, the idea behind low fat intake is that body will provide
fat, which means you need to have some high calories restrictions to initiate
process.

E.g. you need 2k calories for your day-to day life. If you don't want to eat
lots of fat, to get into ketosis you need to decrease your food intake to say
1k, with idea is that 0.05k calories will come from carbs in food, say 0.2k
calories will come from protein in food, 0.75k calories will come from fat in
food, and another 1k will come from body fat.

------
econcon
1\. Dietary cholesterol is only weakly correlated to blood cholesterol.

2\. Most people eat wayy too much. Calories are calories, consume less
calories and run your body in calorie deficit if you wanna lose weight and
surplus if you wanna gain weight.

3\. LDL aka bad cholesterol might not be that bad. There are some new studies
which claim that people who had low LDL suffered more from heart issues. What
gives?

4\. People who eat more sometimes do so to comfort themselves (they've deeper
psychological issues), they'll benefit from eating less.

5\. Polysaturated fats are good fats, monosaturated fats are bad fats.

6\. Carbs are not bad, consuming too much carb is bad for you. Want to lose
weight? Reduce your calorie intake (preferably dinner). Reduce feeding window,
do not eat after 7pm, eat only after 10am.

7\. Lift weight and perform cardio.

That's your current nutritional knowledge.

Want to increase muscles? Much better to start from skinny state and consume
protein, workout and slowly build lean mass through progressive overload. Eat
more protein will not build muscle faster, body will only use what it needs,
not what's given

Most guys/gals on fitness YouTube channels and magnize have achieved that
physique through use of drugs. So do not compare yourself to them and be
disappointed.

------
superbrane
I read some time ago about the Keto diet showing good results even in
Alzheimer/dementia cases. Keto is not the same as low carb but it's close
enough. Our molecular biology and internal chemical reactions are still areas
of research in early phases. Just on a different topic, but in the same
direction - last 10 years research discovered that immunity boosting has much
better results in certain types of cancer than all the other non-surgery
treatments (chemical or radiation).

~~~
toomuchtodo
Keto diet also has efficacy in managing epilepsy.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361831/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361831/)

------
zwaps
I am a bit conflicted. According to the comments, one should do very low carb
diet to adapt to Ketones as energy. For example, fasting would not be enough
for this purpose. But that implies the need for a ketogenic diet.

Very low carb diets are difficult to do, at least if you are not very rich:
Most of them require a lot of meat. Now, that differs by country. These diets
are probably easiest to do in the USA with its huge industrial meat industry.
In other countries, like here in Europe, you'd probably need to be a
millionaire to buy that much meat in the first place. I don't know anyone
doing this successfully.

But in any case: is it ethical? I doubt that this would be sustainable for
everyone. If everyone would eat mostly red meat, we'd probably roast our
planet pretty quickly. I don't think free range farming would support 7
billion carnivores, nor would the fish in the sea.

I realize the people doing Low Carb are not necessarily the same who care
about sustainability. But if there is such a benefit to Ketogenic diets - for
all our sakes - we should think about what happens if everyone wants to do it.

Of course there are options. There are low carb Vegans (e.g.
[https://www.reddit.com/r/veganketo/](https://www.reddit.com/r/veganketo/)),
but boy is it a chore to do. Also, I doubt this can be done with anything
resembling local and unprocessed products. Furthermore, a lot of vegan protein
products are high in soy. Which is fine really for any amount you'd normally
consume. But if you are serious about low carb, you might eat so much that we
get into that "questionable" range in terms of recent research.

Perhaps carbs need not be too low. Yeah we can eat a lot of veggies, probably.
But it'll be a challenge, I think. Or not?

Say, you eat meat once a week. How do you do a ketogenic diet without losing
your mind in planning etc?

~~~
nightvoomer
There are two things being conflated, eating cheap keto and eating vegan keto.

Cheap keto its eating tons of eggs, berries, cauliflower, zuchinni and soy
beans. Eggs are really the main thing though...tons and tons of eggs. Luckily
there are hundreds of different ways to make them.

------
nikkwong
I don't really understand the briefing here; so would taking exogenous ketones
also help mirror the beneficial effects of ketosis seen in this study? They
did mention feeding their participants exogenous ketones but didn't say
anything about those peoples' carb/fat ratios.

I'm all for jumping on the high fat/low carb diet; however, I love getting all
my polyphenols and other beneficial compounds that are part and parcel with
eating plants (higher carb). As many benefits we see from being in ketosis, we
also have tons of data on the health benefits of eating plants, so I've been
confused as to how to get the best of both worlds here.

~~~
projektfu
There are studies looking at this question.

------
bad_user
I have been on Keto for about 8 months, felt terrible and interrupted the
diet, only to later find that a lot of the theory behind it (the CIM model) is
complete bullshit.

And whenever seeing claims of the effects of low carb or keto diets, most
claims are confounded by the diet being hypocaloric, or with a significant
variance in protein when compared with control, with its proponents constantly
shifting the goal posts.

This study seems interesting and it has been known that ketosis can help
epileptics. But take it with a grain of salt ;-)

~~~
dennis_jeeves
What exactly did you eat, and in what quantities? List all that you ate, if
possible. Unfortunately keto has such a broad definition that a lot of harmful
stuff (like seed oils) can be considered part of the diet.

------
sebastianconcpt
_“The bad news is that we see the first signs of brain aging much earlier than
was previously thought. However, the good news is that we may be able to
prevent or reverse these effects with diet, mitigating the impact of
encroaching hypometabolism by exchanging glucose for ketones as fuel for
neurons.”_

The alternation with ketosis as source of energy is key as it seems...

 _The brain’s response to diet was tested in two ways. The first was holistic,
comparing brain network stability after participants had spent one week on a
standard (unrestricted) vs. low carb (for example: meat or fish with salad,
but no sugar, grains, rice, starchy vegetables) diet. In a standard diet, the
primary fuel metabolized is glucose, whereas in a low-carb diet, the primary
fuel metabolized is ketones. However, there might have been other differences
between diets driving the observed effects. Therefore, to isolate glucose vs.
ketones as the crucial difference between the diets, an independent set of
participants was scanned before and after drinking a small dose of glucose on
one day, and ketones on the other, where the two fuels were individually
weight-dosed and calorically matched. The results replicated, showing that the
differences between the diets could be attributed to the type of fuel they
provide to the brain._

------
smallcharleston
The reason I refuse to read about keto is that pretty much all doctors and
public health organizations I’ve seen recommend basically the same things:
whole grains, fruits, vegetables, replace saturated fats with unsaturated if
possible, low fat dairy, nuts, legumes, fish, some poultry sometimes, strictly
controlled alcohol.

Until these guys start recommending something such as keto my basic assumption
is that it’s either a weird fringe diet or a diet only applicable to very
specific medical issues (eg seizures) that me (not a medical professional)
should not try on myself.

If I go to a doctor and they ask how my diet is and I tell them I eat the
stuff I listed above, I’m fairly certain they will tell me good job. If I do
some extreme fringe thing, I doubt it will be their response with the same
likelihood (though a few probably like it).

This is just my personal opinion.

------
tejohnso
Noted that the underlying cause for the improvement comes from ketones. This
should indicate that intermittent fasting would also show similar results. Low
carb diet, keto diet, intermittent fasting, they're all just different ways to
switch the fuel source from glucose to ketones.

~~~
newscracker
Would a time restricted feeding type of intermittent fasting, with a 16/8
schedule, really result in the production of ketones? I thought that it would
take about a day and a half or longer to exhaust carbs and start the switch to
ketones. Then it’s only the longer fasts (like 5/2 days) that could help.

~~~
collyw
If you pee gets more yellow in that time period (I think) its indicative of
ketosis. If anyone is more knowledgeable than me please chime in.

~~~
p0sixlang
I.. don't think that's true at all. Ketones in your urine is indicative of
ketosis. Smell of alcohol on breath is indicative of ketosis. Urine color is
not an indicator for ketosis, it's an indicator for hydration.

~~~
eatmyshorts
You are correct. Urine color is an indicator of hydration. But sugar in your
urine will cause your urine to be cloudy and more opaque. I've noticed that
when I'm in ketosis that my urine is super transparent (just looking at
transparency/opaqueness, not at color).

------
tiffanyh
This isn’t new. Doctors have seen a link between sugar (carbs) and Dementia /
Alzheimer’s

[https://amp.theatlantic.com/amp/article/551528/](https://amp.theatlantic.com/amp/article/551528/)

~~~
tryptophan
No, they saw a link between HIGH carbs in blood over long periods of time
associated with dem\alz.

Eating normal ammounts of carbs isn't going to kill you, it's literally our
main energy source.

~~~
ethanbond
The issue that people, at least Americans, run into is that consuming a
“normal amount of carbs” is shockingly hard if you’re not consciously trying
to avoid them. Foods that don’t really need sugar in them often have it in
huge amounts because it delivers more flavor oomph (and _separately_ delivers
a dopamine hit). This is especially true in the aftermath of the war on fat
because, shocker, fat tastes really good and when you remove it, food tastes
worse. How do you make up for that? Add sugar.

~~~
alberth
Totally agree this is the issue.

Most people don't realize that a plain bagel (55g) has more carbs that a slice
of pie (43g).

[https://www.eatthis.com/foods-high-in-carbs/](https://www.eatthis.com/foods-
high-in-carbs/)

~~~
dnhz
Do you believe that a plain bagel is less healthy than a slice of pie as a
result? The pie will definitely have more added sugars. A plain bagel would
make for a reasonable breakfast. Pie?

------
specialist
What is the current, best thinking on managing LDL, especially while doing
paleo?

I got huge benefits from paleo and partial calorie restriction. The biggest
being my very bad psoriasis all but disappeared.

But it also spiked my LDL.

The statins didn't agree with me. I settled on eating every kind of soluble
fiber I can find. eg: My morning porridge is steel cut oats, quinoa, chia
seeds. I also resumed eating high(est) fiber rice.

Alas, all these seeds and grains have carbs.

I'd like to find strategies for high soluble fiber while reducing carbs. Even
better, would be managing LDL directly.

PS- I spotted u/eatmyshorts comments about LDL and misc.

------
uptownfunk
IF has really saved my life. I definitely feel like i reverse aged a few years
as a result of it. I enjoy food more now, weight is in check, I look younger..
hard to beat the benefits.

~~~
eatmyshorts
As it turns out, insulin resistance, like that associated with type-2
diabetes, is also related to inflammation (apparently due to cytokines:
[https://www.webmd.com/diabetes/inflammation-and-
diabetes](https://www.webmd.com/diabetes/inflammation-and-diabetes)), which in
turn is correlated with heart disease.

As I understand it (disclaimer: I'm not a doctor), the inflammation results in
damage to the blood vessels, which your body repairs by using cholesterol,
among other things, that are in your blood. When LDL cholesterol (the "bad"
kind of cholesterol) is used in this way, it calcifies over time, leading to
hardening of the arteries. As someone with a high CAC score and premature
calcification of my arteries, my doctors have advised me to move to a low-carb
diet and combine that with statin drugs to lower my LDL cholesterol. Low carbs
generally means lots of meat and lots of saturated fat, which is the opposite
advice that doctors traditionally have given for patients at risk of heart
disease.

Lately there have been lots of studies that show that dietary LDL cholesterol
is only very loosely correlated with LDL cholesterol in your blood--primarily
because the cholesterol in your blood is produced in your pancreas, not
ingested/absorbed from your stomach. So I did a self experiment--go on a
ketosis diet for 3 months before I started taking my statins and test to see
if my LDL cholesterol changed. It didn't--it went slightly down in my case.
Then I went on statins--now my LDL cholesterol is at "normal" levels.

So, basically as I understand it, low carb diets can help prevent your body
damaging your arteries in the first place, such that they don't need repair.
Then, the statins lower my LDL cholesterol such that when my arteries do need
repair, the cholesterol that is used doesn't calcify over time. Basically I'm
attempting to address my heart disease from both sides: prevent the damage in
the first place, and remove calcifying LDL cholesterol from my bloodstream
when arterial repair is necessary.

Note that this is all pretty cutting edge stuff, and we don't have good
studies to demonstrate its effectiveness yet. If you have issues with
calcification of your arteries, it is best to work with your doctor to find a
program that works for you.

~~~
cageface
Dietary cholesterol is very directly correlated with blood cholesterol levels.
You can feed someone cholesterol and directly watch their levels spike. But
your body will clear it if you give it time which is why your fasting
cholesterol may not show this if you have naturally low levels.

But during that window if time that cholesterol is active in your blood it's
not doing you any favors. This is why heart attacks very often follow shortly
after a meal.

~~~
eatmyshorts
That is what we used to think. But it's not true:
[https://www.ncbi.nlm.nih.gov/pubmed/22037012](https://www.ncbi.nlm.nih.gov/pubmed/22037012)
[https://www.ncbi.nlm.nih.gov/pubmed/8857917](https://www.ncbi.nlm.nih.gov/pubmed/8857917)
[https://www.ncbi.nlm.nih.gov/pubmed/26109578](https://www.ncbi.nlm.nih.gov/pubmed/26109578)
[https://www.ncbi.nlm.nih.gov/pubmed/7585286](https://www.ncbi.nlm.nih.gov/pubmed/7585286)

Note that dietary cholesterol only correlates to blood cholesterol in about
40% of the population. And even within that group, "Even though dietary
cholesterol _modestly increases LDL_ in these individuals, it does not seem to
increase their risk of heart disease"
([https://www.healthline.com/nutrition/dietary-cholesterol-
doe...](https://www.healthline.com/nutrition/dietary-cholesterol-does-not-
matter#effects) \-- emphasis is mine)

~~~
cageface
You're talking about baseline or fasting cholesterol. You can do the
experiment of feeding someone a high cholesterol meal, then immediately take a
blood sample and see the spike in their blood. This has been confirmed many
times.

------
nickbauman
A lot of folks here are using the term "intermittent fasting". This is a term
that can make people struggling with eating disorders kinda lose their minds.

May suggest to replace this term with what's probably a better way of saying
it anyway, because it's more accurate to what people are really doing when
they say IF: Call it _" time-restricted eating"_. You're eating the food you
eat for a day in a smaller window. Not really fasting.

~~~
lukifer
There is some correlation between the benefits of "time-restricted eating" and
full-blown fasting (autophagy, etc), so it makes some sense to talk about them
similarly. There are many benefits to full water fasts, even for 2-3 days (and
it's much easier to do successfully if one is already in ketosis). See the
work of Dr. Jason Fung:
[https://thefastingmethod.com/](https://thefastingmethod.com/)

~~~
nickbauman
While we're at it: "Intermittent fasting" versus ... fasting until you die?
All fasting is intermittent. IF just doesn't communicate anything regardless.
I think it's clear it's just a bad term. Time restricted eating actually
describes something specific.

~~~
lukifer
Haha, point. To the extent that the term still applies, "periodic fasting"
would be more accurate; but then, that could just as easily refer to yearly
fasting during Ramadan. Does one describe the action, or the absence of
action? The norm, or the exception? I dunno, language is a funny thing. :)

------
togs
I’m confused because I thought the brain liked sugars:

“The bold implication of this idea is that the effects of ego depletion could
be undone by ingesting glucose, and Baumeister and his colleagues have
confirmed this hypothesis in several experiments.”

Kahneman, D. “Thinking, Fast and Slow”. 2011. pg. 43, para. 2, Se. 5.

~~~
wigl
Ego depletion was one of the key losers of the replication crisis in psych.
Book was published right before the peak of the crisis. Basically it's
impossible because the body can't even digest the glucose in time for the
purported effect. Baumeister is also a hack who refuses to let go of the idea
while others have moved on.

changelog: key example -> key losers

------
crad
This is the first time I've seen something reference ingesting or drinking
ketones. While I imagine it doesn't have the dietary benefit for losing fat,
if this is a thing, and it's safe, I'm surprised it's not made it's way into
energy drinks.

~~~
crad
And it has:
[https://duckduckgo.com/?q=ketones+drink&va=z&t=hk&ia=web](https://duckduckgo.com/?q=ketones+drink&va=z&t=hk&ia=web)

Probably should have searched first :)

~~~
arafa
These are ketone ester drinks, but nothing really mainstream or in energy
drinks. Esters are far too expensive and the taste far too bad for that. Most
people have never even heard of these, in my experience.

------
florin0x01
How about weight training and low carb and sometimes IF? Would weight training
prevent age related effects within the brain? Also you can't go full keto if
you also want weight training, imo.

~~~
wtetzner
> Also you can't go full keto if you also want weight training, imo.

You absolutely can, and people are doing it just fine.

Check out Metabolic Autophagy: [https://www.amazon.com/Metabolic-Autophagy-
Intermittent-Resi...](https://www.amazon.com/Metabolic-Autophagy-Intermittent-
Resistance-Longevity/dp/1790686393/)

~~~
tokamak-teapot
Yep working fine here on ‘full’ keto (not sure what other kind there is)
Depends what you want from your weight training. I enjoy it but I’m not trying
to get massive gains.

~~~
florin0x01
Can you detail on this and what type of training you do? Also what type of
gains you experienced?

Sure you can do full keto and weight train but I am interested in the gains
versus low carb / medium carb diets.

As for me, I'm on a low carb diet mostly, although I do enjoy some days of
high carb as well.

~~~
tokamak-teapot
I’ve recently restarted weight training after a few years off due to injury.

I already do plenty of other exercise (martial arts, swimming, yoga, a decent
amount of fast paced walking, circuit training) and I used to weight train so
my form’s okay and I haven’t experienced anything unusual in terms of
soreness.

I’ve been from light weights (~70% of my previous max) slowly up to my
previous max from a few years back and not experienced any problems. I feel
like I’m close to the limit on each exercise but I’m already at my previous
max weights.

And... since I used to do this, I’ve gone keto. So being on keto doesn’t seem
to have any observable negative effect on my weight training.

I can’t say what I’m going to hit because I’m moving slowly and carefully. For
some real stats you’ll need to find studies. I could just be lucky.

------
dot1x
I've been on Keto for 2 months now but I hardly lost any weight. I'm wondering
if my protein intake is too high.

------
5cott0
What's the point of living forever if you're miserable and worn out all the
time from managing oddly unnatural longevity diet regimes?

------
durpleDrank
I love carbs.

------
5cott0
I still don't understand the tech bro fascination with disordered eating.

~~~
wtetzner
Given the current state of health in western countries, I would claim the
stasus-quo is actually disordered eating.

~~~
5cott0
Current status quo is whatever quick fix is fashionable at the moment, i.e IF,
Ketosis, Binge & Purge...

~~~
wtetzner
No, that's the current diet fad, which is not at all the same as what most
people eat.

------
ggffryuuj
Well here I am again. Here are things I think people should know:

Gluconeogenisis does not kick you out of ketosis nor is it’s existence a
counter-point to the keto diet.

I have first hand experience with keto and psychosis. I experienced something
traumatic a while ago and began to have psychotic symptoms similar to
schizophrenia. I had read an article beforehand written by a doctor claiming
that keto benefited his psych patients, so I tried it. It cured me. Most
symptoms gone in a couple days, total remission within a couple weeks. So PSA:
if you or someone you know is having problems with psychotic mental health
problems, keto may help you.

And I should add I was formally diagnosed with psychosis and prescribed
antipsychotics. And the symptoms correlated perfectly with going on and off
keto. Very little ambiguity. They are doing a study on this in Finland but
results won’t be out till December.

