Ketosis is Dangerous!

[MCG]

I am really worried about the obsession with ketosis and Ketostix on this board. Ketosis is not a good thing because, as you know, it means you are eliminating ketones which is very hard on your kidneys. Ketostix were invented for diabetics in order to track when they were in ketosis - so they could avoid it! Trust me that diabetics in my family try their best to avoid ketosis, because when that stick turns to a different color they know it's dangerous. With too many ketones in the blood, you can go into ketoacidosis (dangerously acidic pH of the blood) which can lead to coma. Perhaps if you didn't take such a strict approach to the LC diet, then you wouldn't produce as many ketones at a time, and this would relieve the strain on your kidneys. It's true, the weight loss wouldn't be as rapid, but it's probably worth it to save your kidneys.

Also, the more fat you include in your diet, the more of THIS fat you will burn (as opposed to simply burning the fat off of your body). So one way to save on the amount of ketones you form is to eat only a moderately fattening diet as opposed to the high fat diet that many low-carbers advocate.

Feel free to verify this information on medical websites such as The American Diabetes Association at www.diabetes.org.

Specifically, the ADA states, "Ketone: a chemical produced when there is a shortage of insulin in the blood and the body breaks down body fat for energy. High levels of ketones can lead to diabetic ketoacidosis and coma." "Ketosis: a ketone buildup in the body that may lead to ketoacidosis. Signs of ketosis are nausea, vomiting, and stomach pain."

Be LC - but be safe!

[btdude]

Who are you, and why bother posting here? I recommend that you read the Doc's book, and other materials that outline what ketosis really is. I believe you have this term confused with the term ketoacidosis, which is a consequence of insulin deficient individuals.

[MCG]

I am just another person who is interested in a low carb lifestyle, with a strong education in biology and experience in this area. The reason why I bother posting here is because I want people to be CAREFUL and not do more damage than good on a LC lifestyle. If you read the definitions from the American Diabetes Association you can see that I have not mixxed up ketosis and ketoacidosis. Those were not MY definitions, those were quoted from the ADA. Feel free to look them up yourself. Ketosis is the build up of ketones which can have damaging effects in itself. When they build up to very high amounts you reach ketoacidosis which is the extreme dangerous effect, which can cause you to go into a ketoacidotic coma.

I support low carb lifestyles, just in a healthy and informed way!

MCG

[cc48510]

MCG...I put "ketosis" in their search and it says no results. I put in "ketoacidosis" and it came up with several articles, with info. in them you left out...For example, that ketone burning is only one of the symptoms of DKA. The other is excessively high blood sugar, which is not a problem when LCing.

The article also states that the inability to make insulin contributes to DKA. The average LCer can make insulin. In fact, as the article points out...the only diabetics who get DKA are those with Type I Diabetes. I.E. Those who CANNOT make insulin.

[doiron]

Ketoacidosis can only occur in Type 1 diabetics. Consequently, while this may be useful information for the diabetics on this board, it does not apply to non-diabetic individuals.

[btdude]

Originally posted by MCG
I am just another person who is interested in a low carb lifestyle, with a strong education in biology and experience in this area. The reason why I bother posting here is because I want people to be CAREFUL and not do more damage than good on a LC lifestyle. If you read the definitions from the American Diabetes Association you can see that I have not mixxed up ketosis and ketoacidosis. Those were not MY definitions, those were quoted from the ADA. Feel free to look them up yourself. Ketosis is the build up of ketones which can have damaging effects in itself. When they build up to very high amounts you reach ketoacidosis which is the extreme dangerous effect, which can cause you to go into a ketoacidotic coma.

I support low carb lifestyles, just in a healthy and informed way!
MCG


Then, I challenge you to tell some 20,000 users that their way of life is not right. People in here are going through REAL pain and REAL struggle with weight issues. WE are informed, that is why we all come here. That is why we read the books. That is why we all try to get as much information as we can, before posting shit that scares people.

It is admirable that you are caring the way we all live our new carb lives. Thank you. BUt, Please do not expect to come here, and obtain grand support for your logic. There are plenty of the nay-sayers out there, and THAT is WHY we have THIS site. We come here for support, and for mutual understanding.

[mnbooger]

I went to http://www.diabetes.org

I used their search function and searched for KETOSIS.
# of results.......0
If you can find a page from the ADA that says ketosis can lead to ketoacidosis could you please give us a link to that specific page.

when I searched for KETOACIDOSIS
# of results.......40

From their website
Ketoacidosis (key-toe-ass-i-DOE-sis) is a serious condition that can lead to diabetic coma (passing out for a long time) or even death. Ketoacidosis may happen to people with type 1 diabetes.
Ketoacidosis does not occur in people with type 2 diabetes Emphasis added

Signs of KETOACIDOSIS
Ketoacidosis usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours. The first symptoms are:
Thirst or a very dry mouth.
Frequent urination.
High blood sugar levels.
High levels of ketones in the urine.


High blood sugar and high ketones
On a LC diet you do not have high blood sugar

Treatment for Ketoacidosis
Insulin-to reduce blood sugar ...We don't have high blood sugar
IV-to replace lost fluid and reduce the concentration of acid in blood ....We drink lots of water

Also from from ADA's website
about kidney disease and how diabetes can cause it
When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels (capillaries) with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood.
Diabetes can damage this system. High levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak. Useful protein is lost in the urine. Having small amounts of protein in the urine is called microalbuminuria. When kidney disease is diagnosed early, (during microalbuminuria), several treatments may keep kidney disease from getting worse. Having larger amounts is called macroalbuminuria. When kidney disease is caught later (during macroalbuminuria), end-stage renal disease, or ESRD, usually follows.

High levels of blood SUGAR lead to kidney disease, it says nothing about ketosis or ketoacidosis.

The first time I was on a LC diet the testing strips that I bought tested glucose and ketones. If you have BOTH in your urine it is indeed very dangerous. But ketones themselves are not a problem. And from the non scientific viewpoint of this forum, the longer you are on a LC WOL your body gets better at using the ketones for fuel, thus less of them need to be filtered because your body is using them for energy.

[Lisa N]

MCG...

these other folks are correct. There is a big and distinct difference between benign dietary ketosis and diabetic ketoacidosis. The former is harmless, the latter can be deadly.
As a diabetic, I can tell you that the only reason that I would even bother to test for ketones is if I first tested my blood sugar and found I had a reading over 250. We don't test for ketones because they are dangerous to our kidneys (it's the high blood sugars that are dangerous to our kidneys and vascular system), but because if your blood sugar is high and you are spilling ketones in your urine it means that you are headed for diabetic ketoacidosis and you had better get to the doctor or get your blood sugar down quick or both.
Ketone test strips were originally developed for diabetics to test for ketones in their urine as well as checking for sugar in the urine. This was before the advent of relatively inexpensive and accurate home blood glucose monitors. Now those strips are pretty much dinosaurs and no longer necessary since I can get out my monitor and check my blood sugar 24/7 without the necessity of a doctor or ER visit.
Why should low carbers (not even myself as a diabetic) be concerned about ketones? Because if you are following a low carb plan correctly, it's highly unlikely that you will have high blood sugar which is the other component of diabetic ketoacidosis. You cannot develop the condition if you have a normal blood sugar.
Also, if ketones are dangerous, everyone had better stop dieting immediately whether they are following a low carb plan or not because to lose weight you have to burn fat unless, of course, you are burning your lean body mass instead due to lack of protein. Burning fat produces ketones; they are the byproduct of fat metabolism whether you are low carbing or not. On low carb, you will produce more of them because they become your body's main source of fuel instead of glucose, but anyone on a diet with the goal of shedding fat is surely producing ketones as well.
BTW...I've been low carbing and in ketosis at 30 grams of carb per day for over 2 years and I have yet to develop a problem from it. ;)

[MCG]

Wow.. I suppose I should not have put my post in the "war zone" because it seems that a lot of people come in here armed and ready to attack! To individuals such as "btdude" who believe that I "post shit that scares people" because I haven't researched enough. Btdude, I have researched plenty.. and that research has been conducted through MEDICAL textbooks and journals.. not the Dr. Atkins book who is trying to get you to buy his products.

For those of you who decided that, because you produce insulin, ketosis is not the same for you.. let me explain. It is true that diabetics do not produce enough/any insulin (depending on the type of diabetes) and this causes their blood sugar to rise. Because they have no insulin, which brings the glucose to their muscles to use as fuel, their muscles cannot use glucose as fuel, and instead turn to burning fat.. and the sugar stays in their blood and reaches high amounts. Once their bodies begin burning this fat, ketones are formed. And it's true that there is no need to check unless your blood sugar is over 250, because you would not begin to burn fat until after that point. Just because low-carbers burn fat for different reasons, doesn't mean that the same ketones are not formed. No matter who you are, if you burn fat, you produce ketones and a build up of ketones will lead to ketoacidosis.

Now for the few of you who decided that I was some kind of liar or something because you put "ketosis" into the ADA search engine.. did you honestly think that I would quote the ADA with a blatant lie? I am not a liar. Here is the link:

http://www.diabetes.org/main/info/dictionary.jsp

I'm sorry that it took more than a keyword search to find it, but it's there.

Btdude, in no way did I tell "20,000 users that their way of life is not right." I came on here openly stating that I SUPPORT and am CURRENTLY ON a low carb diet!! I just understand the dangers of some aspects of the diet, and therefore avoid them. I was trying to explain this to others before they do permanent damage. I don't appreciate your comments about how all of these people are suffering yet I'm the horrible person who tells them that they are all wrong and scares them. You don't need to rally the crowds with your emotional talk. I feel very sympathetic for the many people who are suffering, I am not the horrible person you make me out to be. Just because something helps overweight people lose weight, does not make it healthy. Bulemia might help an overweight person lose weight, but you better believe I'm not going to support that either.

Yelling at me because you did a search on ADA's website and didn't find the correct link, even QUOTING that you did that, is not evidence that I am wrong.

I am so disappointed with the angry and uninformed responses I got from this post. To the pleasure of many, I'm sure, I will no longer bother to help people who do not want it. I just hope that a few people read my post and will actually discuss this information with their doctors before they so quickly jump to fight an adverse opinion.

Good luck.

MCG

[Shellyf34]

FYI ketoacidosis is caused when your body is burning its own protein for fuel, while LYPOLYSIS is when you are burning fat for fuel. DR. Atkins said he regrets ever using the term KETOSIS to describe the fat burning process.

[Lisa N]

No matter who you are, if you burn fat, you produce ketones and a build up of ketones will lead to ketoacidosis.

This is incorrect. If you are producing ketones as a low carber, you are in ketosis (as in benign dietary ketosis or BDK). If you are producing ketones as a diabetic AND have a high blood sugar, then you may be heading for diabetic ketoacidosis (DKA). The componenet that you keep missing is the high blood sugars which set off chemical reactions in your body that lead to the acidosis part. Without the high blood sugars, the acidosis does not occur. See here for a definition of DKA: http://www.emedicine.com/emerg/topic135.htm

See here for a discussion on the differences between DKA and BDK:
http://www.lowcarbretreat.com/ketosis.html

You may also want to consider asking a doctor how long it would take for someone in ketoacidosis before one would develop symptoms and need to be hospitalized. The answer is most cases is hours, not days, weeks, months or years.
You also seemed to miss that I have been in this state (dietary ketosis, not ketoacidosis) for 2+ years without ill effect as have many others here. Obviously, this is NOT a dangerous state for me (and my doctor checks my bloodwork regularly) even as a diabetic and since I seriously doubt that my biophysiology is significantly different from the next person, the extrapolation would be that a state of dietary ketosis is not dangerous for anyone.

[btdude]

Originally posted by Lisa N
This is incorrect.
You also seemed to miss that I have been in this state (dietary ketosis, not ketoacidosis) for 2+ years without ill effect as have many others here. Obviously, this is NOT a dangerous state for me (and my doctor checks my bloodwork regularly) even as a diabetic and since I seriously doubt that my biophysiology is significantly different from the next person, the extrapolation would be that a state of dietary ketosis is not dangerous for anyone.

I have seen that I erred ib replying to the original person. Trolling comes to my mind. And I made the mistake of feeding it. In regards to the above quote, I believe the poster has failed to overlook ANY of what we, the informed, have learned and LIVED. It's all well and good, that this person has READ about things in various journals, etc. But we all have read things. CARRY ON to all the LCers out there. You do it for YOU, not for this nay-sayer. Ask your doctor, and do what YOU feel comfy with.

[Lisa N]

I'd also like to issue a challenge. Find me a study that shows that dietary ketosis will lead to ketoacidosis in the absence of elevated blood sugars, prolonged starvation or alcoholism (the 3 known causes of ketoacidosis).
Opinons and definitions are all well and good, but you have yet to show that the metabolic processes of diabetic ketoacidosis and benign dietary ketosis are one and the same. In fact, they are not the same at all because there are significant biochemical processes that are present with diabetic ketoacidosis that are not present with benign dietary ketosis (that's why its called benign!).

[Coolcat]

I'm not even touching the medical/technical aspect of this conversation as I can hardly keep up with it anyhow. I will make a point though. Some people make claims that ketosis is bad to the kidneys or liver or something. I'm new to Atkins and I have faith that this doctor had truely believed in what he was doing for the last 30+ years. That's good enough for me!

Take for a moment to consider what WE the AMERICAN PEOPLE are. We're busy with work. We're fast paced and seem to make NO time for anything beneficial (ex: exercise, food, family, etc). Now look at BIG BUSINESS. They make fast food. They make pharmaceudicals for everything ailment known to man. They make "ab sliders". Just more JUNK for us to have where money can be made.

People think that because they've been drinking tap water all their life and because they're not DEAD yet.. it's OK. Same goes with FOODS. Especially JUNK FOOD. Ever notice that a coke used to be a 12 oz can for $.50 and now it's a 44 oz jug for $.89? Or the 2 for $2 at McDonalds? They're practically giving this crap away because there's still some profit to be made and people like the taste. I dunno how many times I've eaten fast food only to be discouraged afterward about feeling "blah".

Then we have drugs. Woohoo! a cure! yeah, right. I get nothing but a LAUGH at any drug commericals I see on TV now. This purple pill fixes your upset stomach... but.. it can also cause flatulence, constipation, headaches,etc.. ! What a crock! Tell me we're not being duped!

All I'm saying is I want to lose weight. I want to be healthy. I believe Dr. Atkins was nobody's fool. I will pursue this plan as I honestly believe that eating right (sensible protien/fat/carbs) will make me a healthy person.

** Steps off the soapbox ** :)

[wsgts]

I have heard all the garbadge about not eating enough sugar can damage kidneys and that sort of thing. I just got back from the doctor this morning.

Before Atkins(3 months ago): Protein in urine +2

Today: Protein in urine 0

Rest my case,

wsgts

[jedswife]

if you dont know the difference betweeen
KETOSIS AND KETOACIDSIS

i suggest you start looking into some field other than biology.

AND dont start spouting medical advice that is not even correct - you could really cause problems for some poor fool who might believe you know what you are talking about.

god i hope you are not becoming a doctor or a nurse or a NUTRITIONIST.

by the way i have a severe family history of diabetes and was well on the diabetic road myself until ATKINS that is, now i no longer need to be periodically monitored for diabetes.

[SoCalShark]

I got this from here:
http://www.ketosis-ketoacidosis-difference.com/

Ketosis: Is it safe? Why do some people say it's dangerous?

On July 7, 2002, the New York Times published "What if It's All Been a Big Fat Lie?" written by Gary Taubes.

I quote the article: " 'Doctors are scared of ketosis,' says Richard Veech, an N.I.H. [National Institutes of Health]researcher who studied medicine at Harvard and then got his doctorate at Oxford University with the Nobel Laureate Hans Krebs. ''They're always worried about diabetic ketoacidosis. But ketosis is a normal physiologic state."

"Simply put, ketosis is evolution's answer to the thrifty gene. We may have evolved to efficiently store fat for times of famine, says Veech, but we also evolved ketosis to efficiently live off that fat when necessary. Rather than being poison, which is how the press often refers to ketones, they make the body run more efficiently and provide a backup fuel source for the brain. Veech calls ketones ''magic'' and has shown that both the heart and brain run 25 percent more efficiently on ketones than on blood sugar." You can read the full article at www.nyt.com.

Being in ketosis means your body has burned a large amount of fat in response to the fact that it didn't have sufficient glucose available for energy needs. Under everyday conditions, the carbohydrates you eat are converted to glucose, which is the body's primary source of energy. Whenever your intake of carbohydrates is limited to a certain range, for a long enough period of time, you'll reach a point where your body draws on its alternate energy system, fat stores, for fuel.

This condition called dietary ketosis, means your body burns fat and turns it into a source of fuel called ketones. Ketones are produced whenever body fat is burned. When you burn a larger amount of fat than is immediately needed for energy, the excess ketones are discarded in the urine.

Dietary ketosis is among the most maligned and misunderstood concepts in nutrition because it is often confused with ketoacidosis, which is a life-threatening condition most often associated with uncontrolled insulin-deficient Type 1 diabetes. In the Type 1 diabetic, the absence of insulin leads to a toxic build-up of blood glucose and an extreme break-down of fat and muscle tissue. This condition doesn't occur in individuals who have even a small amount of insulin, whether from natural production or artificially administered.

Dietary ketosis, however, is a natural adjustment to the body's reduced intake of carbohydrates as the body shifts its primary source of energy from carbohydrates to stored fat. The presence of insulin keeps ketone production in check so that a mild, beneficial ketosis is achieved. Blood glucose levels are stabilized within a normal range and there is no break-down of healthy muscle tissue.

The most sensitive tests of ketosis ("NMR" and "blood ketone level") show that everyone is in some degree of ketosis every day, particularly after not eating overnight and after exercising. Ketosis is the body's survival system. It is not an abnormality nor does it present any medical danger, except to a Type I insulin-dependent diabetic. The body functions naturally and effectively while in a state of dietary ketosis.

Some of the benefits many people experience while in a state of dietary ketosis for intentional weight loss may include rapid weight loss, decreased hunger and cravings, improved mood, increased energy and, as long as protein intake is adequate, protection of lean muscle mass

:daze:

[SoCalShark]

[QUOTE]Originally posted by MCG
[B]Wow.. I suppose I should not have put my post in the "war zone" because it seems that a lot of people come in here armed and ready to attack! To individuals such as "btdude" who believe that I "post shit that scares people" because I haven't researched enough. Btdude, I have researched plenty.. and that research has been conducted through MEDICAL textbooks and journals.. not the Dr. Atkins book who is trying to get you to buy his products.

Did not read the Atkins book because why? The book came out years before he started marketing products. tsk tsk tsk :(
Thats like saying he invented the diet to make money not to help people. Read his history. Thats not why Doctors are Doctors...

[NadiaA]

Hi everyone

I am no expert and don't pretend to be. I am just a person who started LCing about a month ago and feel great. LCing is not a huge hit in Australia like it is in the US but I'm sure it will be. I am on a version that my naturpath put me on. It is pretty much the same as Atkins but without as much bacon, more lean meat. He told me that my ketosticks should read in the trace to moderate. I didn't ask why but notice that the pinker I am the thirstier I am. I try to stay in the trace because it makes me feel better. anyway enough crapping on. I just wanted to say that his thoughts were that it can be a bit of strain on your body to be in heavy ketosis all the time. He is not a doctor, and doctors here try to talk me out of it because they don't know much about it.

Despite any of this. I think some people here need to take a chill pill and learn to debate a topic with good manners. I would be ashamed to think that one of my family members or friends would talk to another human being in such a rude way regardless of how incorrect they thought someones view point to be. Remember we are all just people after all.

Nadia

[Lisa N]

Btdude, I have researched plenty.. and that research has been conducted through MEDICAL textbooks and journals.. not the Dr. Atkins book

You're not going to find much about benign dietary ketosis in medical books because it's not an abnormal medical condition. It's a normal physiologic response of the body to a lack of glucose to be used for energy or lack of calories to supply the body's energy needs in general. The references that you do find in medical textbooks are all based on diabetic ketoacidosis which IS an abnormal medical condition, but as the article above explains is not the same thing as benign dietary ketosis at all. Medical textbooks also have a tendency to cover things that can go wrong with the body, not things that can go right and most of the references that you will find in a medical textbook are related to abnormal physiologic conditions. It's similar to reading an auto repair manual to find out how the car runs when it's not broken.

I'd also like to remind everyone that while this is the war zone and debates are welcome, it should be done without insults or flames. Just the facts, folks. ;)

[Deej]

If Benign Dietary Ketosis is the result of a person burning their own stored fat for fuel, surely Ketosis must occur in all weight loss programs where calories or carbs or even fat is restricted? If a person is losing body fat, through whatever means, be it Low Carb, Weight Watchers or Slim Fast, then BDK must surely occur. Otherwise we'd all be losing our lean tissue and keeping the fat, right?

What I'm trying to get at, is that Ketosis is always associated with Low Carb & especially Atkins. But surely ANYONE losing weight must produce Ketones to some degree?

I've also read that Athletes produce Ketones a lot of the time, especially when in serious training, and no one accuses them of endangering their health.

[alaskaman]

deejay is right on - I would like to see some study that shows that there is some weightloss program where you burn your fat - the only way to lose it, as far as I know, without being in ketosis. Considering the studies that Atkins and others have cited, that low-fat, high carb dieters lose more of their own muscle mass that lc dieters, I think that lowfat dieters probably produce MORE ketones, and if it is dangerous, they would be the ones to worry about. So the anti lc people shoud give it a rest.

[Karla]

I am not an expert in biology, but I have read a great deal about the effects of insulin on the body. My own personal theory is that ketosis was meant to be the normal state of the body and that the carbohydrate/insulin system is a backup system, only intended for difficult periods when humans were unable to obtain sufficient protein and fat and were forced to eat larger quantities of carbohydrates instead. Why else would eating carbohydrates cause us to store fat while consuming mainly protein and fat allows us to burn fat and stay lean?

And to me the very fact that years of eating way too many carbohydrates and continually flooding our bodies with insulin lessens our sensitivity to insulin and eventually causes the disease of Type 2 diabetes strongly indicates that this is not the normal state of the human body. It may be going too far to say that continuous high levels of insulin act as a slow acting toxin on the body, but I'm not sure.

Just MHO

Karla

[Kristine]

There has never, ever been a reported medical case of *anyone's* kidneys blowing up from dietary ketosis. Period.

Yes, your kidneys work a little harder. That's what they're made to do! If you apply the "don't go into ketosis because it's hard on your kidneys" logic to exercise, for example, then we should all stop cardio exercise, since it's hard on your heart. And we shouldn't lift weights, since that damages your muscles.

Doesn't make sense, does it?

[Lisa N]

A very good link explaining how and when ketones become a problem: http://listserv.lehigh.edu/lists/diabetic/html/ketones.html

[dannysk]

Kristine is right also
We should avoid all exercise because it creates lactic acid (The "burn"). Lactic-acidosis is a very dangerous condition which is 50% fatal.

danny

[pegva]

I am so disappointed with the angry and uninformed responses I got from this post. To the pleasure of many, I'm sure, I will no longer bother to help people who do not want it. I just hope that a few people read my post and will actually discuss this information with their doctors before they so quickly jump to fight an adverse opinion.

Good luck.
MCG

Reading this person's profile, I have to believe he/she is not at all interested in a Low Carb lifestyle.

This is the typical "hit and run" tactic of a Board Flamer!

I wish we could just ignore these people, then they would fade away... but most of us here are Really Interested in the well-being of the members and try to undo the damage done by bottom dwellers.

... we muddle along.

[Battousai]

As a medical Doctor I can tell you this, ketosis is very safe as long as it's done correctly. Everyone who I have talked to and the posts I have read state that everyone is doing it correctly. The only danger is with cholesterol which is really up to debate. Not enough research has been done to say the atkins is a dangerous diet. From my own personal research it's as safe as any LC diet

I suggest you try fighting a battle which we know is dangerous like the #1 drug in america tobacco.


Battousai

[alaskaman]

But Battousai - surely you must be aware that cigarettes are a fat-free product...

[Battousai]

ahh yes fat free, but is it cancer free....

[alaskaman]

Just kidding, obviously - though I wonder how long it will be before someone has the chutzpah to make that claim. Thanks for your information on ketosis. Bill

[Battousai]

I know your kidding friend so was i ;)


One things for sure I hope you never see someone die of emphysema. It's a very sad sight


Battousai

[dirty-c]

Take for a moment to consider what WE the AMERICAN PEOPLE are. We're busy with work. We're fast paced and seem to make NO time for anything beneficial (ex: exercise, food, family, etc). Now look at BIG BUSINESS. They make fast food. They make pharmaceudicals for everything ailment known to man. They make "ab sliders". Just more JUNK for us to have where money can be made.

People think that because they've been drinking tap water all their life and because they're not DEAD yet.. it's OK. Same goes with FOODS. Especially JUNK FOOD. Ever notice that a coke used to be a 12 oz can for $.50 and now it's a 44 oz jug for $.89? Or the 2 for $2 at McDonalds? They're practically giving this crap away because there's still some profit to be made and people like the taste. I dunno how many times I've eaten fast food only to be discouraged afterward about feeling "blah".

Then we have drugs. Woohoo! a cure! yeah, right. I get nothing but a LAUGH at any drug commericals I see on TV now. This purple pill fixes your upset stomach... but.. it can also cause flatulence, constipation, headaches,etc.. ! What a crock! Tell me we're not being duped!



I though everyone should read this again, especially if they never saw it the first time. One of the most fundamental things to understand is that big business DOESNT WANT US TO BE HEALTHY. There is NO MONEY to be made off of healthy people (atleast compare to sick people). The people who own and run these companies are cunning, opportunistic individuals. They believe people are sheep, and they're right.

The first step in straying from the flock of brainless lemmings (aka - the general public) is to realize that these people aren't your friends. Even "helpful" government health organizations are to be to be questioned, if not considered suspect.

[grettel1]

After reading everyone's comments about ketosis and ketoacidosis, I am still very confused. When I first started the Atkin's diet about four weeks ago my Ketones were very high and the color of the strips were dark purple. Now the color of the strips are a light tan. I don't really understand what this means and I am still losing weight despite the ketone levels. Can someone explain this to me?

[Lisa N]

After reading everyone's comments about ketosis and ketoacidosis, I am still very confused. When I first started the Atkin's diet about four weeks ago my Ketones were very high and the color of the strips were dark purple. Now the color of the strips are a light tan. I don't really understand what this means and I am still losing weight despite the ketone levels. Can someone explain this to me?

What this likely means is that when you first started low carbing, your body was not very efficient at using ketones for fuel and there were a lot left over to spill into the urine. Now that your body has been burning those ketones for fuel for a longer period of time, it has become more efficient at using this new energy source and there aren't as many left over. The ketone strips also only measure one type of ketone and the body produces more types than one. To be honest, I don't feel that those strips are a very accurate picture of how you are doing; the scale, tape measure and how your clothes are fitting are a better way to assess your progress. :)
As you can see, just because the strips aren't turning color doesn't mean that your body is not burning fat and producing ketones. As long as you are following the plan correctly and losing weight/inches (and even if you stop for a week or two), I wouldn't worry about it.

[llabonte]

To: Coolcat

I applaude you as you step off the soapbox! ha I wholeheartedly agree. I do have to say this post definitely got people talking!
I have lost 20 pounds since May 13, 2003 and this has been the only success I have seen in two years. Medication and thyroid troubles have been a real problem for me in the past. Atkins has been a lifesaver. If people don't agree then go to Weight Watchers or something. I think we all know how we feel about our LCing and will defend it till the end, or until there is some medical proof of it not being good for us.

I can tell you though, carrying around an extra 68 pounds is not good for me either. So, I got rid of 20 pounds of it. I had a heart scan done at the Mayo Clinic in February and the doctor there told me that for every pound you are overweight your heart has to pump blood another ONE HUNDRED miles a day through bloodvessels! Now that is a strain on the heart! Please dont tell me Atkins is not good for you. I know it is good for me!

[Samuel]

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As a medical Doctor I can tell you this, ketosis is very safe as long as it's done correctly. Everyone who I have talked to and the posts I have read state that everyone is doing it correctly. The only danger is with cholesterol which is really up to debate. Not enough research has been done to say the atkins is a dangerous diet. From my own personal research it's as safe as any LC diet
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I agree with you Doctor. Low carb dieting has improved my blood pressure and all my blood test results with the exeption of bad choleserol, it stayed about the same. Actually I modified my diet now so I eat lean meats and minimum eggs. I depend on nuts to give me most of the fat I need.

Sam

[gawdess]

I say we offer this post up to the FLAMES! and move on....any doctor can confirm there is a difference

[denczek]

I started low carbing in earnest about 6 months ago and I have type 2 diabetes. At first the low carb life style helped to bring my blood sugars down to very good values. After about 6 weeks, I hit a plateau and the blood sugars started to rise. I then incorporated exercise into my diet. My blood sugars then went back down for the next 3 months or so. Everything was great, I was losing weight and my blood sugars were once again under control. During the last 2 months I have had increasing blood sugars as I continued to exercise and eat low carb. In fact, after exercising my blood sugars would rise drastically. After a week of very low carbs and strenous exercise, I got ketoacidosis. My blood pressure dropped to alarming levels and I was very sick. In fact, I had to go in for emergency treatment. For the last month I have had high blood sugars and have been in ketosis often. After the scare with ketoacidosis, I have tried to eat more carbs while still maintaining the low carb diet, just not so low. I now have to be very careful and check my sugars often and use the ketostix to avoid ketoacidosis. I try to drink more water and I try to incorporate healthy carbs every day (fruit, soups, salads, etc). I've had to double up on my insulin and start taking additional medication to control the blood sugars on my low carb diet. It's the constant losing weight and the associated ketosis that is the problem, not necessarily the low carb diet. When the ketones build up and my sugars remain high, I need to back off. It's scary losing weight as a diabetic. I was only diagnosed with diabetes about 3 years ago and before that I never had problems losing weight. Now it's dangerous and I must carefully monitor myself. This is just my experience and this is my life right now. I've read many myths, including some in this newsgroup. Take my word for it, you can get ketoacidosis by low carbing and exercising for an extended amount of time when you are a type 2 insulin-dependent diabetic. Be careful...

MD

[Built]

Hmmmm ... ketoacidosis is ketones in the presence of high blood sugars. Type I diabetics can have this happen if they don't get enough insulin.

Type II diabetics HAVE insulin - but their cells are resistant to it. I was on metformin myself for a while before I started low-carbing.

Type II diabetics generally can't get ketoacidosis, because they have insulin.

According to http://www.ehendrick.org/healthy/001526.htm :

A small number of people with type II diabetes also experience ketoacidosis, but this is rare given the fact that type II diabetics still produce some insulin naturally. When DKA occurs in type II patients, it is usually caused by a decrease in food intake and an increased insulin deficiency due to hyperglycemia.

So, if I'm reading this right, if you don't eat enough food, and your blood sugar goes up (say, from eating nothing but sweets) this can happen.

Not sure how ATKINS could be involved here, but I'm all ears if you have a good explanation.

[CindySue48]

As a nurse of over 25 yrs, I have to add my 2 cents.

Ketosis is burning fat for energy, but as posted by others, ketoscidosis will only occur with HIGH BLOOD SUGAR LEVELS.

Ketosis is not dangerous, ketoscidosis is.

On my recent MD visit, my BS was 96, and my urine ketones were 3+. If ketosis was dangerous, don't you think my doc might have just mentioned it? She didn't because it only indicates that you're burning fat, not carbs for energy.

[Lisa N]

Denczek, it sounds like what you experienced was glycogen dumping that caused your blood sugars to go up dramatically. The exact cause of that could be a variety of things, including too few carbs for the insulin that you take to act upon paired with increased physical demands causing your liver to have to go into overdrive to produce glycogen (you were following a low carb regimen under the guidance of a physician who was closely monitoring you, right?).
Nowhere on this board will you find a post that states that diabetic ketoacidosis is not dangerous, even life-threatening.
What you will find are posts that delineate the difference between dietary ketosis and diabetic ketoacidosis.
For a non-diabetic, dietary ketosis cannot become ketoacidosis as you must also have high blood sugar levels (or serious liver/kidney problems in which case you probably shouldn't be low carbing at low levels) present for that to occur. Even for a type 2 diabetic who is not insulin dependent, it would be very rare to develop ketoacidosis unless there was another underlying problem.
I myself am a type 2, non-insulin dependent diabetic following a low carb (30 grams of carb per day) regimen for 3+ years with excellent results and not even a hint of ketoacidosis.
Sorry to hear that you had a bad experience, but to know what, if anything, went wrong more information would be needed such as how many grams of carb per day you were eating, how many grams at each meal, what your sources of carbs were, etc...

[mio1996]

Eating excess protein could also cause high blood glucose, right? Many lc'ers do eat too much protein for efficient sugar control, including myself sometimes (I am hypoglycemic, so I have problems with too much protein though I am not diabetic). I recently scanned through The Ketogenic Diet (designed as a treatment for epilepsy), and that diet recommends barely adequate protein levels to prevent sugar spikes.

[Sandie47]

I just have to put my 2 cents in this. I have been a paramedic in Ontario since 1991 although I have retired do to a lifting injury. My husband however has been a paramedic since 1981 and presently works Air Ambulance.

Here are the proper meanings of the following:

ketones: produced in the body through a normal change fats undergo in the liver; derived by oxidation from a secondary alcohol; produced by metabolism without sugar.

Ketosis: an abnormal buildup of ketones in body tissures and fluid.Most common in starvation, sometimes in pregnancy and most often in diabetes mellitus.

Ketoasidosis: form of metabolic acidosis that is caused by insufficient insulin, resulting in increased ketone bodies and free fatty acids, hyperglycemia (high glucose level in blood), electrolyte imbalance and hypovolemia.

I do not believe that LC is going to cause problems that will lead to coma or death do to the ketones in your urine. If you do not take an adequate intake of carbs or replenish carbs after exercise you can however develop hypoglycemia as well as after fasting.

Could you have possibly got hypo and hyper mixed up? Hypo in severe leads to coma, hyper gradual decrease in consciousness then shock. Hyper is in ketoacidosis.

Hope I haven't confused anyone.
Sandie

Lost 25 pounds and 25 inches since starting April 22 on LC.

[322432]

What all these people with all the answers forget is that the Eskimo was in ketosis for a million years. Wish they would explain that situation as thay are expounding their brilliance. Seems like most are not sure of themselves; sameo,sameo, if you can convince someone else, then you must be right. Give me a break! :q:













eskimo

[TheCaveman]

On my recent MD visit, my BS was 96, and my urine ketones were 3+. If ketosis was dangerous, don't you think my doc might have just mentioned it?

What is the deal with doctors not even commenting on a positive ketones reading in standard bloodwork?

I've always tested high ketones, and the lab my doc uses prints anything outside the normal ranges in bright red lettering. Impossible that she would miss it every single time. And with nothing else on my report outside the normal range, you'd think she'd pick it out to at least discuss briefly. Nothing.

Truthfully, I always hope she'll mention it so that I can have another conversation about low-carb. Oh well, maybe someday.

[Lisa N]

I think a point that a lot of people are missing here is that under normal circumstances, ketones that are generated as a result of benign dietary ketosis (or BDK) do not build up in the blood stream. They are either burned for energy or excreted via the kidneys, lungs, sweat glands and intestines. Only when the excretion process is blocked, does a buildup occur and this is when problems can result as a result of high levels of ketones present in the blood stream.
Ketonemia that occurs as a result of starvation, hyperglycemia or alcoholism is accompanied by other problems as well that overwhelm the body's ability to excrete the excess.
So...unless you are an alcoholic, in an advanced state of starvation or a diabetic with out of control blood sugars, there's no reason to get all excited about ketones. ;)

What is the deal with doctors not even commenting on a positive ketones reading in standard bloodwork?

Because ketones in the urine in the absence of a very elevated blood sugar does not indicate a problem and even people losing weight on a low fat diet will test positive for ketones in their blood (most people don't lose weight without burning fat and ketones are a byproduct of fat burning. ;) )

[BadgerGirl]

If you go back about 200,000 years, my guess is that ketosis was man's natural state.

[TheCaveman]

If you go back about 200,000 years, my guess is that ketosis was man's natural state.

With no access to plant food for most of they year, wouldn't it have to be?

[BadgerGirl]

With no access to plant food for most of they year, wouldn't it have to be?
Yep, I'm just saying that a state of ketosis couldn't be that dangerous or we'd never have survived as a species. ;)

[TheCaveman]

Yep, I'm just saying that a state of ketosis couldn't be that dangerous or we'd never have survived as a species.

You might even say that the human body, having evolved under those conditions, EXPECTS to be in ketosis for most of the year.

[BadgerGirl]

You might even say that the human body, having evolved under those conditions, EXPECTS to be in ketosis for most of the year.
Yes, indeed.

[TheCaveman]

I'm glad we got that straightened out. The only question left unanswered is if BadgerGirl is married or not.

[BadgerGirl]

BadgerGirl is married to a Viking!

[denczek]

In case anyone is still following this thread, I thought I'd give my personal update. Last week I was informed that I am quickly becoming a type 1 diabetic. Strange that they never did the specific test for type 1 vs. type 2 until now. Anyhow, that would explain the 2 ketoacidosis episodes I experienced while low-carbing. Since then I've started taking a fast acting insulin in addition to my slow acting insulin. Now I can low-carb and not worry about another episode. When I see my blood sugar start to sky-rocket from ketosis (due to low carbing and/or exercise), I simply take more insulin. I feel much better and safer now. I am sticking to the low-carb diet since overall it has been very rewarding.

[CindySue48]

In case anyone is still following this thread, I thought I'd give my personal update. Last week I was informed that I am quickly becoming a type 1 diabetic. Strange that they never did the specific test for type 1 vs. type 2 until now. Anyhow, that would explain the 2 ketoacidosis episodes I experienced while low-carbing. Since then I've started taking a fast acting insulin in addition to my slow acting insulin. Now I can low-carb and not worry about another episode. When I see my blood sugar start to sky-rocket from ketosis (due to low carbing and/or exercise), I simply take more insulin. I feel much better and safer now. I am sticking to the low-carb diet since overall it has been very rewarding.


OK....
1. Type 1 is Juvenile Diabetes. People who are Type 2 on insulin are Insulin dependant, NOT type 1. I don't know of any test for type 1 vs type 2, it's more of a when you were diagnosed and what initially worked for treatment. (I may be wrong here, I've been a RN for 28 yrs, but I'm sure I dont' know everything!)

2. If you're already taking insulin then you're already insulin dependant.

3. LC, if done right, will regulate your blood sugars and many people are able to cut back or even eliminate their meds.

4. Ketosis does NOT cause high blood sugar. Benign Dietary Ketosis is a result of low carb intake, which causes your body to turn to fat for fuel. Ketones are a byproduct of fat breakdown. Diabetic Ketoacidosis is VERY damngerous and should be avoided at all costs in diabetics. This is the result of very high blood sugar and ineffecient insulin. Your body basically ignores the sugar and starts to break down fat.....this causes an acid/base imbalance and can lead to coma and even death. Benign Dietary Ketosis and Diabetic Ketoacidosis are NOT the same thing! No even close!

5. can you please post some examples of what you're eating?

6. What are your Fasting Blood Sugars running? Do you test yourself? What have your numbers been? Have you had an A1c? What are the results? And lastly, are you being treated by an endocrinologist?

[Lisa N]

Denczek, glad to hear that you are getting the treatment that you need but there are a couple of things that I need to point out.

1) Type 2's do not "become" type 1 diabetics. Type 2 diabetics can become insulin dependent, but the cause of the need for insulin between type 2 and type 1 diabetics is very different. There are a couple of possibilities: a) that you are a type 1 who was misdiagnosed and still in the "honeymoon" period, meaning that your blood sugars had not completely gone out of control yet and that your pancreas was still producing some insulin but now that you are past that period and have had further tests, it's becoming more apparent that you are a type 1 or b) that you are a type 2 and that your insulin requirements were underestimated. Either way, if you require insulin to maintain your blood sugars in a normal range even while low carbing, your pancreatic capability to produce insulin is poor.

2) Dietary ketosis does not cause high blood sugars. High blood sugars result in diabetic ketoacidosis. Excercise can elevate blood sugars due to glycogen dumping. Blood sugars can also rise alarmingly even when no food is eaten during sickness or because of trauma or infection (effect of corticosteroid production in response).

I wish you the best of success with low carbing and with your battle against diabetes. :)

[Marge]

Is there any way we can get people to understand Ketosis good, Ketoacidosis bad. Makes a huge difference to diabetics and non-diabetics alike.

[CindySue48]

Denczek....how old are you and how long ago were you diagnosed? Were you ever on oral meds?

[denczek]

For those that that have recently replied to my last update, one of the posters was wrong about type 2 to type 1 transition or my type 1 was originally misdiagnosed as type 2 as Lisa suggested (think the doctors would ever admit a mistake?). It can happen and it has happened to me. Type 1 is when your pancreas stops making insulin and is not necessarily tied to being a jeuvenile. There are expensive tests that test specifically for type 1 diabetes, i.e. the GAD Antibody test which was performed on me as part of a diabetes research group. I probably know more about diabetes that most diabetics and RN's. I have been part of the research group off and on for over 3 years and my endocrinologist is one of the best in Florida.

There is not argument from me nor anyone else in this group about ketosis and ketoacidosis being different conditions. But ketosis in someone that does not produce enough or any insulin at all can turn into ketoacidosis. End of discussion...

Examples of my diet... Yesterday I had a some blueberries when I took my morning meds (metformin xr and glyburide). For a pre-lunch snack I had a few black olives and some mixed nuts. For lunch I had my awesome homemade smoked pork ribs (about 1/2 a rack) with a little stubb's bbq sauce (low carb and delicious). I had some cucumber and some more olives for a pre-dinner snack. For dinner I had 2 chicken thighs that I prepared from scratch and I had my second dose of meds (more metformin and glyburide). For a post-dinner snack I had 2 sugar free popsickles (low carb and low calorie). Before all three main meals I took my blood sugar readings and also injected some Humalog insulin accordingly. At night time I took my Lantus insulin.

I tested with the ketostix twice yesterday. At lunch time I was in slight ketosis and later around dinner time I was in moderate ketosis. My fasting blood sugar this morning was 124. I did not exercise yesterday, but did the day before and will today. The ketosis and/or exercise absolutely raises my blood sugar levels and the Humalog is helping me to knock it back down. That's why I test my sugar before taking the Humalog and combine the reading with the carb count of what I'm about to eat to determine how much to take. I'm still fairly new to the Humalog, but I've been on the Lantus for a couple years. My A1c was 7.5 last week as opposed to 6.9 a couple months ago. I'd have to guess it went up because of the increased ketosis and exercise induced high blood sugars without the Humalog to knock the sugar levels back down.

Thanks to everyone for thier concerns and best wishes. Hope my experience helps those fellow diabetics out there. This disease really sux... Doing everything possible to help my kids and wife avoid it. Unfortunately, I started sticking my wife recently and her readings are high indicating that she may be diabetic or pre-diabetic. With her very poor diet and obesity, it doesn't surprise me...

Still low-carbing and loving it. Good luck to all...

:)

[Samasnier]

Could anyone explain how excercise raises blood sugar, please? I thought it always lowered it.

[Lisa N]

Could anyone explain how excercise raises blood sugar, please? I thought it always lowered it.

When you excercise moderately to strenously, the body releases stress hormones such as epinephrine and cortisol. Both of these have the effect of signaling liver and muscles to release stored glycogen into the bloodstream for energy use which in turn raises blood sugar. In a normal person, the body then responds with a small shot of insulin to keep the blood sugars stable. In a type 2, blood sugars may rise for a short time and then drop if the excercise continues and insulin production kicks in to help the body use the glucose present.
In a type 1, (not enough insulin, remember), the body has no way to get that glucose converted from glycogen from the blood stream into the cells where they are needed and so blood sugars continue to rise unless insulin is injected, but too much insulin and your blood sugars will crash.
This is why, especially in a type 1, it is very important to know what your blood sugar was before you started excercising and what it is doing while you are exercising and it can be quite tricky to balance correctly (neither too high nor too low).

[Samasnier]

Ah, thank you! :)

[ALEKA]

I sure wish she would read Dr. Bernsteins book. In his own story he tells how the wonderful ADA diet almost killed him. Doesn't make sense for a person whose body doesn't tolerate sugar to be told to eat sugar-in any form--potatoes or fruit-At least not to me anyway. But then what do I know?? :lol: :lol:

[rottnhombr]

It's my understanding that the onset of type I need not happen in childhood. It's nicknamed juvenile diabetes because MOST type I diabetics get it under age 20, but it CAN (and does) onset as late as mid-30s. That's when my brother got it.

[rissa]

About 5 years ago, my great uncle was diagnosed with type 1 diabetes - at age 65. My neighbor just a week ago, at age 40- both of them found out they were diabetic when they out of the blue lost their sight with no explanation. A trip to the ER and a whole bloodwork showed diabetes. Both had no signs of diabetes in the past - and had regular medical checkups. It can happen at any time to anyone, really. Both of them have a history of it in their families. I am checked every 6 months for diabetes per my doctor's request. I don't mind one bit - if I never have to wake up blind, it'll be too soon.
My doctor was confused about ketosis/ketoacidosis - they sound so much alike, I was confused about them at first. We sat down with my internist who explained the difference, and how they are very, very different.

[Lisa N]

It's my understanding that the onset of type I need not happen in childhood. It's nicknamed juvenile diabetes because MOST type I diabetics get it under age 20, but it CAN (and does) onset as late as mid-30s. That's when my brother got it.

That's correct, rottnhombr. While the vast majority of type 1 diabetics become diabetics as children or teenagers, it is possible to become a type 1 diabetic at a later age. Conversely, even though type 2 diabetes was originally thought to be an age-related disorder reserved for those over 40 (and commonly referred to as "adult onset diabetes"), we are now seeing it increasingly in children under the age of 12. I think this is, in part at least, one of the reasons that type 1 diabetics who develop it at an older age are frequently misdiagnosed at first as type 2. There are, however, specific antibody tests that can be done to determine with certainty if one is type 1 or type 2 even if you are insulin dependent as a type 2.

[NWatson]

Okay, I'm not questioning the difference between Type one or Type two diabetes, or the difference between ketosis and ketoacidosis....

I'm just curious about something...

With my second pregnancy (my son is now 8 months) I developed Gestational Diabetes (Diabetes also runs in my dads side of the family). The nutritionist I saw had me on a diet of 12 to 15 servings of carbs a day, including bread, bananas and milk... I could also eat pasta etc, but limited, of course. Neither that, nor exercise ever got it under control and I ended up having to take two types of insulin three times a day.

All through the end of my pregnancy, they'd raise the levels of insulin because it never brought it down to the levels they were aiming for.

What makes me wonder is, wasn't the amount of carbs a little high if that's what was causing the problem in the first place?

It really makes me wonder ... I followed their instructions and trusted what they said, although now, after reading so much about LCing, I wonder if the solution wouldn't have been to cut out some of the carbs. But, all through the whole thing, they kept stressing that I follow the diet the nutritionist layed out.

Nonnie

[Lisa N]

You're right on the money, Nonnie (love the name, BTW...we called my youngest that as a nickname until she was old enough to insist otherwise. ;) ).
Diabetes is by nature a problem with carbohydrate metabolism. It makes absolutely no sense to me to take a person who has difficulty with metabolising carbohydrates and insist that they eat primarily carbohydrates. It's equivalent to telling a person who is lactose intolerant to eat a diet that consists mainly of dairy products! :p
12-15 servings of carbs per day was more than "a little high". IMNSHO, that was insanely high and yes, you probably would have fared much better by eating more vegetables (dark green ones, preferably), some low GI fruits such as melons and berries, maybe one or two servings of whole grains, some dairy such as full-fat plain yogurt and cheese, and making up the rest of your caloric needs from fat and protein.

[NWatson]

And these are licensed Diabetic educators and nutritionists that had me on this diet. I didn't understand the whole metabolism and carb mess then, but I'll tell you one thing...if and when I have more children, IF I develop it again (which, God willing, I'll lose the weight first and won't) I'll sure as heck just nod and say yeah, yeah, but then follow my own diet!!! Jeez!!!

It's amazing to me how things could be so screwed up and how licensed professionals are missing these connections!

Thanks for confirming that for me, Lisa!

Nonnie

P.S.-Yeah, I tried the whole 'insisting' thing too, but since it's my real name, I didn't get very far! LOL! :D

[lazysailor]

I'd also like to issue a challenge. Find me a study that shows that dietary ketosis will lead to ketoacidosis in the absence of elevated blood sugars, prolonged starvation or alcoholism (the 3 known causes of ketoacidosis).
Opinons and definitions are all well and good, but you have yet to show that the metabolic processes of diabetic ketoacidosis and benign dietary ketosis are one and the same. In fact, they are not the same at all because there are significant biochemical processes that are present with diabetic ketoacidosis that are not present with benign dietary ketosis (that's why its called benign!).

That's not a sporting challenge. There is no chance for the other side to win!

[brandieb]

haha! you need to read up a bit. it's not at ll dangerous

[Kagior]

But, all through the whole thing, they kept stressing that I follow the diet the nutritionist layed out.

Nonnie

I bet they thought you were cheating because the diet could not possibly be at fault. They had you eating very healthy foods, no junk foods, low sodium and low fat I assume, so in ther minds, the fault must have been coming from you because you must have been cheating.

Someday, I hope soon, health professionals will begin to understand that what is good for one person may not be good for another. If you have insulin tolerance issues, of course you need to be eating fewer carbs. Or, if not fewer, then different ones, like subbing berries for bananas. I was so glad to discover that my weight was actually a genetic problem that could be controlled by what I ate! I liken it to the same feeling that people with bad eyesight have when they put on their glasses. Imagine how you could have felt through your pregnancy if they had recognized that you were honestly eating the diet they reccomended and they realized you needed fewer carbs.

Eyesight can be tested at a very early age now, and I hope that someday some form of nutritional testing will take hold so people will learn what they can and can't have. Of course, no one should ingest white powders except for very occasional instances.

[CindySue48]

With my second pregnancy (my son is now 8 months) I developed Gestational Diabetes (Diabetes also runs in my dads side of the family). The nutritionist I saw had me on a diet of 12 to 15 servings of carbs a day, including bread, bananas and milk... I could also eat pasta etc, but limited, of course. Neither that, nor exercise ever got it under control and I ended up having to take two types of insulin three times a day.

A woman I work with is pregnant. She's also hypoglycemic. Her doc put her on LC to regulate her BS, then she got pregnant.

Her baby doc doesn't want her to limit her carbs, so she's been instructed to have a "concentrated carb" snack if/when she gets hypoglycemic symptoms!

During her first pregnancy she "almost" had to go on insulin. But she went into premature labor. The baby was on the upper end of "normal" weight for full term....but was born 5 weeks early! Her sister (3yrs older), brother (1yr older) and mom are both diabetic.

Of course she's following doctor's orders! I'm not sure how much she's gained....but she looks like she's due any day, and is just going into her 5th month!

[CindySue48]

Oh yea....since there's a "good chance" she'll end up with gestational diabetes with this baby, and the potential damage to kidneys, the nutritionist told her to limit her protein intake.

Don't forget, she's already supposed to be limiting fat, so she's supposed to get pretty much all her calories from carbs!

Of course she's going to end up with diabetes.

[ninnin]

They did the same to me when I had gestational diabetes with my twins. I was standing over the sink crying and gagging trying to eat the amount of carbs they insisted I needed. The blood sugars went up the insulin doses went up and I was stressing out terribly wondering what I was doing wrong.

[MsDad]

I've read this entire thread with much interest. A lot of good info from folks who know because of their own personal experience. Thank you all for sharing! :clap: But has anyone else noticed (like me) that the author of the original post hasn't bothered to grace us with her presence again? I took a look at her private profile - almost no information...can we say troll?? (Thank you Captain Obvious!) Maybe btdude was actually on to something??

[Parrotxoxo]

My Doc, who happened to loose 80 pounds on Atkins, was the one who recommended I go on Atkins.

[notskinny]

Thought I'd share: :thup:

Ketogenic Diet
FEBRUARY 2006

A Modified Atkins Diet is Effective for the Treatment of Intractable Pediatric Epilepsy
Eric H. Kossoff, Jane R. McGrogan, Renee M. Bluml, Diana J. Pillas, James E. Rubenstein, and Eileen P. Vining

The ketogenic diet has been used since 1921 to treat intractable childhood epilepsy. Over the past 85 years, it has not changed significantly. A modified Atkins diet may similarly induce ketosis without an admission or fasting period, and does not restrict protein, fluids, and calories. In a follow-up to our case series from 2003, we report on the first prospective study of a modified Atkins diet. Children ages 3-18 years, with at least 3 seizures per week, who had been treated with at least two anticonvulsants, were enrolled and received the diet for the 6-month study period. Carbohydrates initially were limited to 10 grams per day. All children became ketotic within days. After 6 months, 13 (65%) had >50% improvement and 7 (35%) had >90% improvement. Sixteen (80%) completed the 6-month study; 14 chose to remain on the diet afterwards. Side effects were minimal and weight did not significantly decrease. In fact, children who had their heights and weights remain relatively stable had better seizure control. A modified Atkins diet appears to be an effective and well-tolerated therapy. Epilepsia 2006;47(2).

[emmy207]

Drink lots of water is as essential as eating your greens in this diet.

[rissa]

A woman I work with is pregnant. She's also hypoglycemic. Her doc put her on LC to regulate her BS, then she got pregnant.

Her baby doc doesn't want her to limit her carbs, so she's been instructed to have a "concentrated carb" snack if/when she gets hypoglycemic symptoms!

During her first pregnancy she "almost" had to go on insulin. But she went into premature labor. The baby was on the upper end of "normal" weight for full term....but was born 5 weeks early! Her sister (3yrs older), brother (1yr older) and mom are both diabetic.

Of course she's following doctor's orders! I'm not sure how much she's gained....but she looks like she's due any day, and is just going into her 5th month!

A lot of times an ob/gyn will suggest the "concentrated carb" snack for the health of the baby. A lot of times pregnant women will attribute symptoms of hypoglycemia to pregnancy and not catch their low blood sugar in time before causing serious harm to themselves or the baby. Typically symptoms are only going to be caused very rarely - due to the fact that she should be eating several low carb meals a day. The concentrated carb snack can shoot the blood sugar back up more rapidly. At least she didn't get taken off the lower carb diet alltogether - that I would seriously question. As someone who is hypoglycemic, I do understand when a doc says to eat something highly concentrated in carbs when its real bad.

[rissa]

ahh yes fat free, but is it cancer free....

nope - you pay to get the cancer :)

[rissa]

Hmmmm ... ketoacidosis is ketones in the presence of high blood sugars. Type I diabetics can have this happen if they don't get enough insulin.

Type II diabetics HAVE insulin - but their cells are resistant to it. I was on metformin myself for a while before I started low-carbing.

Type II diabetics generally can't get ketoacidosis, because they have insulin.

According to http://www.ehendrick.org/healthy/001526.htm :



A small number of people with type II diabetes also experience ketoacidosis, but this is rare given the fact that type II diabetics still produce some insulin naturally. When DKA occurs in type II patients, it is usually caused by a decrease in food intake and an increased insulin deficiency due to hyperglycemia.

So, if I'm reading this right, if you don't eat enough food, and your blood sugar goes up (say, from eating nothing but sweets) this can happen.

Not sure how ATKINS could be involved here, but I'm all ears if you have a good explanation.

My mother, a type II diabetic experienced a near death experience with ketoacidosis. Here's the thing that either someone who is a type II that has had this issue is either not telling you, or doesn't know because it wasn't presented to them by their doctor - Pancreatitis will cause this. This has nothing to do with low carb, has nothing to do with a diabetic living a low carb lifestyle - it has to do with all the CRAP that someone like my mother did to herself in the past coming back to haunt her. Does the pancreatitis which prevented her from producing insulin turn her into a type 1 diabetic? Nope. It makes her a type II with pancreatitis.

[Nancy LC]

Dr. Eades just wrote an article describing how Ketosis helps dejunk your cells: http://blog.proteinpower.com/drmike/archives/2006/02/in_going_throug.html

[Whoa182]

This is only one case and there are many people here who have probably been on low carb for a long time and not experienced this, so low carb does seem safe.. but I would really like to see the paper below:

Does anyone have access to this...

Ketoacidosis during a Low-Carbohydrate Diet

http://content.nejm.org/cgi/content/short/354/1/97

it is believed that low-carbohydrate diets work best in reducing weight when producing ketosis.1 We report on a 51-year-old white woman who does not have diabetes but had ketoacidosis while consuming a "no-carbohydrate" diet. There was no family history of diabetes, and she was not currently taking any medications. While adhering to a regimen of carbohydrate restriction, she reached a stable weight of 59.1 kg, a decrease from 72.7 kg. After several months of stable weight, she was admitted to the hospital four times with vomiting but without abdominal pain. On each occasion, she reported no . . .

[doreen T]

This is only one case and there are many people here who have probably been on low carb for a long time and not experienced this, so low carb does seem safe.. but I would really like to see the paper below:

Does anyone have access to this....
It appears to be a letter to the Editor, not a study or research paper. Of course, the author's name doesn't appear with the extract .. I'm curious who that was.


Doreen

[Lisa N]

My mother, a type II diabetic experienced a near death experience with ketoacidosis.

Rissa makes a good point. While it's uncommon for a type 2 diabetic to find themselves in that position, it's possible for a type 2 to develop diabetic ketoacidosis. They would need to be pretty out of control for that to happen, though. :p I do need to stress that ketoacidosis still has nothing whatsoever to do with the type of ketosis that occurs with low carb eating.

A lot of times an ob/gyn will suggest the "concentrated carb" snack for the health of the baby. A lot of times pregnant women will attribute symptoms of hypoglycemia to pregnancy and not catch their low blood sugar in time before causing serious harm to themselves or the baby.

Speaking as a type 2 who has successfully navigated three pregnancies, it's also important to not have your blood sugars bouncing all over the place and constantly running high because just as the baby is subjected to low blood sugars, they are also subjected to high and the resulting damage from that as well. Babies born to mothers who are diabetic and not well controlled are practically guaranteed to be welcomed into this world with a hypoglycemic attack within their first few hours because their insulin is set to what it needed to be at when they were sharing their mom's high blood sugar readings. I was very careful with all my pregnancies and kept my blood sugars as stable as possible but my youngest dd still had her blood sugar crash into the 30's within a few hours of birth requiring treatment. :p

[JandLsMom]

I am not an expert in biology, but I have read a great deal about the effects of insulin on the body. My own personal theory is that ketosis was meant to be the normal state of the body and that the carbohydrate/insulin system is a backup system, only intended for difficult periods when humans were unable to obtain sufficient protein and fat and were forced to eat larger quantities of carbohydrates instead. Why else would eating carbohydrates cause us to store fat while consuming mainly protein and fat allows us to burn fat and stay lean?

And to me the very fact that years of eating way too many carbohydrates and continually flooding our bodies with insulin lessens our sensitivity to insulin and eventually causes the disease of Type 2 diabetes strongly indicates that this is not the normal state of the human body. It may be going too far to say that continuous high levels of insulin act as a slow acting toxin on the body, but I'm not sure.

Just MHO

Karla

what your saying really makes alot of sense! This whole ketosis thing is something we never even thought about till going LC. Dr. Atkins explained ketosis to try to make people understand that it was safe to eat high fat and protein rather than the low fat that had been espoused to our country for 20 yrs.

[JandLsMom]

If you go back about 200,000 years, my guess is that ketosis was man's natural state.

which brings me to a question! Woman got pregnant back then and had babies! They obviously were in ketosis while pregnant. So why do even LC follwers make such a big deal about getting OUT of ketosis while pregnant?

[ojoj]

which brings me to a question! Woman got pregnant back then and had babies! They obviously were in ketosis while pregnant. So why do even LC follwers make such a big deal about getting OUT of ketosis while pregnant?

an over protective legal "get out" clause!

[Bandito]

Most women do in fact reach ketosis while pregnant. They can't keep anything down due to morning sickness, and the body burns ketones as a rusult. This often lasts for 12 weeks during the time that the baby undegoes the most cellular differentiation, the same time the baby is most suseptable to environmental influences. The concern here is not that mom is in ketosis, it is that her body is being depleted in order to support the baby. Provided that mom is being adaquetly nourished, I dont see what detrimental effects ketosis would have on pregnancy. If there was, wouldn't it show up in these critical weeks?

[ReginaW]

which brings me to a question! Woman got pregnant back then and had babies! They obviously were in ketosis while pregnant. So why do even LC follwers make such a big deal about getting OUT of ketosis while pregnant?

Questionable - almost every living traditional society today has specific "dietary specials" they feed newly married women in their tribes - those trying to get pregnant - and that continues when they are pregnant and lactating. The foods offered to these women - high carb foods - honey, roots, sweets made from fruits and honey, etc. Nope, they're not feeding them grains since most of these societies don't eat them, but they do practice a "dietary intervention" that interestingly provides a higher level of carbohydrate in the diet to women. I'm pressed for time - but did some extensive research when I was pregnant and I'll post more later on the subject!

[ReginaW]

Most women do in fact reach ketosis while pregnant. They can't keep anything down due to morning sickness, and the body burns ketones as a rusult. This often lasts for 12 weeks during the time that the baby undegoes the most cellular differentiation, the same time the baby is most suseptable to environmental influences.

I'm not sure who told you that early in pregnancy *most* women are in ketosis because of morning sickness, or any other reason, but it's simply not true - even if they're controlling carbohydrate as long as they're eating about 72g of carbs a day (net minus fiber) or more. Pregnancy does indeed induce ketosis late in pregnancy - it's simply not an issue for the vast majority in the first trimester or well into the second.

Whether ketosis - and let's be clear here, I'm talking continuous ketosis, not the very normal tettering ketosis that almost all pregnant women will experience later in their pregnancy - is harmful to human pregnancy is unknown.

Animal models are clear - continuous ketosis is harmful to an embryo, a fetus and a breastfed baby animal receiving milk from its mother in ketosis. The list of "unfavorable outcomes" range from birth defects to failure to grow properly in utero, from liver problems to lower milk production and poor energy utilization, from inadequate nutrient supply to low bone density in the baby animal, from higher rates of spontaneous abortion (miscarriage) to pre-term labor resulting in low birth weight animals.

These are serious issues and if the animal model even begins to touch on the risks to a human pregnancy, it's clear that one does not want to be in continuous ketosis while trying to get pregnant, when pregnant or when lactating....it's too risky given the large amount of data known in the animal model.

On the other hand, ketosis - that is tettering in and out of ketosis - while pregnant does not appear to be a negative, is part-and-parcel to the later part of pregnancy, and in fact, during labor most likely is important for the mother to have the energy to go through labor and delivery when eating becomes a real challenge (most doctors won't let you eat anyway, but even if you try to eat, odds are you're just going to throw it up).

When DH and I were TTC, I was already eating "controlled-carb" since I'd been maintaining my weight loss for more two years at the time - so I wasn't at risk for continuous ketosis since I was above the usual 60g net threshold for continuous ketosis.

When I did get pregnant, my OB gave his blessing to continue eating controlled-carb, warned I'd gain more weight than an "average" pregnancy even with controlling carbs (which I did) and only made me promise not to dip below 70g of carbs each day (net minus fiber) through my first two trimesters and increase to at least 100g of carbs (net minus fiber) in the last trimester IF I was in ketosis more than not - I wasn't, but I wound up eating more carbs anyway - averaged probably 125g a day (net minus fiber).

Provided that mom is being adaquetly nourished, I dont see what detrimental effects ketosis would have on pregnancy. If there was, wouldn't it show up in these critical weeks?

If it did show up it would be a miscarriage and there simply isn't data to support the assumption that continuous ketosis doesn't factor into the picture or is harmless. What the data does show is that ketosis inhibits appetite, resulting in eating less calories - pregnancy requires more calories and if you're having a hard time getting them in at a level to maintain weight, wouldn't you think it would be more difficult to increase calories to support a pregnancy too?

Add to that, low-carb diets are often inadequate for critical essential nutrients. Sure you can pop a multivitamin, but no one is going to argue that food is your best source for essential nutrients since food also is packed with the co-factors and a spectrum of nutrients that complement each other together rather than in isolation. Unless you're really careful and know how to plan to meet pregnancy requirements with your diet, you're going to be robbing your body and the growing fetus of nutrients you need.

Then there's the issue of glucose requirements for the fetus - if you're not eating enough carbohydrate to support the glucose requirement of the baby, you're going to be making it with gluconeogenesis from protein. Considering our finite capacity for eating protein, you're taking a risk here since if you simply "hit the protein wall" before you eat enough protein for GNG, you're going to cannibalize your muscle to make glucose for the baby - no way around it.

There's also the issue of ketones passing to the baby for energy utilization - from animal models it does not appear that the developing fetus can use the maternal ketones for energy and the data shows they build up in the developing fetus liver, leading to malformations of the liver and/or jaundice at birth. Is that a risk you'd want to take? I don't think so...

Given the potential risks - I totally agree with the recommendation most OB's (who are open to or advocate controlled-carb) make to increase carbs to a certain level to avoid continuous ketosis...we simply don't have any data to suggest it's harmless in pregnancy from day one. Increasing carbs up to a level to avoid continuous ketosis isn't license to eat whatever - just make good choices and include some foods that are higher in carbs but still nutrient-dense, like sweet potatoes or legumes.

[Nancy LC]

How do women in the Innuit and Masai cultures manage?

[ReginaW]

How do women in the Innuit and Masai cultures manage?

The Innuit actually have a few birth defects that are higher than expected or seen in other populations - congenital heart malformations - specifically ventrical septal defects (VSDs), and atrial septal defects (ASDs), long QT syndrome and primary biliary cirrhosis. They also tend to be much shorter in stature than other populations - but I don't personally consider that a "problem," ya know?

The Masai are notorious for gorging on honey when they come upon it and they're one of the societies that have a tradition in marriage where the woman is fed honey and cornmeal cakes to increase her chance to get pregnant in the marriage....she continues to be fed these foods when she's pregnant - and the tribe ensures it has these foods by preserving the honey and cornmeal in gourds throughout the year!

[Nancy LC]

Interesting! Thanks Regina.

I always thought the short stature of the Innuit was probably a good thing for conserving heat.

[Michelle H]

With regards to the "morning" sickness thing, I found the best foods for settling my stomach were high in fat and protein! Yummy. But something like a muffin would make me feel so sick I cannot even contemplate eating one now, 6 years later.

[ReginaW]

Interesting! Thanks Regina.

I always thought the short stature of the Innuit was probably a good thing for conserving heat.

I think their stature is just genetic - much like Asians are built differently than Europeans, so too the Inuit are built the way they are and there is probably a reason - like, as you say, perhaps conserving heat in their environment!

I want to add to the post I made last night - that in the various societies that do have some type of "diet intervention" for women when they're pregnant, the foods added don't make their diet "high carb" - it's an increase in carbohydrate but overall the diet remains very nutrient-dense with protein and fat sources still the mainstay, ya know?

There's also something interesting in the foods that are often added - and it's related to the metabolic effect of eating more carbohydrate - they increase appetite, so the pregnant woman is able to eat more calories than when she's eating mostly protein and fat. I think that's the underlying reason various traditional societies have adopted adding "sweets" and carbohydrate-rich foods into the diets of women trying to get pregnant and/or pregnant/lactating - it enables an increase in calorie consumption which helps support the pregnancy or lactation, probably to a greater degree than the additional nutrients or availability of glucose to cross the placenta play.

The thing I find so fascinating is that somehow they - the society - know that eating such a diet continuously, through all stages of their lives, isn't "healthy" for them - their "normal" diet is much richer with fats and proteins with only an occassional indulgence with food like honey for the majority of their lives, and they only adjust their diet for specific reasons, like pregnancy...and then return to their normal dietary pattern once the period of change is complete, like when a mother has weaned her child.

[Nancy LC]

I just found an interesting paper about the Masai, with a little about their pregnancy practices: http://eprints.lse.ac.uk/archive/00000264/01/Maasai_Demography_PhD.pdf
Page 109

Unfortunately I can't copy/paste the PDF text but it talks about how they reduce their caloric intake drastically in the last trimester.

[ReginaW]

I just found an interesting paper about the Masai, with a little about their pregnancy practices: http://eprints.lse.ac.uk/archive/00000264/01/Maasai_Demography_PhD.pdf
Page 109

Unfortunately I can't copy/paste the PDF text but it talks about how they reduce their caloric intake drastically in the last trimester.

What an incredible find! Thank you for posting the link to it - wow, I have some reading to do!!!! :D

[TheCaveman]

How do women in the Innuit and Masai cultures manage?

Or for that matter, how did every single human mother, until a few thousand years ago, manage?

[ItsTheWooo]

Whether ketosis - and let's be clear here, I'm talking continuous ketosis, not the very normal tettering ketosis that almost all pregnant women will experience later in their pregnancy - is harmful to human pregnancy is unknown.

Ketosis is often associated with starvation or under eating.
Are you sure it is ketosis that is harmful to an embryo, and not necessarily energy restriction?


If it did show up it would be a miscarriage and there simply isn't data to support the assumption that continuous ketosis doesn't factor into the picture or is harmless. What the data does show is that ketosis inhibits appetite, resulting in eating less calories - pregnancy requires more calories and if you're having a hard time getting them in at a level to maintain weight, wouldn't you think it would be more difficult to increase calories to support a pregnancy too?

Good point. Although, I think the appetite reduction from ketosis goes away when you are acclimated to them. So it's probably not a good idea to start a ketogenic diet in pregnancy since you will experience unnaturally high suppression of appetite.

For me ketosis has a much weaker appetite suppressant effect on my body than it used to. Being in deeper ketosis (example: I ate 30 carbs today being very active) is not that much different than how I feel when eating more carbs. The main differences is that hunger is perceived a little less vividly and usually comes with nausea. But, I still do know very well when I'm hungry. Appetite only gets really abnormal if I eat too many, at which I become unbalanced and excessively hungry; the more I eat the hungrier I get.

Of course I am also relatively low weight so my lack of high body fat might have something to do with why ketosis no longer suppresses my appetite (my body wants me to gain weight?) If ketosis appetite suppression ebbs and flows with body fat stores, then, I don't see the danger here either as overfat people ideally should eat less to lose weight, and underfat people should eat and gain, right?

Add to that, low-carb diets are often inadequate for critical essential nutrients. Sure you can pop a multivitamin, but no one is going to argue that food is your best source for essential nutrients since food also is packed with the co-factors and a spectrum of nutrients that complement each other together rather than in isolation. Unless you're really careful and know how to plan to meet pregnancy requirements with your diet, you're going to be robbing your body and the growing fetus of nutrients you need.

I think LC diets are only inadequate if you're under eating. LC food is more calorically dense so it is harder to get the nutrients, but, if you eat generously that problem is mitigated. I eat a lot of bones and I think it's probably a much better source of minerals than all that dairy we are told to eat ;).


Given the potential risks - I totally agree with the recommendation most OB's (who are open to or advocate controlled-carb) make to increase carbs to a certain level to avoid continuous ketosis...we simply don't have any data to suggest it's harmless in pregnancy from day one. Increasing carbs up to a level to avoid continuous ketosis isn't license to eat whatever - just make good choices and include some foods that are higher in carbs but still nutrient-dense, like sweet potatoes or legumes.
I agree it's probably better to be safe than sorry. I am suspicious though that the evidence against ketosis in pregnancy is as firm as you say it is.

[ysabella]

Thing is, they don't test theories out on pregnant women; it's not acceptable in our society. Nobody is going to run a clinical trial and have a bunch of pregnant women eat extremely low carb just to see what happens to the fetuses. So the animal models are all we have to go on for evidence.

I couldn't get that Masai link to work, but I searched on Google and matched the Google text sample to this link here (http://www.iussp.org/Brazil2001/s50/S50_03_Coast.pdf). I can copy and paste the relevant bit:
Historical reports of Maasai early age mortality all stated or implied extremely high levels, often attributed to practices considered to be abhorrent by the Europeans. Merker reported that child mortality among the Maasai in German East Africa was high, “I was often struck by the small number of unweaned infants (i.e.: under two years) and older children. Thus at the beginning of 1902, I found…in an establishment containing about fifty women, only twelve children, of whom three were unweaned. According to the parents, very many children had died” (1910:274).

The 1921 Masai Annual Report noted that “the infant mortality is appalling”, a theme echoed by the 1930-1 Medical Survey of Maasai Province. It suggested:

“a child mortality approaching 500 per 1,000 does not leave a margin for increase but on the contrary is bringing about a steady decrease...A Maa custom gives the child a very bad start in life. During the last three months of pregnancy all Masai women have to go on a starvation diet. Their bad start while yet in utero must be a terrible handicap when at birth they have to contend with gastric disorders from highly unsuitable food, diseases imbibed from fly-polluted milk and lack of sufficient sunlight. Lack of cleanliness brings in its train scabies, sores and infections to the skin. Thus attacked, internally and externally, the wonder is that any of them survive” (1931:42)10.

[jennlee]

The Innuit actually have a few birth defects that are higher than expected or seen in other populations - congenital heart malformations - specifically ventrical septal defects (VSDs), and atrial septal defects (ASDs), long QT syndrome and primary biliary cirrhosis. They also tend to be much shorter in stature than other populations - but I don't personally consider that a "problem," ya know?

The defects are probably do to increasing PCB contamination of their food supply. I suspect this has been a problem for a long time and we are just seeing the results.

http://www.chem.unep.ch/pops/POPs_Inc/press_releases/ottawa-1.htm

http://www.ourplanet.com/imgversn/124/watt.html

[ReginaW]

Or for that matter, how did every single human mother, until a few thousand years ago, manage?

I'd say we don't know - we know the pressures of natural selection have resulted in (micro) adaptions, in that when a variable was unfavorable, genetic adaptions occur over generations...for example, we have multiple redundancies to ensure stable blood sugar levels (specifically to raise blood sugar) and only one to lower blood sugars, thus we can consider low blood sugar was the risk/threat to survival across the species - high blood sugars were not, ergo high intake of food that produced persistent elevated blood sugars was not a threat, but ability to find enough to keep blood sugars normalized was...the result - redundancy to protect the survival of the species with internal mechanisms/pathways to boost blood sugars as necessary - most notable, gluconeogenesis (GNG).

What we don't know is if long-term selection outcomes favored those able to find and eat more carbohydrate or protein sources with higher glucose conversion or not - the redundancy in our metabolism to maintain blood sugar would suggest that failure to consume food to maintain blood sugars was taken care of metabolically with GNG and other metabolic pathways....what we can't say is whether these were favorable or unfavorable during pregnancy - we simply can't determine if the result in the long-term process of adaption was to kill the line over generations in those that repeatedly had to utilize the metabolic pathways to sustain stable blood sugars or those that had reliable food sources to maintain blood sugars. I wish we knew!

[ReginaW]

Ketosis is often associated with starvation or under eating.

Very true!


Are you sure it is ketosis that is harmful to an embryo, and not necessarily energy restriction?

Well, experiments have been conducted in animals where calorie intake is such that they're not energy deficient but ketosis is present, other studies have infused beta-hydroxybutyrate to raise levels and others have adjusted macronutrients in diet to induce ketosis.

From human studies - we have both a starvation model (anorexia/bulemia and/or purposeful calorie restriction diet) related to ketosis in pregnancy -and- also studies where ketosis as part of gestational and/or type 1 or 2 diabetes.

I've yet to find a study inducing ketosis or infusing beta-hydroxybutyrate in healthy pregnant women to see what happens - I think that's because ethically we shouldn't - the findings from animal models and the anorexic/bulemic/dieting groups and the diabetic groups serves to provide understanding of the potential danger of hyperketonemia in pregnancy.

Let's set aside the energy deficient models - they're too confounded with other variables like nutrient-deficiency...the literature is still rich with data from studies in humans and animals where calories weren't at issue....I'll start with the human data and add the last one is energy restricted...

In a comparison study - the children of 'true' diabetics, gestational diabetics, and normoglycemic women were given mental development and intelligence tests at ages 2, 3, 4, and 5. Even after correcting for possible confounding factors like socioeconomic status, etc. their scores correlated inversely with third-trimester levels of ketones:

NEJM - Correlations between antepartum maternal metabolism and child intelligence
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1881416&query_hl=48&itool=pubmed_docsum

After correction for socioeconomic status, race or ethnic origin, and patient group, the children's mental-development-index scores at the age of two years correlated inversely with the mothers' third-trimester plasma beta-hydroxybutyrate levels (r = -0.21, P less than 0.01); the average Stanford-Binet scores correlated inversely with third-trimester plasma beta-hydroxybutyrate (r = -0.20, P less than 0.02) and free fatty acid (r = -0.27, P less than 0.002) levels. No other correlations were significant.

American Journal of Obestrics & Gynecology - Prenatal and perinatal influences on long-term psychomotor development in offspring of diabetic mothers
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8610757&query_hl=51&itool=pubmed_docsum

Children's average score on the Bruininks-Oseretsky test at ages 6 to 9 years correlated significantly with maternal second (p < 0.02) and third trimester (p < 0.001) beta-hydroxybutyrate. There was also a borderline association between the children's scores on the psychomotor development index at age 2 years and maternal third-trimester beta-hydroxybutyrate levels (p = 0.06). No other correlations approached significance.

Diabetes - Long-term prospective evaluation of offspring of diabetic mothers
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1748240&query_hl=51&itool=pubmed_docsum

We found an inverse correlation between childhood IQ and second- and third-trimester maternal lipid metabolism (serum free fatty acids and beta-hydroxybutyrate). This correlation is not explained by adverse perinatal events, socioeconomic status, maternal IQ, ethnicity, or diabetes type. These long-range associations between altered maternal metabolism and childhood growth and development continue to support Freinkel's hypothesis of fuel-mediated teratogenesis.

Israel Journal of Medical Science - Embryotoxic effects of diabetes on pre-implantation embryos
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1960045&query_hl=72&itool=pubmed_DocSum

A high correlation was found between the number of undeveloped embryos and the blood concentrations of metabolic diabetic factors: glucose (in type I diabetes), beta-hydroxybutyrate (in type II diabetes untreated or treated with Daonil), acetoacetate (in insulin-treated type II diabetes), and HbA1c (in both insulin-treated and in Daonil-treated type II diabetes).

Hormone & Metabolic Research - Maternal, amniotic fluid and cord blood metabolic profile in normal pregnant and gestational diabetics during recurrent withholding of food
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2583675&query_hl=72&itool=pubmed_DocSum


Positive correlation was found between the levels of BOHB in the mother and venous cord plasma on the one hand and their levels in the arterial cord plasma and liquor amnii on the other hand implying that this substrate passes unutilized through the fetus to the liquor amnii.

The data from animal studies digs a bit deeper since animal experiments often give us data we can't get with humans due to ethical considerations in designing studies:

Development of rat embryos in culture media containing different concentrations of normal and diabetic rat serum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1462252&query_hl=72&itool=pubmed_DocSum

When the embryonic growth and development were compared at 50% and 80% serum concentrations, increased D-glucose or beta-hydroxybutyrate concentrations caused similar degrees of embryonic dysmorphogenesis. Also, the uptake of each compound by the embryos exposed to elevated levels of the two agents were similar in 50% and 80% serum cultures. There was, therefore, no protection against the teratogenic and growth-retarding effects of increased D-glucose or beta-hydroxybutyrate offered by high serum concentrations in the culture medium (i.e., 80% vs. 50%). Embryos cultured in 50% or 80% diabetic rat serum at 30 mmol/L or 50 mmol/L D-glucose concentration showed similar rates of somatic malformations as did embryos exposed to the same proportion of normal rat serum at similar glucose concentrations.

Morphological and physiological effects of beta-hydroxybutyrate on rat embryos grown in vitro at different stages

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2595599&query_hl=72&itool=pubmed_DocSum

The results of experiments in which embryos were cultured with beta-hydroxybutyrate from 9.5 days of gestation for 24 h (equivalent to 9.5 to 10.5 days of gestation) showed that some effects of beta-hydroxybutyrate are already apparent after 24 hours in culture. Many of the abnormalities produced by beta-hydroxybutyrate can be classified as embryonic retardations rather than malformations--that is, embryos show features characteristic of normal, but younger, embryos. Embryos exposed to beta-hydroxybutyrate for the complete 48 h culture period consume less glucose and produce less lactate than control embryos on a per embryo basis, but not on a per microgram protein basis, suggesting that the reduced metabolism is an effect of beta-hydroxybutyrate-induced developmental delay rather than a cause of it.

Evidence for multifactorial origin of diabetes-induced embryopathies

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2909414&query_hl=72&itool=pubmed_DocSum

The results demonstrate that glucose and D-beta-hydroxybutyrate can act synergistically to produce growth retardation and additively to induce malformations. The addition of the somatomedin inhibitor exacerbates the induction of malformations produced by the ketone body and glucose.

Effect of maternal hyperketonemia in hyperglycemic pregnant ewes and their fetuses

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3946526&query_hl=72&itool=pubmed_DocSum

The fetus of the pregnant diabetic woman is exposed to hyperglycemia frequently accompanied by ketoacidosis. Previous studies have demonstrated that beta-hydroxybutyrate, a major ketone body, crosses the ovine placenta in significant amounts, leading to significant reductions in fetal PaO2 and increased fetal heart rate. In the present study the pregnant ewe was used to evaluate the maternal and fetal cardiovascular and metabolic responses to hyperketonemia in the presence of hyperglycemia and to determine if the combined diabetic insults were more detrimental to the fetus than hyperketonemia alone. A glucose priming dose of 25 gm was administered in the maternal femoral vein followed by a continuous glucose infusion of 200 mg/min to achieve steady maternal plasma glucose levels of 180 mg/dl. Once glucose levels were stable, beta-hydroxybutyrate was infused for 2 hours at a rate of 0.39 mmol/100 ml of uterine blood flow into both left and right uterine arteries. Infusion of glucose alone did not significantly alter fetal cardiovascular and blood gas parameters but did increase the fetal glucose level from 17 +/- 4 to 58 +/- 8 mg/dl. The simultaneous infusion of beta-hydroxybutyrate and glucose produced significant decreases in fetal PaO2 and oxygen content as were reported for hyperketonemia alone and significant time-related increases in fetal lactate levels and fetal heart rate. These data suggest that hyperketonemia in the pregnant ewe leads to quantitatively similar changes in oxygenation in both normoglycemic and hyperglycemic fetuses.

Effects of beta-hydroxybutyrate on rat embryos grown in culture

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3918883&query_hl=72&itool=pubmed_DocSum

the presence of beta-hydroxybutyrate, one of the ketone bodies produced by diabetics. At 10 mM, beta-hydroxybutyrate produced minor abnormalities and at 20 mM it produced major abnormalities in rat embryos.


Effects of hyperglycemia and ketone bodies on the in vitro development of early somite rate embryos

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3449815&query_hl=101&itool=pubmed_docsum

Ketone bodies (acetoacetate and beta-hydroxybutyrate, B-HOB) were individually added to normal or to hyperglycemic sera (total glucose concentrations of 3 mg/ml) in the following concentrations: acetoacetate--5, 10, 20, and 40 micrograms/ml; B-HOB--2, 5, and 8 mg/ml. The higher concentrations of each of the substances induced growth retardation and abnormalities.


Metabolic alteration in neural tissue of rat embryos exposed to beta-hydroxybutyrate during organogenesis

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9450500&query_hl=101&itool=pubmed_docsum

Hyperketonemia has been identified as an important factor in diabetic pregnancy affecting growth and development of the offspring. In order to assess the immediate metabolic alterations in embryos caused by excess ketone bodies, we studied rat embryonic neural tissue exposed to a high concentration of beta-hydroxybutyrate in vitro. Beta-hydroxybutyrate inhibited oxygen uptake of the neural tissue of day 9 and day 10 embryos by 12.8% and 1 1.2%, but did not affect that of day 11 and day 12 tissue. In contrast, glucose utilization of the neural tissue of day 9 and day 10 embryos was not altered. However, a 30% decrease in glucose utilization was observed in the neural tissue of day 11 and day 12 embryos exposed to beta-hydroxybutyrate. Thus, beta-hydroxybutyrate induced different metabolic alterations in the embryonic neural tissue during early and late organogenesis, which suggests different modes of teratogenic action of ketone bodies in different parts of gestation.

Altered mitochondrial morphology of rat embryos in diabetic pregnancy

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7710141&query_hl=101&itool=pubmed_docsum

Ultrastructural analysis of day-9 embryos cultured for 48 hours in the presence of high concentrations of D-glucose, pyruvate, beta-hydroxybutyrate, and alpha-ketoisocaproate also showed high-amplitude mitochondrial swelling in the neuroepithelium. The mitochondrial swelling was, however, not found in embryos cultured in a high concentration of L-glucose, excluding simple osmotic effects of the diabetes-related substrates and metabolites. CONCLUSIONS: The mitochondrial morphological changes appeared in embryos subjected to a diabetic environment during a time period when the congenital malformations in diabetic pregnancy are induced. The results support the notion that embryonic mitochondria are involved in the teratological process of diabetic pregnancy.

Effects of maternal diabetes on early embryogenesis. Alterations in morphogenesis produced by the ketone body, B-hydroxybutyrate

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6862109&query_hl=101&itool=pubmed_docsum

Ultrastructurally, these "vacuoles" proved to be mitochondria that had undergone high-amplitude swelling with a loss of matrix density and few identifiable cristae. No other consistent ultrastructural changes were noted, and the mitochondria of control tissues displayed a typical orthodox configuration. While this study does not conclusively limit the effects to the D-form of B-OHB, possible relationships exist between the ultrastructural alterations, ketone body metabolism, and abnormal morphogenesis.


Effect of lactate and beta-hydroxybutyrate infusions on brain metabolism in the fetal sheep

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2100739&query_hl=132&itool=pubmed_docsum

during both types of infusion, the brain arterio-venous difference for glucose decreased 30% (P less than 0.05). Since the brain arterio-venous difference for oxygen was unchanged, and blood flow to the cerebral hemispheres (measured in 11 studies) was also unchanged, the infusions appeared to cause a true decrease in brain glucose uptake. This decrease paralleled the rise in lactate concentration during lactate infusions, and the rise in lactate and butyrate concentrations during the butyrate infusions. Both substrates have metabolic actions that may inhibit brain glucose uptake. We speculate that the deleterious effects of high lactate and ketone states in the perinatal period may in part be due to inhibition of brain glucose uptake.

Effects of hyperketonemia on mouse embryonic and fetal glucose metabolism in vitro

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3992491&query_hl=132&itool=pubmed_DocSum

The ketone body beta-hydroxybutyrate (B-OHB) has been shown to be teratogenic to early-somite mouse embryos, although the mechanism responsible for these defects has not been determined. In an attempt to define this mechanism, the present study investigated the normal pattern of both glucose and B-OHB utilization in the developing embryo and fetus. Furthermore, the metabolic interaction of these two substrates, i.e., the potential for B-OHB to inhibit glycolysis, was studied. All studies compared early and late embryonic periods of development as well as fetal stages. The results show that the early embryo relies almost exclusively on glycolysis for energy metabolism and suggests that there is an increasing importance of the Krebs cycle with increasing gestational age. Similarly, the early embryo has a low capacity to metabolize B-OHB, whereas later gestational stages display a greater rate of utilization. Finally, there appears to be no inhibition of glycolysis by B-OHB (via so-called "substrate interactions") during early embryonic stages. However, the compound significantly inhibits glycolysis during later embryonic and fetal stages. These studies suggest that the teratogenicity of B-OHB in the early embryo is not due to its effects on modulating glycolysis, although this mechanism may be operating at later periods of gestation.

Fetal fuels. VII. Ketone bodies inhibit synthesis of purines in fetal rat brain

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6742185&query_hl=132&itool=pubmed_DocSum

Unlike the de novo pathway, the salvage pathway measured by incorporation of [8-14C]adenine into labeled nucleotides was not significantly inhibited even by supraphysiological levels of 3OHB (21.6 mM). Serial measurements of the de novo and salvage pathways in neonatal brain slices showed a maintenance of salvage activity during the first 2 wk but a progressive fall in activity of the de novo pathway. Thus ketone bodies could act to restrain the synthesis of purine nucleotide building blocks for new cell formation in fetal but not in neonatal rat brain.

Fetal fuels. V. Ketone bodies inhibit pyrimidine biosynthesis in fetal rat brain

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=6180645&query_hl=149&itool=pubmed_docsum

Ketonemic states complicating late pregnancy are accompanied by lower brain weights in the newborn. Potential mechanisms whereby ketone bodies might inhibit cell proliferation were therefore examined in the fetal rat brain slice by measuring their impact on the de novo pathway for pyrimidine biosynthesis. DL-beta-hydroxybutyrate (10.8 mM) and acetoacetate (5.4 mM) were both found to diminish the incorporation of NaH14CO3 into [14C]UMP by 30%. This effect was similar in fetal tissues from fed and 48-h starved mothers. Graded concentrations of DL-beta-hydroxybutyrate (1.4-43.2 mM) resulted in a progressive inhibition that could not be explained either by isotope dilution consequent to ketone body oxidation or by a generalized inhibition of protein synthesis. The inhibition was not reversed with 10 mM glutamine, the principal nitrogen substrate for de novo biosynthesis of pyrimidines. When the conversion of orotic acid into UMP was blocked with 6-azauridine, DL-beta-hydroxybutyrate (10.8 mM) inhibited the incorporation of NaH14CO3 into orotic acid by 28%. By contrast, maximally inhibitory concentrations of this ketone body (43.2 mM) had no effect on the incorporation of [6-14C]orotic acid into [14C]UMP. Is is concluded that ketone bodies inhibit the de novo biosynthesis of pyrimidines in fetal brain slices and that they do so at a site proximal to orotic acid formation.

I think LC diets are only inadequate if you're under eating. LC food is more calorically dense so it is harder to get the nutrients, but, if you eat generously that problem is mitigated. I eat a lot of bones and I think it's probably a much better source of minerals than all that dairy we are told to eat .


To date, I've probably evaluated over 5,000 low-carb menus - can you achieve a high nutrient intake with a low-carb menu? Absolutely! But - if you're not paying attention to critical essential nutrients specifically when planning a menu, I've found that menus are often deficient in one or more essential nutrients unless care is taken to specifically meet or exceed some nutrients. Problematic nutrients in low-carb diets often include: calcium, resolved with careful attention to leafy green; vitamin D, resolved with careful attention with eggs, butter, cream, fish or addition of cod liver oil - the last has its own problems though of overdose with vitamin A in pregnancy; omega-3's, resolved with careful attention to fish, alpine cheese, nuts, nut oils, seeds; potassium, resolved with careful attention with vegetables, mushrooms and lentils; selenium, resolved with careful attention to select vegetables, lamb, beef, fish and mushrooms.

I can continue, but basically I'm saying that when you're pregnant, if you're not paying attention, it's easy to miss some really critical nutrients if you're eaitng low-carb (less than 60g net) - it's just easier and requires less forethought to meet nutrient requirements with moderate carb levels.

I agree it's probably better to be safe than sorry. I am suspicious though that the evidence against ketosis in pregnancy is as firm as you say it is.

I posted some of the findings from a broad selection of the literature - it's certainly not an exhaustive list, but I think it speaks to the necessity of prudence about dietary extremes in pregnancy. To be clear - I think most know I am a strong advocate for low-carb and controlled-carb diets - I cannot, however, in good conscience say well, low-carb that induces continuous ketosis might be ok when you're pregnant...I'm much more comfortable with a more conservative perspective - that the data simply is not suggestive that ketosis is harmless and until it is shown, convincingly to be harmless, you're better off avoiding continuous ketosis - and doing that is relatively simply - just eat some more carbohydrate...not excessively high amounts, just enough to give more glucose availability from sources other than hepatic-GNG.

[TheCaveman]

....what we can't say is whether these were favorable or unfavorable during pregnancy -

Indeed, clinically, it's hard to know. The only thing we can say for certain is that the bodies of human mothers and babies EXPECT ketosis.

[ReginaW]

Indeed, clinically, it's hard to know. The only thing we can say for certain is that the bodies of human mothers and babies EXPECT ketosis.

Intermittent? Absolutely!

As a favorable influence in energy for labor and delivery? Absolutely!

As a favorable metabolic asset in short periods of food inavailability or while sleeping fast? Absolutely!

Continuous ketosis induced by dietary restriction of carbohydrate on purpose? Highly debatable with, IMHO, the evidence tipping toward prudence to avoid continuous ketosis and high levels of circulating ketones. I think you'd be hard-pressed to find an OB/GYN or RE who'd give a green-light to a ketosis inducing diet while TTC or while pregnant because there isn't any evidence to support that it's harmless, while on the other hand, there are reams of data to suggest potential negative effects, especially from high levels of circulating ketones.

And to be clear - I'm NOT advocating a high-carb diet as the remedy - just an increase of carbohydrate to a moderate level to reduce the risk of persistent ketosis and high levels of circulating ketones.

[sarar]

I'm not going to get into the baby thing. I almost didn't even read this thread 'cause of the predominating ignorance about ketosis vs. DKA. I get stuck having to listen to this from time to time. I've been a Type 1 diabetic for 25 years. I do not produce insulin. I have been in DKA two times. Horrible experience. I was NOT doing low carb at that time. The first time I had a stomach virus and the vomiting and dehydration threw me into it. It didn't help that I had spent the day before in the south Alabama sun helping my kids with Field Day. The second time was due to an insulin pump malfunction. I am on a very fast acting insulin and did not realize that I was getting no true delivery while I slept.

My symptoms of DKA were rapid-- irratic heartbeat. Shallow, difficult breathing, horrific nausea, projectile vomiting, debilitating dehydration. It can be fatal. Sound graphic enough for ya?

Ketosis is not like that. I have no similar symptoms. I don't even get nausea. My endocrinologist is fully aware and supportive of my low-carb plan. In fact, he agrees with me that this is probably the only way I could get the weight off--and reap the health benefits of this loss.

There is a lot of confusion about diabetes....especially Type 1. Most people do not understand that it is an autoimmune casued disease....and that it is presently incurable. Now that I've lost weight, people constantly want to know when I will get off of insulin. I always say, "When I die." As for the ADA....please! I respect the money and efforts spent in research, but that is it. Following ADA guidelines gave me poor control of my diabetes. That is why I appreciate Dr. Bernstein. He got as pissed with them as I did!!! His plan makes sense and works. And, you can't follow his plan without moving into ketosis.

Thanks for fretting about all of us; I'm sure you mean well. But, I'm taking better care of my diabetes and my body with this way of life.
I'm happily peeing purple,
Sara<><

[TheCaveman]

Intermittent? Absolutely!

As a favorable influence in energy for labor and delivery? Absolutely!

As a favorable metabolic asset in short periods of food inavailability or while sleeping fast? Absolutely!

No, not what I'm talking about.

Continuous ketosis induced by dietary restriction of carbohydrate on purpose?

No, continuous ketosis induced by dietary restriction of carbohydrate by season, as botany commanded until a few thousand years ago.

Highly debatable with, IMHO, the evidence tipping toward prudence to avoid continuous ketosis and high levels of circulating ketones. I think you'd be hard-pressed to find an OB/GYN or RE who'd give a green-light to a ketosis inducing diet while TTC or while pregnant because there isn't any evidence to support that it's harmless,

Actually, we have millions of years of evidence that it's required.

What we should really be talking about are the dangers to mothers and babies who aren't in ketosis for most or all of pregnancy.

[ReginaW]

What we should really be talking about are the dangers to mothers and babies who aren't in ketosis for most or all of pregnancy.

Intermittent or continuous?

[Nancy LC]

I met a native american last night, Chippawa. He is from N. Minnesota and I guess they still eat very much like they always have. He was a skinny fellow. I, of course, had to ask about their diet which is:

Game meat, duck, fish and wild rice, berries in season

They have no agriculture at all. I wish I had had the presence of mind to ask him what the diet of preggers consist of.

[davio2shoe]

MCG is TERRIBLY misinformed..at BEST.
The MEDICAL facts are that ANYONE and EVERYONE who burns fat EVER is in ketosis.
So to call it unhealthy is 100 percent false.
Below im listing TWO independent medical studies that give the truth about ketosis. The first a medical DEFINITION of it.
The second is a long term medical study of locarb, ketosis, etc.
http://en.wikipedia.org/wiki/Ketosis http://www.lowcarb.org/ketosis.htm
The facts speak for themselves. EVERYONE who burns fat is in ketosis, even if its short term.