Ketosis dangerous?

[Labarum]

This seems to be the official online advice from the British National Heath Service. Comments?

http://www.nhsdirect.nhs.uk/he.asp?ArticleID=221

Definition
Ketosis is a process in which your body converts fats into energy. During the conversion, ketones are produced. Ketones are fatty acids that your body can use as an energy source.

Your body normally uses glucose to obtain its energy. The glucose you need comes from the carbohydrate in your diet. When your body does not have enough glucose to obtain its energy needs, ketosis occurs. The result of ketosis is to obtain energy from your body’s stored fats. The ketones released commonly give your breath a sweet, fruity smell that may be mistaken for alcohol.

A healthy, balanced diet should provide you with all the carbohydrates your body needs. So, normally ketosis will not need to take place and the ketone levels of your blood will be low. However, if your diet is very low in carbohydrates, or if you are starving yourself, ketosis will begin and your blood ketone levels will begin to rise. Because ketones are acidic, prolonged ketosis can be dangerous as it can change the acidity of your blood beyond the level that your body can tolerate. This may eventually lead to serious damage to your liver and kidneys.

Recently, diets that recommend you eat lots of protein and very little carbohydrate have become popular. These high protein-low carbohydrate diets – known as ketogenic diets – are intended to work by forcing your body to begin ketosis to burn fats and create quick weight loss. Because long periods of ketosis are dangerous to your kidneys and liver, ketogenic diets are never recommended by health professionals for more than short-term use, typically no longer than 14 days. Many nutritionists warn their patients – especially women in the early stages of pregnancy – against following them at all.

If you are diabetic and you fail to have your injections of insulin for a prolonged period, you can experience ketoacidosis. The lack of insulin means that your body cannot use glucose to create energy and ketosis occurs. If left untreated, your body will release so many ketones into your blood that your blood will quickly become dangerously acidic. Untreated diabetic ketoacidosis can lead to coma and death.

[cleochatra]

Re: Ketosis dangerous?

Untreated diabetic ketoacidosis can lead to coma and death

The last sentence changes everything.

It's also a bit of a fallacious red herring.

There is a vast difference being in a meaningful state of ketosis and a diabetically-enmeshed state of ketoacidosis; yet the article confuses the two. It's like comparing lobsters and lipstick.

[Kent]

Re: Ketosis dangerous?

Recently, diets that recommend you eat lots of protein and very little carbohydrate have become popular. These high protein-low carbohydrate diets – known as ketogenic diets – are intended to work by forcing your body to begin ketosis to burn fats and create quick weight loss. Because long periods of ketosis are dangerous to your kidneys and liver, ketogenic diets are never recommended by health professionals for more than short-term use, typically no longer than 14 days. Many nutritionists warn their patients – especially women in the early stages of pregnancy – against following them at all.

Having those produce such studies realize that we actually advocate a high-fat approach blows their mind that they can't even believe to write it. As for their precautions, it is the same ones Dr. A advocates as well. For those with normal kidney and liver functions, this diet does not even begin to approach the danger categories. (I read somewhere it would have to be 5x more daily water intake and 10x the number of ketones before it would be dangerous.) If needed, a source can be provided. As for pregnant women, the only prescribed phase for pregnancy is maintenance mode.

They could have read the DANDR got the same precautions.

[Labarum]

Re: Ketosis dangerous?

I knew this one would get a fast and firm response!

(Hey, Kent, where is that picture you promised sans Tee Shirt?)

[Labarum]

Re: Ketosis dangerous?

A more balanced view?

http://www.muscletalk.co.uk/ketogenic_diets.asp

Low Carbohydrate, High Protein (Ketogenic) Diets for Weight Loss
Article by James Collier BSc (Hons)
(Moderator and contributor to Muscletalk as an expert in nutrition.)




There have been a few posts regarding low carbohydrate, high protein or ketogenic diets on MuscleTalk, so I thought I'd voice my views through an article. I am referring to them in the non-bodybuilding sense here, and more for body weight loss. Ketogenesis may be useful if used appropriately in the last part of bodybuilding contest preparation, but the reasoning behind this is very different to general weight loss.

Collectively, these regimens are known as 'low carb' or 'ketogenic' diets and have many variants. One of the better known is the Atkins diet, around since the 1970s. Others include Radiant Health (Professor Brian Peskin), the Carbohydrate Addicts Diet (Dr Richard Heller and Dr Rachel Heller), the Diet Cure (Julia Ross), Protein Power (Dr Michael Eades and Dr Mar Eades), Eat Fat, Get Thin (Barry Groves), and many more.

The Claims
These diets claim to alter the way we metabolise food, and their advocates argue that obesity is a consequence of dietary carbohydrate rather than dietary fat or total calories. It is claimed that excess dietary carbohydrate raises insulin levels which, in turn, causes more body fat deposition. The theory is that a higher protein in relation to carbohydrate intake lowers insulin levels and causes weight loss. These diets are also said to help food cravings and help fill you up as protein foods promote satiety. Other health claims are that they improve lipid profiles and benefit hypertension.

The Scientific Evidence
There is absolutely no evidence, though, that weight loss can be achieved in any way, other than by creating a negative energy balance, i.e. weight is lost when we burn up more than we eat. There is also considerable evidence that some of the health parameters are closely linked to obesity, and that weight loss by any means improves them1.

There is evidence that calorie deficient low carbohydrate, high protein diets do produce a more rapid and greater initial weight loss compared to isoenergetic more moderate carbohydrate diets, with the associated benefits 2,3. Unfortunately, the initial high rate of weight loss is not only due to reduction in energy stores, but primarily due to changes in fluid balance. The reduction in muscle glycogen (the storage form of carbohydrate) stores is accompanied by a reduction in water; for every 1g glycogen metabolised, 3g of water is lost.

Also, on extremely low levels of dietary carbohydrate (i.e. less than 50-100g per day; 10-20% total energy intake) high levels of ketones are produced. Ketones are used as a fuel by the brain and heart muscle during times of low food intake and help keep us alive. The presence of ketones means increased sodium and potassium and associated water loss (more weight loss), bad breath, taste changes and nausea, which obviously may lead to reduced food intake.

Ketogenic diets are very limited in variety, and variety in the diet is one of the fundamental healthy eating guidelines in order to achieve a balanced diet and optimal nutrition. They fill you up more than on diets of comparable energy intakes with a higher carbohydrate : protein ratio. Protein rich diets also increase thermogenesis, and therefore 24-hour energy expenditure more than with similar energy higher carbohydrate intakes 4. Whether this persists longer term remains untested.

As a consequence of all the above in ketogenic diets, there is greater potential for a negative energy balance, hence consequential weight loss. Weight loss is therefore not due to raised serum insulin levels promoting body fat deposition. There is also going to be a considerable consequential reduction in muscle tissue as protein is burned for energy.

Potential Problems
Low carbohydrate diets are, by definition, high in protein and fat. As less fibrous starches are consumed, there is a reduction in dietary fibre intake too, as well as antioxidant vitamins and minerals. These factors signify increased risk of cardiovascular diseases, cancers, kidney disease and bowel disorders.

Nutritional intakes of people on ketogenic diets have been shown to be low in calcium content, as are the intakes of people following more orthodox weight reducing regimens. This is a result of general low food intake. However, low carbohydrate, high protein diets may also lead to increased calcium excretion and reduced bone mineral content (5). It is very likely that there is an increased risk of osteoporosis later in life.

In Summary
Ketogenic diets are no 'magic' answer for weight loss, and certainly do not follow the well-evidenced healthy-eating guidelines. They also have the potential to cause nutrition related problems to health.

However, there are no studies comparing the short-term use of such diets in relation to health problems, so there may well be benefits of short-term use outweighing any potential risk for certain obese people who really struggle to lose weight by more traditional means 6. There is no evidence describing what 'short term' actually means. Further research is therefore required. Also the extent of physiological adaptation to these regimens is unclear.

There is very good evidence though, that manipulation of low fat, moderate protein and moderate carbohydrate is more promising in respect of efficient and consistent weight reduction 6 This, of course, is improved further with the inclusion of exercise.

Whilst many people do claim some good initial weight loss with low carbohydrate, high protein diets, this rate of loss slows down after a few weeks. Most people also claim to put most, if not all, the weight back on (and sometimes more) when they cease the 'diet'. Therefore defeating the object of following such a stringent plan. Many may follow such regimens for a special occasion or seasonal preference, which could lead to significant weight cycling, identified in its own right as a risk factor for cardiovascular disease.

Low carbohydrate, high protein diets do not fit in with healthy eating guidelines, they are unbalanced and difficult to fit in with lifestyles and family meals. They also take no account of the psychological influences of why people over eat, crucial in any weight reduction programme.

Many MuscleTalk members will be looking to reduce body fat whilst maintaining muscle mass, but ketogenic diets are not the way to go for the reasons discussed above. Remember that most of you will be wanting to either build muscle, or, at least, to maintain muscle mass - this is not achievable with low carbohydrate, high protein diets

[IronEagle]

Re: Ketosis dangerous?

Not able to build or maintain muscle mass? That is hilarious he should come feel my chest/legs/arms I am getting huge on under 40grams of carbs a day. Even Arnold S. said in his book that if you want to slim down watch your carbs.
Of course my Animal products Animal Pak multi and Animal Stak 2 are big contributors to this as well for complete nutritional support with no extra carbs.

Here is good info from Lyle MacDonald's "The Ketogenic Diet" book:

A question

Somewhat difficult to understand is why ketogenic diets have been readily accepted as medical treatment for certain conditions but are so equally decried when mentioned for fat loss. Most of the criticisms of ketogenic diets for fat loss revolve around the purported negative health effects (i.e. kidney damage) or misconceptions about ketogenic metabolism (i.e. ketones are made out of protein).

This begs the question of why a diet presumed so dangerous for fat loss is being used clinically without problem. Pediatric epilepsy patients are routinely kept in deep ketosis for periods up to 3 years, and occasionally longer, with few ill effects (3,5). Yet the mention of a brief stint on a ketogenic diet for fat loss and many people will comment about kidney and liver damage, ketoacidosis, muscle loss, etc. If these side effects occurred due to a ketogenic diet, we would expect to see them in epileptic children.

It's arguable that possible negative effects of a ketogenic diet are more than outweighed by the beneficial effects of treating a disease or that children adapt to a ketogenic diet differently than adults. Even then, most of the side effects attributed to ketogenic diets for fat loss are not seen when the diet is used clinically. The side effects in epileptic children are few in number and easily treated, as addressed in chapter 7.

Lyle McDonald is a prolific writer who has been featured in many major publications. He has a B.S. in Kinesiology from the University of California at Los Angeles. He is considered by many to be the leading authority on low-carb diets. To learn more about his book, The Ketogenic Diet: A Complete Guide for the Dieter and Practitioner, and to review other products and articles by Lyle, please click here.

[Chris]

Re: Ketosis dangerous?

I'm being a very bad contributor, here, because I'm not going to cite any specific links -- I'm at work, and just "sneaking" on the board is bad enough, without taking additional time to research.

However, I'm sure that I remember reading about some clinical studies that showed that Dr. A was right when he claimed a metabolic advantage to low carb weightloss diets. If I remember correctly, the studies showed that the advantage was that low carbers could consume around 300 calories more per day than the low cal/low fat dieters.

Regardless, I love this WOE because, first of all, I can have such "forbidden" foods as heavy cream, real mayo, fried fish, and real butter; and, secondly, because I'm not constantly hungry as I am on a low cal diet.

[Labarum]

Re: Ketosis dangerous?

How do you fry you fish, Chris.

And yes, I remember the 300 Kcals claim.

[Chris]

Re: Ketosis dangerous?

How do you fry you fish, Chris.

And yes, I remember the 300 Kcals claim.

I dunk the fish in either heavy cream, or cream and a beaten egg. I used to buy Keto Crumbs at GNC and dredge the fish in that, but they've stopped carrying it (low carb is no longer a fad, you know), so I've just been using the Atkins bake mix, which works quite well.

I usually have fried fish, with homemade coleslaw, about twice a week, and it's one of my favorite meals. I've even found a tartar sauce, made by Duke's (a Southern US brand) that's very low in carbs and sugar free. I don't always use it, but sometimes have a bit with the fish.

[slimndown]

Re: Ketosis dangerous?

FYI, I heard Keto went out of business . They had some of the best products....Another good crust is using grated parmesan instead of bread crumbs.

I think it is so sad how the medical industry has become SO agenda based. People follow it blindly because it's supposed to be based on scientific facts and it isn't until you do your own research or deeply look into someone else's that you can see it.