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Old 03-24-2013, 07:53 AM   #1
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Ketosis - why and how aggressively....

Do you protect your state of ketosis?

I have been ketogenic for 3 + years almost - 100% as far as I can tell and I protect that like I would a new born baby. I have done a lot of reading on the advantages of ketosis (aside from weight loss) and believe it is an advantage for me in protection from a variety of diseases like cancer, heart disease, diabetes, cognitive diseases .... metabolic disease in general. Not to mention that it has given me relief from the constant intrusive thoughts of food.

So my question is this.... am I an oddity? Is this something that others give thought to? Is this reasonable in others opinions and why? I would love to hear what all you ketogenic folks think on the topic of long term ketosis!
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Old 03-24-2013, 08:54 AM   #2
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Clackley, the first time I heard about this way of eating was from a podcast called Brain-Body Breakthroughs by Dr. Larry McCleary. He is some kind of children's brain doctor and after seeing the results of recovering patients (and parents of patients) on such high-fat diets, he began researching and promoting that way of eating. He suggests it for long-term well-being and health, and of course with fat-loss as well. Another great podcast on being Ketogenic for life is called Relentless Roger and the Caveman Doctor.

I am totally with you on this being a long term way of life, even though I'm a newbie to it. In attempt to combat my unhealthy relationship with food, over the past two years, I have tried being vegan, paleo, low-carb, and keto.. I just have researched and read so much in the realm of nutrition, and it's merely been a matter of experimentation and distraction that took me this long to commit to LCHF. But i'm in it to win it and glad you are too! You're an inspiration. 3 years!
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Old 03-24-2013, 10:39 AM   #3
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Thanks for posting this,clackley! And for your response, Green! I have been wondering same thing? I believe this is only way for me to keep carbs at bay! I love the diet, and I planned to stay with it for life! However, just wondering about long term too??
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Old 03-24-2013, 11:40 AM   #4
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I generally check my blood ketones at least once a day. 2-3 times on days when I work out. I have been in ketosis for about 9 months now with a couple of caveats. In the early months I found there were meals that would bump me to <0.5 mM the next morning. I stopped eating those. Actually I rarely eat out at all now.

Also, I decided to start a power lifting program a few months into this WOE. Although I am often <0.5 mM after a lifting workout, I don't count that as falling out of ketosis because I am invariably back to >0.5 mM the next morning. So I take this to mean that doing anaerobic exercises of this sort for this duration cause my body to burn everything that isn't nailed down.

Why? Well, a number of reasons, but when it comes right down to it I think the USDA and the medical establishment can be trusted to offer advice that is diametrically opposed to what is the best way of eating for most people. That is an oversimplification, because even they will council eating less sugar. But, hey, to a first approximation, I think it is accurate. I take the Peter Attia view point that these guys have promulgated a moderately static set of advice when it comes to diet for decades. Where has that gotten us? They are pretty consistent, so I say we rely on them to be consistently wrong.

Still, that is pretty shaky ground upon which to build. The number of people in persistent ketosis is still quite low, but must be at least 100x what it was a decade ago. That makes us part of a sort of uncontrolled experiment -- a very new dietary cohort. I am sure some of us are hoping that ketosis is the key element to much lower rates of heart disease and cancer. Who knows? Actually the report in the news of arteriosclerosis in mummies has me questioning whether traditional diets really protect against the former malady.

Yet after 50 years on the SAD, I think my health was suffering from it. Seems like it should be worth at least a couple of years on this WOE.
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Old 03-24-2013, 02:57 PM   #5
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I am curious of any of you are NOT still trying to lose weight. Because I have done a lot of research on the insulin/carb response factor. Although we technically don't need carbs, persistent ketosis is a catabolic process. Once your body has burned off all its fat, what next? Does it start burning muscle mass? Ketosis is great if you are trying to lose weight, but what if you're not? You still need some insulin response to build muscle mass and store fat. I just don't see how you can stay in NK forever once the extra fat storage is all gone.

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Old 03-24-2013, 03:00 PM   #6
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LOL, Punkin, can you provide some sources?

Where have you read about someone having 0% body fat? I have never seen that.

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Old 03-24-2013, 03:05 PM   #7
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Punkin- I am puzzled by your confusion about this. The body only taps into its fat stores in the absence of sufficient food intake. Even in ketosis, a person has to have some caloric deficit to lose weight. Once optimum weight has been reached, the person adds enough calories to be eating at a 'maintenance' level--i.e., providing the body with all the energy it needs for daily operation.

I saw an interview with Dr. Phinney on TV a while ago, and he said that he's been continuously in ketosis for 6 years--and maintained his weight. He had no desire to lose weight and didn't.

A ketogenic diet is used with young children who are epileptic because it's been shown that it can often control their seizures without meds. These children need a lot of food for their growing bodies, but there is no problem in maintaining ketosis while eating adequately.
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Old 03-24-2013, 06:36 PM   #8
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@clackley: I like to be in ketosis, but I don't like to get there. I used to fast in earlier years and thought, by coming to lowcarb, it would be easier to get into ketosis, but nada, headache like hell or/and feeling high. Once the glycogen is used up and the ketosis is in full work, these phenomens disappear.

I like to be in a constant ketosis, but I try to "regulate the deepness" of the ketosis. If it's over 50 ml/dl, I start to get slower in thinking and moving and I get a strange taste in the mouth. So, I eat some safe starch and get up again. I experienced, too, that it's easier to get back into ketosis after highcarb days the longer I am in ketosis.
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Old 03-24-2013, 07:21 PM   #9
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I am just curious if there is anyone who is in NK that isn't trying to lose weight.
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Old 03-24-2013, 07:24 PM   #10
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I am curious of any of you are NOT still trying to lose weight. Because I have done a lot of research on the insulin/carb response factor. Although we technically don't need carbs, persistent ketosis is a catabolic process. Once your body has burned off all its fat, what next? Does it start burning muscle mass? Ketosis is great if you are trying to lose weight, but what if you're not? You still need some insulin response to build muscle mass and store fat. I just don't see how you can stay in NK forever once the extra fat storage is all gone.

You increase dietary fat to maintain.
We still produce insulin, but at much lower levels that don't overload the system and allow fat to be burned.

Do you have a source for "You still need some insulin response to build muscle mass ".
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Old 03-24-2013, 07:27 PM   #11
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You increase dietary fat to maintain.
We still produce insulin, but at much lower levels that don't overload the system and allow fat to be burned.

Do you have a source for "You still need some insulin response to build muscle mass ".
Yeah, I would like to know this source as well, Punkin. I've gained 8 pounds of muscle while in ketosis due to taking up strength training in January and would like to know how this was possible, if your assertion is correct.

Thanks in advance I'm always open to conflicting points of view, but I need the science to back it up.

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Old 03-25-2013, 12:15 AM   #12
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I am just curious if there is anyone who is in NK that isn't trying to lose weight.
I'm still in the weight-loss stage myself, but I know of several people on this board who are in maintenance and they remain in ketosis (Kristn aka Mom2Zeke comes to mind), and someone earlier mentioned Dr. Phinney, who has been in ketosis for 6 years.

My question is whether it is necessary to remain in ketosis over the long term to maintain the weight loss and physical benefits. I know Dr. Atkins recommended adding in as many carbs as one could while maintaining the weight loss, but I believe he left the stage, so to speak, before nutritional ketosis was really being formulated as a long-term lifestyle.
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Old 03-25-2013, 04:58 AM   #13
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All you do is have to google building muscle mass and you will find many sources that describe how insulin manipulation is used to build muscle mass. If you want the source you can just buy any of Lyle McDonalds books. He is the one that introduced the body building world to the ketogenic diet. It is the reason why body builders carb cycle. They go in and out of ketosis during carb cycling in order to maximize fat loss and build muscle. Ie. the switch between catabolism and metabolism. Non-cycling ketogenic diets in the body building culture are to lose fat only. If you want to build muscle mass you need to introduce carbs to stimulate the insulin response. The standard ketogenic diet for body builders is LC but also fairly high in protein, compared to a NK diet. It looks a bit more like atkins. However it is still LC.

When you first start strength training you do build muscle mass, that is the case on any diet. However to make gains beyond the newbie stage you seem to need carbs to stimulate insulin release. A lot of body builders do what is called a bulking diet before they do a ketogenic diet. The bulking diet is high carb, once they have built enough muscle mass they switch to a ketogenic diet (generally) to lose the body fat to lean out for competition.

This is why once you're down to your last 5lbs, the pathway becomes convoluted because some people (atkins, kress) talk about reintroducing carbs slowly once you get to maintenance. Which takes you out of ketosis (above 50g). Which means your brain and more of your cells start functioning on glucose again and you are possibly getting a normal insulin response from meals and blood sugar buffering. However some others such as Taubes and Phinney, seem to indicate maintenance is a permanent state of ketosis (below 50g) where the brain remains running on ketones. Depending on how low you are, your liver will never have enough carbs to buffer blood sugar properly and your cells will rarely contain stored glycogen. If you aren't eating enough carbs, your body also won't release a lot of insulin. Is this a problem? It seems as though if your aren't concerned with athletic performance or building more muscle mass it isn't really. For example for a person who has metabolic syndrome the Phinney and Taubes approach would be best, because then there is no chance of over-releasing insulin if your aren't enough carbs to create it.

For others remaining in a permanent state of fat burning may not be the answer to a long term approach.
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Old 03-25-2013, 05:04 AM   #14
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I think the key word in your post is "bodybuilders." We are not bodybuilders here. Maybe you'd get some different points of view if you were on a bodybuilding board. But you're on a weigh loss forum. Most of us have quite a bit of excess fat we can spare. Bodybuilders sometimes have 5-8% bodyfat, and your question would be applicable to them. Not here though, at least in my opinion.

Trillex is very informed about bodybuilders, and I hope these posts pop up on her radar so she can come in and write a post that will most likely school us all. :-)

Kristn also lost a solid amount of weight and decided to remain in ketosis as well in the maintenance stage. Hopefully she can provide some insight as well.

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Old 03-25-2013, 06:57 AM   #15
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Yes. I am very concerned with building muscle mass. I agree the NK is the best way to lose body fat and repair a broken metabolism, and deal with the genetic factors that cause type 2 diabetes. My goals are not just to be skinny
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Old 03-25-2013, 07:27 AM   #16
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I've added muscle on NK with no issues. Have you tried strength training while eating to NK guidelines and failed to build muscle? I wouldn't freak out about it unless you've lost pounds and pounds of muscle while retaining fat, which I highly doubt.

You should check out Attia's blog, I think reading it would help you come to terms with the fact that building muscle is indeed possible in NK, and it is not that difficult to boot.
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Old 03-25-2013, 07:39 AM   #17
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I have read that it is actually easier to gain muscle on N.K..
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Old 03-25-2013, 10:19 AM   #18
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It is not that you can't build muscle in NK, it is that it is more difficult and not as effective. Also there is a difference between building new muscle which is hypotrophy and strength training. There are lots of athletes who are doing strength training to support their sport, but to actually increase the amount of muscle mass you have is difficult. Strength training in NK is certainly possible, I have had no problems there, but building added muscle mass is difficult, that is what you need insulin and carb cycling for. I haven't had a DEXA scan since November so I don't know if I have built any muscle mass since I have been in NK. I doubt it though. I also still have roughly another 5lbs of body fat to lose. I have read Peter's blog, isn't he an endurance athlete? I thought he was.
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Old 03-25-2013, 10:38 AM   #19
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My short experience with NK (1 week approx) caused some tachycardia and palpitations. It could have been the ketosis or an imbalance of electrolytes. Who knows, really? However, based on my own reading, NK seems like a very useful tool in helping people riddled with chronic systemic inflammation and the diseases associated with it. Idk if it's necessarily an appropriate diet for all people, but I don't see it as harmful, either. Just my opinion, of course. For the record, I do have a diagnosed genetic heart condition called Long QT syndrome that means I constantly need an over abundance of potassium and magnesium which may explain my issue with NK. I need to supplement these electrolytes with prescriptions and food to maintain heart stability.
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Old 03-25-2013, 01:15 PM   #20
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I can tell you from first hand experience that my CRP levels(marker for inflammation) went down drastically since doing NK. It took me switching from Atkins to NK to get them down.
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Old 03-25-2013, 01:25 PM   #21
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It is not that you can't build muscle in NK, it is that it is more difficult and not as effective. Also there is a difference between building new muscle which is hypotrophy and strength training. There are lots of athletes who are doing strength training to support their sport, but to actually increase the amount of muscle mass you have is difficult. Strength training in NK is certainly possible, I have had no problems there, but building added muscle mass is difficult, that is what you need insulin and carb cycling for. I haven't had a DEXA scan since November so I don't know if I have built any muscle mass since I have been in NK. I doubt it though. I also still have roughly another 5lbs of body fat to lose. I have read Peter's blog, isn't he an endurance athlete? I thought he was.
I was at 185 pounds when I went from low carb to NK. I lost down to about 175. Then I started a power lifting program without changing my WOE. Over the last 6 months or so, my weight has increased to above 185. I have seen my muscles hypertrophy, but it has been accompanied by some gain of fat.

I think I could fairly easily get back down to 175, but I like to see my lifting PRs increase and I am guessing I would stall were I to start dropping weight.

Also, let me just throw this out there: most of us are culturally programmed to like a very low % bodyfat physique. But, at least intellectually, I think most of us realize that even if we did reach that ridiculously low percentage bodyfat, it is not going to be healthy for us. At least not long term.

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Old 03-26-2013, 07:08 AM   #22
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Clackley, the first time I heard about this way of eating was from a podcast called Brain-Body Breakthroughs by Dr. Larry McCleary. He is some kind of children's brain doctor and after seeing the results of recovering patients (and parents of patients) on such high-fat diets, he began researching and promoting that way of eating. He suggests it for long-term well-being and health, and of course with fat-loss as well. Another great podcast on being Ketogenic for life is called Relentless Roger and the Caveman Doctor.

I am totally with you on this being a long term way of life, even though I'm a newbie to it. In attempt to combat my unhealthy relationship with food, over the past two years, I have tried being vegan, paleo, low-carb, and keto.. I just have researched and read so much in the realm of nutrition, and it's merely been a matter of experimentation and distraction that took me this long to commit to LCHF. But i'm in it to win it and glad you are too! You're an inspiration. 3 years!
Thank you Green for your thoughtful response! I am a big podcast listener and am always looking for new info. I will search down your suggestions.

May60 We should think about forming a 'lifers' thread and have a check in time so we can see how everyone is doing!!

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Old 03-26-2013, 07:12 AM   #23
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I generally check my blood ketones at least once a day. 2-3 times on days when I work out. I have been in ketosis for about 9 months now with a couple of caveats. In the early months I found there were meals that would bump me to <0.5 mM the next morning. I stopped eating those. Actually I rarely eat out at all now.

Also, I decided to start a power lifting program a few months into this WOE. Although I am often <0.5 mM after a lifting workout, I don't count that as falling out of ketosis because I am invariably back to >0.5 mM the next morning. So I take this to mean that doing anaerobic exercises of this sort for this duration cause my body to burn everything that isn't nailed down.

Why? Well, a number of reasons, but when it comes right down to it I think the USDA and the medical establishment can be trusted to offer advice that is diametrically opposed to what is the best way of eating for most people. That is an oversimplification, because even they will council eating less sugar. But, hey, to a first approximation, I think it is accurate. I take the Peter Attia view point that these guys have promulgated a moderately static set of advice when it comes to diet for decades. Where has that gotten us? They are pretty consistent, so I say we rely on them to be consistently wrong.

Still, that is pretty shaky ground upon which to build. The number of people in persistent ketosis is still quite low, but must be at least 100x what it was a decade ago. That makes us part of a sort of uncontrolled experiment -- a very new dietary cohort. I am sure some of us are hoping that ketosis is the key element to much lower rates of heart disease and cancer. Who knows? Actually the report in the news of arteriosclerosis in mummies has me questioning whether traditional diets really protect against the former malady.

Yet after 50 years on the SAD, I think my health was suffering from it. Seems like it should be worth at least a couple of years on this WOE.
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Yes!! This is my thinking as well. So much if framed around a population that eats SAD. What applies to a ketogenic population could be quite different. My conclusions are the same in that years of poor eating were taking me down.
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Old 03-26-2013, 07:21 AM   #24
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My short experience with NK (1 week approx) caused some tachycardia and palpitations. It could have been the ketosis or an imbalance of electrolytes. Who knows, really? However, based on my own reading, NK seems like a very useful tool in helping people riddled with chronic systemic inflammation and the diseases associated with it. Idk if it's necessarily an appropriate diet for all people, but I don't see it as harmful, either. Just my opinion, of course. For the record, I do have a diagnosed genetic heart condition called Long QT syndrome that means I constantly need an over abundance of potassium and magnesium which may explain my issue with NK. I need to supplement these electrolytes with prescriptions and food to maintain heart stability.
I had tachycardia as well although I don't have a diagnosed heart condition. It was about 1.5 yrs. into n.k. and it lasted on and off for about a wk.. In my case it was getting off my b.p. meds that fixed it. I am guessing they were interferring with a now normal b.p..
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Old 03-26-2013, 07:25 AM   #25
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I'm still in the weight-loss stage myself, but I know of several people on this board who are in maintenance and they remain in ketosis (Kristn aka Mom2Zeke comes to mind), and someone earlier mentioned Dr. Phinney, who has been in ketosis for 6 years.

My question is whether it is necessary to remain in ketosis over the long term to maintain the weight loss and physical benefits. I know Dr. Atkins recommended adding in as many carbs as one could while maintaining the weight loss, but I believe he left the stage, so to speak, before nutritional ketosis was really being formulated as a long-term lifestyle.
Dr. Phinney has been in ketosis for 9 yrs. at the time of his book (living). Taubes lives in ketosis as well I think.

Atkins did promote adding back carbs but he also said many will not be able to add back much. He seemed to be aware that carb consumption was directly tied to the state of ones' metabolism. I also think he tried to not seem more extreme than most already viewed him.
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Old 03-26-2013, 07:27 AM   #26
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I love Peter Attia's blogs. I am going to go spend some more time there! Thank you Mizzcase for reminding me of that!
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Old 03-26-2013, 08:27 AM   #27
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I hadn't heard of this podcast before. Thanks for mentioning it!
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Old 04-03-2013, 05:19 PM   #28
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i'm obsessive, i think you have to be to start with anyway

my biggest irritation is people who think its some kind of silly game or fad and spend their time trying to trip me up, one "not so friend" actually wanted me to try the cheescake she had made and assured me it was made with splenda, luckily i detest artificial sweeteners of any kind so i politely declined, i found out later she was lying and wanted to see if i could tell the difference - the silly thing is that if she'd said it had sugar in it i would have tasted a 1/4 teaspoon to keep her happy
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Old 04-04-2013, 12:39 AM   #29
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WOE: Nutritional ketosis
Start Date: April 2011
PerfectDeb, avoid that "friend" like the plague. With friends like that, you don't need enemies.

I was just watching a BBC Science program on fasting and longevity. The presenter has taken up a modified IF diet, and has seen his health improve a great deal, along with a deep reduction of his risk for a number of cancers. What was interesting to me is that so much of what they were recommending resulted in ketosis, with its accompanying health improvements. I suspected that the same benefits could be gained through NK, so I did some research online afterwards.

The top 5 search returns were scientific studies which have shown a definite relationship between ketogenic diets and lower IGF-1, which in turn produces lower rates of cancer, heart disease, and the development of alzheimer/dementia. I suspect those of you who have read a lot about NK know all of this, but I found it very encouraging. Not only will NK improve my quality of life in the short-term, but it may extend my life as well.

So I will guard my ketosis fiercely. ;D

Last edited by MerryKate; 04-04-2013 at 12:42 AM..
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Old 04-04-2013, 01:02 AM   #30
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Join Date: Mar 2013
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Or the people who try to talk "sense" in to you...sigh

I've done my research, primarily because in the beginning this was a search for a more rational common sense way to deal with my husbands type 2 diabetes - I just could not fathom how if a persons body is having trouble dealing with carbs why you would reccomended they eat a high carb diet, regardless of glycemic value. The most logical approach is to remove those carbs give the body a chance to heal and reset

Two and a half years later he's now healthy, yet our GP still maintains he should be eating the diabetes assoc diet plan (potatoes? Are you kidding me?!)

Last edited by Perfectdeb; 04-04-2013 at 01:03 AM..
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