Tuesday, December 16, 2014

Ketogenic Diet Diary, Days 1-6

Glucose metabolism is well understood.
Ketone metabolism is not well understood.

Established: Alzheimers patients have reduced glucose metabolism in their brain, even before symptoms show up.
Hypothesized: Increasing ketones in the brain to complement glucose metabolism with ketone metabolism may help MCI/AD patients.

A hypothesis... has yet to be rigorously tested. A theory... has undergone extensive testing.
Ketone metabolism for fueling brain cells for MCI and AD has some positive tests, but not yet extensive.

Research topics:
Ketogenic Diet
Ketogenesis, the process by which ketone bodies are produced as a result of fatty acid breakdown.
Ketone bodies, there are many
Beta-Hydroxybutyric acid, the main ketone that may help brain function but can also fuel most other human cells other than the liver.

Started on 16 December 2014
Day 1

Goal is percent of diet from carbohydrates less than 5% per day. Purpose is long-term ketone fuel instead of glucose fuel. Reason is to see if it will help the problems I have from Mild Cognitive Impairment (MCI) and a encephalitis in my brain.

Yesterday turned out to be a good pre-diet start at 15.4% of calories from carbohydrates. I had four slices of whole grain bread, two around breakfast and two around lunch. After that I had very low carbs.

I have been tracking every calorie since 23 July 2014 to try to lose weight slowly. Losing weight slowly has been working. I have lost about ten pounds. I went from my fat pants being too tight in the waist to fitting to being loose to skinny pants being tight to skinny pants being loose.

I total from midnight to midnight. Last night I woke up and had a protein drink about ten pm. We did not have eggs or bacon so Carla went to the store early this morning and I waited so I did not have breakfast until about 8:30 and I had 2 scrambled eggs and 2 turkey bacon and a glass of water. I also took my morning supplements and medicine which diet is only affected mostly by the fish oil pills that help with cholesterol. So far my carb intake since midnight is 1.45%! I tried some exercises and I could not do quite as many pushups, pullups, or chin-ups as I had been doing recently. Maybe my excitement is why.

My diet plan is very low carb, around average fat, very high protein. The main source of calories is Premiere Protein chocolate shakes, eggs, and turkey bacon. I add Dasani flavor drops to my water to add flavor and electrolytes.

8:20 pm. I have not noted anything in my notes about anything unusual today except my calorie intake is unusually low at only 945 calories consumed so far today. I plan to have a protein shake and go to bed.

Summary of the first day, posted on the 2nd day:
5 large eggs
5 turkey bacon
4 fish oil pills
2 gummy fiber pills
3 Premiere protien chocolate shakes
.25 oz raw almonds
3 pints of water

1,105 total calories
129 grams of protein
46 grams of fat
35 calories of carbs w/o fiber
3.18 carb calorie %

The first day was no miracle cure for MCI or my encephalitis damage.

I am using the nutrition facts from package labels when available otherwise from a nutrition web site and I am using the rule-of-thumb of 4 calories per gram of carbohydrate so I think you should not blame me if the grams to calorie or calorie to grams conversions do not equal.
My starting weight was about 147. ("about" because exact weight varies throughout the day like if you guzzle a pint of water (16 oz) then you are immediately 1 pound heavier)

Day 2
Many years ago I went on a vegan diet for a whole year to see if it helped my health. This was long before doctors finally figured out my thyroid problem. The only change noticed was improved cholesterol. A ketogenic diet is like the opposite of a vegan diet in some ways. If I stay on this diet for at least a month I will get my blood cholesterol levels checked. They were all in normal range the last I was tested at my annual physical a month ago I know because I have a print of all the lab work. I forgot to order ketone test strips until this morning. They will be here by tomorrow night.

Here is some information about high protein diet:
"The effects of protein are very subtle. It's hard to answer if high protein diets are unsafe," says Heymsfield.
"If you take in too little protein, you lose body protein. If you take in too much, you just burn it as calories." Heymsfield is a professor of medicine at Columbia University in New York City and at the Obesity Research Center at St. Luke's-Roosevelt Hospital.
"In addition to not providing any benefit to general health, eating a high protein diet may have adverse effects, some research has suggested. The authors cite several studies that have found associations between excess protein in the diet and kidney disease. Another study suggests a relationship between high protein intake and prostate cancer."
"Due to the lack of data, conclude the researchers, a maximum intake level for protein cannot be determined for a healthy adult population."
"Taking in excess protein means you'll just be excreting it," Pagenkemper says. "Basically, high protein is just an expensive way to feed yourself."
[adequate water consumption may reduce risks to kidney problems]

I woke up hungry and ate 225 calories at 4:30 and went back to sleep.
I woke up hungry and ate 289 calories at 9:30 and stayed awake.
10:21 am: BP 119/76, pulse 67
Got hungry and ate 259 calories at 12:15.
Took afternoon nap.
Got up slightly hungry and ate 259 calories at 3:45.
Slightly hungry and had snack of 7 almonds 40 calories at 5:00.
Not hungry but ate 259 calories at 8:45 so I would not wake up hungry.
Go to bed at 9:00.

Diet summary from following day
4 large eggs
5 turkey bacon
4 fish oil pills
1 gummy fiber pills
5 Premiere protien chocolate shakes
.5 oz raw almonds
3.5 pints of water

1,326 total calories
183 grams of protein
49 grams of fat
52 calories of carbs w/o fiber
3.93 carb calorie %

Day 3

Woke up at 12:15 a little hungry and drank a protein shake of 160 calories and went back to sleep.
Got up about 8:30 and ate an egg and bacon at 99 calories.
Took a long, hot bath.
Carla took me to a doctor in another city. It was a very tiring trip. We took a cold bag with hard boiled eggs, bacon, and protein drinks in it for me and Carla ate at fast food restaurants

BRAIN DOCTOR VISITCarla helped me figure out what happened at my neurologist's office. Here are some things we remembered.

I told the doctor about my ketogenic diet and she thought it was a good thing to try. The doctor said it could take several weeks to notice a change or longer than that for full effect. I told the doctor I was concerned about the drop in total calories I consumed the first two days because I was not eating as many calories as usual but I was not hungry. The doctor said "protein makes you feel full" so since my diet is very high protein, that explains that. I do not mind losing a little bit more weight so I am not concerned about that right now but later I may adjust my diet to slightly increase fat and slightly decrease protein to help me be hungry enough to maintain ideal weight.

The doctor said I did a good job researching ketones. I asked if I could get a job doing research but the doctor and Carla and the other person there all said no. That was very disappointing. They did not explain why not.

The doctor said I could try something new called Axona instead of a ketogenic diet. Most of this I learned after I got home: Axona is a 40 gram packet of powder that you consume once a day in water or mixed with anything else and it has a large number of Medium Chain Triglycerides (MCT) that are the same as in coconut oil but the spike in ketones lasts for hours instead of only an hour like when I have tried drinking coconut oil. It is a "medical food" so it requires a doctor prescription but is not a drug and it is not a dietary supplement by the legal definition of dietary supplement even though it supplements your diet.

I said I wanted to keep trying my ketogenic diet and maybe try the Axona later because Axona is to help alzheimer's and mild cognitive impairment patients and not cancer patients and I have a lot of friends with cancer and a ketogenic might be able to help them but some people who have had ketogenic diets for cancer had a hard time staying on the diet and I want to see if I can figure out a ketogenic diet that is easy enough for people to stay on and that is one reason I am using a high-protein average-fat low-carb ketogenic diet instead of a high-fat average-protein low-carb ketogenic diet and since the Axona only boosts blood ketones for a few hours I figure cancer patients might need the boosted ketones 24 hours a day like happens with a ketogenic diet if you stick to it.
The doctor gave me a starter Axona box and a prescription and I can try it later either with the ketogenic diet or in lieu of it.

I am going to get retested sometime to measure my memory performance and other brain functions.
The papers that come with Axona show that its positive effects are much better for people who take it every day than the people who forgot some days and very much better than people who took placebo. Test at day 45 showed significant improvement and day 90 tests showed even more improvement. It shows exact test numbers but I do not understand their significance other than that the patients brain performance was better rather than the same or worse.

Diet of day 3
5 large eggs
5 turkey bacon
4 fish oil pills
1 gummy fiber pills
4 Premiere protein chocolate shakes
1 Muscle Milk drink
3 pints of water

1,375 total calories
177 grams of protein
51 grams of fat
36 grams unsaturated fat
61.7 unsaturated fat %
72 calories of carbs w/o fiber
5.21 carb calorie %

Day 4
Woke up about 5:30 and drank a protein drink, 160 calories

I am concerned about what will happen to my cholesterol levels, so that will be tested after 30 days on this ketogenic diet. Fats are far more complex than just saturated and unsaturated. Although saturated fat gets pointed out as bad for human cholesterol it really depends on the type of saturated fat and how it is balanced with other types of saturated and unsaturate fats. For example this statement may be close to true but is oversimplified and has exceptions: "Isocalorically replacing dietary carbohydrates with monounsaturated and polyunsaturated fats has been shown to lower serum LDL and total cholesterol levels and increase serum HDL levels, while replacing carbohydrates with saturated fat was shown to increase HDL, LDL, and total cholesterol levels. Trans fats have been shown to reduce levels of HDL while increasing levels of LDL." Generally you want low LDL and moderately high HDL to be healthy.

Day 4 diet was the same food as the first 3 days: eggs, turkey bacon, protein shakes, almonds, fish oil pills, fiber pills, water.

1,267 total calories
178 grams of protein
46 grams of fat
30 grams unsaturated fat
65.3 unsaturated fat %
51 calories of carbs w/o fiber
3.99 carb calorie %

Day 5

I added a calculation for percent of daily calories from saturated fat to try to watch to keep it below 7% for optimal cholesterol control.

1,267 total calories
178 grams of protein
46 grams of fat
30 grams unsaturated fat
65.3 unsaturated fat %
5.09 saturated fat daily %39 grams of all carbohydrates
15 grams of carbohydrates excluding fiber ("net carbs")
156.56 calories of all carbohydrates
51 calories of carbs w/o fiber
12.36 carb calorie %
3.99 non-fiber carb calorie %

Day 6
Morning: I have had some mild constipation so I am increasing water and fiber pills. I have no appetite. My writing skills seem slightly improved. I have not noticed any other changes.

Noon: My blood ketone level has increased to .7 and my blood glucose level is 130. My last food was a protein shake two hours before the blood tests.

.3 mmol/L blood ketones on day 3 was in the mild ketosis range
.7 mmol/L blood ketones on day 6 are into the nutritional ketosis range, as expected.

My appetite returned, but my total calorie consumption was still pretty low for the day. According to one formula for my gender, age, height, and weight, I should be burning in the neighborhood of 1,800 calories a day not counting any exercise.

I ate an ounce of cheddar cheese because I noticed its nutritional components make it ketogenic, but I did not notice that it would knock my % of calories from saturated fat above 7%. It was also a bad idea on this day because cheese can increase problems with constipation.

1,159 total calories
132 grams of protein
55 grams of fat
31 grams unsaturated fat
57.2% of fat was unsaturated
8.08% of total calories were from saturated fat38 grams of all carbohydrates including fiber
11 grams of carbohydrates excluding fiber ("net carbs")
153.52 calories of all carbohydrates
35 calories of carbs w/o fiber
13.25 carb calorie %
2.98 non-fiber carb calorie %

Friday, June 27, 2014

(The Allegory of) Ten Men Drinking Beer

Suppose that every day, ten men go out for beer and the bill for all ten comes to $100. If they paid their bill the way we pay our taxes, it would go something like this:

The first four men (the poorest) would pay nothing.
The fifth would pay $1.
The sixth would pay $3.
The seventh would pay $7.
The eighth would pay $12.
The ninth would pay $18.
The tenth man (the richest) would pay $59.

So, that’s what they decided to do. The ten men drank in the bar every day and seemed quite happy with the arrangement, until one day, the owner threw them a curve. "Since you are all such good customers," he said, "I’m going to reduce the cost of your daily beer by $20." Drinks for the ten now cost just $80.

The group still wanted to pay their bill the way we pay our taxes so the first four men were unaffected. They would still drink for free. But what about the other six men – the paying customers? How could they divide the $20 windfall so that everyone would get his "fair share?" They realized that $20 divided by six is $3.33. But if they subtracted that from everybody’s share, then the fifth man and the sixth man would each end up being paid to drink his beer. So, the bar owner suggested that it would be fair to reduce each man’s bill by roughly the same amount, and he proceeded to work out the amounts each should pay.

And so:
The fifth man, like the first four, now paid nothing (100% savings).
The sixth now paid $2 instead of $3 (33%savings).
The seventh now pay $5 instead of $7 (28%savings).
The eighth now paid $9 instead of $12 (25% savings).
The ninth now paid $14 instead of $18 (22% savings).
The tenth now paid $49 instead of $59 (16% savings).

Each of the six was better off than before. And the first four continued to drink for free.

But once outside the restaurant, the men began to compare their savings.

"I only got a dollar out of the $20,"declared the sixth man. He pointed to the tenth man, "but he got $10!"

"Yeah, that’s right," exclaimed the fifth man. "I only saved a dollar, too. It’s unfair that he got ten times more than I!"

"That’s true!!" shouted the seventh man. "Why should he get $10 back when I got only two? The wealthy get all the breaks!"

"Wait a minute," yelled the first four men in unison. "We didn’t get anything at all. The system exploits the poor!"

The nine men continued to complain and accuse the tenth man and then started planning to make the tenth man pay more. The tenth man finally walked away sadly, as the nine shouted accusations at him.

The next night the tenth man didn’t show up for drinks, so the nine sat down and had beers without him. But when it came time to pay the bill, they discovered something important. They didn’t have enough money between all of them for even half of the bill!

(copied from Scott Brewster with one edit)