Month: January 2020

The more time I spend reading and having discussions in keto and carnivore groups the more I notice the dogma and misinformation that is spread. Unfortunately these two very healthy diets are becoming as bad as Veganism for it’s level of unscientific and dogmatic views. We need to be willing to be wrong and when we find evidence to falsify our hypothesis we need to course correct and admit we were wrong and why. If we don’t stop ignoring some facts and common sense, this way of life will never be accepted by the mainstream.

Three of those views are:

1. Carbs are evil in every sense of the word and can never be beneficial.
2. Protein can be consumed ad libitum and will never turn to glucose.
3. Calories don’t matter. I’ve been guilty of saying this in the past.

These are the views I want us to get real about and realize that nothing is black and white. Everything is very very grey.

The first thing we are going to talk about is Carbs are evil:

As most of you know, I have been on a ketogenic diet for the better part of 15 years. I started off like everyone else that found keto and saw success and I feared carbs. I thought for sure that carbs in and of themselves caused all disease and made us fat. I spent 10 years doing high intensity Crossfit on zero carbs and while I was fairly successful, I feel my body composition changes were slow. I also got sucked into the trap of low calories. I saw a memory recently from myself complaining that I was eating 1500 calories a day and exercising 6 days a week and not losing weight. I am sure many of you resonate with that.

One fine day I was listening to a podcast about a fruitarian that was eating 50lbs of fruit and veg a day and he was lean and 130lbs. This made me laugh immediately, for one simply because there is no way in hell that anyone could eat 50lbs of any kind of food in a day, and two because he would be fat in no time from all the carbs. I decided to give it a try for the sake of science and to prove I would get fat.

Of course I couldn’t eat 50lbs so I aimed to get 2100 cals a day which was below my normal intake but I was so scared I would gain weight I wanted to mitigate it. I was consuming in excess of 300g of carbs every day.

You can read about that here:

Ketonian goes Vegan

This was probably my most valuable experiment I ever conducted. It taught me more about how little we know than anything else ever could have.

These were the major take aways:

1. It is nearly impossible to over eat on a whole food plant based diet. You just can’t get that much food into you. I was stuffed and had a hard time reaching my target calories.
2. Not only did I not gain weight, I lost weight.
3. My blood glucose was absolutely normal and healthy.

This led me to have to figure out why I didn’t get fat despite eating 300 plus grams of carbs every day. How did I lose weight? Why was my blood sugar control so good?

This led me to further my understanding of glycogen storage and how that contributes to insulin sensitivity and exercise. We have roughly 500g of glucose storage in liver and muscle. If we don’t exceed that storage level and we exercise at enough intensity to empty most of it, we will never get fat or insulin resistant. Especially if we are eating low fat. The reality is that carbs don’t make us fat. Carbs with fat make us fat. The carbs raise insulin and the fat gets stored. Just eating carbs alone can’t make us fat and just eating fat alone can’t make us fat. It requires both just like fire requires both oxygen and a spark. Oxygen won’t ignite or burn without a spark and a spark without a fuel wont make fire.

Here are some more articles that get deeper into insulin resistance and glycogen storage if you want to read more.

What causes insulin resistance?

Why carbs are a problem and when?

How does the body actually deal with carbs/fat/protein?

Carbs don’t make us fat and neither does fat!

I won’t get into how carbs can be beneficial here as this will be long enough. I will do another blog post on that another day. Just suffice to say that if you are an athlete that does alot of very high intensity training there is no fear of consuming carbs before that training and it can only increase our performance in that high intensity range. Do we need them? No. Can they help performance? Yes.

Now lets talk about protein in excess:

If you want to spot someone who knows nothing about human physiology you can spot them by saying something like “Protein doesn’t turn into cake in your body.” or “Gluconeogenesis is demand driven so protein doesn’t turn to glucose.”

These people have clearly never taken a basic biochemistry or Anatomy and Physiology course. This is like day one stuff. No protein doesn’t turn to cake because cake is a complex mix of fat and carbohydrate. Protein does however, verifiably turn to glucose in the human body.

Here is a study on healthy people where they traced amino acids using isotope tracers and followed them from ingestion all the way to glucose. Just 23g of protein resulted in the creation of 4g of glucose.

https://diabetes.diabetesjournals.org/content/62/5/1435

It gets higher and higher as the dose gets larger. We can only use so much protein for building and maintaining lean tissue. There is no logical answer to how we could possibly utilize all the protein we eat if we are consuming more than the body needs to maintain. Since we can go days and days without eating and see little to no loss of lean tissue then clearly our need for net new amino acids is not 300g per day. Donald K. Layman is arguably one of the leading experts on protein metabolism in the world. Both he and one of his proteges, Dr. Gabrielle Lyon have both said that if you consume 100g of protein you will get 60g of glucose. This is just a basic fact of human physiology.

Here is a youtube video with Gabrielle Lyon on protein.

Dr. Lyon trained with one of the foremost protein experts today, Donald K. Layman, and is herself a very credible source. At 35:10 she states: 

“Out of 100g protein consumed we get 60g of glucose via gluconeogenesis.”

Hmmmmmm………..Protein expert says this. OK. Who says excess protein never gets converted to glucose? Not protein experts that is for sure.

Then again at 1:11:00

Dr. Lyon “A meat based diet is not a low carb diet. For every 100g of protein you get 60g of glucose.”

So yes, protein does get converted to glucose. Basic physiology and biochemistry. The question is does it matter? Yes and no.

For the active person it won’t matter a bit. The little bit of extra protein will get converted in the liver to glucose, that glucose will get shunted into glycogen in the liver and will be easily used when they exercise. Since it doesn’t ever leave the liver and go into circulation it doesn’t raise blood glucose, this is why people argue it doesn’t get converted at all, and it doesn’t spike insulin.

For the sedentary person it will matter. They can have this protein fill up glycogen in the liver and at that point it will start filling up muscle glycogen. The liver glycogen will get used bit by bit all the time but the muscle glycogen is retained for high intensity activity so it will stay there. Eventually they will saturate muscles if they don’t train it out. That leaves them only with liver glycogen which is only 100g. If they then continue with the protein loading they will overfill that at which point this glucose will get converted to fat and stored. This is why there are people every single day complaining of weight gain on the Carnivore diet. They are not training enough to empty out the glycogen made from the excess protein. Then people just tell them that this is “healing” or “muscle gain”. That is bullshit. You do not gain lean mass from just eating more protein. This is like saying that people will gain muscle just by taking steroids without training. You won’t. In order for muscle to grow they have to be trained. Just eating something or just taking drugs is not going to make you grow more muscle. The weight gain is some weight from the glycogen (4-6lbs can be gained from glycogen) and the rest is fat. End of story.

Lastly, lets talk about Calories:

Even I got caught in the trap of saying that calories don’t matter. It is a nice dream but unfortunately that is not reality. They do and keto and carnivore are not magic. The truth is that these diets work in different ways and the meaning of calories changes because hormones also matter. It doesn’t mean that only insulin matters and calories don’t. They both matter.

The problem we get into here is that simply cutting them to lose weight never works long term. This is not because they don’t matter. It is because they do matter. They matter very much. Cutting calories does not work long term because the body adapts to the calories you eat. The body does not want to lose fat. Fat is protective. As you cut calories the body will down regulate it’s energy output to match what you put in. This is why we lose less and less weight week after week on any diet. This is the body protecting itself from starving. So if we cut calories the body just stops using as much.

The problem with this is that people get frustrated when they stop losing weight and go back to eating crap and in large amounts. Because your body is now using less energy it means that you are now in a much larger caloric surplus than you were before. Now you gain weight quickly. This happens in every diet. Even keto and carnivore.

If you try and trick it by going even lower than yes, you will potentially lose more weight. Then you will adapt again and stop. You can’t keep dropping forever. It has to stop somewhere. Then you get frustrated and quit and it is even worse as your metabolism is slower.

It gets even worse if you have lost weight and gained it back. Every time you do this you have taught your body a lesson on how to not lose weight. It now understands the adaptation process and how to lower metabolism faster. Each time you do this lose and gain cycle you make your body better at not losing weight. This is why we have people that can’t lose weight no matter what they do. They have taught their body how to be experts at slowing metabolism and not losing weight.

How do we fix this?

Well if we look at some of the most successful dieters on the planet we would be looking at bodybuilders. They diet down to crazy low body fat and do it repeatedly at least once per year. How do the do it? Well some don’t. Some only get one or two shows then have to drop out because they arrive at the same issue as many people just trying to diet for weight loss and health. The ones that are successful practice metabolism management. It is often referred to as reverse dieting.

Reverse dieting is a controlled increase in caloric intake while keeping weight stable. This will bring the metabolism back up to a normal level so a new diet phase can be done again. The longer you reverse diet the more successful you will be at dieting again. Typically the recommendation is to reverse diet for as long as you did the weight loss diet.

I think that is enough getting real for today. We need to change the conversation. Stop being so dogmatic.

Carbs are not the sole cause of obesity or sickness. This is equally as crazy as vegans saying that fat alone is the sole cause of obesity and sickness. They are both required. The question is what combo is optimal.

Protein does convert to glucose and depending on who you are this may or may not matter.

Calories do matter. They just matter in slightly different ways depending on your bodies hormonal state.

Keto ON,

Coach Jack

I have started a new facebook group called Common Sense Keto Athlete. This group will be a place for people who don’t need to lose weight or are prioritizing performance over weight loss. The same rules will not apply to this group as in the main group. More open discussion will be allowed when it comes to carbs and protein and basically any other hack for performance.

A great study just passed to me from the illustrious Ben Bikman.
Study looking at how insulin inhibits autophagy …….Except in exercise.

Insulin inhibits autophagy signaling independent of counter regulatory hormone levels but does not affect the effects of exercise

“In conclusion, one hour of cycling exercise increases phosphorylation of ATG14 at Ser29 in a pattern that mirrors ULK1 phosphorylation at Ser555 (activating site), suggesting that ULK1 serves as an upstream kinase for ATG14 in human skeletal muscle. These effects were independent of high and low insulin levels during exercise.”

Essentially what this says is that exercise causes autophagy regardless of the level of circulating insulin.

It still remains true today that the only real way to measure autophagy in humans has been with exercise and it can be measured in hours. There has yet to be a study in humans measuring autophagy from fasting to the extent it can be measured in just an hour of exercise. Even when insulin might be high.

From what I can tell, Ben’s opinion on autophagy is that it is running when insulin is low and that is happening when you are in ketosis. I don’t think he tells people not to fast but I don’t think he does it personally. He discusses this in this Podcast.

My opinion is that those that are seeking autophagy need not worry so much about fasting and just keep insulin low.

Better yet, seek it through something healthy, like exercise.

Here is another study showing autophagy from exercise regardless of nutritional status.

Activation of autophagy in human skeletal muscle is dependent on exercise intensity and AMPK activation

“Taking into account AMPK-dependent autophagy activation, these findings support the notion that HI is the most potent way to increase autophagic flux during cycling exercise in human skeletal muscle, independent of nutritional condition.“

So I have been fighting the idea that high protein is a good idea for a long time. You don’t need high protein and often high protein is bad if you are sedentary and insulin resistant. If you are lean and fit and very active than high protein is fine. No harm in it at all. The extra protein will be converted to glucose and be stored in glycogen and it won’t even really affect your glucose levels. You will use it in the gym. No big deal.

If you are not fit, not lean and are trying to lose weight then high protein will also turn to glucose and it will get put into glycogen and it will prevent you from being keto adapted as you will just be maintaining a glucose based metabolism.

The higher protein advocates will always pull out studies trying to show how great high protein is. This one is so far my favorite one.

The person who posted it was trying to argue that protein does not turn to glucose and posted this study:

The effects of consuming a high protein diet (4.4 g/kg/d) on body composition in resistance-trained individuals

What is really amusing is that this study doesn’t even talk about anything to do with protein turning into glucose. What is more amusing is that the result of this study is not positive towards eating high protein. It is actually case in point why there is zero benefit to eating more protein.

In this study they had 30 young, healthy and well trained individuals eat either their same diet for 8 weeks and do their same workout or had them eat 4.4g per KG of protein per day on top of their regular diet and continue the same training.

Here was the diet info:

The control group ate 138g of protein per day and roughly 2000 calories. They actually lowered their caloric intake and their protein intake during the trial period.

The Experimental group ate 307g of protein per day and roughly 2835 calories. They increased their protein by 47% and increased calories by 38%.

Great. So from the way this person was fighting with me I assumed I was going to see some tremendous results in regards to either fat lost or some crazy muscle gains. I was ready to be impressed.

Are you ready? Here is the body composition results from eating 2.22 times the protein.

So needless to say I was less than impressed.

Despite already having a larger lean mass, a lower fat mass and a better body composition than the experimental group, the control group still managed to gain a respectable amount of lean mass and obtained a better change in body composition while reducing their protein and calories.

Control had a 1.3kg gain in fat free mass and an increase in 0.3kg of fat mass. Strange that they gained fat mass when reducing calories but these tests are also not all that accurate so I would call it negligible.

Experimental group had a better change in fat free mass with 1.9kg and a small but insignificant loss in fat mass of -0.2kg.

The end result in body composition change:

Control group – reduced body composition from 15.1% to 14.2% (-0.9%)

Experimental group – Reduced body comp from 16.9 to 16.3% (-0.6%)

Are you impressed? I certainly was. 🙂

The funny part of this is that I have said time and time again, glucose that is made from excess protein is always stored in glycogen anyway and what happens when we store glycogen? For every gram of glycogen you get 4g of water with it. What does that mean? You will see an increase in lean mass with an increase in stored glycogen as lean mass is determined by measuring everything that is not fat. Glycogen is not fat so it will show as a gain in lean mass on a body comp test such as the one they used BodPod. The total amount of lean mass gain from glycogen alone is 2.5kg. Could all of the lean mass gain be from glycogen alone? Possibly LOL.

So my conclusion from this paper:

If you want to waste money you should absolutely consume more than double the amount of protein as you need. You will result in a less desirable body composition change and likely nothing more than an increase in stored glycogen than if you eat an appropriate amount of protein.

How much money in just protein was wasted here? While it didn’t matter here because it was provided by the researchers, imagine if it was you.

145g extra per day for 8 weeks equals 8,120g of protein. They used whey protein.

Even a cheap protein is about $45 for 2.7kg of protein so that means you would have spent $135 in protein powder to have a worse change in body composition than the people who actually ate less protein.

Great result.

This is not going to be fancy. Just a post that was on the facebook group that I felt should be here for prosperity.

There was a post the other day in the facebook group Common Sense Keto that was deleted and it was talking about reversing diabetes and eating chocolate and how that affected glucose levels.

This post is an explanation of the physiology behind this.

What causes Type 2 diabetesThere are different theories on this but the only one that even makes plausible sense to me is Personal Fat Threshold (PFT).Short story is that everyone has a genetic capacity to store energy as fat and once that level is reached, the cells are full and can no longer take in more energy with the level of insulin that the pancreas is putting out.
To get more detailed with the actual process we need to look at energy storage and management in the human body.

Glucose is essential but also dangerous to have in high levels in the blood. The body manages this tightly using insulin. When glucose levels are high insulin rises and puts it away. It first goes to liver and muscle and is stored as glycogen. Glycogen is just long chains of glucose essentially. We can store 500g roughly.

so long as we don’t exceed that 500g we will never have high blood sugar and there can never be T2D.

If we do exceed this amount the body needs to deal with it in another way and since energy is valuable for survival it is never wasted. The body converts it to fat via a process known as de novo lipogenesis (DNL). This simply means creation of new fat. This fat is then packed away into fat cells for later use.

At this point we are still perfectly fine and could live this way forever with no chance of T2D so long as we don’t consume more energy in a day than we use. This is where calories in vs calories out is 100% accurate. If you have full glycogen and you convert all carbs you eat to fat plus you eat a lot of fat you are going to accumulate alot of fat but as long as you use enough energy to empty out the fat you accumulate each day there will be no diabetes.

Now the problem is most people do not empty out glycogen and they certainly don’t empty out all the fat the accumulate each day on a SAD diet. Once the fat cells reach their limit, that is when diabetes starts.

The pancreas will start making more insulin to force the glucose out of the blood. it does this because insulin causes fat cells to grow which allows them to take in more fat which allows the glucose to be cleared from the blood again.

The problem here is that the increased demand on the pancreas also causes it to die. The cells that make insulin actually start to die off. If insulin is prescribed and given this can save the cells somewhat by taking off the pressure. The more you push the limits of storage the more insulin is needed.

Can you reverse Type 2 diabetes?

That depends. We have to separate T2D from insulin resistance (IR).
T2D is a chronic issue with blood glucose management while insulin resistance is the inability to clear glucose as a result of the cells not responding to insulin. Very different things.

Insulin resistance is actually not pathological by nature. It happens all the time and for good reason. It can become pathological if not dealt with soon enough but it can always be reversed and pretty easily.

T2D is totally reversible unless you have done too much damage to the pancreas. If you have left it untreated for too long or too poorly managed then the insulin producing beta cells die off and you can no longer produce enough insulin to properly manage glucose levels and this is when it is not reversible.

Now how do we reverse it these things?

All that is required to reverse insulin resistance is to empty glycogen stores. If these are empty then you have at least partially reversed insulin resistance. The reversal will be limited to 500g worth of glucose but for those first 500g you are not going to be insulin resistant and can absolutely have a high carb meal and see normal blood glucose levels.

The problem with this is that it is very temporary and does not empty out as fast as it fills. Once the body gets some glycogen it will hold onto it. It will preferentially run gluconeogenesis and make glucose over using the glycogen so once you have that glycogen it can take days to empty out.
To really reverse insulin resistance you have to empty out fat cells. You have to lose weight. Once you have emptied fat cells you have reversed insulin resistance for the most part. There will be lots of room to get glucose out of the blood.

For some people, depending on how long they have been in the IR state, they might still have some higher than normal glucose levels for some time until the body re adapts to not having to operate from a place of chronic IR. The longer you spend with empty glycogen and unfilled fat cells the better your glucose responses will get.

So in closing, if you have been keto for any amount of time you will have empty glycogen. If you have lost weight you will have lots of room to get glucose out of blood and you will have reversed T2D and insulin resistance so long as you have not permanently damaged your pancreas.
You have cured it in essence. Until you refill your glycogen stores and fill your fat cells back up again.

Anyone on keto will be able to eat one meal, even a few days of carbs and see normal glucose response times. Because you have empty glycogen.
This does not mean you are able to do this long term. it just means that still have empty glycogen and have not yet filled it up. When you do, and you will, you will start gaining weight again. When you gain enough weight you will again, be insulin resistant and will again be diabetic.

There is really no “cure” to T2D because it is not really a “disease” unless you have killed your pancreas. It is just a state where the body is at max storage capacity for energy at which point it starts becoming a disease.
You can reverse it and restart it many times over. Until yo have killed your pancreas then it is a disease and reversal is impossible.

This has been a question I have seen passed around for years and nobody seems to have a solid answer. Mostly they just say it is because you are adapted and you don’t need as much so you make less. I have seen one fairly plausible explanation in that the kidneys take up more ketones and retain more in the beginning.

I have never really liked either of those answers and finally, I think I have a very plausible mechanism.

In my last post I discussed the Krebs Cycle and how ketones are made when there is an excess of one of the precursors for it named AcetylCoA. Another thing that influences the amount of ketones is another intermediate of the Krebs Cycle called Oxaloacetate (OA).

We also discussed how OA is necessary in the process of making glucose out of non glucose metabolites known as gluconeogenesis (GNG). We learned that the body reserves alot of OA for this process because it is critical to maintaining glucose levels in the body. Like life or death critical. The liver will always keep it for GNG before letting the krebs cycle use it if it is low supply. So if there is alot of GNG happening it will deplete the levels of OA that is available for the krebs cycle to process AcetylCoA and this will result in higher ketone levels. This can be seen in people who do intense exercise with no available glycogen to supply the exercise. Like in a fasted state or even just in ketosis. The lack of available glucose from glycogen will cause a very high level of gluconeogenesis which will deplete the levels of oxaloacetate. If these folks check ketones shortly after their workout they can see very high levels. I have seen levels well above 8.0 mmol.

With this being said, when we first go keto there is a high rate of GNG happening as our body is still very used to using glucose as a fuel. So at this point we would be using much of the available OA to make glucose. This in turn would decrease the amount of krebs cycle activity and cause an elevated amount of ketones. As we adapt to the ketogenic diet our body slowly starts to need less and less glucose. The brain uses less as it gets used to using ketones and the muscles actually get used to using fatty acids directly. The muscles also develop a type of physiologically normal insulin resistance to keep them from using glucose that could be retained for the parts of the body that absolutely must use glucose like the red blood cells, some parts of the eye and some parts of the brain. As we adapt to use less and less glucose we will see a reduction in the level of GNG. With the reduced GNG we see less utilization of OA. This will leave more available for the krebs cycle which will better be able to empty the AcetylCoA pool. If we empty the AcetylCoA pool we end up with less ketone build up!

Boom. The longer you are adapted to keto and your body needs less glucose the less oaxaloacetate is used for making glucose and the more that is available to process AcetylCoA to energy directly rather than diverting to ketones.

Seems like a very plausible mechanism to me. Let me know what you think.

Keto ON,

Coach Jack

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I was having a discussion about epilepsy. That led to high ketones which led to how you get high ketones and when. 

This led me to the paper below. 

Oxaloacetate Deficiency in Mct-Induced Ketogenesis

This is a study on why MCT causes increased ketones but it tells us so much more. Let’s start with how ketones are made:

Ketones are made when insulin is very low and all stored glucose in the liver has been depleted. That is the basic part of it. Lets get a little deeper. First we have to look at the Krebs cycle or also known as the citric acid cycle. The Krebs cycle is the first major step in ATP creation.

It all starts with AcetylCoA at the top but the other major player we are going to talk about today is just to the left, Oxaloacetate. When insulin is very low there will be lots of fat being released from adipose tissue. When glucose is broken down for use in the krebs cycle it only results in one AcetylCoA but when fat is used it breaks down to two. When you have lots of AcetylCoA like when insulin is low then you end up having a limiter in the amount of cycles the krebs cycle can turn due to the limit of Oxaloacetate. Oxaloacetate is also needed to run another process we know about, gluconeogenesis or GNG for short. Since GNG is critical to the maintenance of blood sugar level it gets priority over the amount of oxaloacetate that is supplied to the Krebs cycle so there is a limit to the amount of AcetylCoA that can be turned to ATP. When you have lots of fat converted to twice as much AcetylCoA and the krebs cycle is limited in how fast it can process it, you get a build up of AcetylCoA waiting at the krebs cycle door. This results in ketogenesis.

So now we understand that when we have ketones we already have more AcetylCoA than the krebs cycle can use to create energy so it gets diverted to ketones. Now lets look at MCT oil and what it does.

MCT oil cannot be stored as fat. It must be oxidized in the liver to AcetylCoA. When we have ketones in the blood this means we already have too much AcetylCoA so adding MCT oil at this time is not going to do anything other than make more ketones. It can’t go through the Krebs cycle any more than any of the other fats at this point. All it is doing is keeping the AcetylCoA pool full and generating ketones. We only need so many ketones. More ketones does not equal more energy. ketones are not energy. They are potential energy. Just like glucose and just like fats. They are just a potential energy source. They still have to be metabolized like any other fuel and having more of it does not mean we are going to use it. Ketones will really only be used in certain tissues like brain and red blood cells and they can only use so much. Having super high levels is not a benefit. Especially when it is MCT oil supplied. You are better off to leave it out.

Now why won’t it help you lose weight and might actually keep you from losing weight.

Because it goes right to the liver while other fats go to adipose first before they get into circulation, MCT oil is going to take precedence over other fats in the AcetylCoA pool. It has to be utilized first because it cannot be sent back to storage and it can’t circulate in the blood. It must be used first. If it is taking precedence then it will leave fat that has come from adipose tissue, like your own bodyfat, in circulation where it could eventually make it back into storage if and when insulin levels rise.

Writing this article led me to discover an answer to why people tend to make less ketones the longer they are on keto but that will be an article for another day. 🙂

Keto On,

Coach Jack

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