The Ketogenic Diet: Uses in Epilepsy and Other Neurologic Illnesses.

Fools claim that I am anti-ketogenic diets. Am I ****! beta-Hydroxybutyric acid has its uses...

From https://www.fuelforthought.co/the-ketogenic-diet-uses-in-epilepsy-and-other-neurologic-illnesses-2/

From The Ketogenic Diet: Uses in Epilepsy and Other Neurologic Illnesses:-

"Inconsistencies in studies attempting to correlate seizure protection with levels of ketone bodies suggest that another mechanism may be involved in the diet’s beneficial effects on seizures. Several mechanisms have been proposed, including changes in ATP production making neurons more resilient in the face of metabolic demands during seizures; altered brain pH affecting neuronal excitability; direct inhibitory effects of ketone bodies or fatty acids on ion channels; and shifts in amino acid metabolism to favor the synthesis of the inhibitory neurotransmitter GABA."

GABA is an interesting neurotransmitter, as it's the chief inhibitory neurotransmitter in the mammalian central nervous system.

I know of two other substances that enhance GABA's effects - Alcohol and Benzodiazepines.


In conclusion:

I'm in favour of ketogenic diets under medical supervision, as therapy for neurologic conditions etc.

I'm not in favour of ketogenic diets under lay supervision, as a supposed aid for weight loss.

Why Calories count (where weight change is concerned).

I have to add the words "where weight change is concerned", as nobody who knows what they're talking about claims that calories have anything to do with body composition or health (unless a prolonged imbalance makes somebody very underweight or very overweight).

From https://docs.google.com/file/d/0Bz4TDaehOqMKSXZHUUVxWnl5VTQ/edit?usp=sharing

Arguments used by Calorie Denialists include:-

1) Calories don't count because the human body isn't a Bomb Calorimeter and treats different macronutrients differently.
 
100g of liquid paraffin burns in a Bomb Calorimeter, yielding 900kcals. In a human, it passes through completely undigested. Ah-ha!, I hear you saying. This proves that the Energy Balance Equation is invalid. Uh, nope!

Calories in = Calories entering mouth - Calories exiting anus

As 100% of liquid paraffin calories entering the mouth exit the anus, Calories in = 0

This is why Sam Feltham's "Smash the Fat" "experiment" is utter nonsense. A high percentage of the large amount of raw almonds he ate would have exited his anus incompletely chewed, undigested & unabsorbed.

See the picture above? In the late 1800's, W.O. Atwater established Atwater Factors (3.75kcals/g for digestible Carbohydrates, 4kcals/g for Proteins, 5kcals/g for Ketones, 7kcals/g for Alcohols & 9kcals/g for Fats*) using Human Calorimeters, not Bomb Calorimeters.  

∴ Atwater Factors are accurate.

*Fats containing different fatty acids have slightly different kcals/g. Fats containing long-chain fatty acids are 9kcals/g. Fats containing medium-chain fatty acids e.g. coconut oil are ~8kcals/g.

For more information, see Atwater


2) Calories don't count because Dietary Efficiency varies for different macronutrients.

Uh, nope! The Heat Power generated by the body is regulated by a NFB loop involving the Hypothalamus, Pituitary, Thyroid Axis, also Uncoupling Proteins (UCP's), also shivering, so as to maintain a body temperature of 37°C ±3°C. If this wasn't the case, different amounts & types of foods (also, changes in ambient temperature & clothing) would cause large variations in body temperature resulting in death, as the enzymes in our bodies function correctly over a limited range of temperatures.

Heat Power generated by the body (W) = Temperature difference between the body & ambient (°C) divided by Thermal resistance between the body & ambient (°C/W)

∴ Dietary Efficiency is irrelevant.

Can very-low-carb diets impair your mental faculties?

I wanna tell you a story...

In 2006, I had a test done on my pituitary gland*, called an Insulin Shock Test. It was pretty much what it said on the tin. I laid on a hospital bed, I was injected with an overdose of insulin and I was monitored for blood glucose and growth hormone levels every 30 minutes.

My blood glucose fell and fell and fell and fell until it reached ~1.5mmol/L (~27mg/dL). What happened was interesting. I came out in a cold sweat and developed a tremor. Apart from that, I felt fine. The consultant in charge was chatting to me and I was chatting to him. Eventually, I was given a sandwich, a yoghurt and a banana to eat.

Some time later, when I had stopped sweating and shaking, the consultant returned and told me that I had become confused. My brain had ceased to function correctly due to a lack of blood glucose (the insulin had totally suppressed serum FFAs and ketones, so there were no other brain fuels available), but I was too mentally-impaired to know that I was mentally-impaired. As far as I was concerned, everything was fine & dandy. This is like the Dunning-Kruger effect.

Referring to Blood Glucose, Insulin & Diabetes, as blood glucose falls due to either starvation or a lack of dietary carbohydrate, insulin falls and glucagon rises, stimulating the liver to convert liver glycogen into glucose for export to the blood. Eventually, liver glycogen becomes depleted and blood glucose falls again. The pituitary gland notices this and secretes AdrenoCorticoTropic Hormone (ACTH) which stimulates the adrenal cortex to secrete cortisol. The adrenal glands are also stimulated to secrete adrenaline (a.k.a. epinephrine). Cortisol increases the conversion of amino acids and other substrates into glucose by the liver and kidneys. If blood glucose continues to fall, the pituitary gland secretes growth hormone (GH), which has an anti-insulin effect.

From https://anthonycolpo.com/boosting-growth-hormone-with-diet-training-fact-or-fiction-part-2/:-
"after the zero-carb phase, subjects reported symptoms of hypoglycemia that included weakness, irritability, mental confusion, nausea, hunger, cold sweating and disturbed co-ordination. GH levels were higher during exercise after the low-carb phase, but so too were levels of other fuel mobilizing hormones such as epinephrine, glucagon, and cortisol." Epinephrine, glucagon, and cortisol are stress hormones. Chronically-high blood levels of stress hormones disrupt sleep and cause irritable, aggressive behaviour.

Ethanol inhibits gluconeogenesis in the liver (possibly also in the kidneys) resulting in worse hypoglycaemia. Worse hypoglycaemia results in more ACTH & adrenaline secretion and worse hypercortisolaemia, which can adversely affect the hippocampus, impairing memory.

In conclusion, if you want to eat a very-low-carb diet, long-term:-1) Don't do much high-intensity exercise. See "Funny turns": What they aren't and what they might be.
2) Don't drink much (if any) booze.

*My pituitary gland failed the test by secreting only 40% the amount of GH that it was supposed to. For six months, I was given GH to inject using a special pen with a 8mm x 0.3mm needle. By the end of the six month trial, I had perfected the art of painless injection. The trial was discontinued due to lack of any noticeable benefit (17 days supply of GH @0.3mg/day cost £120!).

Things that make you go pink.

Strenuous exercise. Alcohol. High-dose Niacin. All of these things make you go pink. All of these things are also good for your heart & circulation. As I mentioned in Red, red wine and very sharp pointy things, one glass of red wine significantly lowered my blood pressure in less than 10 minutes, probably by making my arteries dilate (which made me go pink) and by reducing my mental stress which lowered my stress hormone levels.

According to JBS2 guidelines (which I don't fully agree with), CVD risk factor increases with increasing blood pressure. It also increases with increasing TC:HDL ratio. What increases HDL? Things that make you go pink. What we now need is a study showing the effects of blushing on the risk factors for CVD!

Red, red wine and very sharp pointy things.

Suffice it to say that I've been feeling a bit stressed recently, what with all the hoo-ha over my mum's nursing home etc. Today, I'm going to be prodded & cut open with very sharp pointy things as I'm having a right inguinal hernia repaired with polypropylene mesh.

Last Wednesday, I attended the pre-op' assessment and failed with a BP of 154/100. I explained that I had a very important meeting with Social Services on my mind and it was causing me much stress so I was told to get a re-test at my local surgery on Friday. As the meeting on Thursday didn't go quite as I'd hoped (case closed), my BP on Friday was 160/100. My GP upped my Amias dose from 8mg/day to 12mg/day and told me to get a re-test on Monday. I had to get my diastolic reading (the lower of the two numbers) below 90 or my op' would not take place today.

On Monday morning I tested my BP at home using my £9.99 Lloyds Pharmacy automatic BP meter (which usually gives the same reading as my GP's sphygmomanometer) and the lowest reading I could get was 135/99. Uh-oh! Desperate times call for desperate measures.

I hardly ever drink alcohol, but I had a bottle of Blossom Hill Californian Red in the cupboard for *ahem* special occasions, so I had a 250mL glass of it on an empty stomach. Woo-hoo! It went straight to my head and I felt slightly flushed. Ten minutes later, I was in the doctor's surgery having my BP tested. It was 140/86. Result! I told my GP what I'd done and he was O.K. with it. So, red wine for the win!

Before you all rush off and get hammered, here's an article from the Harvard School of Public Health about Alcohol: Balancing Risks and Benefits. The article used to contain a graph but it's been edited-out in the latest version. Luckily, I had a copy of it on my hard disk which I shall upload here.

As women have smaller livers than men, the cirrhosis graph shoots up faster for women as alcohol consumption increases beyond 1 drink per day.