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Blog Post on Metabolic Syndrome, Ketosis and The Nervous System.

Ema

Senior Member
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4,729
Location
Midwest USA
Really interesting thoughts on how the nervous system and hormones interact with our diet and weight gain/loss efforts.

Reposted with permission...from http://itsthewooo.blogspot.com/2014/02/the-goal-is-not-to-make-keto-meter-read.html#more

The goal is not to make the keto meter read 3+.

I more or less wrote this blog entry a few days ago, but I'm writing it again for emphasis.

First, let me ask you why you are reading this blog? Because you are on a low carb diet probably. Also, because you like teh lulz.

Why are you on a low carb diet? To control your blood sugar, perhaps? To control an endocrine problem related to blood sugar disorders like PCOS? To control obesity? To help a neurological problem like migraines or depression ? I can reliably bet your response isn't "I'm on a low carb diet to get my keto meter to say 4" .

This was taken yesterday. Here's another photo. I've lost a lot of body fat in a short period of time. I'm not even weighing myself but my pictures make it obvious I am way thinner than I was just a few wks ago. I gained a lot of fat during fall crap out, and I am almost as thin as I was in November.

If your keto meter is telling you that your blood ketones are >0.1 or so, YOU ARE IN KETOSIS. Normal people do not have ketosis readings much greater than that. Maybe after exercising while on a diet they will be slightly higher than .1 , but only on ketotic diets will you see BOHB levels of 0.5, 0.6, 0.7, 0.8 etc. For people eating relatively normal mildly ketogenic diets typical BOHB levels are going to be like 0.6 to 1.5 range like the kind of readings I am getting.That would represent very low carbs, very high fat atkins type eating.

A person who is sick, with diabetes, with life threatening insulin deficiency will have BOHB levels of like >8. This is ketoacidosis. Starving people eating nothing at all get to like ~4 or ~5. Starvation involves pathologically low insulin, just like diabetes. With this in mind think about what it must take to 4 while eating food? Assuming the person is eating enough calories (vs simply eating 500 cal per day and starving self on a "keto diet"), the only way to get ketones this high is to more or less pare down your diet to oil/butter, and fast. If you think this kind of diet is without consequences you are insane. People are not meant to live on butter and isolated fat. Basing your diet on butter like substances sounds like a horrible idea to me unless there is a really strong medical reason like disease.

The ketotic diet can become very cult like, it's amazing how one is made to feel like a failure if their keto meter isn't high enough.It's not enough to be IN KETOSIS these days; no, you need to be "winning" the ketosis video game by reading 3.5 ketones or whatever. The fact I have maintained massive wt loss for over a decade isn't enough, nope, ketones only 1.5 when exercising!

This is success, not a keto meter number.

As I've written before, it is also going to be *easier* for people who are obesity resistant to get very high keto numbers simply because of nervous system dynamics. Not only do they fail to store much fat eating cookies and cakes (relative to the constitutionally obese) but the same rules apply to ketotic diets, and they easily tear apart their fat tissue/ resist storing it for energy. This produces those super high keto numbers. Hyposympathetic types who are highly predisposed to obesity like wooo are just not going to be able to score ketones of 3. I would literally probably have to be starving to ever see ketones that high. I think even if I were eating pure fat and exercising an hour a day it wouldn't get much above 2.

It's important to remember the ketones don't really make you lose weight, they are only a sign of very low insulin signalling in adipose and imply lack of weight gain/active weight loss. There is evidence ketones themselves help promote leptin signalling and may be useful for wt control, but definitely mostly it is true that cause and effect are reversed WRT the importance of ketones. Jimmy Moore is not maintaining weight because his ketones are 4. It's more accurate to say because Jimmy Moore is eating/fasting/exercising to have ketones of 4, he is therefore maintaining weight.
The thing is, the reverse isn't true and super intense keto is not really *necessary* to lose or maintain weight. Just because it is true being in major ketosis makes it difficult to gain weight doesn't mean you HAVE TO be in super ketosis or else yr DOOOOMED to get fat. I haven't had a ketone reading greater than 1.4, and I am still losing weight. There is no linear relationship between adipocyte energy balance over time and ketone numbers. Merely, the ketones function as a yardstick estimating the current insulin signalling of fat tissue.

Ketones just really aren't even that important even for energy. With long enough time of a VLC diet the mitochondria rely less on ketones and oxidize FFA more directly for energy directly. If so, it stands to reason with prolonged adherence to an extreme low carb diet blood ketones eventually decline naturally anyway; or, at least, aren't all that important as a measure of energy. Intuitively I feel as if ketones themselves, the number the ketometer is reading, have very little to do with my energy. I have been on a VLC for *years* and most evidence suggests ketones are a short term adaption to glucose deprivation. With extended/prolonged VLC intakes, the body adapts to using FFA for energy.

The main benefit of tracking ketones is forced adherence to an insulin inhibiting lifestyle. It isn't enough to just "low carb"; it only works if your fat cells are not getting an insulin signal. Ketone tracking helps accomplish this most specifically.
  • Eating tons of food? Binging out on cheese?
  • Not exercising? Sitting fat ass in chair?
  • That keto meter is going to tell you about it in the morning.
It doesn't lie. If your basal insulin is high from eating too much energy (this includes FAT), and not moving at all, your ketones in the morning are going to laugh at you. The keto meter is like this bossy fitness coach telling you to fast , eat less, and exercise more. While CICO is a hilarious failure and a joke, it is a biological fact all energy is insulinogenic, all energy positively influences adipocyte growth dynamics (although to what extent is HIGHLY variable; e.g. very obesity resistant people can't even fatten on junk food, whereas extremely obesity prone people like wooo will fatten even eating too many calories of a ketogenic diet). The reason CICO kinda sorta works is because eating less and exercising more, even of a cheetos diet, will typically reduce insulin. Ketogenic diets are simply a much more intelligent and arguably healthier way to do that . Although, if you get into the "100% butter diet" form of ketogenic, as far as I'm concerned you might as well CICO on doritos because the health impact is the same for most people, grossly nutrient deficient.

Proneness to weight gain , as I stated, is very individually variable. What I am calling "obesity proneness" is the sum of a myriad of neuroendocrine dynamics influencing the adipocyte. Type as well as amount of dietary energy is just another factor , although obviously a critical one as no obesity can occur without food energy just as a boat full of holes can only sink if you try to sail it. Blaming food calories for obesity is like blaming the ocean for making a boat full of holes sink. Proper boats are meant to float and proper bodies use fat tissue for energy vs storing it escalating fashion. The following is a broad list of the main factors determining obesity proneness. These factors control insulin signalling int he adipose.
  • sympathetic nervous system: adrenergic receptors on adipocyte , thyroid hormone, influence rate of lipolysis and fat oxidation. This also doubly influences insulin sensitivity (less SNS, more insulin sensitivity)
  • parasympathetic tone: actively antagonizing and suppressing the action of the SNS, also directly contributes to gastric motility and digestive function which means higher insulin levels with feeding, inhibited use of fat for energy. If it is excessive a person experiences frequent hypoglycemic excursions and sluggishness. The obese may be parasympathetic dominant if they have hypothalamic obesity. The post obese are all without exception parasympathetic dominant as a normal function of leptin deficiency in the CNS.
  • "Carbs make insulin" is an extremely one dimensional way of viewing the problem of obesity. Actually, all food makes insulin (even butter), and insulin level is just a tiny fraction of the story. While all adipocyte growth occurs and inhibition of lipolysis relates to insulin , insulin isn't some free agent; it is a slave of the nervous system. If you have a low SNS and a high PNS you might have very low insulin but guess what? Insulin signalling in adipocytes is going to be super duper high and you are going to get fat even on trivial intakes. You are also going to have functional hypothyroidism and feel like crap with no energy 24/7. The thyroid and SNS have reciprocal relationships, and both stop insulin action in fat tissue while raising fat oxidation.

You know what? After doing this ketometer experiment for a few days, I can honestly say being in deeper ketosis does not help with weight control. It does, but the causation is reversed. My ketones are >1 when I have done exercise and consolidated eating via semifasting. It is active insulin inhibiting behaviors truly causing the resistance to weight gain even eating tons of calories.The ketones are just a useful yardstick to estimate effectiveness, but by no means is it required that ketones be elevated to lose weight effectively. Also, there is much more involved to a proper keto diet (just like a proper weight loss diet) than simply eating fat and not eating carbs. Eating a bag of macadamia nuts sitting in a chair is not making me feel energetic and lose weight. In fact, being sedentary while pigging out on ketogenic food is a great way to have low fasting ketones and to gain body fat (at least for me, given how prone to obesity I am).

To cut to the chase I would probably say, for simplicity sake, yes, I lose weight when my ketones are over 1. However, this is a gross misrepresentation of what is really going on. In reality it is most proper to say BECAUSE I have been consolidating eating (semi-fasting) and exercising, my insulin levels are significantly lower, which is provoking fat loss and symptomatically my fasting ketones are higher. Do you see the difference between these two concepts, because it is a HUGE one. In the latter framework, ketones are merely a passive symptom of insulin levels for the obese person, much in the way blood sugar is a symptom of insulin for the type 1 diabetic.

When obese people see rising ketones as part of a ketogenic diet this is a redundancy with insulin signalling being inhibited in the adipocyte. This may be achieved by serum insulin reduction, or it may be achieved with sympathetic stimulants / catecholaminergic drugs that provoke increases of SNS acting on the adipocyte. Both will raise ketones because they inhibit insulin from talking to fat tissue. The reason meth users (or wellbutrin users, or phen/fen users) become thin is sympathetic stimulants prevent insulin signalling of fat tissue, via very high fat oxidation from the stimulant. Stimulant drugs and the SNS produces a condition which is polar opposite of normal weight loss... however, whenever ketones appear it is only a symptom, not a cause of fat loss. It is not required either.

Functionally this is no different than a type 1 diabetic being able to predict their insulin levels by their blood sugar. If their blood sugar is 250 they didn't take enough insulin. Other things may lead to high blood sugar (as expected, all drugs that disrupt insulin signalling of the fat tissue will typically worsen diabetes, but make obesity way better e.g. stimulants and thyroid). Generally speaking rising sugar reflects lower insulin/not injecting insulin. Diabetics will say for simplicity sake that high blood sugar causes diabetes, but pathophysiology wise this really isn't true; the high sugar is a symptom . In weight loss, ketones are a symptom of losing weight, and only SOMETIMES is this true.

In typical wooo fashion I am going into excessive needless detail and escaping the main point I am trying to make. Summary of ideas:

  • Ketones are a symptom of insulin inhibiting behaviors. Ketones do not cause weight loss, although it may be true they help inhibit weight via central effects; it is still overwhelmingly true ketones are at best a placeholder for insulin levels/signalling activity in the adipocyte.
  • For most of us the goal is simply to lose weight, have energy...doing everything you can to raise that keto number may be very counter intuitive indeed.
  • Eating more fat in obese prone people will often lead to elevations of insulin/ insulin signalling in adipose and ironically lower fasting ketones. The best way to get a high ketone number, which means to say, a low insulin level, is to EXERCISE, ENERGY RESTRICT and/or FAST. Eating nothing at all is ideal, and also leads to the fastest weight loss.
  • People who are generally obesity resistant with really great SNS tone are going to have high fasting sugar and high ketone levels very easily. They also feel really great on these diets because of how well their body can make energy from fat tissue and how reluctant it is to store food in adipocytes. They may shame and guilt you for not being "keto enough" but they do not understand these things are regulated by the nervous system. I have been trying to explain to DLS pablo that his body works differently from mine for like weeks now and he still tells me how great he feels eating one meal a day and I'm doing it wrong.
  • Remember above all else, THE GOAL IS NOT KETONES. I am guilty of it, falling into the trap of feeling "bad" I'm not ketogenic enough, but take a step back and look at big picture and remember the real goals.

For me personally , the biggest benefit of specific keto is for my depression and emotional state. I am open to idea it is helping me lose weight but the improvement is mood is much more specific / obvious. If my only concern was weight I would not be doing keto at all. I would be pigging out on protein , eating lean protein and lower fat things.

Keto is great for wt control but the very high fat moderate protein diet makes it EASY to get fat relative to high protein, lower fat & carb diet. OTOH, the high protein/low fat diet is horrific for mood (probably seizure too lol) so keto is what wooo needs. But if you are big fatty who only care about not being fat, base meals on protein and don't worry too much about keto. 99% of normal people feel really stuffed eating meat and get super skinny following basic meat based atkins. Oh, and stop worrying about your keto meters.

Posted by ItsTheWooo at 8:12 AM
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