Another cure

It took this doctor of veterinary medicine a whole four (4) days to cure his sister's LAF.

"I generally keep my mouth shut under these circumstances, but she asked
for advice, point blank. It was much tougher to sort out her AF than I had expected. Even with a magnesium supplement (just finished a stint on Weight Watchers, so probably deficient in everything) it took 4 days to stop the fibrillation attacks. I had expected it to clear up after the first LC meal, but I guess it had been on going for 2 years, so some delay is acceptable...

Why don't cardiologists read these papers?"

[high-fat-nutrition.blogspot.com]

One danger I experienced on a ketogenic diet (80% fat/20% protein) was magnesium wasting during the ketogenic transition period. Obviously, during this time, one is excreting a lot of water since there are 3 grams H20/ gram glycogen. As you use up the muscle glycogen, you excrete the water - hence the early rapid weight loss.

I had not had afb in many many months. I was supplementing with very significant quantities of magnesium (>1.2 grams/day) & potassium.

I was experiencing "hard" heartbeats when I would lie in bed. Remembered the association with low potassium. Added several extra grams of potassium intake. Still the "hard" beats continued nightly. Finally this led to afib. I converted the afib with PIP flec in an hour and went back to sleep. Was wearing a recording HR monitor. Woke up several hours later with a regular heart rate of 125. Now flec conversion will result in a higher than normal heart rate for a while. However this is usually 80 or 90, not 125. I immediately went and took 200 mg of elemental magnesium as citrate powder plus 400 mg of magnesium as glycinate tablets. Within 10 minutes, my HR steadily declined to 80 BPM.

Subsequently I've continued the keto diet, however I'm now taking > 2 grams day of elemental magnesium in forms of Waller Water, glycinate and citrate. I'm way past the keto conversion period, so wasting should not be an issue now.

Just a caveat for those pursuing this approach.

George

Live link:
[high-fat-nutrition.blogspot.com]

GeorgeN wrote:

>
> Subsequently I've continued the keto diet, however I'm now
> taking > 2 grams day of elemental magnesium in forms of Waller
> Water, glycinate and citrate. I'm way past the keto conversion
> period, so wasting should not be an issue now.
>
> Just a caveat for those pursuing this approach.



George, are you still on a ketogenic diet and also vegetarian?
Please can you tell me more,
TIA,
Joyce

[high-fat-nutrition.blogspot.com]
Excerpt from there:

"The heart becomes hyperexcitable when low on K, and that could lead to these nuisance arrhythmias. "

Earl, are you reading this?

PeggyM

George,

What are the basic criteria for YOUR current keto diet?? I'd love to know as I'm sure that you're the kind of guy who will have looked into the subject REALLY thoroughly and will have developed your own best-balanced approach. So please share! I have cut down on carbs food-intake-wise over recent years and would like to go further with this approach as I still have 50 or so pounds or so to lose before I get to my optimim weight (currently 255 pounds, 6' 5" 50" chest, 37" waist).

Mike F.

Here’s a clip on ketosis from the expert on metabolic disturbances, Ron Rosedale, MD. This comes from his book, The Rosedale Diet which is about metabolism and leptin.
Pp 22-23

“First of all, let me correct a popular misconception about high protein diets and ketones. Ketones are a by-product of fat burning and they are a good, efficient fuel. Under normal circumstances, your cells should be able to burn ketones and keep them at a low level. It is healthy for cells to burn ketones especially your brain cells. In fact, the so-called ketogenic diet is now the treatment of choice for epilepsy where drug therapy has failed.

Ketosis is often confused with ketoacidosis which occurs in severe uncontrolled diabetes when virtually no insulin is produced and ketones are allowed to buildup to extraordinarily high levels which can be dangerous.

This is not to say I think a high protein diet is good; it is bad for other reasons. Protein is acidic and is broken down into two potentially toxic waste products: urea and ammonia. You don’t want to overload your body with these nasty by-products of protein metabolism.

Furthermore, the more protein you eat, the more proficient you become at making glucose from the protein in your diet and from the protein in your muscle and bone. As I tell my diabetic patients, this is something you do not want to be good at!

Remember, you need to eat enough protein to replace and repair body parts, but not so much that you must burn off the excess as sugar, thus disrupting your metabolism. On the other hand, a high fat diet is best as long as you eat primarily good fats and don’t eat sugar-forming foods with it.”

End quote

Joyce,

No, it is not plant based. I may try that at some point, however decided to get to target weight first.

Mike,

See links on Dr. Phinney (MD PhD) (originally provided by William) as well as to Ron Rosedale's book (provided by Jackie). Phinney talks about the current human analog to this diet - the traditional peoples of northern Canada.

<[www.afibbers.org];

One think you'll note is that Phinney increased both potassium and magnesium intake for those on his program as a ketogenic diet does cause the kidney to increase excretion of both.

I also got this book, The Ketogenic Diet, by Lyle McDonald, through interlibrary loan: [www.bodyrecomposition.com] This is a very detailed & researched book into keto diets. The end point of such a diet is fasting or starvation - however these are not good as your body then uses its own stored protein (muscle) to make glucose for the brain.

In summary: glucose (carbs) can cause blood glucose spike leading to insulin spike. This causes the body to use glucose for fuel, stop using free fatty acids for fuel and store any fat ingested with the meal. Therefore, if you want to use stored free fatty acids for fuel must keep blood sugar low and stable. I would define low as < 85 mg/dl and > 60 mg/dl (divide by 18 to get mmol/l).

Brain can either use glycogen or ketones for fuel. Takes about three weeks to fully transition. During transition, body will deplete stored muscle glycogen. Then start making ketones in liver from free fatty acids. To utilize the ketones takes about 3 weeks. Even then the brain uses some glucose. It must come from protein (if you are not ingesting carbs). This is NOT a high protein diet. It is a sufficient protein diet. Rosedale suggests about 1 gram protein/day per kg of ideal body weight (my summary of his program which is somewhat more complicated). My dietitian friend verifies this is what she prescribes.

McDonald recommends higher intake of protein, especially during the transition period when it is being used for glucose. His book is written more for body builders who are weight lifting a lot.

Too much protein will spike blood sugar (and insulin). So this is not an "eat all the protein diet" you want program. Rosedale comments about this. He suggests a max of 20g protein/serving. A conversation with a friend who has a type 1 diabetic child confirms the blood sugar spike from overconsumption of protein.

I violate the 20g/serving rule but generally follow the 1g/kg/day rule.

During the transition period, it is not fun for those who are active athletically. Your type 1 muscle fibers (slow twitch) happily use free fatty acids for fuel. Your type 2 muscle fibers (fast twitch) want glycogen. Rock climbing was awful during this period. I learned that a carb shot of 25-50g of carbs before the activity (100-200 calories) was sufficient to overcome this disadvantage, however it would not interrupt ketosis. This has not proven necessary once the full conversion has taken place. Though might be necessary for full competitive athletics. Once conversion has happened, you can happily go long distances at 70% of max heart rate. It is the short, power moves (like sprinting) that suffer.

In short here is the program:

1 gram/kg ideal body weight protein/day

>30 grams carbs/day especially during the transition

concentrate on high quality fat - omega 3 - good, wild caught fish, grass fed beef, lamb, bison or whatever, omega 3 eggs, olive oil, nuts (not legumes or cashews - which are relatively high in carbs).

non-starchy/low sugar vegetables including, but not limited to: lettuce, spinach, broccoli, brussel sprouts & etc.

Calories do count - if you eat too much fat or protein, you still won't lose & can gain weight. So want sufficient protein to protect your muscles, but that is all. You want to eat enough fat so that your caloric intake is down say 1000/day from your metabolic requirement (leading to about 2 pound/week weight loss). You don't want your body in starvation mode. Generally this approach is easier than just restricting caloric intake, as carb cravings drop away & hunger is lessened.

As always, moderate exercise helps and can help keep you in deep ketosis. However it is hard for most people to exercise enough to create a significant caloric deficit. Diet is the approach for that for most.

Rosedale gives more details. He also talks about this diet resetting the hormone leptin - which is responsible for hunger. Says many fat people are leptin resistant just like insulin resistant.

I've monitored my blood sugar with a high quality glucometer (Bayer Ascencia Contour). It generally stays in the 75-85 mg/dl range. Hypoglycemia (>60 mg/dl) is not a problem here. A pet cat died suddenly & very unexpectedly yesterday & I noticed my blood sugar was at 104 w/o ingestion of any carbs (I'd only had 3 eggs for the day). This tells you that stress or emotional upset can increase blood sugar (which can lead to potassium / magnesium wasting - hence a trigger for afib).

All of the above assumes that one is not diabetic and on blood sugar meds or insulin. If you are, have a conversation with your doc before trying this, though it should be effective. If you are diabetic I suggest Dr. Bernstein's references which describe this approach for the diabetic [www.diabetes-book.com]

The first 5-15 pounds you loose on this program will be from excretion of water stored with the glycogen in your muscles. There are something like 3 grams of water/gram of glycogen. This will come off quickly and will also reverse very quickly when you add carbs back in. This is not the weight loss you are looking for. You are looking to reduce the fat weight and not the lean muscle weight.

Hope this is detailed enough.

Cheers,

George

George,

Great post. Thank you and very interesting and informative.

No diebetes here SFAIAA. Blood sugar usually at 5 mmol/l for me.

I have been prone to gout for the last 10 years however, so I guess I'll have to watch that and will as such have to introduce any changes relatively slowly.

Interesting anecdotal observation about your pet cat (sorry to learn of your loss BTW), emotional stress, blood sugar elevation/spike and mag and pot wasting. Certainly explains why a lot of folks find that emotional upset can lead to an episode of LAF.

One thing I drink daily at the moment that really settles my stomach and has a lot of proven health benefit is green coconut water - 2 or 3 330ml tins per day (each has 700mg K). I'm a bit dismayed to see that each tin contains 5g of carbs.... although that isn't exactly a lot of carbs.... but I REALLY would love to get my body to burn fat rather than sugar.

One last thing; please let me know what a typical couple of days eating for you comprises of foodstuffs-wise?

Thanks again,

Mike



Post Edited (11-30-09 08:27)

George,
Many thanks, that is huge change of eating for you.
What swung it for you?
Have you found you need less supplemental taurine?
Joyce

George,
Just read your post to Mike more thoroughly and I'm so sorry about your cat.
Stress is definitely a trigger for many ailments.
Losing a pet is awful.
Hugs,
Joyce

Joyce,

Can't say that taurine requirement has or has not changed - I still take the same amount.

"What swung it for you?"

Several year ago, found I was sensitive to many vegetable proteins. If you want to lose weight, have several choices. Being a human biochemical experiment, I decided I'd try it.... and take notes. Also, in the summer I moved my mother out of her house to be near me. In her paperwork, I found sports physical exam from year 12. It listed my weight. This is before I bulked up to play American football at university. I decided I should probably finish my time on the planet at my high school weight. The keto approach looked like an efficient way to do so.

We've had a lot of discussion lately about acid/alkaline balance. The Waller Water helps here, but what I'm eating is pretty acid, so I'm not sure how I'll change things on a long term basis - once I hit my weight target. Maybe raw vegan ... that'd be alkaline.

Mike,

So here is a typical day:

Morning - 3 omega 3 eggs sauteed in ghee (clarified butter), olive oil or grapseed oil at low temp.

Lunch, a tin of sardines or salmon

Dinner - a huge salad of greens, broccoli & whatever non-starchy veggies plus 1/2 pound ground grassfed beef, buffalo, ostrich, chicken, turkey or wild caught fish. Initially was using fat from cooking as salad dressing, but found I was eating too many calories so drained that. Sometimes I'll sautee some eggplant in one of the "good" fats.

Some supplemental nuts - not almonds as I react to them, but other tree nuts.

This is about 80 - 95 grams of protein, depending upon nut quantity. So somewhere between 320-380 calories/day in protein.

Hunger is generally not an issue. I have several times had breakfast & then rock climbed for 6 hours, skipping lunch & been fine with just having dinner. Blood sugar would be in low 70's (mg/dl) at the end of the day. Hypoglycemia is generally a function of eating carbs. I should note again that excess protein can cause a blood sugar (as well as an insulin) spike.

By the way, my "hard" heart beats were not an issue after adding my additional mag. (from post above). Also are not an issue after transition period.

Unless you eat a lot of greens, keto diet can be constipating. I use magnesium citrate to control this.

I am active and generally do 30 minutes of bodyweight (core & strength training)/day if I'm not doing something else - like rock climbing, biking or skiing. This has not changed.

Cheers,

George

Thanks again George.

I'm not a long way off you in terms of an average day's food. It's just that I snack on sesame seed bars (with glucose) when i need a 'hit' plus I still imbibe alchohol almost daily in the house (although nowhere near as much as I used to) so I need to keep cutting that down to nothing except the odd social dram or beer. The usual daily small bag of mid-afternoon over-flavoured (drool!) crisps will also have to go........ bah!

Today:
8 am - sesame seed snack bar & 330ml can green coconut water
11-30am (after rough coastal walk incl. ascend 400 foot cliff (on foot - steep but not rock-climbing)) - raw carrots, 1 avocado, cherry toms, small tin mackerel. Bit balsemic vinegar, tabasco and mayo.
6pm - stir-fried broccoli, pork loin, mushrooms in oilve oil with tomato puree, soy and harrissa to flavour.
Later I'll have another 330ml tin of green coconut water,

I'm still nowhere near a ketagenic diet there am I!!

Mike F.



Post Edited (11-30-09 11:42)

Hi Mike,

So here is a suggestion - get a glucometer. The aforementioned one (Bayer Ascencia Contour) was the most accurate home model I could find several years ago. I started with an inexpensive "house" brand from a local pharmacy. I later learned that the error band was wider than what I was interested in. The bayer is +/- 3 mg/dl as I recall (as opposed to +/-15 or 20 on the house brand).

You don't have to test all the time - only as a research project. It is great biofeedback to see what certain foods do to your blood sugar. 45 minutes after eating is usually max blood sugar spike.

I'm coaching a neighbor who needs to loose some weight but didn't want to do full blown keto. I suggested he learn how to eat not to spike his blood sugar above 85 mg/dl (or even 100). He is working on this. If your blood sugar doesn't spike, neither will your insulin & you will tend to stay in free fatty acid burning mode, whether or not you are in ketosis. You will find it is a function of quantity of carbs as well as speed of carbs. My neighbor found out that eating desert after breakfast was not a great idea, blood sugar wise!

Cheers,

George

Hi George,

Thanks for the additional info and suggestions. I guess the obvious problem for me is that my FBS is usually about 100 mg/dl (5.5 mmol/l) historically this last 20 years or so (usually done once or twice per year). As such, I'm already pretty much at 100 mg/dl BEFORE I eat and, as such, I guess I need to be aiming at not getting BS up above 120/130 mg/dl or so 45 mins after eating a meal if I'm going to reasonably emulate the criteria you have set for your neighbour??

I can get a Bayer Ascentia Contour in the UK here:

[www.medisave.co.uk]

but I'll have to give the supplier a phone tomorrow toget some +al info as regards lancets and strips etc.

Cheers,

Mike F.

My one advice is the higher your BS is on average now, the more it might be indicated that you have insulin insensitivity. This would suggest it would behoove you to push yourself more towards a keto diet with very few carbs & alcohol. I'm pretty sure the keto diet would fix that in a few days.

Just testing yourself will be enlightening. Then you can figure out what to do about it.

Mike - I agree with George. Most individuals are on the path toward insulin resistance (caused by diet) and lack of magnesium. Insulin resistance or Metabolic Syndrome is reversible but it requires strict discipline and you will have to do the very low carb and no alcohol for it to be successful.
Jackie