Comment by d1sxeyes | Hacker News Reader

Comment by d1sxeyes | Hacker News Reader

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I find this a bit problematic. I'm not sure that the metabolism of glucose is anything other than a proxy for brain activity, and so this may just be expected behaviour (hardly a shock that someone with ADHD has less brain activity in areas associated with attention).

The second study is based on a very small number of participants (only 14 kids with ADHD and 11 without), at varying different stages of puberty (worth carefully considering whether glucose processing in a 7 year old is fairly comparable to a 14 year old).[0]

There's still some stuff to explore on this topic, but the conclusion that changing the way people consume sugar can have an impact on ADHD is, in my opinion, premature.

Obviously, 'reliable, steady' sources of glucose and 'protein-rich' diets are not bad, and better nutrition is likely to help relieve any diet-exacerbated symptoms of ADHD, but I think more research is needed.

[0]: the linked article states '28 children ages 7 to 14—17 with ADHD and 11 without'. I think this is pretty easy to misread, but it's not incorrect. It's an em dash between 14 and 17. The range is 7-14, and the bit after the em dash is the breakdown. It's not as I initially read it '28 children with AHDH aged from 7 to 14-17' (on further introspection, it wouldn't really make sense like that anyway).

While I agree with you on the basic premise that those scans are likely reflection of how ADHD brain works in general and not strictly how ADHD brains processes glucose.

It's been shown that ketogenic diets - where whole body and brain switch to fat/ketones instead of glucose for power helps with Epilepsy (and was it also Parkinsons).

In my biochemistry class at MIT during undergrad, the professor showed during the section on the krebs cycle that the pop-culture concept of "ketogenic diet" is almost never actually doing what people believe.

To force your body into a purely ketone metabolism, you'd need to restrict not just carbohydrates but also protein. If a person is eating a high-fat, high-protein diet, their body will make glucose/glycogen from that.

Not to say there isn't value in a low-sugar diet. There's a whole cascade of other things happening metabolically in response to blood sugar. Just that the notion of "burning ketones instead of glucose" is a medical myth, like "depression is because you have too little serotonin in your brain".

>To force your body into a purely ketone metabolism, you'd need to restrict not just carbohydrates but also protein. If a person is eating a high-fat, high-protein diet, their body will make glucose/glycogen from that.

That is expected and fine. It wont make glucose/glycogen in the same way/manner it would do from carbs though, and it's not really a problem for getting into ketosis and staying there (as shown by ketone measurements).

That professor was making a pedantic argument it seems.

THere's some evidence, yes, but there's also research that suggests that ketogenic diets can lead to increased risk of heart failure, blood pressure issues, increased risk of kidney stones, so it's really a bit of an evaluation on a case by case basis on what the benefits vs drawbacks are in each individual case, rather than a blanket recommendation that everyone with ADHD/epilepsy/Parkinson's/whatever follows a ketogenic diet.

There are also often gallbladder stones.

AFAIK they usually form ahead of ketogenic diet - when people are eating little fat and dont need much enzyme/bile - it's not flushed from gallbladder often enough.

And then increased fat consumption on ketogenic (or Paleo, Mediterranean, Carnivore ...etc) diet requires flushing gallbladder - and only then you realize you have gallbladder stones.

Anyway - true ketogenic diet is hard to pull off and maintain. Even just few glasses of milk (~2.5g of carbs per 100ml) could take you out of ketosis.

Same for basically any typical fruit (e.g. apple, pear, orange, banana...etc) where one fruit is enough carbs to take you out of ketosis.

So it's more realistic to sustain low carb with <=50g of carbs per day, and get most of benefits (including weight loss without increasing exercise) without too much risk of all the mentioned negatives.

Of course YMMV, and you should consult at least your GP (or other specialists) before changing your diet a lot.

In personal experience - such low carb diet works nice in combo with skipping breakfast (not quite intermittent fasting, but time between first and last meal is shorter than time from last meal until next days meal).

If anyone is like me and can't really skip breakfast, nor at least delay first meal until noon.

I've found drinking "bulletproof coffee" takes case of hunger and energy until actual lunch time.

Despite media hype it can be just water, coffee - instant or grounded Turkish/Greek/Balkan style, espresso isn't enough liquid for full mug - with butter and coconut aka MTC oil.

And of course if such coffee doesn't work for you as meal replacement. Then eggs, bacon/sausages, avocado (no bread, no beans, no orange/apple/etc juice) is a perfect (practically 0 carbs) meal that works for breakfast, brunch or dinner.

Premise there is that while "normal" (average neuro typical) brain works just fine with either glucose or ketones - it's different for non-typical brains.

And through bypassing damaged or suboptimal glucose pathways, you also bypass problems that come with it.

Of course it might also be that ADHD brains simply do come from evolution of what used to be Hunters (as opposed to Gatherers). It wouldn't be too unreasonable to think Hunters ate more fat and protein than Gatherers.

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