Questions about keto-adapted diet

George, I have a few questions about the Keto- adapted diet.
1) What kind of fat do you eat?
2) ' How long does it take to get Keto- adapted ?
3) Is it an all or none thing , or if you make strides in that direction does it help change from glucose burning to fat burning?
4) Do you eat fruit?

I've had success with my afib using the strategy as outlined by Jackie, almost 7 months afib free. But I'm looking to make more changes that may be beneficial. I was also a pretty competitive exerciser, competing in triathlons, and bike races. Although I've been able to get back to light to moderate exercise, I'm pretty scared to push it for fear of triggering the afib. I'm intrigued by your "trick" as you called it. Your ability to maintain fitness on lighter exercise by burning mostly fat. I don't plan on going back to racing, but I'd like to be able to ride my bike up and down the mountains , or go cross country skiing without constantly fearing a relapse.

Thanks for all your input,

John

John,

Here is one resource: <[eatingacademy.com] Dr. Attia has formed a non-profit to answer many of the questions associated with the standard dietary advice. I believe he said he's raised $40 mil and is trying to raise $150 mil for this venture. There is alot of info on his blog and in his video interviews. It is an excellent resource. There are other docs who've investigated this. Most do it when they have an issue and try the standard advice and it doesn't work. Then they try the low carb approach and find it works. Those in practice then gingerly help their family, then friends, and finally their patients as the advice is so counter to the standard advice.

1) What kind of fat do you eat?
Mostly organic ghee (clarified butter) from grass fed cows, organic coconut oil and fat from fatty meats. I'll get 80% lean, 20% fat meat. Again, I strive for grass fed animals. My understanding is that the fatty acid profile on grass fed animals is more like that of wild fish. I'll also eat whipping cream. I stay away from concentrated sources of omega 6 fats.

2) ' How long does it take to get Keto- adapted ?
A two weeks or so, initially. I think there is more adaptation as time goes on, but the basic adaptation takes a couple of weeks.

3) Is it an all or none thing , or if you make strides in that direction does it help change from glucose burning to fat burning?

My experience is that nutritional ketosis is a binary state. You pretty have to stay under 50g carbs/day till you are adapted. For me, once adapted, you can "cheat" as long as you are strict quite a bit of the time. I don't know what the unadaptation time is (and don't really care to find out). A cheat day for me might be 100g carbs. If I've cheated for a few days, I'll either get really strict and exercise or perhaps fast for 24 or 36 hours to make sure I've got a nice ketotic state and to insure that I stay adapted.

4) Do you eat fruit?
A little bit, but not very much. Fruits are carby.

Here are a couple of excellent resources: <[www.amazon.com] <[www.amazon.com] Phinney and Volek are two of the top researchers in this area. Phinney is an MD who got his PhD studying this at MIT. You can probably find more from them if you search here on me and Phinney in the archives. here is one post with links <[www.afibbers.org] and a search <[www.afibbers.org]

A couple of notes for afibbers.

Low sodium chloride is stressed here. In his Low Blood Pressure Solution book. Richard Moore suggests a 4:1 ratio of potassium to sodium on intake. He mentions that this signals the kidney to excrete excess sodium. He also mentions that high levels of insulin signal the kidney to conserve sodium. The 4:1 helps override this. Well, if you adopt a <50g/day carb diet, your insulin levels will drop and you will start dumping sodium. If you aren't consuming enough sodium, your kidneys will dump potassium too, to keep the ratios balanced. The point here is DON'T start a low carb/high fat diet while on a low sodium diet.

I didn't realize this when I started my LCHF diet and had an issue, that led to an afib episode. It was most likely not enough sodium. I was consuming potassium and mag like crazy.

Phinney, Volek and Attia all discuss this. I would add a few grams of sodium in, if you want to try this.

Since I cook everything starting with real food, I don't get a lot of sodium in my food, except what I add, and I do add some at every meal. Probably a couple of grams a day.

Hans had mentioned CR73 <[www.afibbers.org] where we discussed ketosis before. My friend that I reported on there gets adrenergic PAC's with heavy exercise UNLESS she keeps her carbs below 60g/day. She is not an afibber, but an ablated WPW patient. Still don't know why, but it is very repeatable. Her PAC's were frequent enough that they reduce her exercise capacity significantly when she gets them.

Also, getting keto-adapted was not fun for me. From what I know now, most of the discomfort could have been avoided by taking in more sodium, at least that is the theory. In low carb land, the discomfort is called the "low carb flu." So if you increase sodium all that I describe here might not happen to you: You basically run your muscles and liver out of glycogen. You can feel like you have the flu. Your muscles also don't really work well. I recall rock climbing and trying to make a move and my muscles just would not respond. Once you are adapted, all this goes away and it is fine. I really like being keto-adapted. I really would not like to repeat the adaptation, if I don't have to, hence my attention to this. I would do it, but prefer not to.

Let me know if you have more questions.

George

Many diets out there how about this one:


Quinoa, mushrooms and coca: Bolivian says ancient Andean diet has kept him alive for 123 years



Carmelo Flores

By Santiago Limachi, Reuters

FRASQUIA, Bolivia — Bolivian indigenous farmer Carmelo Flores, who could be the oldest person to have ever lived, attributes his longevity to quinoa grains, riverside mushrooms and around-the-clock chewing of coca leaves.

John - Glad to read you are doing so well... You're on the right track. If you can add in some of George's tips, that will serve you well and healthily, too.

Keep us posted on your progress.
Best,
Jackie

Liz,

Thank you for the sarcastic post. Serously, it sounds like a traditional peasant diet to me. I'm sure the guy also has some genetic advantage that all his dead peers did not.

Unfortunately the popularity of quinoa in the first world has increased prices at home such that it has become too expensive for many Bolivians. <[www.nytimes.com]

Genetics plays a large role in all of this. Data suggest that 70% of people are carb intolerant to one degree or another. The other 30% can do whatever they want with impunity. The data also indicate that most native peoples are very carb intolerant and are very subject to Type II diabetes.

I listened to a talk given by an Canadian physician of either First Nation or Inuit genetics. He ended up with T2 diabetes and found he could keep himself in remission with a diet of 30 grams/day of carbs or less. He subsequently went around lecturing to the natives and telling them they needed to go back to the diet of their ancestors. They took that to mean Fry Bread. He had to educate them that Fry Bread was brought to them by the white man and the diet he was talking about was pre-white man.

George

George:

Wasn't meant to be sarcastic, I just thought that mans diet was the strangest diet I have seen and yet he is supposed to be about 120 years old, I also have a weird sense of humor. I have always believed that genetics plays a big role in our health/longevity, I have been taken to task for that on this forum, I am sure you get a lot of feedback on your diet but why give a hoot, if it is benefiting you in all the ways you say, that's all that matters. I know that I and I am sure everyone else on this forum learn something from your posts.

Liz

Liz,

Thank you.

While the diet may be very unusual from our perspective, it isn't as wild as you might think and seems to be a pretty healthy diet. The quinoa is a complete protein and has a relatively low glycemic load and index. Quinoa also has many other nutrients. The mushroom are very low glycemic load and index. The coca has a lot of oils and minerals and acts as a mild stimulant (like caffeine) and appetite suppressant. Unfortunately for that guy, the UN made coca illegal in '61 because it can be made into cocaine, so it may be harder to come by. The chewed coca does not have the same properties as cocaine. I also saw on a news report that the guy says he also eats locally caught fish as well as beans.

I'm pretty tuned in to different diets. My girlfriend is vegan and I was mostly vegan for many years. My blood lipid panels were excellent, but my blood sugar response to eating carbs was suboptimal, hence my current diet. Even though I did high altitude endurance races as a vegan, when I switched to a low carb, high fat diet, I dropped 35 pounds fairly quickly.

I'm certainly not suggesting everybody take up my diet, only giving people an idea of the range of possibilities.

George



Edited 1 time(s). Last edit at 08/20/2013 09:47AM by GeorgeN.

Thanks for the great information George. That web blog from Dr. Attia is full of information. I'm going to study up and see what I can do. I'm not sure if I can get down to 50 grams /day of carbs, to keto adapt, but my initial goal is about 100 grams. My wife is a vegetarian , so that kind of makes it hard to make a huge switch.
Anyway, thanks again,

John

John,

There certainly are many general health benefits to getting down to 100g/day carbs, you just won't be in ketosis.

Yes, my girlfriend is vegan. We pretty much fix different meals and eat together. I'm fixing her dinner tomorrow night, it will be a bit carby for me, but not bad. Spaghetti squash lasagna and cauliflower mash.

Good luck!

George - I have heard that a ketogenic diet is also recommended for someone with cancer, which my husband now has. I was just researching this tonight and am a little confused. With cancer, they don't want you to lose any weight (and he doesn't need to). However, if someone is trying to reduce or eliminate carbs/sugar with the keto diet, won't they also lose weight? I have read that sugar will basically fuel cancer, so this seems like a diet to seriously consider.

I am continally impressed by your herculian efforts to track and measure all that goes on in your body and then find ways to avoid Afib over all of these years! Thanks for sharing your ideas and successes.

Barb

Barb,

I've been doing this for around 5 years. As a vegan, I was very active and fit - I used to run a 13 mile race that started at 6,200' and topped out around 14,200'. However I carried the excess weight from playing American football in college. When I started this low carb high fat diet, I dropped about 35 pounds, to about what I am today 6' 0" 175#'s, a BMI of about 23.7. I've been weight stable at this weight +/- a couple of pounds for 4 or more years. I am very active. I just returned from a two week raft paddle trip with side hikes of the Colorado River in the Grand Canyon. We paddled 242 river miles. I did not lose any weight, despite sticking to my diet (which is almost always only 2 meals/day and no snacks) and either paddling or hiking 9-12 hours/day. I have tree trunks for legs (16" calves, 23" thighs, 32" waist and 13" biceps), but I am not considered skinny. If you start a low carb diet (under 50g/day), you will lose a couple of pounds of water as you consume the glycogen in your muscles. There is something like 3 or 4 grams of water per gram of glycogen. When you use this glycogen, the water gets excreted. This is the "water weight" people talk about when starting a diet. If you increase your carbs, you will gain this back instantly as the glycogen refills your muscles.

Dr. Phinney did a study on bicycle racers in the early '80s. They were very fit and active and weight stable during the study: <[www.nutritionandmetabolism.com]

If you read a lot of Dr. Attia's blog (first listed above). You'll see he works out 2 hours/day and is horribly fit, but also weight stable. <[eatingacademy.com] I think Attia may have mentioned cancer on one of the videos linked on his blog.

I would recommend 1.2 grams of protein/kg body weight if your husband tries it.

If you go down this path, I recommend educating yourself by reading Dr. Attia's blog and the Phinney & Volek references I listed above at a minimum.

My mom had cancer for 14 years and ultimately died of a respiratory infection. However she always used to tell me "sugar causes cancer."

Here are some interesting but technical talks on fructose by Robert Lustig MD:

<[www.youtube.com]
<[www.dietdoctor.com]

This doc treats infertile women with a LCHF diet very successfully - only relavent in that it appears to normalize their metabolism so they can concieve. A stretch for cancer, but the common thread may be that it normalizes the metabolism and eliminates may of the bad things Lustig talks about: <[www.youtube.com]

Good luck!

Let me know if you have additional questions.

George

Barb,

I recall a study on children with inoperable brain cancer done in '96. They put them on a very low carb diet and as I recall, their outcomes were much better than expected.

I've also read of test tube studies where the ketones were toxic to cancer cells. And, more from memory - ketones use a different pathway for metabolism than the standard insulin pathways. Cancer cells have lost this ability, therefore, if you adopt a very low carb diet you might be "starving" cancer cells to a certain extent while the other cells are happily feeding on ketones.

I'm sorry I didn't record the references, but you might want to start chasing down those rabbit trails.

George

Thanks for your reply, George. Do you know how low the carbs would have to be to work? And is there a way to do that without losing weight?

Barb

Barb,

To actually be ketotic, it is generally said you need to be 50g/day carbs or less. I'm sure there is individual variability.

That being said, there is most likely benefit to reducing carbs without being ketotic.

Here are some steps you could consider:

1. eliminate all sugar of any kind (not a trivial exercise if you use prepared food).
2. go from "white" carbs to "brown" carbs (i.e. low glycemic index carbs) and make sure your carbs are "whole" vs. "refined"
3. go all the way to ketotic

The water weight is not significant, in my mind. It will come off and go on very quickly and surely can't be the weight they are talking about with regard to cancer. If I "cheat," I'll add 5 pounds of water weight immediately from the added glycogen. Likewise, if I've cheated, then go strict, I'll take the 5 pounds off in a day.

As to my "core" muscle and body weight, I'm weight stable eating this way and have been for years.

George

Thanks for your replies, George. Sorry for asking about the weight loss when you had already addressed that...somehow I missed that post until now.
I have also learned of a study done in the UK where lung cancer patients undergoing radiation and taking Metformin (a diabetes drug) had much better results then those who were not taking this drug, While I am not a big proponent of drugs, i do realize that they have their place. After asking the radiologist if that's something my husband could take, I was not surprised to hear him say that "it's not proven" and he couldn't recommend it. So I decided that next time I'm going to change my question to say, "Have you ever had a diabetic patient that was on Metformin and also had lung cancer? If so, did you let him stay on this medication? Were there any contraindications?" This way he would not be endorsing this drug, but he would have to give me the facts and potentially, be saying it shouldn't cause a problem and might help.

Just trying to be ready with options....

Sorry if I've gone off topic in this area...I'll try not to do that here as this is for AFib, not cancer.

Appreciate your info and the links provided, George ~ Barb

HI Barb,

With regard to Metformin for Doug, does he have diabetes too? I'm not sure if this would be a good alternative to Metformim but the herbal extract Berberine is an excellent natural substitute for Metformin in managing and in many cases helping to reverse type 2 Diabetes and improve insulin sensitivity. It also has a whole laundry list of positive biochemical effects.

In addition to acting as a powerful glucose control agent, it lowers blood pressure, and cholesterol too ( basically it improves the full Metabolic X syndrome list of symptoms) and can act very much like a class III anti-arrhythmic agent as well (similar to Amioderone, Sotalol etc without most of the side effects) and has potent, anti-oxidant, anti-inflammatory, anti-viral, anti-bacterial and anti-fungal properties as well.

Google Berberine for type 2 diabetes or insulin resistance and you'll see many references. Also google Berberine and lung cancer ... here is just two such article: Berberine in Lung Cancer and this one: 'Synergistic Tumor-Killing Effect of Radiation and Berberine Combined Treatment in Lung Cancer: The Contribution of Autophagic Cell Death .. these are just two of many references to Berberine and lung cancer.. It has positive effects on other cancers as well.

Several studies show that Berberine helped repair damaged good cells by radiation while killing off lung cancer cells and that it helped kill off cancer stem cells as well. One 2012 study showed that Berberine especially when combined with another drug agent I forgot the name of actually was associated with an increase in the cancer stem cell population. This is typical of many preliminary studies but the majority show a positive reduction on both the active cancer cells and cancer stem cell line when Berberine is administered with radiation therapy.

At least they are looking in to it, but be on the alert when reading studies on herbs like Berberine to know who is behind the study. Drug companies and many research institutes have a huge vested interest in trying to throw cold water, or some degree of doubt, on any non-patentable herbal agent that is showing promise in an area these companies are spending billions of dollars to develop competing drugs for.

Many MDs probably wont be familiar with Berberine, nor will they be favorably inclined to recommend it without two dozen drug company sponsored double blind studies to keep them off the hook if they suggest trying it.

Nevertheless, Barb you are on the right track in how to bring it up to your oncologist. Don't ask if he can recommend it. He may well have never heard of it. But approach it just as you suggest above in asking about Metformin. And do your own research to make sure there are no contraindications in using Berberine with certain chemo or other drugs Doug now needs.

Often times even if there is a contraindication with a certain Chemo agent, that is true only while he is on the chemo treatment and as soon as he goes off he might be able to safely take Berberine even if it should not be combined while actively taking a given chemo or other drug.

Its certainly worth looking into, as Berberine is such a close analog for Metformin in an even less side-effect producing herbal form.

Best wishes for Doug and his treatment program!

Shannon



Edited 2 time(s). Last edit at 08/23/2013 02:49PM by Shannon.

Barb - the most important issue with a cancer patient is maintaining an alkaline pH. Cancer thrives in an acidic environment. Therefore, assessing the result of intake from drugs, supplements and foods as to whether they metabolize to acid or alkaline ash becomes critical and it's often not something that is included in cancer treatment protocols.

I certainly wish both you and Doug the very best. You have a lot on your plate.
Special thoughts and blessings to you both.

Jackie