Your gut wall cells, enterocytes, need some carbs, some of the time.
I have been writing about this for quite a while.
Keto might be great, but not as an ongoing lifestyle.
Cycling with it, on and off, is a great option.
Also, if you test over 6 .2 micromoles for TMAO in your blood, high red meat and egg yolks in your diet may be harmful on your heart and kidneys.
I run this TMAO blood lab on all new patients. It drives the traffic of dietary choices and even some supplements.
Those with elevated levels often do not do well with continuous keto high animal protein diets. Until that TMAO goes back down to normal.
What else?
What about keeping lost pounds off, with keto or any diet?
Our body’s weight has a "set point". A set point that is epigenetically connected to our environment.
If food is plentiful, our hormones force us to eat until our bodies feel that there are enough fat stores to survive.
Because of environmental influences such as highly processed food, endocrine disruptors, preservatives, climate change, and regulation of temperature, our brains have decided that we need more adipose tissue than we did 50-100 years ago.
Oy veh.
An article in Medscape by Caroline Apovian, MD has theorized that today’s highly processed and simply less nutritious and more toxic food (even if you try to eat “organic”, because remember even the rain is polluted) has caused a dysfunction of the pathways that regulate our body weight.
Oy veh again.
How to counteract that?
Not easy.
The ketogenic diet works temporarily just like any other diet where calorie intake is lower than usual. It seems to be agreeable to many people because they say they feel full after eating protein, fat, and some vegetables.
Protein and fat are satiating.
If strictly followed, a ketogenic diet will force the body to burn fat and go into ketosis.
Without a source of glucose, the brain will burn ketones from fat stores.
Owen and colleagues discovered this in 1969 when they did their now-famous studies of fasting in inpatients at Brigham and Women's hospital, using IV amino acids to protect muscle mass.
But…
Is going keto healthy for the long term?
Dr. Caroline Apovian says no.
Dr. Apovian says:
We need some high-fiber carbohydrate sources like whole grains, fruits, and vegetables to keep the colon healthy (those enterocytes like to munch on short chain fatty acids that come from some carbs, healthy carbs) and obtain the vitamins and minerals needed to make the Krebs cycle, or citric acid cycle, work at its best. This is how your body makes energy.
If promoting ketogenic diets for weight loss in obesity and type 2 diabetic patients, they also need to be strategically trained on how to keep weight off later, without strictly eating keto all the time. They need to be trained in cycling keto. On and off.
Patients must be instructed to avoid all highly processed foods.
Patients must be trained in feeling what it is like to feel full, and have “cross-talk” between their head and stomach. I wrote a very easy read book on this called “Retraining Your Tongue” to help develop this brain/stomach cross talk ability.
Studies have shown that highly processed foods, created to maximize flavor, and fool our brains into wanting us to buy more and more, tend to make us eat more.
Compared to people eating the same number of calories in unprocessed foods.
Brain Is In On Your Portion Control
When we eat, our gastric fundus and intestinal stretch receptors start the process that informs the hypothalamus about food intake.
When your gut stretches, this informs your brain to help you push yourself away from the table.
Highly processed foods are usually devoid of fiber and volume and pack in the calories in small volumes so that the stretch receptors are not activated until more calories are ingested.
Highly processed foods fool our brains into wanting to eat more and more.
There are also gut hormones that are secreted before and after meals, such as ghrelin, glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and cholecystokinin (CCK), among a slew of others.
These peptide hormones are all secreted from gut cells into the blood or vagus nerve, or both, and alert the brain that there is or is not enough food to maintain body weight at its set point.
Highly processed foods futz with our satiety hormones.
The ketogenic diet can fool the brain temporarily by using protein and fat to elicit satiety with less food intake in calories.
But… after a while, gut hormones and other factors begin to counteract the weight loss with a reduction in resting energy and total energy expenditure.
You start to gain the weight back. And perhaps even start to get surprisingly fatigued.
Losing weight is not easy.
Check your TMAO levels.
Cycle your keto.
Care take your enterocytes.
Move more.
Best not totally avoiding carbs for long on-going periods.
If you are in my LIVE and PRO level membership groups, Lisa Beck gave a great talk on a new weight loss program designed by a critical care doc. The replay is in the Live Level Archives accessible by Live and Pro members. Go to drlindseyberkson.com/membership if interested in sleuthing around to learn more.
I have lost 13 pounds in one month so far on this diet. I am one of the folks that say I eat great, and work out a lot, oh my, but it’s so hard to lose weight. I am also a DES daughter and there are articles written about many issues with DES offspring including resistant fat. But this diet so far is working. I will keep you in the loop.
What are your thoughts on going Keto long-term?
Dr. B.
Reference:
Keto for Life? Reasons to Think Twice - Medscape - Feb 06, 2023.
Such great thoughts, Dr. Berkson! Thank you for intelligent and meaningful conversation. Do you think this new diet would be good for people working through mold toxicity? Mold disrupts leptin and causes resistant fat, so always looking for new diet ideas that might be useful and well tolerated.