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Comment by sfjailbird | Hacker News Reader

Just some anecdata: I have followed a disciplined keto diet for two-and-a-half years. I eat close to no carbs (apart from fiber). I do, however, like sweet stuff, so I use artificial sweeteners. Lots of them, every day. A mix of stevia, aspartame, sugar alcohols like erythritol, and so on.

I have never had an issue with them (that I am able to notice, of course, not saying they can't have some hidden harmful effects). For those saying that they are a slippery slide to eating more real sugar, I don't think so. At this point I recoil at eating anything with real sugar. It is overwhelmingly sweet, it almost burns in the mouth, and later I get bloated and retain water. I believe this is one of the criticisms of artificial sweeteners - that it lowers your ability to clear blood sugar, since you're just not used to having to produce a lot of insulin at one time. Well I don't actually want to eat a lot of sugar ever, so I'm okay with that.

I'm almost certain that artificial sweeteners have some bad effects somehow, but the bad effects of sugar are plentiful and obvious, so for now the trade-off makes sense, to me.

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I'm on my 1888th day after I changed my way of eating, and I hate when this happens to me, I mean, losing the ketosis because something I ate had too much sugar. It happens in some asian restaurants where they cook salmon with sugar and they don't tell you, in some places they add sugar to most japanese salads / wakame. I get bloated and retain water, I get out of focus easily, and I'm tired for the most part of the day. One day a friend of mine thought he had vodka (which does not kick you out of ketosis) instead he gave me some transparent licor, very sweet. I had the most profound high on sugar of my life, with just one shot, I had a high rush of feelings and pleasure, increased heart rate, I wanted to go out and party. I had nightmares that night, in the dreams I needed to run or escape. It took me 72h to fully recover. That said, I've written the most creative pieces of code, mostly backends in functional programming while on ketosis

Fellow keto-er here. There is definitely some hidden ultra sugar in some of those restaurant sauces. I've had a similar experience with takeout Chinese that was "just" chicken & vegetables. Two bites and I felt myself catapult out of ketosis, including the sugar rush you describe and even heart palpitations.

Another thing is that some artificial sweeteners instantly kick me out, too. Worse than sugar. I forget which one it is but I grabbed a "sugar-free" energy drink one time. I spit out the very first sip but still got kicked out of ketosis including the heat and sugar rush, that's how strong it was.

That said, stevia and monk fruit are totally fine for me. No effect whatsoever. I slightly prefer the taste of monk fruit.

You can just feel yourself go in and out of ketosis? What's that like?

Not always, but if it's super drastic. Feels like a massive sugar rush (or maybe it is actually just the sugar rush I'm experiencing when I accidentally eat hidden sugar?)

Get super hot, feel like my blood is rushing, heart beats.. not faster but.. louder?

So basically you came to a point you can't even eat fruits? How is it supposed to improve your health/life?

Most people (like myself) that keep in ketosis are doing so for weight loss.

Being fat is a lot more deadly than not eating fruits.

When I cut up an apple or wash some strawberries for my son, I eat a slice or two or maybe a strawberry. Blueberries work well, etc. It's just a choice to balance your diet a different way (I am not nearly as strict as OP). There's a lot of fibre in fruit, you can make it work, but most people don't realize how much sugar is in fruit and it isn't good for you if you are managing type-2 diabetes, or whatever.

a. Vegetables > fruit, and I eat a lot of vegetables, to substitute for the carbs. For example, I usually eat broccoli instead of potatoes.

b. Many fruits are 'keto friendly', like blueberries, strawberries, actually mostly berries :), but also something like water melon, in moderation.

c. A lot of modern fruit is engineered to be high in sugar and water and low in nutrients, so they might not even be so healthy as you think.

d. I can actually eat sweet fruit (although I don't often want to). I was talking more about sugar-crammed stuff like cake and soft drinks.

Lots of good points. I still eat fruit under specific circumstances. Rainier cherries, early season white peaches, and home ripened Red d'Anjou pears. All these fruit have this short 2-3 day window when they are beautifully ripe, silky mouth feel and when the fruit warms in your mouth, it releases a perfume that fills your nose with their own unique scent. These are food worth eating.

A close follow-up fruit is the small strawberries you get in Estonia at the end of June. They may also have them in Finland but I don't think I got there in time to try them. Again good texture, mouth feel and that wonderful aromatic strawberry flavor you don't get in most places. Certainly not from American supermarket berries.

Yea a lot of it is that your palate actually changes after a few months. It usually takes 4-6 months for me and then, when I go back, I notice that I don't enjoy the foods as much any more. Instead I've found new favorites to enjoy on my new diet.

Definitely happened with keto. You notice too that even when you get really hungry you don't fantasize about candy any more but about steak :)

Modern fruit isn't "engineered to be low in nutrients", this is straight up FUD. Selective breeding is all about tradeoffs and micro-nutrient density has historically been hard to select for, but your average supermarket apple is bursting with potassium, phosphorus, and vitamins C and E.

It might sound weird, but it's good for you.

Everybody eats wrong until diabetes, treatment resistant epilepsy, mental disease(bipolar, schizophrenia), some type of insulin resistance, overweight, etc (only these come at the top of my head) punches you in the mouth.

Then you have to eat correct. Which is low carb, high fat, low-to-medium protein.

And that is keto diet.

> How is it supposed to improve your health/life?

Lowering carb intake improves your health. While fruits "feel" good, it's mostly just sweets/carbs/fructose.

I just eat a bit of everything without doing any excess while avoiding (not 100% of the time though) processed food. What we call mediterranean diet I think. I am based there anyway. Except from cheese and chocolate I mostly buy only raw ingredients and cook myself. I do think this is the most healthy diet, both physically and psychologically as you don't feel like you need to give up something.

If I have en envy for say, cookies. First I will cook them myself. That leads to 3 things:

1. I need extra motivation, 20 or so minutes + more dishes to wash on top of the rest of the usual daily cooking.

2. I use basic, raw ingredients I control and not something stuffed supplements, fructose, palm oil and other bad shit.

3. I won't eat them all like there is no tomorrow because I know the value of them and I will have to make them again next time I want some.

Having said that I don't refuse the weekly ice cream (but it comes from an artisanal ice cream vendor, not the stuff from the supermarket) and won't give up on the occasionnal restaurant.

> I just eat a bit of everything without doing any excess while avoiding (not 100% of the time though) processed food.

Have you ever calculated the grams of fat/carbs/protein? *I bet* you're under-eating protein.

> What we call mediterranean diet I think.

This is not defined. Many countries do it differently.

Sounds like they’re happy and healthy. Why are you criticizing?

Haha I think that's a common keto response.

Person 1: I do keto

Person 2: I just eat <moderate/balanced/adequate/healthy/clean>

This seems to imply to person 1 that person 1 could do the same, which is often not true. Ketogenic diets have a whole bunch of benefit that no amount of moderation/balance will get to a person with those issues.

So ketoers often take issue with such comments when they seem to imply to be just as useful for dealing with said issues.

Ketoers are the ultimate peddlers of bro science.

Seems like a legit criticism :)

Care to expand?

I was mostly looking for protein. Nobody "eating in moderation" includes 500g of beef/day in there. It's usually just carbs or empty-stuff (salads that are mostly water).

I just want specifics. "Eating in moderation" often results in 50g of protein/day.

Epilepsy-specific ketogenic diets aren't recommended for people who don't have epilepsy. Their high-fat content far outweighs keto diets for diabetic patients or people on keto diets for general weight loss.

Also, keto diets don't affect someone's schizophrenia or bipolar disorder.

> Epilepsy-specific ketogenic diets aren't recommended for people who don't have epilepsy.

Many times you can lower the fat after some time/years even on epilepsy.

> Also, keto diets don't affect someone's schizophrenia or bipolar disorder.

You're wrong. I'm not saying it will "fix" it, only sometimes. But definitely improve quality of life. You might need epilepsy-keto though.

See https://metabolicmind.org/ & https://www.youtube.com/@metabolicmind/videos

Your links generally don't appear to be linking to scientific research groups. Metabolic Mind is funded by a wealthy family whose son claims to be cured of bipolar from a keto diet.

Many such cases

I was rate-limited yesterday, but you certainly replied so fast you had no chance to read/listen a little bit.

The thing is a non-profit.

See https://metabolicmind.org/metabolic-therapy-emerging-evidenc...

Or a subreddit for keto science https://old.reddit.com/r/ketoscience/search?q=bipolar&restri...

The top link https://old.reddit.com/r/ketoscience/comments/10bnaoi/ketoge...

https://www.sciencedirect.com/science/article/pii/S266691532...

Or https://brainenergy.com/ book.

Doctors who do keto for bipolar/schizophrenia basically follow the epilepsy protocols.

----------

Who will pay the studies? Are you gonna wait 40 years for the research to be top notch? There are doctors that have experience and can help you https://www.diagnosisdiet.com/directory

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EXAMPLE FROM REAL LIFE FOR YOU: I've taken a med that DOES_NOT_WORK_AT_ALL under 100mg, while for me it worked on 25mg, and even 6mg!!

There is no research for it. What should I do? Wait 40 years for the research to come up at 6mg?

I don't have epilepsy but keto fixed another sleep condition (Non-24 wake/sleep disorder) that is not generally "known by science" to be fixable.

I think fruit is seriously overrated from a health perspective. The main benefit of fruit comes when comparing it to candy, white bread, and desserts. Fruit usually has a bit more fiber. Many modern fruits still have a ton of sugar, and it's absolutely possible to give yourself diabetes just eating too much fruit.

Vegetables are packed with nutrients and fiber, without all the sugars that fruit brings.

I tend to think sugar and flour belongs at the top of a pyramid, fruit in the middle, and veggies is the base. However cutting out fruit altogether probably won't hurt at all.

I have a selection of studies saved for every time the anti-fruit line gets brought up.

https://news.ycombinator.com/item?id=28182058

>it's absolutely possible to give yourself diabetes just eating too much fruit.

[citation needed]

I don't have a study, but I seem to recall that fruit juice and smoothies may be problematic.

Fruit juice is generally not healthy because it excludes most or all of the edible fruit pulp, which includes all of the fruit's fiber and much of the fruit's antioxidant content. Whole fruits, on the other hand, have been shown time and time again to be a healthy food choice for most people.

> Our findings suggest that there is significant heterogeneity in the associations between individual fruits and risk of type 2 diabetes. Greater consumption of specific whole fruits, particularly blueberries, grapes, and apples, was significantly associated with a lower risk of type 2 diabetes, whereas greater fruit juice consumption was associated with a higher risk. The differences in the associations between individual fruits were not accounted for by variation in the glycemic index/glycemic load values of individual fruits. Overall, these results support recommendations on increasing consumption of a variety of whole fruits, especially blueberries, grapes, and apples, as a measure for diabetes prevention.

https://www.bmj.com/content/347/bmj.f5001

People who look at only the macronutrient ratios (fat, carbohydrates, and protein) while disregarding everything else tend to underestimate the health benefits of fruits. Nutrition is more than just macronutrients.

My understanding is the fiber of the whole fruit is important: it slows absorption of the sugar and adds bulk to aid digestion in general. Typically some or all of it is removed in juices and smoothies. I think of removing fiber as similar to adding sugar.

fwiw, I eat a low-carb diet (up to ~90g of net carbs, so not strict keto). I often eat some fresh or from-frozen fruit: blackberries, raspberries, blueberries, strawberries, orange (half a navel or a whole mandarin), or a few apple slices. I never drink juice. I don't feel fruit gives me any nutrition I can't get elsewhere. I can get vitamin C for example from various vegetables including red peppers, cabbage, and dark leafy greens. I also take a multivitamin because it's hard to get enough of some nutrients (notably vitamin D) that fruit doesn't help with anyway.

> [citation needed]

I don't have a citation either, but google search reveals the following points:

1) One serving, or one medium apple, provides about 95 calories, 0 gram fat, 1 gram protein, 25 grams carbohydrate, 19 grams sugar (naturally occurring), and 3 grams fiber. 2) Recommended amount of consumed sugar for an adult is 30 grams per day. 3) You can also find a lot of citations how increased sugar consumption increases chances of diabetes.

So two apples already gets you above the recommended amount. An apple is basically 80% sugar in terms of calories: 19 * 4 / 95 = ~80%

Your comment is misleading. About point no. 2, that’s the recommended amount of added sugar, not counting fruits.

There are no studies to my knowledge that show increasing fruit intake increases chances of diabetes. But there are studies that show that the risk of diabetes goes down by increasing fruit intake.

To my understanding, that included fruit sugar, not only added sugar:

https://www.nhs.uk/live-well/eat-well/food-types/how-does-su...

> The government recommends that free sugars – sugars added to food or drinks, and sugars found naturally in honey, syrups, and unsweetened fruit and vegetable juices, smoothies and purées – should not make up more than 5% of the energy (calories) you get from food and drink each day.

But even if the recommendation is added sugar -- what is the real difference between added and "natural" occurring sugar? Does this distinction invalidate my comment above? The point being that it's quite possible and even easy to consume several times, or even order above the reasonable amount of sugar by eating fruits. The apple is not even the sweetest one.

> and unsweetened fruit and vegetable juices

This does not count sugar in fruits or vegetables, but their juices.

It is a very ridiculous claim. There’s a study (don’t have the link to it as I’m writing from my phone). It says that increasing fruit juice intake leads to an increased risk of diabetes. Whereas increasing fruit intake leads to a decreased risk of diabetes. I hope someone else can find it.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453647/

Citation needed, aye?

Fearing diabetes is kinda missing the forest for the trees; the laser for the shark; the BED for the banana - it's deranged priority.

But thou asked.

1. https://en.m.wikipedia.org/wiki/Self-Defence_Against_Fresh_F...

2. https://m.youtube.com/watch?v=MlroOdP8p2Y

The glycemic load of fruit varies tremendously. You can find undomesticated fruit in the wild that is high-sugar / high-GI, and domesticated fruit (engineered over 1000s of years) that isn't. Fiber, micronutrient and phytonutrient content also varies, but in the main, they all provide health benefits.

> it's absolutely possible to give yourself diabetes just eating too much fruit.

It isn't, because that's not how it works. You get diabetes from obesity / high-calorie intake, not sugar. Sugar has deleterious effects but it will not in itself make you diabetic. https://www.health.harvard.edu/topics/diabetes#diabetes4 , https://www.cdc.gov/diabetes/library/features/diabetes-cause...

Can you point to a single person who has given themselves diabetes from eating too much fruit?

I doubt you could give yourself diabetes from fruit without really trying. The chewing just gets old real quick.

But I also don't think you miss much by cutting fruit out entirely. It's a bunch of sugar, a lot of fiber, and a few vitamins that you can easily get from other places like green, leafy vegetables.

Really nothing unique about fruit unless you just really like fruit.

But I also don't think you miss much by cutting music out entirely. It's a bunch of sounds, a lot of noise, and a few repetitions that you can easily get from other places like your natural environment.

Really nothing unique about music unless you just really like music.

...

But I also don't think you miss much by cutting art out entirely. It's a bunch of brush strokes, a lot of colors, and a few layers that you can easily get from other places like the world around you.

Really nothing unique about art unless you just really like art.

But I also don't think you miss much by cutting vision out entirely. It's a bunch of wavelengths, a lot of rod and cones, and a few optic nerve stimuli that you can easily get from other places like your brain itself.

Really nothing unique about vision unless you just really like vision.

...

But I also don't think you miss much by cutting walking out entirely. It's a bunch of muscle stimuli, a lot of breathing, and a few images that you can easily get from other places like moving in place.

Really nothing unique about walking unless you just really like walking.

Yes. And?

I can't reply to the child comment, but my main point its ridiculous to reduce down human enjoyment into "nothing is strictly necessary and there is no point to human existence or experience" and "you can get all the component pieces of a thing, so what is the benefit of the combined thing" as an argument for cutting things out. But yes, I don't disagree with "you don't need to eat anything complex really if you don't enjoy it and just care about basic sustenance".

It is ridiculous to get mad at someone who doesn't eat fruit for not eating fruit.

You like fruit? Great, eat fruit. Enjoy!

If OP was anorexic or undernourished or deprived of some essential nutrient there would be a point in pointing that out. But fruit?

I'm not mad at anyone here, no worries. Mainly just posted originally + here because I think some of the arguments being made are fairly ridiculous as stated, and primarily because I think the claim that you can get diabetes from eating too much fruit is just untrue in practice.

I mean maybe if you wanted to you could ;)

But not in practice, I agree. I was actually fruitarian for a few weeks and man it's HARD to chew enough food to even get your calories in, lol. Plus it's all cold so it's extra annoying cause you never get the thermal heat of cooked food!

Eat fruit then. The OP chooses not to, they're not telling you not to.

Important note that the vast, vast majority of fruits that humans consume are as natural as a chihuahua. Apples, bananas, oranges, etc are unnaturally sweet products of generations upon generations of selective breeding.

Blackberries, blueberries, and certain other fruits that are naturally sweet in the wild are an exception. The quantity of sugar in an apple is something that was rarely, if ever, found in nature before.

Still. So much fiber, so much chewing.

I'm not saying diabetics should go out and make banana smoothies. But I tried going fruitarian for 30 days in my 20s and I simply couldn't. I couldn't eat enough food to meet energy balance.

Maybe if you made banana puree all day but it gets real disgusting real quick.

I find fruit pretty self-limiting.

> vast majority of fruits

And vegetables. Everything gets selective breeding once it is a crop.

Or pigs. Basically inedible after they bred the fat out of them in the 80s/90s :(

Can genetic engineering rapidly bring to market fruit with all the flavor but 1/3 the sugar?

> later I get bloated

Anecdotally, this may be because you've decreased your intake and retention of B vitamins, which are water-soluble and essential in metabolizing carbs. Since you retain less water on keto, you have less B vitamins available to digest carbs (and you don't need them, because you're not eating carbs). A lot of people who eat keto feel bloated whenever they eat carbs, to the point that even if they want to quit keto they struggle to do it because carbs make them feel awful. I ate keto for about a year and stopped a couple months ago and experienced this.

So to anyone eating keto who may want to stop but feels awful when eating carbs, supplement your B-vitamins for a month or so, particularly B1/thiamine.

This is the first time I’ve seen anyone claim B vitamins play a role in carbohydrate metabolism. Do you have any sources?

Edit: Aha, from a bit of googling it looks like they are required cofactors for various enzymes.

> I'm almost certain that artificial sweeteners have some bad effects somehow, but the bad effects of sugar are plentiful and obvious, so for now the trade-off makes sense, to me.

Unknown bad effects are better than known bad effects? Not sure if thats sound logic.

> At this point I recoil at eating anything with real sugar.

It’s amazing what drinking regular coke is like after being off sugar for awhile. I swear the mouth-feel of drinking the syrup they make it with is there.

It's hard to give up the black oil, er, soda. I don't really like plain water. I can't take anything with most artificial sweeteners, they are migraine triggers for me. I bought a SodaStream, a 10 lb. bottle of CO2 and a few BiB syrup cases of Barq's Root Beer and have been lowering the concentration of syrup the past few months. I'm down to 1/4 the normal concentration of syrup. Eventually, I should be acclimated to the taste of fizzy water by itself... still not much of a fan.

Carbonated water plus orange or lemon peel is great!

There are several brands of flavored soda beverages that don't have any sweeteners, sugar or artificial. LaCroix is one of them.

The taste has been described as being "like sitting next to someone who is thinking about drinking an orange soda/root beer/etc."

> It’s amazing what drinking regular coke is like after being off sugar for awhile.

It's exquisite. I drink one every few months when we go out to a restaurant. Or a Dr Pepper, another favorite of mine. If you drink them every day, they're pretty boring. But once in a while, they're fantastic.

> I eat close to no carbs (apart from fiber).

How many net & total grams of carbs a day are we talking here?

> I do, however, like sweet stuff, so I use artificial sweeteners. Lots of them, every day. A mix of stevia, aspartame, sugar alcohols like erythritol, and so on.

Another point of keto is to also remove the carb/sweets addiction over time(I know it's hard, am addicted/recovering myself).

> How many net & total grams of carbs a day

Total grams doesn't matter. The point is the glycemic impact. Some people are very sensitive to carbs and can't eat a banana without throwing off ketosis, and others can have upwards of 30g of net carbs a day and still stay in ketosis. My goal is 20g or less, and my ketones still stay in the 1.5-2.0 range unless I overdo protein instead of fat.

For most people, the starting point is around 15g net carbs a day. If you're serious about keto (and staying healthy while doing so) you'll want a ketone testing mechanism as well as guidance from your doctor about adjusting medications since ketosis mimics a fasting state for a bunch of your metabolic processes.

> If you're serious about keto

I aim for >=2 mmol/l for ketones and <=4.5mmol/l for glucose (blood tests).

I think it also depends on the types of sugars. I can seem to tolerate way more lactose and still maintain ketosis, for example.

Plus there are different "levels of ketosis" and I'm not sure there's much research on it. E.g. my Non-24 is in remission even when I eat more of a VLCD. My ketones aren't as high but it works just as good for my purpose. I don't know if that level would be enough for an epileptic, for example, or someone who gets other benefits from keto.

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