Long Term Impact : Ketogenic Diet

Are there studies on larger groups about the long term impact (5+ years) of Ketogenic diet on type II diabetics? Alternatively are there studies on people with other conditions that could possibly be applicable to T2Ds ? I am looking at specific answers to the following queries:

1. Does it mess up uric acid ?

2. Are there supplements or is there an additional dietary intervention that can continue to provide the benefits of a stricter low carb diet while maintaining the blood pH balance (e.g., upping vegetable intake)

3. What are the top 3 supplements to manage a ketogenic diet on a longer term basis while containing the side effects (if any).

4. Is V-LCHF an independent variable in dyslipidemia ?

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  • Here's one study recalling from top of my head:

    body.io/following-ketogenic...

    As an Indian (Type 2 on no medications for sixth year running) who has repeatedly experimented Keto in short bouts here are my observations:

    1. It's a difficult diet to sustain and for vegetarians, it becomes still more difficult.

    2. Heart rate and blood pressure goes up -- possibly because of loss of micro-nutrients

    3. Not much fiber in diet, so something needs to be done for this since it may impact gut flora. I have read cases of people trying to add Unmodified potato starch to feed the gut bacteria.

    General observation while looking at experience of other Indian diabetics who tried keto

    1. Can impact thyroid functioning for some.

    2. Lipids can go haywire for some.

    Supplements -- I have personally seen that while increasing a muti-vitamin -- Supradyn -- from 1 to 3 a day, heart rates and blood pressure were better.

    YMMV (Your Mileage May vary)

  • Thanks. Prompt as ever. I did go through this one earlier. We need a bigger longer study it seems. Gut microbiome does take a hit (N=1). Potato starch can be disruptive in my case. Home made sauerkraut is a better option for me along with OptiBac extra strong (20 bn + if I remember correctly). The disapproving doctor mentioned that monitoring urine micro albumin may not be a bad idea. Docs push back on LCHF / V LCHF (what else) whipping up fears of messed up lipids and declining kidney function.

  • Though an animal model study, but better than no study and only opinion:

    newswise.com/articles/low-c...

    Docs are permanently tied to their belief that SFA is bad for heart, despite multiple research/study to show that it is not.

    N=1 Dr Bernstein claims to have reversed his kidney disease living on 30g carbs/day. Here's one youtube video from him -- interesting to see how there's a flip-flop and how funding can muzzle real studies :)

  • Bernstein, Bernstein, Bernstein. Coolest T1 on the planet!

    Super post. Haven't seen this, thanks!

  • Great you have a mindset resisting doctors who have a mindset.

  • Great. LCHF community needs express answers as any test report (why lipids of course) if off pushes one towards the mainstream healthcare experts which is a frustrating disorienting experience as ultimately they do not have answers. The choice is - oral medication for glycemic control and a little more carbs (not a choice for sustained LCHFer) or do your LCHF if you will but then statins are a must (again not a long term choice).

  • LCHF and Statins - It's mostly the hyper responders or genetically inclined to LIPIDS going haywire who have LIPIDS go haywire on LCHF. However, that population is small. That said, we Indians normally hover around 100 grams carbs as opposed to 30g or 50g that's normally presumed in western source. This is because most find it difficult to get to the 50g carbs territory.

    For the hyper-responders, they can experiment by additionally replacing part of dietary SFA in LCHF with MUFA, but problem with MUFA is that it is very unstable so really cannot be used for cooking.

    In fact, I have seen many go off statins on the ~100g carbs LCHF that we tend to follow. Besides LIPIDS, one should also look at inflammation markers -- like hsCRP -- and other things like lp(a), apoB/apoA1 ratio etc while evaluating the need for statins. Also, per one study, LDL only explains 25% of the CVD story:

    bostonheartdiagnostics.com/...

    In addition one should note that not everyone metabolizes statins the same way:

    bostonheartdiagnostics.com/...

    Does mainstream doctor ever look at these data before prescribing statins?

  • A lot of esoteric questions that could go on forever.

    Keep it simple,

    If in doubt, eat like your grandparents who lived to 80 plus.

  • Thanks for the helpful inputs. Will do a rethink on my lipids tracking. ApoB / A-1 seems to be a better area of focus. I wish I could manage with 100g or below. I shoot beyond an eAG of 125 and that isn't too exciting.

  • I'm not sure about a ketogenic study specifically, but the longest study of LCHF has been the history of human-kind.

    As a species we are only just recovering some of the stature we enjoyed pre-agriculture. I don't think there's much doubt that we had to adopt agriculture to avoid starvation, but for the modern food industry to claim grains should be the majority of what we eat demonstrates a bias that does not have our health interests at heart.

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