There are many misconceptions about ketosis. The most common is mixing it up with ketoacidosis – a rare and dangerous medical condition that mostly happen to people with type 1 diabetes if they don’t take insulin. Even some health care professionals tend to mix up these two situations somewhat, perhaps due to the similar names and a lack of knowledge about the distinct differences.
Early studies reported high success rates; in one study in 1925, 60% of patients became seizure-free, and another 35% of patients had a 50% reduction in seizure frequency. These studies generally examined a cohort of patients recently treated by the physician (a retrospective study) and selected patients who had successfully maintained the dietary restrictions. However, these studies are difficult to compare to modern trials. One reason is that these older trials suffered from selection bias, as they excluded patients who were unable to start or maintain the diet and thereby selected from patients who would generate better results. In an attempt to control for this bias, modern study design prefers a prospective cohort (the patients in the study are chosen before therapy begins) in which the results are presented for all patients regardless of whether they started or completed the treatment (known as intent-to-treat analysis).
Perhaps you fall into the category of Olympic athletes who would dope with damaging drugs, even if they knew it would kill them. However, if you desire a long, high-quality life, you don’t want to be a washed up ex-exerciser with diabetes, or you don’t want to experience joint, nerve and brain inflammation, damage and degradation, you may need to adjust your lens.
^ Lawrie 2014, pp. 92-. "A much delayed onset of rigor mortis has been observed in the muscle of the whale (Marsh, 1952b). The ATP level and the pH may remain at their high in vivo values for as much as 24h at 37ºC. No adequate explanation of this phenomenon has yet been given; but the low basal metabolic rate of whale muscle (Benedict, 1958), in combination with the high content of oxymyoglobin in vivo (cf 4.3.1), may permit aerobic metabolism to continue slowly for some time after the death of the animal, whereby ATP levels can be maintained sufficiently to delay the union of actin and myosin in rigor mortis."
I asked James Fell if he had some practical advice on sustainable dieting. “When it comes to weight loss,” he said, “the only thing that matters is caloric deficit. However, quality of diet affects quantity. A higher quality diet is more likely to be one that allows you to eat a lower quantity of calories and still be satisfied. That being said, there are many different ways to find a high-quality diet.”
Basically, the proven science is in the pudding. A highly cited low-carb study from The New England Journal of Medicine concludes with the statement, “The low-carbohydrate diet produced a greater weight loss (absolute difference, approximately 4 percent) than did the conventional diet for the first six months, but the differences were not significant at one year.” The study mentions health benefits from the low carb diet, of course, but that it’s largely unsustainable.
What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet or the low-glycaemic index treatment diet, because they find the difficulties too great.
I never stopped eating Keto friendly. I think I was just over eating and snacking, they have always been problems for me. My birthday, Christmas, New Years, overconfidence, my own depression, and an injury that keeps me from the gym, I let it add up. Joining in with my family with stevia desserts and cheese plates, it might be okay for some folks on Keto, not me. I didn't gain, so now I understand maintenance mode, I just couldn't break my low weight, I don't know how many times I relost the same 5 pounds.
There’s not enough of it to matter in coconut oil, it tastes bad, and it often results in stomach/gastric upset, but it does get converted quickly into ketones. If your MCT oil brand of choice makes your throat burn or has a weird flavor, one reason may be that the distillation did not remove enough of the C6. There are other reasons this can happen too, discussed below.
-Nervous System Damage: It’s been shown that patients with neuropathy whose after-meal glucose readings were above the diabetic threshold sustained damage to their large nerve fibers. Even neuropathy patients whose glucose readings remained well within the normal range showed damage to their small nerve fibers. Studies have shown that within any blood sugar range, the higher the glucose, the greater the damage to nerve fibers.
After initiation, the child regularly visits the hospital outpatient clinic where they are seen by the dietitian and neurologist, and various tests and examinations are performed. These are held every three months for the first year and then every six months thereafter. Infants under one year old are seen more frequently, with the initial visit held after just two to four weeks. A period of minor adjustments is necessary to ensure consistent ketosis is maintained and to better adapt the meal plans to the patient. This fine-tuning is typically done over the telephone with the hospital dietitian and includes changing the number of calories, altering the ketogenic ratio, or adding some MCT or coconut oils to a classic diet. Urinary ketone levels are checked daily to detect whether ketosis has been achieved and to confirm that the patient is following the diet, though the level of ketones does not correlate with an anticonvulsant effect. This is performed using ketone test strips containing nitroprusside, which change colour from buff-pink to maroon in the presence of acetoacetate (one of the three ketone bodies).
In many developing countries, the ketogenic diet is expensive because dairy fats and meat are more expensive than grain, fruit and vegetables. The modified Atkins diet has been proposed as a lower-cost alternative for those countries; the slightly more expensive food bill can be offset by a reduction in pharmaceutical costs if the diet is successful. The modified Atkins diet is less complex to explain and prepare and requires less support from a dietitian.
Adherence to a keto diet food list isn’t always great, though. A review published in January 2015 in the Journal of Clinical Neurology found that only 45 percent of participants were able to follow the approach as prescribed. “The poor compliance was attributed to side effects, social isolation, and cravings,” says Yawitz. And some people in the study “reported the diet simply wasn’t helping them lose weight,” she adds. Brissette agrees with this line of thinking. “In my opinion, the keto diet isn't sustainable and takes the joy and fun out of eating,” she says.
You’re very welcome, Judy! I’m glad it’s helpful. If you are keto (as opposed to low carb), unfortunately peaches would not allow you to stay in ketosis. You can check my keto food list to help determine what is keto friendly. Of course, there are worse things than fresh fruit 🙂 but in the end our bodies still see the sugar. That being said, it doesn’t mean you sabotaged the whole day. Just pick up again – you got this!! (And for next time, try some fresh berries in moderation when you’re craving fruit.)
“Certainly, the quality of fat counts,” says Yawitz. “There’s a big difference nutritionally between bacon and almonds. As much as possible, people set on the keto diet should emphasize plant-based, unsaturated fats like nuts, seeds, olive oil, and avocado, which have even been shown to protect the heart.” If you have high cholesterol or other risk factors for heart disease, you should speak with your doctor before beginning the keto diet. This is because the diet may — but doesn't have to — include large amounts of saturated fat. Some studies have shown increases in cholesterol and triglycerides in people following the diet, while other research reveals that the keto diet may actually decrease heart disease risk as well as saturated fat intake.