Controversial Thoughts: The Dangers of Long- term Ketogenic diets

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Paul Saladino37m · 2021-10-01

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Well SupportedA fasting insulin level below 5 micro IU/mL is considered healthy.Well SupportedDiabetics who consumed 175 grams of honey per day for eight weeks lost approximately two kilograms.Well SupportedDecreasing monounsaturated and saturated fat while increasing polyunsaturated fat intake, keeping total fat stable, decreased total testosterone by 15% in one study.Well SupportedThe free testosterone to cortisol ratio is a useful marker for training stress and requires a moderately high carbohydrate intake for validity.Well Supported

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Wearing a CGM can reveal glucose dysregulation in pre-diabetic and normal individuals.

Well SupportedPaul Saladino remains insulin sensitive despite significant carbohydrate consumption due to his blood work foundation and not being obese or diabetic.

Partially SupportedPaul Saladino's current diet macros are approximately 20% carbohydrates (150g), 50% fat (150g+), and 30% protein (200g), totaling around 2750-3000 calories daily.

Well SupportedStress hormones like catecholamines, epinephrine, and cortisol can increase during fasting or carbohydrate restriction to help liberate stored glycogen.

Well SupportedReducing carbohydrates in the diet may improve muscle fullness, sleep quality, absence of muscle cramps, and reduce palpitations.

Well SupportedInsulin has anti-natriuretic actions in the kidney, helping prevent electrolyte loss.

Well SupportedFruits and honey are the least toxic and best source of carbohydrates, with many fruits providing electrolytes like magnesium and potassium for hydration and energy.

Well SupportedThe relationship between glycemic index, glycemic response, and disease outcomes is limited even in observational studies.

Well SupportedIt is not possible to adequately supplement electrolytes to maintain normal levels on a ketogenic diet.

Not SupportedKetogenic diets can decrease T3 thyroid hormone levels and cause muscle loss.

Not SupportedAfter 1.5-2 years on a strictly carnivore diet, problems began to be experienced.

Well SupportedPolyunsaturated fatty acids may interfere with triiodothyronine binding to thyroid receptors.

Not SupportedA ketogenic diet can decrease testosterone production and increase sex hormone binding globulin, leading to decreased free testosterone.

Well SupportedThe carnivore diet can be beneficial for individuals with eczema and autoimmunity.

Not SupportedKetogenic diets are not optimal for long-term human health, except for specific conditions or short-term appetite reduction.

Well SupportedIncorporating honey and fruits into the diet can help normalize SHBG and optimize hormone levels.

Well SupportedFasting insulin is the easiest lab metric to monitor for potential negative effects of consuming fruit and honey, especially if linoleic acid intake is low.

Well SupportedThe free testosterone to cortisol ratio is a useful marker for assessing overreaching in athletes and individuals with very low body fat.

Well SupportedLong-term ketogenic diets are associated with elevated SHBG, potentially lowering free testosterone.

Well SupportedReintroducing carbohydrates and other dietary changes returned Paul Saladino's hormones to optimal levels and increased libido.

Well SupportedInterpreting blood work should involve triangulating fasting insulin, fasting glucose, and hemoglobin A1c, or using a CGM.

Well SupportedMonitoring both the peak glucose level and the speed of recovery to pre-meal glucose values is crucial for assessing metabolic health.

Well SupportedKetogenic diets are being researched for neurodegenerative disorders like Parkinson's and Alzheimer's disease.

Well SupportedCarbohydrate deprivation diets can lead to lower T3 levels and increased reverse T3, indicating impaired T4 to T3 conversion.

Well SupportedIndividuals on a carbohydrate-deprived diet may experience lower testosterone and higher cortisol post-exercise.

Well SupportedOverfilled fat cells release free fatty acids, which disrupt insulin signaling and glucose handling, leading to metabolic dysfunction.

Partially SupportedDietary carbohydrate-to-protein ratio does not affect inflammatory markers; body fatness is positively associated with serum CRP.

Partially SupportedHigh free fatty acids and high insulin can occur in pathological states like sickness, injury, or inflammation, inducing insulin resistance.

Not SupportedLong-term ketosis can negatively affect cortisol metabolism, thyroid hormones, and other physiological functions in some individuals.

Partially SupportedAdding carbohydrates back to the diet, starting with honey and fruit, may improve issues encountered on ketogenic diets, particularly concerning electrolyte balance.

Not SupportedFollowing a strict carnivore diet for about a year and a half can decrease active thyroid hormone (total T3) and slightly decrease testosterone.

Partially SupportedIncluding carbohydrates, specifically honey, increased total testosterone from 562 to 742 and free testosterone from 4.64 to 6.4.

Partially SupportedEliminating processed sugars and seed oils high in linoleic acid can reverse diabetes or insulin resistance.

Not SupportedHealthy individuals should not adhere to long-term ketosis as it is likely to cause problems.

Partially SupportedPaul Saladino eats beef and ruminant organs due to their nutrient density and lack of concern about linoleic acid content.

Partially SupportedPaul Saladino considers fruit and honey in his diet as part of a low-carbohydrate diet if less than 40% of his calories come from carbohydrates.

Partially SupportedThe speaker consumes 2700 to 3000 calories daily, is 5'10" and 170 pounds, and follows a low-carbohydrate diet with 150-175 grams of carbohydrates daily.

Partially SupportedFasting insulin is a critical blood test that everyone should consider getting.

Well SupportedKetogenic diets improve glucose disposal and insulin sensitivity in some individuals.

Partially SupportedTemporary high blood sugar spikes to 150 mg/dL are not problematic if the body manages them effectively and the overall area under the curve is low.

Partially SupportedInsulin can directly increase the activity of epithelial sodium channel, sodium phosphate transporter, sodium hydrogen exchanger type 3, and sodium potassium ATPase.

Not SupportedPolyunsaturated fatty acids, particularly those found in margarine, are detrimental to health.

Not SupportedA fasting glucose level of approximately 120 mg/dL after five years of strict ketosis is indicative of physiological insulin resistance.

Partially SupportedIntervention studies typically find little relationship between glycemic index or load and physiological measures of disease risk.

Partially SupportedA high-carbohydrate diet can slow down immunity.

Partially SupportedElectrolyte issues develop when insulin signaling is limited by not eating carbohydrates, and this disruption cannot be fixed by electrolyte supplementation.

Not SupportedPaul Saladino does not fear fructose or sugar within a food matrix and does not believe long-term ketosis is beneficial for humans.

Partially SupportedA carnivore diet provides adequate vitamin E, which is found abundantly in fats.

Partially SupportedConsuming less than 40% of calories from carbohydrates classifies as a low-carb diet based on Western definitions.

Partially SupportedContinuous glucose monitors are beneficial for triangulating information about metabolic health.

Partially SupportedConsuming carbohydrates can alleviate symptoms like muscle cramps and palpitations in individuals on a carnivore diet.

Partially SupportedA ketogenic diet is defined as consuming less than 50 grams of carbohydrates per day, typically less than 20 grams.

Partially SupportedThe area under the curve (AUC) of blood sugar readings on a continuous glucose monitor is a key indicator of metabolic health.

Partially SupportedLimiting carbohydrates can be a temporary fix for diabetes but does not address the root cause.

Partially SupportedLong-term ketosis increases blood free fatty acids, signaling peripheral tissues to refuse glucose and resist insulin.

Partially SupportedLong-term ketogenic diets can result in a baseline blood sugar between 110 and 120 mg/dL.

Partially SupportedInsulin is a necessary hormone and does not cause metabolic dysfunction on its own; metabolic dysfunction should be feared instead.

Not SupportedA ketogenic diet leads to reduced carbon dioxide production, which may be detrimental to metabolism and the efficacy of vitamins like K2.

Partially SupportedInsulin has anti-natriuretic actions, meaning it promotes sodium conservation.

Not SupportedLong-term ketogenic diets may negatively impact platelet function.

Partially SupportedC-peptide levels were lower with the inclusion of carbohydrates in the diet compared to a zero-carb diet.

Partially SupportedKetogenic diet-induced physiological insulin resistance is faster to correct than polyunsaturated fatty acid-induced metabolic dysfunction but leads to high baseline glucose.

Partially SupportedA vegan diet can lead to significant glucose elevation in the middle of the night, indicating poor insulin sensitivity.

Partially SupportedConsuming a few tablespoons of honey, strawberries, mango, or papaya is acceptable.

Partially SupportedThe glycemic index and glycemic load have little relevance.

Not SupportedHigh intake of magnesium and potassium can be dangerous, especially potassium.

Not SupportedExcess insulin from carbohydrates is not the primary cause of metabolic dysfunction or diabetes; insulin resistance in the liver leading to inappropriate gluconeogenesis is the root cause.

Partially SupportedHigher TSH generally indicates the brain is working harder to stimulate the thyroid gland to produce thyroid hormones.

Partially SupportedJennifer H. experienced improved mood balance and workout enhancement after taking bone marrow and liver supplements.

Partially SupportedA hemoglobin A1c of 4.7 suggests an average blood glucose of approximately 85 mg/dL.