Ketogenic/Bulletproof/Paleo/LCHF Diet

[ChrisD]

So in light of Yesterday's paper on Gut Microbiome alterations in CFS ( https://eurekalert.org/pub_releases/2017-04/cums-cfs042117.php ), I am reassessing my Dietary options to possibly tackle potential Commensal/inflammatory/Pathogenic bacteria...

Since Jan 2016 when I first started experiencing Fibro/arthritis type symptoms, I have been following an anti-inflammatory, elimination diet probably most akin to the Bulletproof diet (Green - Roadmap). Then over the course of the last year I have gradually reintroduced various things or experimented to see what I can tolerate, but Gluten/Sugar/Processed food/Alcohol are definite no-no's, Dairy I am on the fence and I have reduced Meat consumption considerably.

I have cycled between strict Ketogenic, Relaxed LCHF, Strict Fruit/Veg diet (Gerson/Medical Medium) to see what works best for me. I think I do pretty well when having a Bulletproof coffee in the morning which throws you into ketosis and clears brain fog, adds slight energy increase and then Paleo, LCHF for the rest of the day. I would not consider changing from this really.

HOWEVER after a quick bit of reading on the bacteria identified in Yesterdays paper and an annalysis of the three stool tests I have had, it would appear that this diet is actually supporting these imbalances. See here: https://www.ncbi.nlm.nih.gov/pubmed/24336217
''The animal-based diet increased the abundance of bile-tolerant microorganisms (Alistipes, Bilophila and Bacteroides) and decreased the levels of Firmicutes that metabolize dietary plant polysaccharides (Roseburia, Eubacterium rectale and Ruminococcus bromii).''

Alistipes seems to be the main culprit, so does a High-Fat diet support it's proliferation? Any thoughts?

 

[arewenearlythereyet]

I would try an eat a balanced diet. You could go completely insane trying to theorise based on the extremely small amount we know ref biome. Putting a blanket term on "processed foods" also doesn't make any sense from a scientific point of view. There are some specifics but just saying processed is a little generic. Pasteurised milk is processed. Everything you eat is digested down to very small molecules before you or any microorganism can use them so whether they are processed or not has very little effect. More important is nutrient density and balance of of food types (protein fat CHO).

There are pros and cons for each thing you try and restrict and differing amounts of benefits vs downsides. If you ellimnate gluten you are eliminating wheat and the associated fibre and vitamins you get from it which will cause other gut and diet issues. You can however benefit from eating less refined carbohydrates generally and rebalancing to find a level of carbs that works for you. I found ketogenic was too restrictive so ended up with a 100-150g carb moderate diet and subbed the carbs I was eating with fat. This has given me less reflux and nausea symptoms, but this quickly returns if I over do it and go up to 200-220 for a week. Typically it seems to take around 3-6 weeks for your body to adjust to changes so expect IBS during the changeover period.

You also need your essential amino acids and these are best obtained from a variety of protein sources. Eggs are a good nutrient dense option here since you get all the other vitamins and lipids as well as a decent protein.

The best way to have a balanced micro biome is to eat a balanced diet. Restriction diets often have an element of pseudoscience with them so try and challenge the scientifically proved benefits they are espousing. Paleo is absolutely flawed when you look at the science of the theory, however no one will argue that rebalancing your diet to eat more vegetables and less refined carbs is a bad thing. It's just the premise that's nonsense (paleolithic man was the epitome of our digestive evolution), so you can ignore the bit about avoiding dairy since the theory is in "la la" land. Avoiding all sugar and not eating fruit is also wacky since we evolved to eat fruit. Moderating fruit to one or 2 pieces a day should be fine given the benefits of fibre vitamin c etc.

Moderation on refined sugar and carbs is the key. So avoiding gluten really just equates to reduce refined starch. It shouldn't matter whether you eat rice, potato bread etc, the carbs Are converted to glucose in the end. So it's the amount of carbs you eat, not whether they have gluten with them.

Last thing on fibre. There is a lot of studies that show that a high fibre diet helps naturally shift old bacterial cells and other debris from the gut walls and maintain a healthy gut. Many restriction diets mean low fibre, so you may end up with other problems with these so aiming for 30g fibre a day would be a good target.

Sorry realised I've written war and peace......and it's probably not what you want to hear.

 

[ChrisD]

Not at all, thanks for a thorough and informed response The only things I would say is that maybe I should be more specific when I say processed foods; I just try to eat things with minimal ingredients (additives/preservatives/fillers etc.) and the reason for this being mainly that I started to notice that I was quite clearly reacting to such foods. Gluten was the main culprit of causing inflammation and bringing on Muscle and joint pain and further malaise, starches like Corn, Rice and sometimes potato will or atleast would cause the same issues (one year ago). I can usually eat Rice and Potato now but Corn and Gluten still cause me a lot of problems and I would imagine it is the same for most CFS patients.

I do believe there is a lot of merit in using a Ketogenic diet periodically, almost as a treatment. A lot of functional health doctors will advocate this. I find that I have far more energy during the day with a High fat breakfast such as BP coffee, Greek Yogurt, Eggs with butter and Avocado than if I was to have Porridge or Granola - that's just an observation on my part but I would recommend anyone who is struggling to adopt this.

There is some evidence to say that Wheat and Gluten provide Thiamin and Riboflavin and that people who go GF could suffer deficiencies but the negatives outweigh the positives as Gluten is incredibly inflammatory to the gut. So you can either supplement B1/B2 or indeed receive them from other areas of your diet very easily.

But I totally agree on speculating on adapting the Microbiome from our diet, it is too much of a fine science that we are only just beginning to understand, we can only do our best. I definitely feel significantly better when using a Kefir Colostrum yogurt and prebiotics daily, so will continue with that - I just hope one thing sticks and another vacates!

Also if anyone is interested, then I keep something of a food diary here https://www.instagram.com/foodimmunity/

 

[arewenearlythereyet]

I think the key is to keep doing the things that make you feel better.

There certainly is an absence of true data (including the inflammatory response from Gluten and others).

What we do have is a lot of information about food groups and digestion, so I would try and start from basic principles when you can.

To put context to food allergies and food intolerance's etc., wheat is often cited as a food intolerance for people of all walks of life mainly because we eat a lot of it. The trouble is when you look into this in more detail, a lot of the symptoms are confusing carbohydrate bloating with an immune response. This is only what I've seen from surveying the general population rather than people with CFS. You also see a lot of bloating talk on the internet which is often misleading.

Its definitely worth not getting sucked into the hype on this particular one. A lot of it is very misinformed. Coeliac disease is a completely different kettle of fish of course but luckily is much rarer and does have markers. Another factor is that eating bread and pasta is much easier to overdo carbs than potatoes or rice from a portion size point of view so this sometimes drives a perception of the gluten being more significant than it is.

Having said all that ...PWME\CFS have weird immune systems so who knows whats going on really. I don't suffer from food intolerance's, but things may develop as my disease gets worse. (another thing to look forward to). I certainly do better limiting carbs (I start eating them in the afternoon and avoid carbs at breakfast like you)

The thing which is quite disconcerting for me as someone with CFS is histamine....which can drive a whole load of digestive symptoms seemingly regardless of what I eat. I have definitely noticed a pattern of GI issues and PEM. So the sequence goes ...Over do it...Get PEM....get diarrhea and skin rash etc.

One things for certain ...we have a moving feast when it comes to symptoms which is why diet will only ever be a way of making us more comfortable

 

[Manganus]

First of all: I've no idea about names that are given to different kinds of diets. I do not comment on what kind of diet ought to be better or worse.

I would try an eat a balanced diet. You could go completely insane trying to theorise based on the extremely small amount we know ref biome. Putting a blanket term on "processed foods" also doesn't make any sense from a scientific point of view. There are some specifics but just saying processed is a little generic. Pasteurised milk is processed.

I on the other hand find the term processed food to be very convenient.

For me, it's chiefly kind of a reminder: what do I prefer to buy, what do I prefer to exclude?

I'm in no way religious about diets, but in my case it's been a huge advantage, when I some 5-6 years ago made the effort to test which kinds of food that led to improved symptoms/wellbeing. The first condition was that I have control over the ingredients used while cooking.

In other words: I buy "unprocessed" food as far as it's possible. If I cook starting with fresh vegetables and whole meat (or fish) instead of different kinds of half-ready products, I can include or exclude what I want myself.

It's not a question of beliving that "everything modern" or "industrial food" in principle may be dangerous. That may be so, or not. I don't care. Rather I want to use only such ingredients that I've tried and put on my (chiefly) mental list of food stuff that don't make me worse.

Example: I use one kind of oil. (An olive oil.) If I buy half-ready products, they are already prepared with a multitude of ingredients, like Rapeseed oil, trans fats and Palm oil. They may well be harmless. I don't know. But I have not tested, in an orderly way. Hence I prefer to avoid them.

The same goes for sugar substitute and glutamate (MGM). They may be harmless. But I prefer to avoid, when possible.

The reason may seem "unscientifical". I have no proof of them doing harm. It's the other way around: I avoid that, that I yet have no proofs of (or experience of) being good for me.

(At restaurants and when someone else invites me to eat, I eat what's on the plate.)