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Old Mon, Dec-18-17, 21:26
M Levac M Levac is offline
Senior Member
Posts: 6,498
 
Plan: VLC, mostly meat
Stats: 202/200/165 Male 5' 7"
BF:
Progress: 5%
Location: Montreal, Quebec, Canada
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From my point of view, there's a few errors in that text. A few corrections, also from my point of view.

Exogenous ketones cause both insulin and blood glucose to drop. This is due to an otherwise normal feedback loop where ketones regulate themselves through activation of liver insulin receptors. In turn, this triggers a sequence of steps, the first is inhibition of ketogenesis (self-regulation of ketones production), the second is inhibition of glycogenolysis (regulation of glucose release from the liver), last step is insulin degradation with insulin-degrading enzyme (don't need the insulin, it's done its job). The liver and the brain have the insulin-degrading enzyme, all other tissues do not.

Recently, I read another text that tried to explain this topic. In it, I found something that adds to my paradigm. By activating liver insulin receptors, ketones are the key to what's been called insulin resistance. In essence, lack of ketones is the primary cause of insulin resistance - the insulin receptors do not get activated. A chain of events follows. Ketones are needed for the last step of insulin degradation. Thus, even though insulin still inhibit ketogenesis - blood ketones drop to zero - insulin remains higher than otherwise, and acts on all other tissues accordingly, i.e. fat tissue especially. Since this condition is primarily caused by dietary carbs, this then also stuffs the liver with glycogen, through insulin's second step of inhibiton of glycogenolysis. At some point, it's possible that the liver just can't store any more glycogen, in spite of ample insulin, blood glucose lingers, diabetes type 2. Here, we can easily see that diabetes type 2 must be described as hyperglycemia, hyperinsulinemia, and total absence of ketones. If the liver truly became insulin resistant, there would be plenty of ketones in the blood, since that's the first thing insulin acts on when it hits the liver.

Incidentally, insulin's second step - inhibition of glycogenolysis - is the primary means by which excess glucose is cleared from the blood. All other ideas, i.e. cells use up glucose as some turbo fuel or whatever, is just BS. If there's carbs coming in, there's insulin going up, there's ketones dropping to zero. Cells require a specific balance of various substrates, namely glucose and ketones, for proper cellular function. For glucose to be used up, it must be accompanied by ketones. The lower the ketones, the slower glucose gets used up. Glucose gets used slowly enough already, there's basically a tiny reserve of it. Excess is primarily stored, not used. Excess must be stored, and quickly, for normal metabolism to resume.

In effect, when carbs come in, they disrupt normal ketones metabolism, that feedback loop of self-regulation of ketones production. Without carbs, ketones metabolism remains virtually constant even throughout a meal. No disruption. Protein also disrupts this, but to a lesser extent. Protein does not provide a single calorie of energy. The primary pathways for dietary protein is structure, enzymes, etc - building blocks.

Eating a lot of additional fat is absolutely self-regulating. Try it for yourself. Eat a stick of butter, tell me about it. Personally, when I tried it, it was very hard the first time, easier later on but still not easy. When I played golf, that was often my lunch, a stick of butter. No adverse effect I can even think of, including any difficulty in maintaining my weight (I had reached the limit of the possible at that point).

As for it being hard to achieve any degree of ketosis, that's not merely a question of diet. As Taubes often says, carbs is the primary cause, not the only cause. Always, always, always keep that distinction in mind when talking about how hard it is to get into ketosis. If carbs can do it, and if carbs is just the biggest thing, then there must be other things capable of doing the same, let's see what they are.

Anecdotally, I had tons of ketones coming out the wazoo when I was the most physically active of my life. So, that last paragraph is a lie from my point of view.

You can't possibly manage your energy balance. It's impossible to know what Eout is at any point.

OK, I skimmed the article. There's too many errors from my point of view. I won't read it in detail. I won't take any advice from it. Maybe there's still some good stuff in there, I won't know.
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