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Comment by DiabloD3 | Hacker News Reader

The brain runs almost entirely on beta-hydroxybuterate, and human mitochondria have a very efficient process to use BHB (instead of glucose) for power.

The most efficient diet for humans is one high in fat, moderate in protein, and low in carbs; which explains the absolutely curable disorder known as Diabetes II (aka chronic insulin resistance).

And before anyone jumps on the "keto is a fad diet" bandwagon: if it is, indeed, a fad, it is a fad that modern humans have eaten for 200,000 years, and our ancestors have eaten for another 2 million before that. If our taste for fat did not make us human, it certainly defines a particular trait of ours that all humans depend on.

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I certainly function (mentally and physically) better in a state of ketosis. Notwithstanding my personal anecdote, I want to add to your observation on energy/atp (in the mitochondria) efficiency and BHB/ketones.

A lot of people counter argue that the body/brain run more efficiently primarily on glucose and glycogen rather than ketones. While it is true if you introduce sugar (glucose) into the blood, cells will generally begin to produce energy/atp primarily from glucose over ketones. However, it is not because the glucose is more efficient, in fact ketones are smaller making them the a more efficient fuel source of the cells. For example, bc they are smaller they cross the blood-brain barrier more easily and are more efficiently used by brain cells to be converted into energy/atp (in the mitochondria).

I think there is a reason we call it “getting knocked out of ketosis” because that is our natural state. That is forget high fat/low carb and abstain from all calories and drink only water to stay hydrated and the body will go into ketosis, which is what we are talking about when we discuss “fasting” as a metabolic state (vs say a culturally/religiously defined “fast”).

The body runs more efficiently on glucose when measured in terms of oxygen consumption. That's why very few elite endurance athletes eat ketogenic diets. Their performance is limited by how much oxygen they can metabolize.

I’d say historically (modern history) you didn’t see any athletes eating ketogenic diets, but more and more you are seeing athletes (especially endurance athletes) eating Keto diets. Keto is great for aerobic activity, the idea of a tribe of early man persistence hunting a mammoth for example would have performed better long term in ketosis having unlimited stores of fuel (fat) rather than draining their glucose in 8 or so miles and “hitting a wall”.

It’s anerobic activity (sprinting or bodybuilding/Olympic lifting) where there may be a slight detriment in performance.

I’ve run marathons in both ketosis and running on glucose. I won’t go there because it’s anecdotal but marathoners, body builders and Olympic style lifters are not the norm and have different requirements especially competing for records. No doubt it’s one thing to live in a natural state of ketosis and treat yourself to a performance boost with some fruit when you are about to burn any glucose than what almost the entire modern world does and spikes their insulin levels all day every day and their body/cells basically not even familiar with how to use ketones as a fuel.

Sure it's possible to eat a ketogenic diet and complete a marathon, but we know from basic biochemistry that it takes more oxygen molecules to produce a given amount of energy from fat metabolism than from sugar. So for elite athletes whose performance is limited by how much oxygen they can get to their muscles it makes the difference between winning and losing.

Diabetes II can also be “cured” by a high carb low fat diet. Not all carbs are equal; the problem is refined carbs.

You can cure diabetes with refined rice, fruit, fruit juice, and sugar diet (Kempner rice diet). The problem isn't any particular macronutrient, it's most likely an excess of calories.

> The brain runs almost entirely on beta-hydroxybuterate

This is not true.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900881/

Quote: The mammalian brain depends upon glucose as its main source of energy, and tight regulation of glucose metabolism is critical for brain physiology.

https://www.ncbi.nlm.nih.gov/pubmed/27826689

Quote: β-Hydroxybutyrate (βOHB), a ketone body, is oxidised as a brain fuel. Although its contribution to energy metabolism in the healthy brain is minimal, it is an interesting metabolite which is not only oxidised but also has other direct and collateral effects which make it a molecule of interest for therapeutic purposes.

> The most efficient diet for humans is one high in fat, moderate in protein, low in carbs;

This is not true.

Scientifically proven best diet: Whole food plant based high carb, low-moderate fat and low protein.

Unless the body is starving, fat and protein are not converted to glucose (the main energy source for cells) to cover energy needs.

Fat Consumption is the Only Cause of Weight Gain (2018-07-14). https://neurosciencenews.com/fat-consumption-weight-gain-957...

Why Doctors Don't Recommend A Vegan Diet | Dr. Michael Greger (2015-05-17). https://www.youtube.com/watch?v=_d1Ca6SsKfE

Dr Garth Davis: Americans have become obsessed with Protein (2015-10-28). https://www.youtube.com/watch?v=XQCt3IhaUtU

Omnivore or Herbivore? https://livinontheveg.com/omnivore-or-herbivore/

Besides:

https://www.youtube.com/channel/UCGJq0eQZoFSwgcqgxIE9MHw/vid...

>>Fat Consumption is the Only Cause of Weight Gain (2018-07-14). https://neurosciencenews.com/fat-consumption-weight-gain-957...

Wow the sugar industry is still at it. Read the abstract. The study concludes that mice are incapable of auto-regulating caloric intake because fat stimulates their pleasure pathways causing them to overeat. Kinda like how sugar behaves in humans. See the graphical abstract[0] for a pictorial depiction the authors have helpfully provided.

[0]: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(18)...

You are right to question this study and the conclusion of the article. Still, the study shows some important points:

- Professor John Speakman, who led the study, said: “The result of this enormous study was unequivocal – the only thing that made the mice get fat was eating more fat in their diets.

- “Carbohydrates including up to 30% of calories coming from sugar had no effect. Combining sugar with fat had no more impact than fat alone. There was no evidence that low protein (down to 5%) stimulated greater intake, suggesting there is no protein target. These effects of dietary fat seemed to be because uniquely fat in the diet stimulated the reward centres in the brain, stimulating greater intake.

Anyway, one has to wonder why the body has a natural tendency to eat carbs (only in plants like healthy fiber) if they are not part of the natural diet: Sweet fruits. Sweet vegetables. Sugar. Starch products. Processed meat with vegetable spices and not just bloody pure meat like carnivores with the appropriate digestive system.

Sugar and Fat Bingeing Have Notable Differences in Addictive-like Behavior https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714381/

WHY LOW CARB DIETS ARE A SCAM (2016-11-30). https://www.youtube.com/watch?v=1dj-Wmmt0FE&feature=youtu.be...

The Science of Cheese Addiction (2017-03-25) https://www.youtube.com/watch?v=1hE6lhQu7k4

You're wrong about most things but it's definitely cool to see cheese addiction come up in mainstream media. I used to eat whole blocks of the stuff at a time and when I quit I was literally shivering. That stuff might be alright in small doses if you have an eating disorder and need to make food more palatable, but it is not good for adults.

As a Midwesterner, I feel attacked.

EDIT: in all seriousness, I appreciate your anecdote. This thread is convincing me of how little I know.

Don't believe everything you read, even rehashed science journals. You only have to look at what pro cyclists eat to know that fat isn't a cause of weight gain. When I stopped sugar and carbs (but still ate fruit so no ketosis) and started eating high amounts of fat the weight dropped off of me. I was already normal weight (185cm @ 85kg) and I lost 10kg. Fat has absolutely no blame in weight gain.

...for some people anyway.

Fat keeps you satiated for much longer and also helps avoid the sugar spikes that accompany carbs.

Protein and carbs are both more satiating. High-fat diet doesn't necessarily improve blood sugar regulation, since insulin resistance can increase.

https://www.ncbi.nlm.nih.gov/m/pubmed/7498104/ https://www.ncbi.nlm.nih.gov/m/pubmed/26615402/

The study you linked talks about saturated fats.

>A diet very high in fat and saturated fat adversely affects insulin sensitivity and thereby might contribute to the development of type 2 diabetes.

It's well established that sugars are responsible for type 2 diabetes.

>Isoenergetic 1000 kJ (240 kcal) servings of 38 foods separated into six food categories (fruits, bakery products, snack foods, carbohydrate-rich foods, protein-rich foods, breakfast cereals)

This is a badly designed study. It doesn't test the macro level satiety. It says "fat content" which I am going to presume is in the snack foods which are also high in semi-complex sugars.

The thing with all of these studies is that they are easy to try at home on yourself. It's well documented that the sugar industry paid to give fat a bad name but if you eat a high fat, plentiful protein and low carb diet for a month you will now the truth. You can feel it, you can see it.

> The study you linked talks about saturated fats.

True, saturated fat is probably the worst on this front, and unsaturated fat, if it comes packaged with things like vitamin e (to help prevent oxidation) might not be so bad.

> It's well established that sugars are responsible for type 2 diabetes.

No, it's actually not. This is a popular theory, but it's not very well supported. In terms of NAFLD, a strong contributer to insulin resistance, the worst offenders (in the context of a hyper-caloric diet ) are saturated fat and sugar (at 33% of the effect of sat. fat). Sugar only becomes bad when it's converted to fat, which only happens to a significant degree in hyper-caloric diets, when the liver can't dispose of the glucose quickly enough.

Your anecdotal evidence is nice and all, and may work for you, but is no substitute for meta-analysis of controlled studies.

https://caloriecontrol.org/meta-analysis-of-sugar-and-type-2...

The diet you describe is what I am using to treat my AS. It's not cured it by any stretch but it has done wonders and is improving my health steadily the deeper I go into this dietary journey.

I have understood that saturated fats are bigger culprit for type 2 diabetes than high carb intake. Also sugars are larger risk than carbs in general.

Type 2 is insulin resistance. In other words your body produces insulin to clear sugar from the blood but the body no longer responds (actually clears the sugar from the blood) to insulin.

The resistance (type 2) is built up over time (historically it was “adult onset”) to insulin spikes. I don’t believe saturated fats introduce sugar into the blood, so they don’t cause insulin spikes, which means they don’t contribute to resistance (at least not directly).

In a roundabout way they may contribute to a surplus of calories and the storage of fat, ultimately causing obesity, which does seem to speed up the resistance to insulin. But all things being equal the same surplus of calories on a high carb diet will be more detrimental because there will be insulin spikes and the insulin will also enlarge fat cells allowing the body to store more fat (ie become obese more efficiently).

https://www.ncbi.nlm.nih.gov/m/pubmed/26615402/

Yes the study suggest high fat diets may effect insulin sensitivity....so long as the test subjects are consuming carbs ALSO and triggering insulin. In other words the didn’t test effects of high fat diets while subjects were otherwise avoiding insulin spikes.

So yes eating fats is an issue while eating carbs and spiking insulin. You won’t find a single medical case of T2D where the subject hasn’t repeatedly spiked insulin with carbs/sugar.

High fat diets can cause insulin resistance. So can high protein diets. Overall blood sugar regulation remains similar across most macronutrient ratios as long as calories are controlled, as cells scale their receptivity to insulin to maintain homeostasis. The number one controllable factor is calorie intake (minus calorie expenditure), not macronutrient breakdown, and there isn't any one priveledged breakdown that universally works for everyone to control calorie intake.

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