Monday, October 9, 2017

Dear Mark: Is Keto Ancestral, Ketone Breath, and Keto for Lupus?

Inline_Dear_Mark_10.09.17For today’s edition of Dear Mark, I’m answering some questions about keto (hey, you folks keep asking!). First, is being on a ketogenic diet actually congruent with our ancestry? Is there historical precedent? Next, is bad breath really a reliable indication of being in ketosis? And finally, could going keto help treat the autoimmune disease lupus?

Let’s take a look:

First, Ryan asked:

My understanding and experience with Ketosis as a state, is that it is not necessarily hard to get into, but is difficult to maintain for any period of time. By “difficult” I mean you have pay very close attention to everything you are eating, or you will easily slip out of Ketosis…

So, my question is this. From an evolutionary perspective, is long term Ketosis something we “should” be aiming for? Assuming long term ketosis was optimal, it seems that we would have evolved to easily maintain it under a number of circumstances, and not easily slip out of it, instead of the opposite.

Thanks for all you do!

Ryan

Interesting question, Ryan. I dig it.

I’ve written about whether or not we need to be in long-term ketosis, coming to a similar conclusion. It isn’t necessary for most people, and it’s probably not optimal, either.

Why ask folks to go keto for 4-6 weeks then? That’s not “long term,” but it’s longer than “transient.” Paleolithic hunter-gatherers wouldn’t have gone that long without food, nor would they have consciously avoided carbohydrates if they were available. There’s no evidence of long-term wholly ketogenic populations.

But that doesn’t mean they weren’t producing ketones on a regular basis. Before everyone had constant access to cheap food without having to work for it, ketosis was more common. It wasn’t a constant state of being, but it was always in the vicinity. The food situation was ketotic in three main ways:

  1. Glucose wasn’t as plentiful as it is today. The starchy tubers you could access came packaged with a ton of fiber. That reduced the amount of digestible glucose and increased the amount of tuber a person could eat and still produce ketones.
  2. Constant snacking wasn’t tenable. There was no fridge to open when you were bored. You couldn’t just dig through a non-existent pantry. The kind of constant low-level eating that keeps glucose topped off and inhibits ketone production—snacking—just didn’t happen very often. A lot of time elapsed between meals, which was very conducive to fat-burning and ketone production.
  3. Obtaining food required physical activity. Exercise, in and of itself, stimulates ketone production by increasing energy expenditure and reducing energy availability. If you have to physically work for your food, you will produce ketones. And sometimes the hunt comes up short, AKA you train on an empty stomach.

You’re correct that extended, protracted ketosis probably wasn’t the norm for our hunter-gatherer ancestors. Rather, they spent most of their time in what I call the keto zone, where one slips easily into and out of ketosis. The Keto Reset offers a way to emulate that ancestral metabolic environment by condensing it into a shorter time frame, to make up for the lack of lifelong dalliance with transient ketosis and the enhanced fat metabolism it creates.

Just a quick question, Mark. Does being in ketosis cause bad breath? My daughter has an unusually acute olfactory sense and swears I have keto breath. Am old, sedentary, 25 lbs overweight (belly) and trying to slim down via intermittent fasting and carb restriction.

Yes, ketone breath is a common indicator of ketosis.

All signs point to “yes.”

Just wondering about something. Has anyone suggested anything about Lupus, an autoimmune disease. I’ve had Lupus for 27 years. After going on low carb I am in remission. Not sure, but it has to have something relevant. No longer on any of the medications. Thankful!

There’s reason to believe going low-carb or ketogenic can help lupus and other autoimmune diseases.

For one, many of the foods known to trigger or exacerbate autoimmune diseases are higher in carbs, like grains. Going low-carb necessitates their elimination. The Primal eating plan, whether ketogenic or not, also eliminates refined foods in general and industrial seed oils in particular, both of which are inflammatory and can contribute to autoimmune flareups.

Two, ketogenic diets may directly affect the inflammasome involved in lupus. Inflammasomes are the mediators of inflammatory pathways in the body, and their activation is linked to many different diseases. Activation of the NLRP3 inflammasome in particular is a critical mechanism in the progression of lupus—and ketogenic diets are known to inhibit it.

Three, “fasting-mimicking diets,” or ketogenic diets, have been shown to improve outcomes in rodents with autoimmune encephalomyelitis, a type of brain and spine inflammation. They do this by actually regenerating immune cells damaged by the progression of the autoimmune disease. All the rodents improved their symptoms and 20% entirely reversed them.

Four, it’s working for you! This is the most convincing piece of evidence that it helps, at least for you.

That’s it for today, folks. Thanks for reading. Be sure to chime in down below with your own input.

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Weekending Around

^^One week ago on Sunday!

This past weekend was busy and wonderful, and all around town. It was awesome!

Friday

Compared to the last one, we had a pretty low-key family and sports-filled weekend.

On Friday night we were happy to hang around at home and snuggle on the porch. Once Mazen was asleep (he actually did an early dinner with Matt), Thomas and I made this DELICIOUS Blue Apron meal of fried catfish with roasted squash and kale. The fish was epic! Plus – first pumpkin beer of the season! : )

Saturday

We are always scrambling to get to soccer on time on Saturday mornings. It starts at 9:00 a.m., but since everyone in our house sleeps till 7:00 and likes a lazy breakfast, I always look at the clock at 8:30 in a panic! Cue the quick whole wheat English muffin with butter and coffee before jetting out the door!

We were on time, though! It was a beautiful morning.

After soccer we headed home to finish up some house work and then packed up to head to Bodos for lunch to go and then Random Row to watch the UVA v Duke football game. I got a Cleo salad with smoked salmon on top and had two beers!

Late afternoon we relaxed on the deck while Mazen and the neighbors played a wagon game for over and hour. We love our neighbors!

Saturday night we biked downtown and had dinner at Commonwealth.

I forget how much I love the menu there! There are so many great options to choose from.

We ordered the ham biscuits and autumn empanadas to share, and Mazen had a burger. Those fries were soooo crispy and perfectly seasoned!

For dinner I was crushing hard on this butternut squash bisque. If I’m remembering right, it was vegan, and I think it must have been made with coconut milk because it was super creamy, thick, and the perfect sweetness. I would like to go back and have it again! T got jerk chicken which was Caribbean spiced and also really good.

Sunday

Pre-soccer oatmeal fuel! I mixed a bit of Good Culture Cottage Cheese in, including the pineapple topping (which is what you see on top), plus almond butter!

Our soccer game was all the way up at the Blue Ridge School, which is quite the haul. The drive is worth it once you’re there, but one time I got really lost on my way so I have bad memories of the drive. Our game was great, though, and we beat the Honeybadgers 4:1!

The post-game team celebration was held at the nearby Stone Mountain Vineyards. The view!! You could actually see the field we played on in the V of the mountains there. We were so high up.

Rosé – last taste of summer?

Britt and I shared this cheese and baguette plate. The bread was HOT, and that goat cheese was spiked with raspberry preserves. We had just burned 1,000 calories (according to my watch) and I devoured this! Hunger is the best sauce, fo’ sho.

Say CHEESE!

Hope you guys had a nice weekend. What did you do?

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Clean Eating Mexican-Style Stuffed Spaghetti Squash Recipe

Few things give me joy the way Mexican foods do. And while my dishes are often far from authentic, I have fun playing around with the flavors that our Latin friends enjoy on a daily basis.

I’ve had… Read more →



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