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Comment by iamben | Hacker News Reader

I've been on a ketogenic diet for a year now and sleep has been the biggest thing. I was a light, restless sleeper and I noticed very quickly how how much better my sleep got. I'd fall asleep quicker and it feels (and tracks) deeper. I don't wake as much, sweat nearly as much when I sleep and wake up feeling far more rested.

Sleep aside, I don't sweat nearly as much during the day and I've shaken almost most all the IBS related problems I had. Feels a bit like a miracle. Trouble is, I wish (much like the article) I could understand exactly what it was that I cut out that made the biggest difference. Bread? Alliums? Fructose?

I guess the only way would be to reintroduce things slowly and test, or revert back to a carb heavy diet and remove stuff one by one... But when you're (finally) feeling great you don't want to mess it up :-/

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I've found with me that, after trying keto for ages and loving how I felt but hating the diet itself, I managed to pin point the issue down to grains. Any form of grain, be it rice, wheat, barley, oats etc, all seemed to mess me up big style. I'n now on a diet of mostly fruit, nuts, beans, seeds and tubers and I'm better than I was on keto on almost every measurable factor. I think cutting out the carbs initially improves the lives of most people because it's a group of food that contains the biggest offenders in terms of IBS related trigger, but it's rarely carbohydrate in itself.

In terms of reintroducing foods, don't go back to carbs and cut back! You're just setting yourself up to fail. Just reintroduce carbs slowly up. Start with tubers and root veg, as from what I've read they're often the easiest in terms of digestion. Then move on to fruits, then nuts, then seeds, then finish with grains. It could well be you're gluten intolerant so there are only a few types of grain you're sensitive to.

Maybe it is glycemic load? I completely agree, but I get hit hard by sugars, bread, mashed potatoes and cheap fries (really good fries I justify).

If you still want to enjoy fries, get an air fryer and just spray sliced potatoes with a very small amount of olive oil. Then cook only up to temperature of 250F/120C to prevent acrylamide from forming (it might take 30-60 minutes to be finished).

I used to be hit hard by regular fries (was feeling sick for a day, felt them staying in my stomach for a while etc.) until I switched to the aforementioned method. Taste is almost the same, but digestion is unproblematic now.

Processed carbohydrates will by definition hit you hard. Added oil is also hard. Try intact grains, e.g. rice, quinoa, millet, barley, etc. Even whole wheat bread or pasta will hit harder than boiled wheat grains.

Added oil is just fat, not bad for you. Specifically since op mentioned keto.

But they're not talking about keto if they're eating fries etc. Added oil is not good - in excess fat builds up in the cells and is responsible for insulin resistance. With ketosis this is temporarily staved off, but you will still likely have insulin problems when you go off keto, it doesn't actually fix anything, just offer temporary relief.

I don't think it's that, as I'll go ham on like 2000 calories of potatoes and beans after working out and feel great. My thoughts are that it must be a histamine response to some compound found in grains and some spices.

Thanks! This is great advice. If and when I return to the world of carbs I'll definitely do it like this. Keto as a diet really works for me (wonderfully). So many of my favourite foods!

It's a shame there's so much pseudo-science around food intolerances, as I'd basically dismissed out of hand that I might be intolerant to some foods.

As part of a separate diet, it's become clear to me that bread caused the life-long indigestion I've suffered, and that eggs were causing my skin to be bad, neither of which were links I'd made before.

Also currently on a diet that isn't keto -- I'm eating a lot of vegetables, and the occasional rice dish, and not being careful with sugar in sauces -- but lacks white carbs, and getting many of the benefits people who are on keto diets are claiming. As per the article, my sleep is massively improved, largely because I've stopped getting up in the night 20 times to pee.

I advise all my friends to do a "one food and work up" diet. I had massive problems with sleep, my skin, my bowel movements, general fatigue, long-onset DOMS after working out - the list goes on. These are completely gone now I pin-pointed the issue. I cut back everything, and added things one ingredient at a time. I started with only root veg, then added legumes, then brassicaceae veg (kale, cauliflower, broccoli etc.) That covered all my nutritional needs bar B12, which I supplement. From there, I've slowly added one more food every couple of week.

My only guess is that I have a histamine response to some kind of compound found in grains and certain types of spices. The body is a strange machination. Honestly, doing the reduction diet was the best thing I've ever done. If you could make a medication that brought me from how I felt 3 years ago to where I am now, you'd be worth more than Bezos.

for how long did you eat the one food item for? ( is that all you would eat?)

About 2 weeks with 'low risk' foods, and up to 4-6 weeks with 'high risk' foods - low risk being low FODMAP foods, and those that you rarely hear of allergies with. 'High risk' were things like nuts, which many people react very poorly to. I'd add them to the foods I already knew were safe to eat. So for example, I've recently taken to adding buckwheat (which is weirdly a fruit) to my stews and granola after workout. I'm slightly concerned that I may react badly, so I won't add anything new to my diet for a while until I'm 100% sure that it's not causing any under-lying inflammation. I'll mentally keep track of variables like my gym performance, mental acuity, ability to absorb new information, tiredness levels etc. I very much play it by ear though. If I'm especially stressed, or miss workouts, or suffering from any other thing to could contribute to me feeling tired or down, I'll lay off adding any new foods because it will skew 'results'.

This sounds very similar to Mast Cell Activation Syndrome and it might be worth your time to ask a doctor about it if you haven't already.

Thanks, I'll definitely look into this. I take anti-histamines and aspirin to regulate some of my symptom outbreaks as per a recommendation from my GP, so the fact that it's mentioned as a treatment certainly perks my interest.

My wife had struggles very similar to yours. She had herself tested for a super broad range of allergies and intolerances (this wasn't cheap) and found that her histamine levels were 20x the upper bound of "normal". This was in a time when eating a single chocolate chip cookie could knock her out for days.

She then did an elimination diet much like yours (but without the keto - she just cut out anything that either is high in histamine or encourages histamine production in the body). She's a different person now. Her gut mostly recovered in the sense that the same cookie would now make her feel bad for a few hours and sometimes not even that. It's great.

Just in case it interests someone, she maintains a food blog particular for histamine intolerant people at https://histaminefriendlykitchen.com/

It makes sense that histamine messes with sleep. The drug modafinil (Provigil, Nuvigil) is a pro-histamine and considered a nootropic because it reduces sleepiness and even increases focus.

I wonder, can one use a pro-histamine food as a nootropic?

Have you checked for diabetes?

I have, because I’m super super sensitive to sugar, get thirsty a lot, and pee a lot but ... the tests are always normal. Cutting out sugar has made any symptoms go away.

There are food allergy tests that you can take, too. I've done the ALCAT test, and it was very helpful. It's a blood test, and provides a big list of red/yellow/green foods.

e.g. Red = likely to cause a strong negative reaction.

I found it to be extremely helpful in finding things that were causing issues.

Kale, Cumin, etc. Things that I would not have easily identified on my own.

I did one of those, and later found out the one I did was pretty non scientific :-( I’d urge caution there

What about quinoa? If that's still an issue, what have been your favorite substitutes for grains? I'm fond of riced cauliflower.

Quinoa is great, as are lentils and corn. You can also get lots of different types of cous-cous made using legume flour. Those are my go to's if I want to add something grain like to my meals. I've experimented with some others like Teff and Amaranth, but they still made me feel sluggish and restless.

Whole grains will be packed with protein and fiber, and the refined flours lacking these may lead to blood sugar voodoo when consuming past a certain threshold. Like refined sugar consumption it's though that empty carbs also have a similar effect. I suspect the primary issue with wheat is it's almost never in whole grain form.

I thought it was the lectins in the grains that cause a lot of problems for people.

I don't think that's been substantiated. Legumes, potatoes, tomatoes and some fruit are lectin-rich. Blue-zones diets tend to lean more heavily on legumes. There's the whole gluten thing for wheat and others but it's unclear to me how much of an impact that may have.

Super helpful advice, thank you

The thing with fibre and carbs (like in fruits) is that the fibre will line your intestine so you don't absorb the carbs as much, but allows the carbs to pass to the next intestine where the gut bacteria there loves the stuff.

This sounds quite interesting to me, have you tried a FODMAP diet for your IBS symptoms before switching to keto? I've been going back and forth on FODMAPs for the last year and a half to try and pinpoint what it is that triggers my symptoms, however no matter how "cleanly" I eat I often end up getting symptoms from foods that are supposedly safe for me (or no symptoms at all from stuff that a few months ago would've given me days of problems). I'm looking to switch it up a bit since it doesn't seem like FODMAP is a viable long term solution and it's not solving my problems entirely, would you recommend looking into keto?

I never tried a FODMAP diet - I guess at the time it just seemed _too_ restrictive. I suppose keto is just as restrictive, but it's like anything right? You're never going to be able to give up smoking until you're ready to give up smoking. I was just at a point in life where I could embrace something and it worked for me.

Based on how _I_ feel, I'd definitely recommend it. But I'm (definitely) not a doctor, and you're (most probably) not me(!), so I can't tell you whether it would work for you or not. That said, there are some fabulous communities, a lot of advice, data and science about keto though - have a read of some and if you think it fits, give it a go and see how you feel :-)

I had the same experience with a fasting/keto regimen. The fasting had a big impact on how deep my sleep was. At times it almost felt like coming out of anesthesia at the hospital.

I have always had great sleep, so for me it's easy to notice when my sleep is affected since it's so rare.

Top 3:

- weight. The fatter i get, the worse i sleep. And it's a vicious circle.

- rafined sugar. Too much of it will make me restless, including the sweating you mentioned, but also accelerated cardio respiratory rythm.

- things agressive on the intestine such as too much milk (i'm NOT lactose intolerant)

Screens, late intense lights and coffee seldom affect my sleep, although the later is starting to now that i'm getting older.

I think no refined sugar will be my starting point if and when I ever reintroduce carbs. I've always exercised pretty consistently, I didn't have much weight to lose when I started the diet, and I still eat a load of cheese - so I think it's probably my best guess as a starting point.

Coffee is a funny one - I've never been able to make a direct correlation between that and sleep (it doesn't seem to have too much effect), but when I cut coffee down to (for the most part) a single cup in the morning, I now notice that a second cup will give me jittery legs.

I'd argue cutting refined sugar is good for everyone, and probably the easiest place to start when you're trying to lose weight / live more healthily. Replace sugary coke with a sugar free version, or put less sugar in coffee (that's how I started); the cravings, if you have them, will gradually diminish.

I believe cheese fits in a keto diet as well. If you want to adjust that a bit, go for hard / old cheese instead of soft ones. Also go for real cheese, none of that "sandwich slices" stuff in unrefrigerated plastic packaging.

Maybe pre-diabetes?

https://www.webmd.com/diabetes/features/diabetes-lack-of-sle...

Nah, I've had that checked multiple times.

Interesting! I have the opposite experience. I've gone on a bunch of very low-carb diets, maybe ten at this point (not sure if they were exactly ketogenic or not), and I've enjoyed them. But every time I try low-carb, my sleep gets extremely light (I'll wake up 3 or 4 times a night), I sleep a couple hours less than normal, and I get weirdly vivid dreams. It's always the weird sleep that makes me quit the diet.

I wonder if it's symptomatic of low-fat diets, or insulin resistance from too many carbs. Apparently going very low-carb can cause insomnia for some people as well.

Self-experimenting is important I guess. I'm faring better with my nutritional intake.

I recommend discussing with a medical professional if you sweat. Sweat means inflammation, fever or slight fever. It could be nothing but it could be also symptoms of pre-diabetes type 2, cancer or other chronic disease.

It could also mean your duvet is too thick, or that it's summer...

yes, that's true. But he also states that he sweats more depending on food. That means his body has an inflammation reaction towards certain foods. Could be sugar/refined grains (which untreated could lead to diabetes type ii), other people have inflammation when eating BBQ red meat (which increases risks of cancer)

Sounds super interesting. Can you provide a link or a quick list of the things that you eat for your diet. I’m currently having great difficulty sleeping due to IBS.

Sure. Can't give you an exact list, but start with https://www.reddit.com/r/keto/wiki/faq and then take a look at dietdoctor.com who have a 2 week (I think) intro to keto which gives you some decent variation with keto food (and worked really well for a friend of mine). I use MyFitnessPal to track what I eat and keep below 20g of net carbs every day (usually coming in around 10-15).

Good luck with it - IBS is absolutely miserable.

Do you drink? I gave up drinking for a few years for weight reasons, and my IBS fixed itself, and didn't come back when I started drinking again.

Beer certainly exacerbated my symptoms. Alcohol has become a much-less-often thing for me (mostly because you can't really have 'a quick pint'). I've benefitted most mentally here though, I think? You don't realise how often you have that post drinking booze-blues (even in the most minor way) until you don't have it very often.

Coincidentally, cleaner alcohol (vodka) seems to minimise the mental and physical hangovers far more than drinking beer.

I pretty much don't. Although I like to taste a glass of different types of beer when I go to a new region (here in Europe). I have noticed that it does trigger the IBS symptoms roughly 40% of the time. Thanks for the comment. I think I'll give up on the tasting because like the parent mentioned IBS is miserable.

Maybe you want to consider to switch to a whole food plant based diet. Other than the other „lifestyle“ diets such as low carb, the plant based is actually backed by science. A good source is nutritionfacts.org and the book „how not to die“ by the same author. If you asked me to switch two months ago, I‘d say no way. But the science behind it convinced me to try it and it is so much easier than expected.

Appreciate the comment; I tried veganism as a test for a month a few years ago and didn't get on with it at all. Keto seems to work pretty well for me - I enjoy the food and there's plenty of science to geek out on :-)

The science is actually very shaky. I've looked at the first 30 or so studies Greger cites and they often seem not to give (with statistical significance or at all) what he seems to claim. There are also many duplicated sources to increase the citation page count. He also cherry-picks very strongly.

If the science is a private website and a book by the same person, it's not really "science".

And by mixing and matching different research papers, any diet peddler/author/etc can make it appear as their specific diet is "backed by science" (when it's just a bunch of disparate papers in its favor, without context -- e.g. later responses to those papers, quality and reproducibility, papers that study the exact opposite claims and also work, etc).

The only real science is not in studies (that are a dime a dozen, of widely different quality, and most are shoddily done and discredited by later studies), but in what's accepted by the nutritionist/medical professionals as nutrition 101.

>* The website is not by a single individual with commercial interests. All revenue from the book goes to his foundation, which runs the website*

Not sure for the particulars of this case, but setting up a "foundation", "non profit (which gives one huge salaries as 'expenses')" and so on, are the oldest tricks in the book for con-men, from churches, to donations, activists, etc...

So "all money goes to the foundation" is hardly comforting (the foundation can be setup to cut them a big payslip for their consulting/services/running it, save him tax, etc, in the end make them more than they would make with a "for profit" entity).

What's the best that we can eat? --> What we're evolved to eat What did hominids eat up to 10.000 years ago? --> Everything except carbs as we know them today

There's your connection of science to low-carb

Carbs in the quantities that we have them these days are ridiculously unnatural,

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