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Old 05-20-2013, 01:37 PM   #1
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Interesting weekend and ketosis question

I had a good friend visit me this weekend. She lost 20 lbs since January on WW. She tracks and logs everything (which by that alone, was turning me off). But the whole weekend she kept convincing me to try WW. She kept saying "But you can eat whatever you want". She is about a size 16 now. In high school she was a size 5/6 and a cheerleader and can eat whatever she wanted. Literally, she would eat hamburgers (w/buns), pizza, rice, whatever. She stayed very slim. It was only until after she had kids that she blew up. She never had an issue with sugar/carbs growing up. I always have. Since I was 10. My experience with her this weekends just goes to show that not every diet is for everyone! I would never try to convince her to do low carb bc it's probably not for her! She can probably tolerate higher carbs and that's okay. To each their own. I do remember Dr. Atkins saying that the younger you have had a weight issue, and the more severe your sugar addiction is, the more you would benefit from this diet and that is me.

Anyway, if a person not doing low carb, say, just calorie restriction loses weight, they are not in ketosis, correct? So what state would they be in and continue to lose weight?
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Old 05-20-2013, 01:50 PM   #2
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Ketosis just means burning fat. Maybe you are talking about the ketogenic state where the brain starts running on ketones for fuel instead of glucose. That is why a lot of people can still lose weight on a HC, calorie restricted diet. You can still experience ketosis, you don't have to restrict carbs to burn body fat.
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Old 05-20-2013, 02:04 PM   #3
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I didn't know that! So I'm assuming a low carb diet just puts you in a deeper state of ketosis?
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Old 05-20-2013, 02:16 PM   #4
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You don't have to be in ketosis to lose weight. Calorie restriction will work, at least for the short term. The question is, what can you maintain? Your friend says she can eat whatever she wants, but the truth is, she can't. She's got caloric restrictions. Something's got to give to change the status quo of weight.

For me, it's easier just not to get started on the carbs. I don't want one half piece of bread, I want 5 pieces of bread. I don't want a little scoop of sticky white rice, I want a big bowlful covered w/some great Thai thing. W/low carb foods, while I like them, I can't nor do I want to eat as much of them. Not to mention the appetite suppression of Low Carb foods.
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Old 05-20-2013, 03:41 PM   #5
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Ketosis just means burning fat. Maybe you are talking about the ketogenic state where the brain starts running on ketones for fuel instead of glucose. That is why a lot of people can still lose weight on a HC, calorie restricted diet. You can still experience ketosis, you don't have to restrict carbs to burn body fat.
I believe you may be confusing ketosis and lipolysis - ketosis is not required for losing weight, nor do many folks ever utilize a steady state of it, including the dietary population. But lipolysis is absolutely occurring in anyone maintaining long term energy deficits. So many confusing terms
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Old 05-20-2013, 03:50 PM   #6
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To answer the OP - on the diet you describe, she isn't anywhere near ketosis, let alone a ketogenic state. She is burning fat stores for energy, no doubt, which is lipolysis, but her body has not changed to a primarily fat burning metabolism to do it. The best way to describe it is that she is in long term calorie deficit and her body is utilizing dietary energy first, then stored body fat, to run. But the difference isn't between ketosis and a non-dieted metabolism, but between ketosis and glycolysis.

Those describe the two pathways by which our cells create ATP (essentially, how they break down nutrients for energy). Our bodies preferentially break down glucose when it is present, and do not revert to ketosis unless the dietary glucose is suppressed and the stores in our muscles and livers are used up (biiiig oversimplification), then the body switches to burning ketone bodies instead. Over time, if we suppress dietary glucose enough, we begin to preferentially burn ketones instead - and this keto adaption, which is the goal of most long term low carb plans (in their losing phases, at least).

It is not, however, crucial for weight loss.

But those if us who respond poorly to saccharides on a hormonal level may have too much difficulty maintaining a sufficient calorie deficit without ketosis - the blood sugar swings too much, the cravings are difficult to surmount, there is increased discomforts like cold intolerance, exhaustion, nutrient deficits, etc. So while some people can lose fine on higher carb plans (and ALL plans that maintain a long term energy deficit sufficient to begin burning stored body fat will experience weight loss) not all dieters can comfortably live on a high carb plan low enough in calories to lose weight for an extended period of time. Thus, they require a different tool to achieve the same end.

Clear as mud, right?
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Old 05-20-2013, 03:55 PM   #7
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Here's a good academic summary of the energy pathways our bodies use:
Glycolysis

Lipolysis is what we want, we can't get there without energy restriction to the point of burning stores in our body. That is related but somewhat tangential to which pathway we preferentially cultivate in our bodies - either metabolic pathway can allow for body mass reduction after certain conditions are achieved.
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Old 05-20-2013, 03:58 PM   #8
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But those if us who respond poorly to saccharides on a hormonal level may have too much difficulty maintaining a sufficient calorie deficit without ketosis - the blood sugar swings too much, the cravings are difficult to surmount, there is increased discomforts like cold intolerance, exhaustion, nutrient deficits, etc. So while some people can lose fine on higher carb plans (and ALL plans that maintain a long term energy deficit sufficient to begin burning stored body fat will experience weight loss) not all dieters can comfortably live on a high carb plan low enough in calories to lose weight for an extended period of time. Thus, they require a different tool to achieve the same end.

Clear as mud, right?
I don't know if that is often the case. The people I know that are on other diet plans for weight loss are eating around the same amount of calories that I do - 1200-1500, and that is nowhere low enough for cold intolerance, exhaustion, nutrient deficits. Someone can be eating 2000 calories of processed lc junk a day vs someone who eats 1200 higher carb with an emphasis on vegetables and lean proteins and the higher carb/lower calorie person will be the one that's better nourished. Plus, low carb doesn't exactly allow that many more calories. Most people that are near their thin goal weight or at goal have to eat less, whether it's lc or not.

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Old 05-20-2013, 04:01 PM   #9
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You don't have to be in ketosis to lose weight. Calorie restriction will work, at least for the short term. The question is, what can you maintain? Your friend says she can eat whatever she wants, but the truth is, she can't. She's got caloric restrictions. Something's got to give to change the status quo of weight.
.
It's just as hard to maintain on low carb. And, there are calorie restrictions on low carb as well, you can't eat a ton and expect to keep losing.
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Old 05-20-2013, 04:03 PM   #10
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And yet I experience the same symptoms on a highly nutritious diet of 1800 calories per day. Energy needs differ and all the nutritional quality in the world won't mitigate the metabolic adjustments the body undertakes in energy deficit. Not all those symptoms are commonly experienced, it's a spectrum and gets more severe the steeper and longer the deficit, and the higher body mass change already experienced, but those symptoms come from the energy differential, not the quality of the food, with the exception of nutritional deficiencies (which arguably I shouldn't have included on the list, but they are easier to incur and the effects more severe the steeper the gradient between the individual's energy needs and what here actually taking in, and again, duration makes a difference here, too).

The severity is somewhat individual, certainly, just as all things relating to health differ depending on the system we're dealing with. But with any significant deficit (greater than 20% reduction in intake as compared to maintenance levels) maintained without pause for an extended period of time (we'll say four weeks and longer) will inevitably precipitate some degree of symptoms relating to energy conservation by the body.

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Old 05-20-2013, 04:17 PM   #11
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And yet I experience the same symptoms on a highly nutritious diet of 1800 calories per day. Energy needs differ and all the nutritional quality in the world won't mitigate the metabolic adjustments the body undertakes in energy deficit. Not all those symptoms are commonly experienced, it's a spectrum and gets more severe the steeper and longer the deficit, and the higher body mass change already experienced, but those symptoms come from the energy differential, not the quality of the food, with the exception of nutritional deficiencies (which arguably I shouldn't have included on the list, but they are easier to incur and the effects more severe the steeper the gradient between the individual's energy needs and what here actually taking in, and again, duration makes a difference here, too).

The severity is somewhat individual, certainly, just as all things relating to health differ depending on the system we're dealing with. But with any significant deficit (greater than 20% reduction in intake as compared to maintenance levels) maintained without pause for an extended period of time (we'll say four weeks and longer) will inevitably precipitate some degree of symptoms relating to energy conservation by the body.
But, how are you determining this energy deficit? Should a 150 pound woman be eating 2000 calories? No, not if she's not a pro-athlete she shouldn't be, so just because she was eating that much before doesn't mean that that is what her body requires and that she is at a deficit for her body if she suddenly eats a more reasonably 1500 calories.

All drops in calories will lead to a small drop in metabolism but that is normal and not harmful, and actually there are studies that show that it could improve longevity.

You must have a very high metabolism to experience all of those problems on 1800 calories because that is more than most women can eat without gaining. And, wouldn't cold intolerance be caused by the actual weight loss and not the method? Less fat=less insulation so you get cold more easily.

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Old 05-20-2013, 04:39 PM   #12
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To answer the OP - on the diet you describe, she isn't anywhere near ketosis, let alone a ketogenic state. She is burning fat stores for energy, no doubt, which is lipolysis, but her body has not changed to a primarily fat burning metabolism to do it. The best way to describe it is that she is in long term calorie deficit and her body is utilizing dietary energy first, then stored body fat, to run. But the difference isn't between ketosis and a non-dieted metabolism, but between ketosis and glycolysis.

Those describe the two pathways by which our cells create ATP (essentially, how they break down nutrients for energy). Our bodies preferentially break down glucose when it is present, and do not revert to ketosis unless the dietary glucose is suppressed and the stores in our muscles and livers are used up (biiiig oversimplification), then the body switches to burning ketone bodies instead. Over time, if we suppress dietary glucose enough, we begin to preferentially burn ketones instead - and this keto adaption, which is the goal of most long term low carb plans (in their losing phases, at least).

It is not, however, crucial for weight loss.

But those if us who respond poorly to saccharides on a hormonal level may have too much difficulty maintaining a sufficient calorie deficit without ketosis - the blood sugar swings too much, the cravings are difficult to surmount, there is increased discomforts like cold intolerance, exhaustion, nutrient deficits, etc. So while some people can lose fine on higher carb plans (and ALL plans that maintain a long term energy deficit sufficient to begin burning stored body fat will experience weight loss) not all dieters can comfortably live on a high carb plan low enough in calories to lose weight for an extended period of time. Thus, they require a different tool to achieve the same end.

Clear as mud, right?
Yes! No one had ever described it like that! I understand now
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Old 05-20-2013, 05:02 PM   #13
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Nolcjunk - That's exactly what I was saying - it doesn't matter what the dieting method is, in the end the body needs an energy deficit to lose (though the ease of it can definitely vary depending on the dietary choices made and body undergoing them) and that illicits a cascade of hormones in the body that respond to that situation - if it did not respond in some degree that would be the very definition of physiological dysfunction (illness).

The degree of response varies, as I stated above, but like a reflex the body WILL process the energy from food and WILL respond if there is a gap between intake and need sufficient enough to burn stored energy. In short spurts or very gentle gradients the response is quite blunted, but a very severe deficit and one maintained for a significant length of time will precipitate metabolic adjustment. It doesn't mean you stop losing or even experience intolerable discomfort - that depends on the individual and the specifics of the diet - but there is a definite hormetic response (good definition here: Hormesis Defined)

As for me - I have lost a third of my original body mass and maintained that loss for a long time, that is a severe and profound impact to my brain and tissue's energy management. I am quite young (27 now, yay!), have had significant adipose hyperplasia in the years I got obese, maintained pediatric obesity, and am currently breast feeding, exercising, and generally living in a 163 pound body that used to be upwards of 270. My BMR is significantly higher than, say, a middle aged woman with moderate activity and a 120 pound body. I have a system that is predisposed to accumulating fat easily and quickly, and in fact growing new fat cells readily to accommodate that. I have a fair bit of lean body mass in a muscled and fairly dense frame, and that frame is already coping with the loss of over 1/3 of its mass. To maintain right now, while breast feeding, I can eat in the 24-2600 calorie range comfortably. Right now I'm eating about 1850. That is a significant gap in intake vs. metabolic maintenance rate, and I'm doing it for months on end after already sustaining almost five years of deficit eating in varying degrees.

I do not have a fast metabolism, quite to the contrary for someone my age it is sluggish and overly sensitive to insulin spikes. But I'm burning 600-800 calories daily in nursing, alone, not to mention working out and being on my feet most of the day, with a still-reasonably large body to fuel. I do not know anyone in my weight or age range who maintains their body mass on less than 1800 calories, fastidiously tracked, per day.

I'm not denying that choosing 1800 calories of volumetric-approved food or like I eat - plenty of fat, vegetable matter, and animal products with minimal processing - has a much more favorable impact on the body than the same calories in, say, twinkies. But energy still rules the day on weight management (not a direct or linear relationship, especially comparing a keto-adapted body to a glycogen-adapted one) and even the most nutritious diet and the bevy of supplements I chug each day is going to erase the effects of persistently shrinking myself.

How well and how much someone's metabolism downregulates as their intake changes is as variable as our fingerprints. I don't know about that 150 pound woman, but if she's younger 2000 calories may very well be what her body runs on, and potentially even loses on. And she is likely not harming herself but moving down to, say, 1400 per day. She'll lose mass - both fat tissue and lean mass - and her body will display adaptation as it settles down into whatever size it maintains on at that energy amount - probably in the 125-130 range, unless she is so uncomfortable she breaks her diet first. Whether she would benefit from the weight reduction is quite individual and just because the body adapts doesn't mean it is a *harmful* adaptation. But it absolutely does happen, and in the case of some dieters that response can make it extremely difficult to stay on the diet (willpower is finite, your body's ability to keep itself alive is not something so easily overcome for sheer vanity, depending on the degree of change). This is where a lighter deficit, say 100-250 calories per day, along with a more nutritious and satiating diet, and perhaps even a metabolic advantage like is gained in keto adaptation - that is where these tools can make the difference. 1800 calories for me on a whole foods, low carb diet is tolerable, even in such steep and long energy deficit. And I still have discomfort but it is manageable. That same deficit on low calorie alone, with higher carb intake, was unbearable. I have a whole layer of hair regrowing to prove it, as I had a massive shed from the stress (I got shingles because of it, too, but that's a long story for another time). Becoming effectively hypothyroid is quite uncomfortable, especially if the symptoms are extreme enough. But a small degree of that can most certainly be tolerated and the body will usually adjust to the maintenance calories at a given new weight, if persistently and comfortably maintained.

This is pretty tangential and obviously individual, but I hope something in the above novel addresses your line of questions to me? I can't even remember what 'brilliant' conclusion I was seeking, so I hope you're able to find it because I lost the thread

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Old 05-20-2013, 09:18 PM   #14
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Old 05-20-2013, 10:49 PM   #15
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It's just as hard to maintain on low carb. And, there are calorie restrictions on low carb as well, you can't eat a ton and expect to keep losing.
Maintenance is obviously hard for many. But whether it's hard, harder, or "just as hard" is an individual thing and not something you can make a global statement about. One person may be able to maintain much better on low carb than another, same w/low fat and any other woe.

And I'm well aware you can't eat a ton and expect to keep losing, no matter what plan you're on.
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Old 05-21-2013, 01:54 AM   #16
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With regard to ketosis, there's a weird metabolic *trick* that happens during bodybuilding "cutting" diets. Bodybuilders typically do what's called a "cyclical ketogenic diet" (CKD) to "cut" bodyfat for competition, in which most of the week is spent eating a ketogenic level of carbs but CKDs re-feed massive amounts of carbohydrates into the body at least once per week. The weird, *tricky* thing is that during the initial hours of the re-feed -- while they're eating 100-150g carbs every 2-3 hours -- bodybuilders who test their blood ketone levels find that they're still as deeply in ketosis as they are on their ketogenic days.

When glycogen stores are depleted, the body will preferentially refill its glycogen stores instead of burning the re-fed carbohydrates as fuel. So the body continues to fuel its systems using fat, rather than using the dietary carbohydrates as fuel. This metabolic mechanism has been acknowledged since the mid-1990s, via this influential study:
Ten healthy men were studied using the euglycemic clamp technique, indirect calorimetry, and percutaneous vastus lateralis muscle biopsies for analysis of glycogen synthase (GS) and pyruvate dehydrogenase (PDH) activities in the basal and insulin-stimulated states. Insulin-stimulated glucose disposal was unchanged (STD 46.1 +/- 4.3 v LCD 46.0 +/- 4.3 mumol/kg.min, P = NS), but marked alterations in the routes of glucose disposal were noted. Insulin-stimulated glucose oxidation (Gox) was markedly reduced following LCD (STD 18.6 +/- 1.9 v LCD 8.23 +/- 1.9 mumol/kg.min, P = .0001), and nonoxidative glucose metabolism (Gnox) was enhanced by LCD (STD 24.9 +/- 0.9 v LCD 38.9 +/- 4.3 mumol/kg.min, P = .03). Following LCD, both the total and active forms of PDH (PDHt and PDHa) were significantly depressed. After LCD, GS activates (FV0.1, %I, and A0.5) were unaffected in the basal state, but were greater than for STD (P = .004) after insulin stimulation.

Low-carbohydrate diet alters intracellular glucose metabolism but not overall glucose disposal in exercise-trained subjects.
Low-carbohydrate diet alters intracellular glucos... [Metabolism. 1995] - PubMed - NCBI
So the researchers found that the "routes" of glucose "disposal" were different following a ketogenic period, in that glucose "oxidation" (the burning of glucose as fuel) was "markedly reduced," while "non-oxidative" glucose metabolism (primarily glycogen storage) was "enhanced" and "glycogen synthase" (the enzymatic process of converting glucose to glycogen) was increased, as compared to the process that occurs when carbohydrates are fed into the body following a "standard," non-ketogenic period.

Part of the reason that bodybuilders can stay in ketosis for a relatively long period of time during a high-carb re-feed is because weight training up-regulates the enzymes that control glycogen storage and glycogen synthesis, and exercise also increases insulin sensitivity in skeletal muscle in a way that preferentially "partitions" nutrients to re-feed muscle tissue. So the fact that bodybuilders regularly do weight training contributes to their ability to re-feed carbohydrates while staying ketosis.

But another part of the reason that bodybuilders stay in ketosis during high-carb re-feeds is because the liver takes a minimum of 5 hours to up-regulate the enzymes that process glucose as fuel. During a ketogenic period, the liver down-regulates the enzymes that process glucose as fuel and the liver can't *instantly* reverse the process when carbohydrates are re-fed so the body continues using fat as its primary fuel source -- and the liver continues producing ketone bodies -- until the liver re-engineers the metabolism to resume the process of primarily burning glucose as fuel. This is why people who take a "glucose tolerance test" (GTT) after sustained periods of very low-carb eating often get ridiculously abnormal test results -- because the body doesn't have a sufficient amount of enzymes in circulation to quickly manage large influxes of glucose.

There are some indigenous groups who normally eat a relatively low amount of dietary carbohydrates as part of their traditional diet so, when medical people test these tribes for diabetes, the patients have to be pre-fed carbohydrates for several days before taking a glucose tolerance test because this population would ordinarily have a lower level of the necessary glucose-processing enzymes as a result of their typical low-carbohydrate intake.
The NDDG and the WHO recommend that individuals undergoing an oral glucose tolerance test (OGTT) consume a minimum of 150 gm of carbohydrate on each of three days preceding the OGTT. Carbohydrate restriction affects the diagnostic accuracy of the OGTT.

The impact of low carbohydrate consumption on glucose tolerance, insulin concentration and insulin response to glucose challenge in Dogrib Indians.
The impact of low carbohydrate consumption on ... [Med Anthropol. 1989] - PubMed - NCBI
So ketosis can be really *weird* because the metabolic processes are controlled by the liver, and the liver doesn't *immediately* re-engineer these systems in response to dietary intake. Although ketosis is induced by the restriction of dietary carbohydrates and the process is reversed by the re-feeding of dietary carbohydrates, the system is quite complicated so there are some situations in which a person can eat massive amounts of carbohydrates while maintaining a ketogenic level of ketone production. It's a strange, rare, and specialized situation but I find it super interesting because the body is a very cool, elite machine that is impossibly complex.
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Old 05-21-2013, 02:03 AM   #17
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And that's one of the reasons I warn people against trusting ketostix when they've just had a high carb meal. It can take several hours for someone to be kicked out of ketosis, but they'll swear that it didn't happen, because they tested the next urine sample.
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Old 05-21-2013, 02:32 AM   #18
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And that's one of the reasons I warn people against trusting ketostix when they've just had a high carb meal. It can take several hours for someone to be kicked out of ketosis, but they'll swear that it didn't happen, because they tested the next urine sample.
There are some bodybuilders whose bodies will stay at a significant level of ketosis for anywhere from the first 12 to 24 hours of a high-carb re-feed -- 24 hours of which can contain more than 1,000g of carbohydrates, depending on lean body mass (the standard formula is 12-16g of carbohydrates per kilogram of lean body mass per day).

I think this extension of ketosis happens in bodybuilders mostly due to the influence of weight training on glycogen storage, and also because a carefully calibrated re-feed *should* be timed to primarily partition nutrients into glycogen storage. But I don't think we really *know* how other populations respond to re-feeds because there hasn't been much research on this in "normal" (non-bodybuilder) bodies.
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Old 05-22-2013, 06:37 AM   #19
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Artic mama-- love your posts. Always informative, concise and non- divisive. I
Your explanation of Ketosis and lyposis really helped me to understand how calories play a part of a ketogenic woe and how Ketosis aids to lose weight for those of us who choose to lose weight this way without denying that weight loss is attainable for many diets . Also, I think your explanation will help many people
Who have assumed they failed because they ate off plan then automatically give up . Thank you!
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Old 05-22-2013, 09:32 AM   #20
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Artic mama-- love your posts. Always informative, concise and non- divisive. I
Your explanation of Ketosis and lyposis really helped me to understand how calories play a part of a ketogenic woe and how Ketosis aids to lose weight for those of us who choose to lose weight this way without denying that weight loss is attainable for many diets . Also, I think your explanation will help many people
Who have assumed they failed because they ate off plan then automatically give up . Thank you!
I totally cosign this! You have a gift for making points clear and for isolating what's most important or most engaging for the reader. Also, your writing has a very charming, personable *voice* that I truly enjoy.

I also really enjoy Ntombi's posts! You're very friendly and outgoing -- but it's actually better than getting input from a typical friend -- because it's never empty cheerleading. I always feel like you're saying what *needs* to be said, and that you always consider multiple impacts of a situation.
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Old 05-22-2013, 09:52 AM   #21
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totally concur . . about all of you!
I feel like I am getting the chemistry and biology that I missed in high school and college.
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Old 05-23-2013, 06:02 PM   #22
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Join Date: Oct 2008
Location: Alaska
Posts: 2,779
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Stats: 257/145.8/140
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Start Date: Began losing 10/08. Working off last 20 lbs.
Awe, you guys are so sweet . I'm glad I could help!
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Old 05-24-2013, 08:10 AM   #23
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Yes, I wanted to chime in and compliment Arctic Mama, Trillex and Ntombi as well. The scientific and practical information in your posts is truly helpful to those of us who are just coming to understand the way this works.

It's very tempting to believe in the puritan philosophy that successful weight loss is a matter of good character and discipline, but those of us who've been around this block a time or two know that there is more to it than that. It turns out this is a very complex biological and chemical problem that goes to the very basis of human survival.

Gaining insight into the science is extremely beneficial to everyone. So thanks. I too, really appreciate your contribution.
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