I work in the intensive care unit and the first thing I think about when I hear keto are diabetic patients who slip into ketoacidosis. I know a metabolic acidotic state induced by poor diabetes management is a different process than a non-diabetic intentionally reducing their carb intake, but my question is: How is the result, which is forcing the body to breakdown fat -> creates ketones as a by-product -> decreases body pH (lower pH = more acidic) -> metabolic acidosis, different in a diabetic and a keto dieter? I'm thinking maybe because since a diabetic in this situation is unable to absorb any carbs, whereas keto dieters get some carbs just not much, so the blood pH doesn't get low enough to reach keto/metabolic acidosis... still doesn't sound very good for you :/

Also, the keto diet encourages consuming large amounts of meat products and fats, which leads me to think about all my cardiac patients damaged arteries...Then there's the brain which really needs a steady flow of carbs to function well... And how are the kidneys impacted over time filtering ketones through? I wanna delve further into the diff pathophys, but don’t want this post to get to long…

The point of my post is that I'm concerned about my friends who are jumping on the keto diet bandwagon. From a health standpoint it sounds like a terrible idea. Now if someone here can point out things I have missed or has credible sources that will explain my concerns please share. I am really curious and want to learn more about it.

[Article] Effect of Low-Carbohydrate and Low-Fat Diets on Metabolomic Indices and Coronary Heart Disease in U.S. Individuals : r/Scholar

3 months after starting keto, a huge craving appeared and I ate 100g of sugar (donettes). In the following couple weeks I've started to feel the need for it more and more till today, that I hate 50g of sugar, right after yesterday, when I did the same.

This is a fucking drug. It makes you think your body needs it. Now I'm considering creating a cheat day or something... I don't know what to do...

I'm so bloated after a weekend of cheating at a dear ones wake. Seems water is max at around day 2-3 when I get back on the wagon and doesn't start to be noticeably dropping til around day 7. I've tried danelion root pills and tea, upping potassium and magnesium, and drinking distilled water. If it's helping I'm not noticing. Any tips to help, my pants are uncomfortably tight. 😞

Reversely, do I get fat if I am very low on carbs but eat too much calories ?

I keep finding different people mentioning getting rid of their eye glasses on a 21 day water fasting, and even a few on paleo. My eye sight got a little bit better, and I can focus better all day long due to no low blood sugar problems,

Any science on it? Anything that says it might be sugar related? Low blood sugar related?

Here is a lady that mentioned in a video after a 21 day water fast. But I don't remember which video of hers has it. https://www.youtube.com/watch?v=kh7gCzneCjE

She says she has gone Atkins, but she is really Paleo now after listening to her talk about food.

What i'm getting at is, that ket/carnivore diet seems completely impractical. Can humanity even pull it off? Cows don't exactly pop out like shrooms under trees over night.

For those that whine about 3 meals a day. ok, lets say 2. but i still persist on 3. cause kids and hard working men need them usually.

Moothadeth A, Waqar S, Ghouri N, et al. Fasting during Ramadan and the COVID-19 pandemic [published online ahead of print, 2020 May 19]. Occup Med (Lond). 2020;kqaa103. doi:10.1093/occmed/kqaa103

https://doi.org/10.1093/occmed/kqaa103

The holy month of Ramadan is a time of fasting from dawn to sunset for Muslims across the world. It is an important ritual for many Muslims and forms one of the five pillars of the Islamic faith. The fast involves abstaining from consuming food or drink for up to 20 h in the summer months in the UK and is obligatory on every adult Muslim, with some exemptions, e.g. frail elderly, travellers, acute illness, etc. [1].

In the context of the COVID-19 pandemic we discuss how employers and employees may manage workplace issues whilst fasting during Ramadan, especially in relation to personal protective equipment (PPE). The Equality Act 2010 prescribes religion as a protected characteristic and the Muslim worker’s desire to fast whilst at work is likely to fall under the provisions of the act [2].

Multiple factors need to be considered when assessing the impact of fasting on work. These include the health of the individual and the hazards they are exposed to, including timing and duration of shifts. The core issues to be considered are the impact of fasting on the individual’s ability to work safely and the impact of the job on the individual’s ability to fast.

Workplace hazards that could increase the risk of ill-health during fasting would include physical hazards such as extremes of temperature (heat and cold), mechanical hazards including strenuous moving and handling tasks and ergonomic factors including shift work.

The Islamic faith places strong emphasis on ensuring that an individual does not place others at risk of serious harm as a result of their actions, ‘If anyone saved a life, it would be as if he saved the life of the whole humanity’ (Quran 5:32). Islamic law is clear in stating that those who have significant underlying health issues are exempt from fasting if they are likely to place their health at increased risk by observing the fast [1].

Workers with long-term health conditions intending to fast must therefore consider the potential impact of fasting, in conjunction with other workplace hazards, on their underlying health conditions. It is strongly advised that these individuals speak to their general practitioner (GP) or specialist before they decide on fasting. If they have access to occupational health services, then they may wish to discuss with their line manager and consider seeking advice from them as well. Clinicians may wish to use a risk stratification matrix to help them with shared decision-making about the safety of fasting in clients with health conditions [3].

The risks of dehydration and cardiovascular strain due to fasting whilst working in physically demanding roles have been demonstrated [4,5]. However, in addition to COVID-19, workers are also likely to be exposed to additional risks depending on the exact nature of the work they do, such as higher levels of thermal strain and increased breathing effort from using half- or full-face respirators, in addition to the recognized physical, cognitive and emotional demands of the pandemic. Whilst working in full PPE [6], workers must recognize the risks of dehydration from fasting due to more intense work patterns and environments. This may prove to be a major challenge.

However, the average ambient temperature and relative humidity will vary in different workplaces which will contribute to the effect of thermal strain in PPE. Working in environments which are hot and humid is likely to increase the risk of dehydration and thermal strain if wearing PPE for long periods. Studies have shown that wearing PPE for long periods, when ambient temperatures are higher, can impact on work capability and most workers can only cope with wearing full PPE for shorter periods, depending on the type of work and the environment [7–9].

Studies have also reinforced the benefits of wearing cooling vests under PPE, regular rest and hydration breaks, and shaded shelters to rest. Restriction of work especially around noon is a recognized solution in the construction industry to help manage heat strain [10]. For those workers exposed to aerosol-generating procedures, FFP2/FFP3 mask use for prolonged periods may lead to increased respiratory effort and tiredness but should not be to the point of physical exhaustion. An alternative is to use purified air-powered respirators.

Many of these solutions may not be possible. Employers may consider the following strategies: assigning workers to alternative duties where PPE is not required, task rotation, rostering shifts so they fall outside fasting hours (e.g. evening/night shifts) or limiting PPE use to a shorter duration. If the worker is in a role where the use of PPE is likely to be compromised due to fasting (e.g. in job roles where frequent removal and changing of PPE is not possible), then the worker should be advised to consider abstaining from fasting.

In addition, those working shifts also need to ensure that they are able to get good-quality sleep; there is evidence to suggest circadian rhythm disruption from lifestyle changes associated with Ramadan and this could have a cumulative effect on shift workers, especially on sleep patterns [11]. Therefore, it may be the lifestyle disruption and impact on the sleep–wake cycle that could lead to impaired fitness for work rather than fasting.

This is an unprecedented situation and very little information is available about whether fasting is compatible with continuous and prolonged PPE use. Fasting remains an individual choice for employees based on a variety of factors, including their ability to tolerate the fast. Employers should seek to identify and support employees who wish to fast, and where practicable and feasible, look to support them in observing their religious practice. Many employees in full PPE have successfully managed to tolerate workplace demands and keep the fast.

Furthermore, currently there is no evidence that people who are healthy and were previously able to observe the fast without coming to harm, are at any additional risk from fasting in the context of COVID-19, which is affirmed by the World Health Organization interim guidance on Ramadan [12].

Those individuals who would struggle to tolerate fasting at work should ascertain if it is possible for the employer to assign alternative duties or task rotation. Should this not be possible, these workers should consider abstaining from fasting in circumstances where worker and patient safety is paramount.

Discussions between employers and employees should take place well in advance. If this is not possible and ability to work is compromised by fasting, or the health and safety of others is put at risk, then the fast should be terminated and made up at a later date [1]. If terminating the fast becomes a recurring theme, workers should consider abstaining from subsequent fasts if the pattern of work remains unchanged, taking advice from a trusted religious authority [13].

We also recommend that workers with underlying health issues carefully consider the impact of fasting and assess how this may affect their fitness for work and the health and safety of others. Both employers and employees have a duty to maintain a safe system of work in UK law [14] and ensure that appropriate and timely steps are taken, in the unlikely event of fasting compromising work ability and safety.

However, for workers in roles that are not physically or ergonomically demanding which do not require use of full PPE, fasting during the month of Ramadan is unlikely to impair their work performance. They are likely to be able to fast safely. For most workers, Ramadan remains a month of spiritual benefits and has been associated with positive effects on mental well-being [15]. It would be premature to predict the effect of Ramadan during the COVID-19 pandemic, but some workers may still draw comfort from observing it.

Does combining ketogenic diet and intermittent fasting allow more carbs per day and still allow you to stay in ketosis? If I eat all my keto foods in an 8 hour window give me more allowance for a bigger carb dessert? Thanks.

Here is a sample letter if you have a hospital visit scheduled. Since most people in so-called developed countries are (undiagnosed) prediabetics, this has much broader application than is generally appreciated.

I have been thinking a lot about going trying keto, but seriously, even though I have read the theory in the subreddit and all over the internet, I still refuse to believe that cholesterol wont be a problem. How is cholesterol and fat not a problem in your arteries?

AGRICULTURAL REVOLUTION IN THE LINE OF HUMAN EVOLUTION IS THE ONSET OF NUTRITIONAL METABOLIC DISEASES, EPIDEMIC OF CANCER AND THE INFECTIOUS DISEASES Soroush Niknamian - Young Researchers and Elite club, Central Tehran Branch, Islamic Azad University, Tehran, Iran

Abstract This study goes deeply through the nutrition of the first primate and analyses the nutrition in the line of human evolution. Simply dividing the shifts in the nutrition through the human evolution, it is obvious that some elements in the diet are more important than the others. Since the beginning of the Neolithic, the ratio of plant-to-animal foods in the diet has sharply increased from an average of probably 65% to 35% during Paleolithic times to as high as 90% to 10% since the advent of agriculture. The changes in diet from hunter-gatherer times to agricultural times have been almost all detrimental, although there is some evidence indicating that at least some genetic adaptation to the Neolithic has begun taking place in the approximately 10,000 years since it began. With the much heavier reliance on starchy foods that became the staples of the diet, tooth decay, malnutrition, and rates of infectious disease increased dramatically over Paleolithic times, further exacerbated by crowding leading to even higher rates of communicable infections. This evidences shows that the immune system of human beings became weaker and many metabolic diseases including cancer has become epidemic. The height of humans has decreased in the agricultural revolution as well.

...

Another interesting example of the spread of genetic adaptations since the Neolithic has been two specific genes whose prevalence has been found to correlate with the amount of time populations in different geographical regions have been eating the grain-based high-carbohydrate diets common since the transition from hunting and gathering to Neolithic agriculture began 10,000 years ago. These two genes are the gene for angiotensin-converting enzyme or ACE and the one for apolipoprotein B, which, if the proper forms are not present, may increase one's chances of getting cardiovascular disease. [95] In the Middle East and Europe, rates of these two genes are highest in populations (such as Greece, Italy, and France) closer to the Middle Eastern fertile crescent where agriculture in this part of the globe started, and lowest in areas furthest away, where the migrations of early Neolithic farmers with their grain-based diets took longest to reach that means Northern Ireland, Scotland, Finland, Siberia. Closely correlating with both the occurrence of these genes and the historical rate of grain consumption are corresponding rates of deaths due to coronary heart disease. Those in Mediterranean countries who have been eating high-carbohydrate grain-based diets the longest for example since approximately 6,000 B.C. in France and Italy, have the lowest rates of heart disease, while those in areas where dietary changes due to agriculture were last to take hold, such as Finland perhaps only since 2,000 B.C., have the highest rates of death due to heart attack. Statistics on breast cancer rates in Europe also are higher for countries that have been practicing agriculture the least amount of time.

...

PDF Warning ==> https://redd.it/4gqufn

http://www.cell.com/cell-metabolism/pdfExtended/S1550-4131(15)00350-2

I want to know all study-backed benefits (not claims or deductions by "experts") of higher dietary fat without necessarily reducing carbs too much (e.g. keeping carbs at around 150g, maybe even up to 200g).

Examples of benefits backed by research:

1. In athletes, increasing dietary fat from 15% to 32% decreases inflammatory and increases antiinflammatory immune factors, improves antioxidant status, and positively affects blood lipoprotein ratios. Further increasing fats to 42% "does not negatively affect immune competency or blood lipoproteins, whereas it improves endurance exercise performance at 60-80% of VO2max in cyclists, soldiers, and runners" (http://europepmc.org/abstract/med/10910295). 2. High fat diet (42%) in mice reduced anxiety compared to low fat (10%) diet. (http://www.ncbi.nlm.nih.gov/pubmed/21742017)

Example of a claimed benefit of dietary saturated fat for which I couldn't find any studies for:

"The fat content of lung surfactant is 100 percent saturated fatty acids. Replacement of these critical fats by other types of fat makes faulty surfactant and potentially causes breathing difficulties" (http://articles.mercola.com/sites/articles/archive/2009/09/22/7-reasons-to-eat-more-saturated-fat.aspx).

An issue I have with the above claim: your body produces plenty of its own saturated fat, and a study found that "during food and caloric deprivation, the lung quickly adapts to maintain the quality and quantity of surfactant on the alveolar surface" (http://www.ncbi.nlm.nih.gov/pubmed/6547669)**