Why is ketosis (hyperketonemia) a bad thing?
Dr. Andrew B. Chung, MD/PhD
"Finally, the longer you stay in ketosis, you begin to oxidize
lipoproteins, so these are long-term consequences which begin to explain
why high protein diets fail."
Source:
http://www.usda.gov/cnpp/Seminars/GND/Proceedings.txt
Humbly,
Andrew
--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/
Matti Narkia
"Dr. Andrew B. Chung, MD/PhD" <and...@heartmdphd.com> wrote:
>From Dr. Barry Sears (2/24/2000):
>
>"Finally, the longer you stay in ketosis, you begin to oxidize
>lipoproteins, so these are long-term consequences which begin to explain
>why high protein diets fail."
>
>Source:
>
>http://www.usda.gov/cnpp/Seminars/GND/Proceedings.txt
>
- The text is from March, 2000. We know now much more about
LC diets.
- Sears does dot substantiate his claims with references.
- Typically, ketosis in LC diet lasts about 3 months, that's
hardly long-term.
- Sears has his own Zone diet to promote, and therefore his own agenda.
- Zone diet is also low-carb diet, Sears dos not seem object LC diets, but
high protein and high carb diets.
- Sears practically assassinates your low-fat high-carb hero's Dr. Ornish's
diet. Do you agree with him about that, too? If not, why are you so
choosy?
--
Matti Narkia
Dr. Andrew B. Chung, MD/PhD
> Fri, 24 Oct 2003 11:27:48 -0400 in article <3F9944F3...@heartmdphd.com>
> "Dr. Andrew B. Chung, MD/PhD" <and...@heartmdphd.com> wrote:
>
> >From Dr. Barry Sears (2/24/2000):
> >
> >"Finally, the longer you stay in ketosis, you begin to oxidize
> >lipoproteins, so these are long-term consequences which begin to explain
> >why high protein diets fail."
> >
> >Source:
> >
> >http://www.usda.gov/cnpp/Seminars/GND/Proceedings.txt
> >
> - The text is from March, 2000. We know now much more about
> LC diets.
>
They remain "ketogenic."
>
> - Sears does dot substantiate his claims with references.
>
That's ok, we've already done that for the readers of these threads here at SMC.
>
> - Typically, ketosis in LC diet lasts about 3 months, that's
> hardly long-term.
>
Not ime.
>
> - Sears has his own Zone diet to promote, and therefore his own agenda.
>
Then it should be easy for you to refute his statements. Afterall, he only has
his agenda to back them up (or so you claim).
We'll be waiting.
>
> - Zone diet is also low-carb diet, Sears dos not seem object LC diets, but
> high protein and high carb diets.
>
Is it your claim that the Zone diet is ketogenic?
>
> - Sears practically assassinates your low-fat high-carb hero's Dr. Ornish's
> diet.
Ime, I have not seen coronary disease in folks who have lost to and maintained
near-ideal body weight following the Ornish diet. However, I have not had much
success with starting and keeping folks on the Ornish diet in the past (before
conceiving the 2PD approach). On the other hand, the 2PD approach has worked
wonderfully:
http://www.heartmdphd.com/wtloss.asp
> Do you agree with him about that, too?
See above.
> If not, why are you so
> choosy?
>
See above.
--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/
Matti Narkia
<20031024125715...@mb-m25.aol.com> suf...@aol.comnospam (Susan )
wrote:
>
>>Sears does dot substantiate his claims with references.
>
>
>>
>> - Typically, ketosis in LC diet lasts about 3 months, that's
>> hardly long-term.
>
>day. See The Ketogenic Diet by Lyle McDonald. page 73? Lots of references to
>the research.
>
Well, what I wrote is basically what Foster et al say in
http://content.nejm.org/cgi/content/full/348/21/2082
And as I mentioned in another message, Westman claims in
http://www.ajcn.org/cgi/content/full/75/5/951-a
that ketosis in adults can be prevented by a daily CHO intake of about 50 g.
I think we need some references to settle these issues. Unfortunately I
don't have Lyle McDonald's book. Perhaps I try to acquire it.
>>
>> - Sears has his own Zone diet to promote, and therefore his own agenda.
>
>He's a huckster for sure.
>
If you say so, I don't know much about him.
>>
>> - Zone diet is also low-carb diet, Sears dos not seem object LC diets, but
>> high protein and high carb diets.
>
>The Zone is moderate carb, but not below 100gms per day for most folks, which
>is the generally accepted threshold for low carb.
>
Ok, it has about 40% carbs I think, so it's definitely not very low carb,
but some Medline authors criticizing Zone, call it low carb. But I agree,
perhaps moderate carb is a better description.
>It's certainly lower than most folks eat, though.
>
Yep.
--
Matti Narkia
Matti Narkia
<3F9972B4...@heartmdphd.com> "Dr. Andrew B. Chung, MD/PhD"
<and...@heartmdphd.com> wrote:
>Matti Narkia wrote:
>
>> Fri, 24 Oct 2003 11:27:48 -0400 in article <3F9944F3...@heartmdphd.com>
>> "Dr. Andrew B. Chung, MD/PhD" <and...@heartmdphd.com> wrote:
>>
>> >From Dr. Barry Sears (2/24/2000):
>> >
>> >"Finally, the longer you stay in ketosis, you begin to oxidize
>> >lipoproteins, so these are long-term consequences which begin to explain
>> >why high protein diets fail."
>> >
>> >Source:
>> >
>> >http://www.usda.gov/cnpp/Seminars/GND/Proceedings.txt
>> >
>> - The text is from March, 2000. We know now much more about
>> LC diets.
>
>They remain "ketogenic."
>
So? No proof has been presented that ketosis in LC diets is harmful.
>>
>> - Sears does dot substantiate his claims with references.
>
>That's ok, we've already done that for the readers of these threads here at SMC.
>
You are grossly mistaken.
>>
>> - Typically, ketosis in LC diet lasts about 3 months, that's
>> hardly long-term.
>
>Not ime.
>
So you think 3 months is long term?
>>
>> - Sears has his own Zone diet to promote, and therefore his own agenda.
>>
>
>Then it should be easy for you to refute his statements. Afterall, he only has
>his agenda to back them up (or so you claim).
>
>We'll be waiting.
>
Burden of the proof is on the person who presents the claim.
>>
>> - Zone diet is also low-carb diet, Sears dos not seem object LC diets, but
>> high protein and high carb diets.
>>
>Is it your claim that the Zone diet is ketogenic?
>
That's not an issue here, but no. Neither are other LC diets as soon as
their carb intake is after initiation phase increased to a certain, still
fairly low level, which according Westman is 50 g/d and according to Susan
100 g/d.
--
Matti Narkia
Valley Of Mu_n
<and...@heartmdphd.com> wrote:
>From Dr. Barry Sears (2/24/2000):
>
>"Finally, the longer you stay in ketosis, you begin to oxidize
>lipoproteins, so these are long-term consequences which begin to explain
>why high protein diets fail."
>
>Source:
>
>http://www.usda.gov/cnpp/Seminars/GND/Proceedings.txt
>
>Humbly,
>
>Andrew
Interesting.
http://antwrp.gsfc.nasa.gov/apod/ap031021.html
Lift well, Eat less, Walk fast, Live long.
Dr. Andrew B. Chung, MD/PhD
> Fri, 24 Oct 2003 14:43:00 -0400 in article
> <3F9972B4...@heartmdphd.com> "Dr. Andrew B. Chung, MD/PhD"
> <and...@heartmdphd.com> wrote:
>
> >Matti Narkia wrote:
> >
> >> Fri, 24 Oct 2003 11:27:48 -0400 in article <3F9944F3...@heartmdphd.com>
> >> "Dr. Andrew B. Chung, MD/PhD" <and...@heartmdphd.com> wrote:
> >>
> >> >From Dr. Barry Sears (2/24/2000):
> >> >
> >> >"Finally, the longer you stay in ketosis, you begin to oxidize
> >> >lipoproteins, so these are long-term consequences which begin to explain
> >> >why high protein diets fail."
> >> >
> >> >Source:
> >> >
> >> >http://www.usda.gov/cnpp/Seminars/GND/Proceedings.txt
> >> >
> >> - The text is from March, 2000. We know now much more about
> >> LC diets.
> >
> >They remain "ketogenic."
> >
> So? No proof has been presented that ketosis in LC diets is harmful.
When would you like to revisit the topic of hyperketonemia?
>
> >>
> >> - Sears does dot substantiate his claims with references.
> >
> >That's ok, we've already done that for the readers of these threads here at SMC.
> >
> You are grossly mistaken.
I write truthfully.
>
> >>
> >> - Typically, ketosis in LC diet lasts about 3 months, that's
> >> hardly long-term.
> >
> >Not ime.
> >
> So you think 3 months is long term?
>
Ime, folks on ketogenic LC diets have "ketone breath" for the duration that they are
on the diet (ie they have hyperketonemia for as long as they are on the diet).
> >>
> >> - Sears has his own Zone diet to promote, and therefore his own agenda.
> >>
> >
> >Then it should be easy for you to refute his statements. Afterall, he only has
> >his agenda to back them up (or so you claim).
> >
> >We'll be waiting.
> >
> Burden of the proof is on the person who presents the claim.
It is your claim that Sears made the statement regarding the harmful effects of
ketosis (aka hyperketonemia) to promote his Zone diet.
We'll continue to wait for your proof.
>
> >>
> >> - Zone diet is also low-carb diet, Sears dos not seem object LC diets, but
> >> high protein and high carb diets.
> >>
> >Is it your claim that the Zone diet is ketogenic?
> >
> That's not an issue here, but no.
Then why are you calling it "also (ketogenic) low-carb diet" ?
> Neither are other LC diets as soon as
> their carb intake is after initiation phase increased to a certain, still
> fairly low level, which according Westman is 50 g/d and according to Susan
> 100 g/d.
>
For ketogenic LC diets, when carbs are increased, weight loss typically reverses.
--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com
Mu_n Of Mars
>Actually, it's according to Lyle McDonald's exhaustive
lol
>and well referenced
>research in The Ketogenic Diet. Page 73, IIRC.
lol
http://antwrp.gsfc.nasa.gov/apod/ap031024.html
Matti Narkia
<a22e4037d1a81d6d...@news.teranews.com> "Dr. Andrew B. Chung,
MD/PhD" <and...@heartmdphd.com> wrote:
>Matti Narkia wrote:
>
>> Fri, 24 Oct 2003 14:43:00 -0400 in article
>> <3F9972B4...@heartmdphd.com> "Dr. Andrew B. Chung, MD/PhD"
>> <and...@heartmdphd.com> wrote:
>>
>> >Matti Narkia wrote:
>> >
>> >> Fri, 24 Oct 2003 11:27:48 -0400 in article <3F9944F3...@heartmdphd.com>
>> >> "Dr. Andrew B. Chung, MD/PhD" <and...@heartmdphd.com> wrote:
>> >>
>> >> >From Dr. Barry Sears (2/24/2000):
>> >> >
>> >> >"Finally, the longer you stay in ketosis, you begin to oxidize
>> >> >lipoproteins, so these are long-term consequences which begin to explain
>> >> >why high protein diets fail."
>> >> >
>> >> >Source:
>> >> >
>> >> >http://www.usda.gov/cnpp/Seminars/GND/Proceedings.txt
>> >> >
>> >> - The text is from March, 2000. We know now much more about
>> >> LC diets.
>> >
>> >They remain "ketogenic."
>> >
>> So? No proof has been presented that ketosis in LC diets is harmful.
>
>When would you like to revisit the topic of hyperketonemia?
>
From
Volek JS, Westman EC.
Very-low-carbohydrate weight-loss diets revisited.
Cleve Clin J Med. 2002 Nov;69(11):849, 853, 856-8 passim. Review
http://www.ccjm.org/pdffiles/Volek1102.pdf
<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12430970&dopt=Abstract>
"Are ketones bad?
During prolonged fasting or adherence to a very- low-carbohydrate
diet, whole-body metabolism gradually shifts toward obtaining a
greater percentage of energy from lipid sources, which can result in
the production of ketone bodies in the liver. Clinically, ketone
body production indicates that lipid metabolism has been accelerated
and that all the enzymes involved in metabolic pathways of lipid
metabolism (eg, lipolysis, fatty acid transport, beta-oxidation, and
ketogenesis) are operational. During starvation or periods when
carbohydrate intake is very low, ketone bodies serve as an
alternative oxidative fuel for peripheral tissues to spare
carbohydrate and protein. In this sense, ketone bodies could be
considered the perfect fuel for dieters.
Catabolism of protein is reduced by ketones,35 which probably
explains the preservation of lean tissue observed during verylow-
carbohydrate diets.9,11,12 The small amount of glucose required by
the brain and red blood cells can easily be met via gluconeogenesis
from protein and fat. There are no direct data from which we can
ascertain whether the low level of ketosis accompanying this diet is
harmful or harmless."
>>
>> >> - Sears does dot substantiate his claims with references.
>> >
>> >That's ok, we've already done that for the readers of these threads here at SMC.
>> >
>> You are grossly mistaken.
>
>I write truthfully.
>
Truthfully to your beliefs, perhaps, but doing gross mistakes while doing
that. You should really check your beliefs against reliable evidence.
>>
>> >>
>> >> - Typically, ketosis in LC diet lasts about 3 months, that's
>> >> hardly long-term.
>> >
>> >Not ime.
>> >
>> So you think 3 months is long term?
>>
>
>Ime, folks on ketogenic LC diets have "ketone breath" for the duration that they are
>on the diet (ie they have hyperketonemia for as long as they are on the diet).
>
>> >>
>> >> - Sears has his own Zone diet to promote, and therefore his own agenda.
>> >>
>> >
>> >Then it should be easy for you to refute his statements. Afterall, he only has
>> >his agenda to back them up (or so you claim).
>> >
>> >We'll be waiting.
>> >
>> Burden of the proof is on the person who presents the claim.
>
>It is your claim that Sears made the statement regarding the harmful effects of
>ketosis (aka hyperketonemia) to promote his Zone diet.
>
You are not writing truthfully now. I did write that Sears has his own
agenda, because he wants to promote his Zone diet. That should be taken into
consideration when assessing the reliability of his claim, in the same way
than the possible effect of financial connections of researchers should be
taken into consideration when assessing the reliability of the results and
conclusions of their studies. It seems that you already have made the
assessment concerning the Sears' agenda's effect on his claim.
Burden of the proof of Sears' claim is on Sears, or on you, because you
presented it as evidence. Without supporting reference the claim is
unsubstantiated.
>
>> >> - Zone diet is also low-carb diet, Sears dos not seem object LC diets, but
>> >> high protein and high carb diets.
>> >>
>> >Is it your claim that the Zone diet is ketogenic?
>> >
>> That's not an issue here, but no.
>
>Then why are you calling it "also (ketogenic) low-carb diet" ?
>
Again you are not writing truthfully. I did not call Zone diet ketogenic.
It's a matter of opinion whether it's called low-carb or moderate-carb. It
certainly contains less carbs than most people eat and what is recommended
by current dogma. In some Medline abstracts Zone it's called low-carb,
therefore I did the same, but I have nothing against calling it
moderate-carb either. Certainly it's not high-carb or very-low-carb.
>> Neither are other LC diets as soon as
>> their carb intake is after initiation phase increased to a certain, still
>> fairly low level, which according Westman is 50 g/d and according to Susan
>> 100 g/d.
>
>For ketogenic LC diets, when carbs are increased, weight loss typically reverses.
>
There is no data to prove that. Unless you're can provide the proof, you're
just writing what you wish were true.
--
Matti Narkia
Thorsten Schier
"Dr. Andrew B. Chung, MD/PhD" schrieb:
>
> From Dr. Barry Sears (2/24/2000):
>
> "Finally, the longer you stay in ketosis, you begin to oxidize
> lipoproteins, so these are long-term consequences which begin to explain
> why high protein diets fail."
>
> Source:
>
> http://www.usda.gov/cnpp/Seminars/GND/Proceedings.txt
Thank you for this interesting text.
Now let's have a look at this statement of Sears in context:
11 The longer you stay in ketosis, you turn yourselves into
fat
12 magnets, and you accumulate body fat more readily. The
more
13 saturated fat you eat, you tend to basically make
yourselves
14 more resistant to insulin. Finally, the longer you stay
in
15 ketosis, you begin to oxidize lipoproteins, so these are
16 long-term consequences which begin to explain why high
17 protein diets fail.
The first two sentences are doubtful a the very best, so we would be
well advised not to accept at face value the last one, which you cited.
Sears does not give any evidence and the study you cited was about
ketosis in insulin dependent diabetics, which is a very different thing
from the ketosis induced by a low carb diet. See below.
Dr. Sears words about Ornish's diet are very interesting:
18 Now, Dr. Ornish will tell you later today that
his
19 diet has cured heart disease, reversed it. Let's say
what
20 are the facts? This is the data he presented in 1995.
Yes,
21 his patients lost weight, but look. Their HDL levels
went
22 down dramatically. Their triglyceride levels increased,
and
23 he has said already earlier and been quoted that that is
due
24 to basically high levels of insulin, increased
25 triglycerides, and the ratio of triglycerides to HDL
1 increased. According to Harvard Medical School, that's
not
2 good.
[...]
10 I do not recommend a high carbohydrate diet,
and
11 the reason why? Because two years later the data came
out
12 that those who followed the Ornish diet had twice the
number
13 of fatal heart attacks. Perhaps when Dr. Ornish speaks
14 today he can explain how can he reverse heart attack and
15 double the number of fatal heart attacks.
So the triglycerides went up and the HDL went down, even though the
patients on Ornish's diet lost weight. The people who followed this high
carbohydrate diet had twice the number of fatal heart attacks. All this
doesn't sound too good and emphazises the dangers of high carbohydrate,
low fat diets.
Now let's here what Dr Atkins has to say about ketosis:
22 DR. ATKINS: When ketones are used as fuel, the
23 most consistent finding is a decrease in appetite.
Insulin
24 is not involved in ketone production. Thus, the
25 consequences of elevated insulin, which are many -- there
1 are increases in triglycerides, in blood pressure, in
2 adrenaline, in cortisol; all of these are avoided.
3 Obese individuals and people who are overweight
4 are keto resistant. Pay attention to this term. What it
5 means is that there will be no accumulation of ketones in
6 the blood.
7 Next?
8 (Whereupon, a slide was shown.)
9 DR. ATKINS: The best documentation of keto
10 resistance was brought to us by two very important
11 researchers, the department heads of London's Middlesex
12 Hospital, Alan Keckwick and Gaston Pawon.
13 In their documentation they showed that obese
14 subjects given the ketogenic diet that I'll tell you
about
15 momentarily produced a flat level of ketones rising from
two
16 milligrams to an average of four milligrams, never more
than
17 six, whereas the non-obese subjects had their ketones
18 escalate rapidly.
19 This is one reason why overweight people will
20 never have problems with ketosis, but ketosis is a
negative
21 catch word for many people. The only reason can possibly
be
22 that they're confusing it with diabetic ketoacidosis.
23 Next slide?
24 (Whereupon, a slide was shown.)
25 DR. ATKINS: But look how diametrically opposed
1 they are. Ketoacidosis occurs in Type I diabetes,
meaning
2 it occurs because of an insulin absence or an insulin
3 deficiency. Benign ketosis is achieved in overweight
4 subjects whose metabolism is characterized by the fact
that
5 they put out too much insulin.
6 Ketoacidosis is caused by an increased intake
of
7 carbohydrate, benign ketosis by a decreased intake of
8 carbohydrate. There is, of course, acidosis in
9 ketoacidosis, but in benign dietary ketosis the pH is
10 normal. There is no acidosis. In ketoacidosis, patients
11 are extremely symptomatic, and in ketosis the subjects
12 describe an improvement in well being. Now, that's
pretty
13 different. Don't let anybody confuse it ever again.
So the are fundamental differences between the ketoacidosis in insulin
dependent diebetics and the benign ketosis induced by a low carb diet.
Any study on ketoacidosis is irrelevant when it comes to assessing
possible dangers of the low carb diet induced ketosis.
Thorsten
--
"Nothing in biology makes sense, except in the light of evolution"
(Theodosius Dobzhansky)
Ron Ritzman
<Moo...@firemail.de> wrote:
>So the are fundamental differences between the ketoacidosis in insulin
>dependent diebetics and the benign ketosis induced by a low carb diet.
>Any study on ketoacidosis is irrelevant when it comes to assessing
>possible dangers of the low carb diet induced ketosis.
Diabetic ketoacidocis is "dietary ketosis on steroids". They only
differ in degree. (and of course the presence of metric assloads of
unusable glucose) Dr. Chung's concern is that even mild ketosis, while
not life threatening, over the long term can damage the body's
vasculature.
On the other side, ketosis has a purpose. During the famine/feast
cycles experienced by our ancestors, ketosis made it easier to survive
famines by reducing the body's glucose requirement, preserving body
proteins, and blunting hunger somewhat. Of course most of our
ancestors didn't live long enough to find out what the "long long
long" term consequences might have been.
I wonder if anybody has considered studying "keto kids" (epileptic
children treated with a ketogenic diet) as adults to see what the long
term consequences of their diets were.
--
Ron Ritzman
http://www.panix.com/~ritzlart
Smart people can figure out my email address
Thorsten Schier
Ron Ritzman schrieb:
>
> On Sat, 25 Oct 2003 12:56:55 +0200, Thorsten Schier
> <Moo...@firemail.de> wrote:
>
> >So the are fundamental differences between the ketoacidosis in insulin
> >dependent diebetics and the benign ketosis induced by a low carb diet.
> >Any study on ketoacidosis is irrelevant when it comes to assessing
> >possible dangers of the low carb diet induced ketosis.
>
> Diabetic ketoacidocis is "dietary ketosis on steroids". They only
> differ in degree. (and of course the presence of metric assloads of
> unusable glucose)
This high level of glucose seems to be a rather important difference.
Other differences are the absence of insulin in ketoacidosis and of
course the acidoses whereas in dietary ketosis the blood retains a
normal value of pH.
And of course the degree matters. A blood sugar concentration of 300
mg/dl is regarded as dangerous (and rightly so), but a concentration of
90 mg/dl is considered to be ok. No one would call the latter
"hyperglycemia". Yet Dr. Chung insists to call the moderate levels of
ketones in dietary ketosis "hyperketonemia". I wonder why.
> Dr. Chung's concern is that even mild ketosis, while
> not life threatening, over the long term can damage the body's
> vasculature.
>
Of course it might be possible that even the dietary ketosis has advers
effects. However, up to now, no one in this discussion has been able to
provide any shred of evidence for such effects.
Dr. Andrew B. Chung, MD/PhD
<snip>
> >When would you like to revisit the topic of hyperketonemia?
> >
> From
>
> Volek JS, Westman EC.
> Very-low-carbohydrate weight-loss diets revisited.
> Cleve Clin J Med. 2002 Nov;69(11):849, 853, 856-8 passim. Review
> http://www.ccjm.org/pdffiles/Volek1102.pdf
Being your reference is a "review," there is no actual data.
<review snipped>
> >> >> - Sears does dot substantiate his claims with references.
> >> >
> >> >That's ok, we've already done that for the readers of these threads here at SMC.
> >> >
> >> You are grossly mistaken.
> >
> >I write truthfully.
> >
> Truthfully to your beliefs, perhaps, but doing gross mistakes while doing
> that. You should really check your beliefs against reliable evidence.
Simply the truth. Anyone who can Google knows it.
> >> >>
> >> >> - Typically, ketosis in LC diet lasts about 3 months, that's
> >> >> hardly long-term.
> >> >
> >> >Not ime.
> >> >
> >> So you think 3 months is long term?
> >>
> >
> >Ime, folks on ketogenic LC diets have "ketone breath" for the duration that they are
> >on the diet (ie they have hyperketonemia for as long as they are on the diet).
> >
> >> >>
> >> >> - Sears has his own Zone diet to promote, and therefore his own agenda.
> >> >>
> >> >
> >> >Then it should be easy for you to refute his statements. Afterall, he only has
> >> >his agenda to back them up (or so you claim).
> >> >
> >> >We'll be waiting.
> >> >
> >> Burden of the proof is on the person who presents the claim.
> >
> >It is your claim that Sears made the statement regarding the harmful effects of
> >ketosis (aka hyperketonemia) to promote his Zone diet.
> >
> You are not writing truthfully now.
I continue to write truthfully.
> I did write that Sears has his own
> agenda,
In the context of discussing his statement at the beginning of this
thread.
> because he wants to promote his Zone diet.
Again your claim.
> That should be taken into
> consideration when assessing the reliability of his claim,
In your opinion.
> in the same way
> than the possible effect of financial connections of researchers should be
> taken into consideration when assessing the reliability of the results and
> conclusions of their studies.
Actually, imho, research data should be evaluated independent of the
source of research funding.
> It seems that you already have made the
> assessment concerning the Sears' agenda's effect on his claim.
See above.
> Burden of the proof of Sears' claim is on Sears, or on you, because you
> presented it as evidence.
You requested a reference to another physician who is concerned about
the potential harmful effects of hyperketonemia. You did get what you
asked for now didn't you?
> Without supporting reference the claim is
> unsubstantiated.
Just because you choose to ignore experimental evidence of
hyperketonemia's potential for physiological harm does not mean the
experiment evidence that I have presented does not exist. Wishing it
away isn't going to make it go away.
> >> >> - Zone diet is also low-carb diet, Sears dos not seem object LC diets, but
> >> >> high protein and high carb diets.
> >> >>
> >> >Is it your claim that the Zone diet is ketogenic?
> >> >
> >> That's not an issue here, but no.
> >
> >Then why are you calling it "also (ketogenic) low-carb diet" ?
> >
> Again you are not writing truthfully.
It remains my truthful observation.
> I did not call Zone diet ketogenic.
> It's a matter of opinion whether it's called low-carb or moderate-carb. It
> certainly contains less carbs than most people eat and what is recommended
> by current dogma. In some Medline abstracts Zone it's called low-carb,
> therefore I did the same, but I have nothing against calling it
> moderate-carb either. Certainly it's not high-carb or very-low-carb.
Try to remember that for the duration of our discussions that when we
refer to LC diets, we are talking about the ketogenic variety (ie
Low-Carb rather than Lower-Carb).
--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com
Matti Narkia
<a4b1bd78.03102...@posting.google.com> nos...@heartmdphd.com (Dr.
Andrew B. Chung, MD/PhD) wrote:
>Matti Narkia <mn...@despammed.com> wrote in message news:<7rdkpvouuop9aubno...@4ax.com>...
>
><snip>
>> >When would you like to revisit the topic of hyperketonemia?
>> >
>> From
>>
>> Volek JS, Westman EC.
>> Very-low-carbohydrate weight-loss diets revisited.
>> Cleve Clin J Med. 2002 Nov;69(11):849, 853, 856-8 passim. Review
>> http://www.ccjm.org/pdffiles/Volek1102.pdf
>
>Being your reference is a "review," there is no actual data.
><review snipped>
>
Your intellectual dishonesty never ceases to surprise me. You off-hand
dismiss a review article written by two university professors, based on all
the existing studies at the time of writing, for which the references are
provided, and which was published in a peer-reviewed Medline journal -
simply because no "actual data" is provided. You cannot fail to understand
that the "actual data" is readable by anyone from the original articles,
which are listed as references.
Yet you accept at its face value an oral unsubstantiated remark by a rather
dubious physician turned to nutritionist, although this oral remark contains
absolutely no data whatsoever and no references supporting it.
Can you see the contradiction in your behavior? Can you claim that you act
honestly and truthfully, trying to find the truth?
As a remainder for the readers I repeat the citation from the above review
article which was snipped by you:
"Are ketones bad?
During prolonged fasting or adherence to a very- low-carbohydrate
diet, whole-body metabolism gradually shifts toward obtaining a
greater percentage of energy from lipid sources, which can result in
the production of ketone bodies in the liver. Clinically, ketone
body production indicates that lipid metabolism has been accelerated
and that all the enzymes involved in metabolic pathways of lipid
metabolism (eg, lipolysis, fatty acid transport, beta-oxidation, and
ketogenesis) are operational. During starvation or periods when
carbohydrate intake is very low, ketone bodies serve as an
alternative oxidative fuel for peripheral tissues to spare
carbohydrate and protein. In this sense, ketone bodies could be
considered the perfect fuel for dieters.
Catabolism of protein is reduced by ketones,35 which probably
explains the preservation of lean tissue observed during very low-
carbohydrate diets.9,11,12 The small amount of glucose required by
the brain and red blood cells can easily be met via gluconeogenesis
from protein and fat. There are no direct data from which we can
ascertain whether the low level of ketosis accompanying this diet is
harmful or harmless."
>
>> That should be taken into
>> consideration when assessing the reliability of his claim,
>
>In your opinion.
>
>> in the same way
>> than the possible effect of financial connections of researchers should be
>> taken into consideration when assessing the reliability of the results and
>> conclusions of their studies.
>
>Actually, imho, research data should be evaluated independent of the
>source of research funding.
>
Perhaps you should read the following articles:
Bodenheimer T.
Uneasy alliance--clinical investigators and the pharmaceutical industry.
N Engl J Med. 2000 May 18;342(20):1539-44.
PMID: 10816196 [PubMed - indexed for MEDLINE]
http://content.nejm.org/cgi/content/full/342/20/1539
Angell M.
Is academic medicine for sale?
N Engl J Med. 2000 May 18;342(20):1516-8.
PMID: 10816191 [PubMed - indexed for MEDLINE]
http://content.nejm.org/cgi/content/full/342/20/1516?ijkey=Mo315Ero3.QR6
Bodenheimer T.
Conflict of Interest in Clinical Trials: A Risk Factor for Scientific
Misconduct
August 15, 2000
http://ohrp.osophs.dhhs.gov/coi/bodenheimer.htm
Research sponsored by drug companies is biased
This week in the BMJ
BMJ, Volume 326, Number 7400, Issue of 31 May 2003
http://bmj.bmjjournals.com/content/vol326/issue7400/twib.shtml
Melander H, Ahlqvist-Rastad J, Meijer G, Beermann B.
Evidence b(i)ased medicine--selective reporting from studies sponsored by
pharmaceutical industry: review of studies in new drug applications.
BMJ. 2003 May 31;326(7400):1171-3. Review.
PMID: 12775615 [PubMed - indexed for MEDLINE]
http://bmj.bmjjournals.com/cgi/content/full/326/7400/1171
Lexchin J, Bero LA, Djulbegovic B, Clark O.
Pharmaceutical industry sponsorship and research outcome and quality:
systematic review.
BMJ. 2003 May 31;326(7400):1167-70. Review.
PMID: 12775614 [PubMed - indexed for MEDLINE]
http://bmj.bmjjournals.com/cgi/content/full/326/7400/1167
Als-Nielsen B, Chen W, Gluud C, Kjaergard LL.
Association of funding and conclusions in randomized drug trials: a
reflection of treatment effect or adverse events?
JAMA. 2003 Aug 20;290(7):921-8.
PMID: 12928469 [PubMed - indexed for MEDLINE]
http://jama.ama-assn.org/cgi/content/abstract/290/7/921
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=12928469&dopt=Abstract
Stelfox HT, Chua G, O'Rourke K, Detsky AS.
Conflict of interest in the debate over calcium-channel antagonists.
N Engl J Med. 1998 Jan 8;338(2):101-6.
PMID: 9420342 [PubMed - indexed for MEDLINE]
http://content.nejm.org/cgi/content/full/338/2/101
Chris A Commens
Truth in clinical research trials involving pharmaceutical sponsorship
MJA 2001; 174: 648-649
http://www.mja.com.au/public/issues/174_12_180601/commens/commens.html
Good manners for the pharmaceutical industry
Editorial
The Lancet, Volume 349, Number 9066 07 June 1997
http://www.thelancet.com/journal/vol349/iss9066/full/llan.349.9066.editorial_and_review.8563.1
Scandal of scientists who take money for papers ghostwritten by drug
companies
Guardian, Thursday February 7, 2002
http://www.guardian.co.uk/Archive/Article/0,4273,4351264,00.html
Academic Credibility vs. Industry Cash
Scientific American, November 01, 2000
http://www.sciam.com/article.cfm?articleID=00066377-E72E-1C67-B882809EC588ED9F
Report Examines Financial Conflicts In Academic Research Setting
http://www.thompson.com/libraries/fooddrug/clin/samplenews/clin0211.html
Academic Research Tainted by Commercial Funding
Medical Tests Skewed, Study Finds
http://www.mindfully.org/Health/2003/Academic-Research-Commercial22jan03.htm
In Place of Nations
by John le Carre
The Nation magazine, April 9, 2001
http://www.thirdworldtraveler.com/Corporations/InPlace_Nations.html
Conflicts of Interest in Biomedical Research
http://www.cptech.org/ip/health/conflict/
Campaign Against Fraudulent Medical Research
http://www.pnc.com.au/~cafmr/
Conflict of Interest
http://www.researchprotection.org/COI/COI.html
Also, I suggest you read Sharon Hope's excellent post in this ng:
Muscle aches and statins by Sharon Hope
http://groups.google.fi/groups?selm=J35gb.225640%24mp.141651%40rwcrnsc51.ops.asp.att.net
Some of the articles presented above have been picked from there.
>
>> Burden of the proof of Sears' claim is on Sears, or on you, because you
>> presented it as evidence.
>
>You requested a reference to another physician who is concerned about
>the potential harmful effects of hyperketonemia. You did get what you
>asked for now didn't you?
>
No. Your memory is either poor or very selective. In other context in
another thread _you_ wrote something like that _most scientists_ are
concerned about hypeketonemia with LC diets. I asked you to mention two. Now
first, I'm not sure if Sears can be regarded as a scientist, I wouldn't.
Secondly, I asked for two.
>> Without supporting reference the claim is
>> unsubstantiated.
>
>Just because you choose to ignore experimental evidence of
>hyperketonemia's potential for physiological harm does not mean the
>experiment evidence that I have presented does not exist. Wishing it
>away isn't going to make it go away.
>
As Volek and Westman write in their review article:
"There are no direct data from which we can
ascertain whether the low level of ketosis accompanying this diet is
harmful or harmless."
>
>> I did not call Zone diet ketogenic.
>> It's a matter of opinion whether it's called low-carb or moderate-carb. It
>> certainly contains less carbs than most people eat and what is recommended
>> by current dogma. In some Medline abstracts Zone it's called low-carb,
>> therefore I did the same, but I have nothing against calling it
>> moderate-carb either. Certainly it's not high-carb or very-low-carb.
>
>Try to remember that for the duration of our discussions that when we
>refer to LC diets, we are talking about the ketogenic variety (ie
>Low-Carb rather than Lower-Carb).
>
Low-carb diet is not equivalent to ketogenic diet. I agree that most LC
diets are ketogenic at least part of the time, but not necessarily all the
time. In literature low-carb ketogenic diets are often also called
very-low-carb diets. Some low-carb diets may not be ketogenic at all (if the
daily carb intake > 50-100g for the whole duration of the diet).
--
Matti Narkia
Ron Ritzman
"Susan " <suf...@aol.comnospam> wrote in message
news:20031025085723...@mb-m15.aol.com...
> Yes, after up to a few years on the special diet they eat, but it bears no
> resemblance to the diets of normal low carb dieters. They're also
deprived of
> protein.
Yes, the difference being that with keto kids, the ketones themselves are
the "medicine" so the dietition carefully designes the diet so that the
ketosis is as "deep" as safely possible. Any issues with reduced PH would be
more of a concern with keto kids then with "Atkids".
> IIRC, the most common complications are kidney or gallstones.
I wonder if the fluid restriction on the ketokid diet might have
something to do with this. Most Atkids on the other hand drink enough
water to float a battleship.
Dr. Andrew B. Chung, MD/PhD
> 25 Oct 2003 15:05:35 -0700 in article
> <a4b1bd78.03102...@posting.google.com> nos...@heartmdphd.com (Dr.
> Andrew B. Chung, MD/PhD) wrote:
>
> >Matti Narkia <mn...@despammed.com> wrote in message news:<7rdkpvouuop9aubno...@4ax.com>...
> >
> ><snip>
> >> >When would you like to revisit the topic of hyperketonemia?
> >> >
> >> From
> >>
> >> Volek JS, Westman EC.
> >> Very-low-carbohydrate weight-loss diets revisited.
> >> Cleve Clin J Med. 2002 Nov;69(11):849, 853, 856-8 passim. Review
> >> http://www.ccjm.org/pdffiles/Volek1102.pdf
> >
> >Being your reference is a "review," there is no actual data.
> ><review snipped>
> >
> Your intellectual dishonesty never ceases to surprise me. You off-hand
> dismiss a review article written by two university professors, based on all
> the existing studies at the time of writing, for which the references are
> provided, and which was published in a peer-reviewed Medline journal -
> simply because no "actual data" is provided.
Justifiably so since I have cited a reference earlier in this thread
that providing experimental data that backs up Dr. Sears assertion
that hyperketonemia may cause the oxidation of lipoproteins.
> You cannot fail to understand
> that the "actual data" is readable by anyone from the original articles,
> which are listed as references.
Then cite those articles that have the data refuting the above claim
and we'll discuss them
>
> Yet you accept at its face value an oral unsubstantiated remark by a rather
> dubious physician turned to nutritionist, although this oral remark contains
> absolutely no data whatsoever and no references supporting it.
I'll remind you again that you requested this information. FWIW Dr.
Sears is a biomedical researcher according to his biography.
> Can you see the contradiction in your behavior?
No
> Can you claim that you act
> honestly and truthfully, trying to find the truth?
I know the truth.
> As a remainder for the readers I repeat the citation from the above review
> article which was snipped by you:
Ok, if you really want me to comment about this review article...
> "Are ketones bad?
>
> During prolonged fasting or adherence to a very- low-carbohydrate
> diet, whole-body metabolism gradually shifts toward obtaining a
> greater percentage of energy from lipid sources, which can result in
> the production of ketone bodies in the liver. Clinically, ketone
> body production indicates that lipid metabolism has been accelerated
> and that all the enzymes involved in metabolic pathways of lipid
> metabolism (eg, lipolysis, fatty acid transport, beta-oxidation, and
> ketogenesis) are operational.
Actually, clinically when there is hyperketonemia (i.e. ketone
production), most physicians first think about the Krebs cycle being
shut down.
> During starvation or periods when
> carbohydrate intake is very low, ketone bodies serve as an
> alternative oxidative fuel for peripheral tissues to spare
> carbohydrate and protein.
The usual way of looking at ketone bodies is *incomplete* catabolism
of fat.
> In this sense, ketone bodies could be
> considered the perfect fuel for dieters.
If they did not have physiologically adverse effects.
> Catabolism of protein is reduced by ketones,35 which probably
> explains the preservation of lean tissue observed during very low-
> carbohydrate diets.9,11,12
It would also be reduced by carbohydrates.
> The small amount of glucose required by
> the brain and red blood cells can easily be met via gluconeogenesis
> from protein and fat.
There is no gluconeogenesis from fat.
> There are no direct data from which we can
> ascertain whether the low level of ketosis accompanying this diet is
> harmful or harmless."
However, there is data that raises the concern that hyperketonemia
accompanying his diet may be harmful.
> >
> >> That should be taken into
> >> consideration when assessing the reliability of his claim,
> >
> >In your opinion.
> >
> >> in the same way
> >> than the possible effect of financial connections of researchers should be
> >> taken into consideration when assessing the reliability of the results and
> >> conclusions of their studies.
> >
> >Actually, imho, research data should be evaluated independent of the
> >source of research funding.
> >
> Perhaps you should read the following articles:
>
<snip>
I have.
It remains imho.
> >
> >> Burden of the proof of Sears' claim is on Sears, or on you, because you
> >> presented it as evidence.
> >
> >You requested a reference to another physician who is concerned about
> >the potential harmful effects of hyperketonemia. You did get what you
> >asked for now didn't you?
> >
> No. Your memory is either poor or very selective. In other context in
> another thread _you_ wrote something like that _most scientists_ are
> concerned about hypeketonemia with LC diets. I asked you to mention two. Now
> first, I'm not sure if Sears can be regarded as a scientist, I wouldn't.
Why not?
The FDA did. Were they in error?
> Secondly, I asked for two.
I am a scientist (see the PhD).
> >> Without supporting reference the claim is
> >> unsubstantiated.
> >
> >Just because you choose to ignore experimental evidence of
> >hyperketonemia's potential for physiological harm does not mean the
> >experiment evidence that I have presented does not exist. Wishing it
> >away isn't going to make it go away.
> >
> As Volek and Westman write in their review article:
>
> "There are no direct data from which we can
> ascertain whether the low level of ketosis accompanying this diet is
> harmful or harmless."
Sounds like they wouldn't bet there wouldn't be *direct* data in the
future showing the harmful effects of hyperketonemia in LC dieters.
However, there is in vitro data that hyperketonemia causes lipid
peroxidation which can cause accelerated atherogenesis. This does
justify concerns that LC dieting may be unsafe. Please know that in
vitro data is sufficient for the FDA to reject drug approval.
> >> I did not call Zone diet ketogenic.
> >> It's a matter of opinion whether it's called low-carb or moderate-carb. It
> >> certainly contains less carbs than most people eat and what is recommended
> >> by current dogma. In some Medline abstracts Zone it's called low-carb,
> >> therefore I did the same, but I have nothing against calling it
> >> moderate-carb either. Certainly it's not high-carb or very-low-carb.
> >
> >Try to remember that for the duration of our discussions that when we
> >refer to LC diets, we are talking about the ketogenic variety (ie
> >Low-Carb rather than Lower-Carb).
> >
> Low-carb diet is not equivalent to ketogenic diet. I agree that most LC
> diets are ketogenic
It's about time.
> at least part of the time, but not necessarily all the
> time.
Not ime.
> In literature low-carb ketogenic diets are often also called
> very-low-carb diets. Some low-carb diets may not be ketogenic at all (if the
> daily carb intake > 50-100g for the whole duration of the diet).
If you are unsure, you have my permission to add "ketogenic" to your
desciption of LC diets.
Dr. Andrew B. Chung, MD/PhD
> "Dr. Andrew B. Chung, MD/PhD" schrieb:
> >
> > From Dr. Barry Sears (2/24/2000):
> >
> > "Finally, the longer you stay in ketosis, you begin to oxidize
> > lipoproteins, so these are long-term consequences which begin to explain
> > why high protein diets fail."
> >
> > Source:
> >
> > http://www.usda.gov/cnpp/Seminars/GND/Proceedings.txt
>
> Thank you for this interesting text.
>
You are welcome.
>
> Now let's have a look at this statement of Sears in context:
>
> 11 The longer you stay in ketosis, you turn yourselves into
> fat
> 12 magnets, and you accumulate body fat more readily. The
> more
> 13 saturated fat you eat, you tend to basically make
> yourselves
> 14 more resistant to insulin. Finally, the longer you stay
> in
> 15 ketosis, you begin to oxidize lipoproteins, so these are
> 16 long-term consequences which begin to explain why high
> 17 protein diets fail.
>
> The first two sentences are doubtful a the very best,
Hardly. There is an induction of those enzymes involved in fat metabolism
when one consumes fat. There is some data that suggest that ingestion of
saturated fats may promote insulin resistance.
> so we would be
> well advised not to accept at face value the last one, which you cited.
Sounds like you are picking and choosing what you want to hear.
>
> Sears does not give any evidence and the study you cited was about
> ketosis in insulin dependent diabetics,
Would suggest you look at figure 1 of the full text of the article which Matti
has helpfully provided.
> which is a very different thing
> from the ketosis induced by a low carb diet. See below.
>
See above.
Perhaps you should read Dr. Ornish's rebuttal.
Yes, there is a difference in blood pH but not in the ketones.
> Any study on ketoacidosis is irrelevant when it comes to assessing
> possible dangers of the low carb diet induced ketosis.
>
The cited study that I provided was *not* about ketoacidosis. See Figure 1 of
the full text as provided by Matti.
--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com
Thorsten Schier
Insulin blocks lipolysis and promotes lipogenesis. So why would someone
on a diet that reduces insulin levels become a "fat magnet"?
> > so we would be
> > well advised not to accept at face value the last one, which you cited.
>
> Sounds like you are picking and choosing what you want to hear.
Don't we all do this to a certain degree?
In fact I tend to not accepting anyones advise at face value when it
comes to nutrition. If someone wants to convince me, they have to
provide evidence or at least a plausible explanation why something
should be healthy or unhealthy.
> >
> > Sears does not give any evidence and the study you cited was about
> > ketosis in insulin dependent diabetics,
>
> Would suggest you look at figure 1 of the full text of the article which Matti
> has helpfully provided.
I will comment on this article in another post later today.
I did. Well, I don't think that it is very convincing to blame the
deaths in the diet group on non-compliance. What takes a bit of the edge
of Dr. Sears argumentation is that we are only talking about two deaths
versus one. So these deaths may have been a coincidence.
There is. On a ketogenic diet the production of ketones is not
uncontrolled as it is in ketoacidosis.
> > Any study on ketoacidosis is irrelevant when it comes to assessing
> > possible dangers of the low carb diet induced ketosis.
> >
>
> The cited study that I provided was *not* about ketoacidosis. See Figure 1 of
> the full text as provided by Matti.
>
See above.