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capisce | 8 years ago

How does this interact with intermittent fasting or low-carb diets?

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MattRix|8 years ago

I can only speak for myself, but in the period where I am keto-adapting, I feel irritable and have low self control... but once I'm keto-adapted (ie. in ketosis), I have MUCH better self-control than normal.

polskibus|8 years ago

I'm curious about that - I'm no expert in keto-diet. How do you assess self-control? I mean, could it be just reversion to the mean, you swing into very low then bounce back and feel like it's better than it was before?

LyndsySimon|8 years ago

I don't know. My impression from reading the reports of others in keto communities is that blood glucose levels are typically about 30% higher - around 130 mg/dL - when in ketosis, including during fasting.

Obviously my impressions are not data, but I thought I'd present them here because it seemed counter-intuitive to me that significantly restricting carbohydrates would result in high blood sugar levels.

iamt2|8 years ago

Depends on the individual person, when they measure, and how they measure.

First, you're not going to get really accurate measurements unless you've calibrated your meter against a set of venous-based lab blood draw results, across bands of glucose levels. Second, unless someone describes that they are taking their measurements on the same time of day each day, under the same contextual conditions, then it's tough to separate out the measurements independent of the context.

Example: someone says they take a measurement at 11 am every day. Sounds good, except if they don't reveal they drink a Starbucks sugar-coffee a couple hours earlier on their way into work, then it gives the wrong impression. On the other hand, if someone says, first thing in the morning, I wake up and take a measurement, eat nothing, only drink water, do no activity more vigorous than getting ready for work, and measure again one hour and two hours later, then you have a better baseline to compare against.

What you really want to see to establish your impressions as data are multiple keto-adapted people wearing Dexcom 5 CGMs, calibrating periodically with a meter that meets your typical glucose testing range with the greatest accuracy [1]. Then throw those people out of keto-adaptation, measure their ketones as they come back into keto, and compare their glucose levels.

I'm only a data point of one, but I've been keto-adapted so long that the Ketostix urine test strips can no longer detect my acetoacetate-based ketone levels (when you are keto-adapted long enough, you need to measure beta-hydroxybutyrate and not acetoacetate as ketone markers). I'm Type 2, but controlled without medication through diet and exercise. My one and two-hour post-prandials are below 100 mg/dL, usually below 90 mg/dL. I test upon waking up, two hours after waking up to measure dawn phenomena, then every 1-2 hours while water fasting until I break the fast, some time between 1100-1500h, when I use a six-hour feeding window to get in at least 200g of protein and as much leafy greens as I can handle. Then I test again before going to bed.

My keto diet level is 20g net carbs per day. Empirically, when I break out of keto to verify whether or not it is still a factor in my ongoing treatment, I can go as high as 150 post-prandial, and I get a headache. There are definitely diabetics who test higher on keto than off keto, but they are in the minority; it would be interesting to find out if the keto community participants who you read about are diabetics or not. I'm convinced that based upon my personal experience that was guided by the outcomes reported by other Type 2's however, that most (not all) pre-diabetic and diagnosed Type 2's can revert their condition and control it with significant lifestyle changes for a long time before resorting to medication at a very late stage in life, if ever.

[1] http://integrateddiabetes.com/2016-blood-glucose-meter-compa...

leonroy|8 years ago

I used to practise IF regularly and anecdotally found fasting really killed my ability to focus, make decisions and code until I get past that 12 hour hump of ravenous hunger.

It became disruptive enough that I gave up IF on work days and now practise it only occasionally on holiday or weekends. That said my gut flora (see the new research on how gut flora influences the brain [1]) might be reliant on simple carbs and sugar (I have a coffee + pastry habit).

1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4228144/

DiThi|8 years ago

I've found IF to be much, much easier when doing keto. It is possible that most of the gut flora reliant on carbs and sugar die off after some time.

zinssmeister|8 years ago

I do both of these things and especially when I am on a low-carb diet I have a very short fuse. Politeness goes out the window and compromising as well.

freeflight|8 years ago

I remember seeing a paper about relationships between genetic addictive disorders, impulse control, and carbohydrate intake. Tried before finding it, but just can't remember the right terminology.

As somebody with a family history of addiction, I can confirm that I get all kinds of cranky without my carbs. Imho some brains just crave those constant dopamine kicks, losing all impulse control in the process, carb intake seems to play a role in that whole dynamic [0][1].

A couple of years ago I did some "metabolic balance" diet which was very low carb for a couple of months, mostly to treat my migraines. After initial irritation, I felt really good physically but I had a constant craving for all the tasty carb stuff, like white bread/noodles, wearing me down mentally. I don't think I could live like that for years.

[0] https://www.ncbi.nlm.nih.gov/pubmed/1349715

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131727/

MattRix|8 years ago

How low do you mean when you say low carb? And for how long? Whenever I first start doing keto I can be irritable, but after getting into ketosis I have much more self control (way more than when not dieting at all)