Thread by @TroKalayjian

THREAD-

In this thread, I am going to explain how & why I believe low carb & ketogenic diets work

One of the most consistent findings w/KDs is a surprising voluntary decrease in food intake. This is the way in which the diet works & I will summarize the various mechanisms

1/11

In the clinical setting, a LC & VLCKD typically have increased protein versus a standard american diet.
In various studies, including this one ->ncbi.nlm.nih.gov/pubmed/17299116 increased protein intake was shown to increase satiety while preserving LBM.

2/11

Protein also has interesting properties related to thermogenesis. Roughly 20% of kcal w/r/t protein digestion are lost to thermic effects. Diets high in protein like LC & modified VLCHP-KD thus may create a deficit w/o decreasing calories ncbi.nlm.nih.gov/pmc/articles/P…
3/11

LC & VLKCD also have unique properties relating to effects on satiety hormones.

In this 1 year study, Peptite YY, a hormone that increases satiety, is preserved in LC diets versus low fat diets. ncbi.nlm.nih.gov/m/pubmed/26803…

4/11

In this study, it appears that ketosis specifically preserves CKK another hormone that induces satiety, subsequently when patients were in weight maintenance and not in ketosis CCK is markedly reduced.

academic.oup.com/ajcn/article/8…

5/11

In this study, when patients were ketotic, the weight loss induced increase in ghrelin was suppressed. nature.com/articles/ejcn2…

Grehlin is hormone that increases hunger, and yet it seem ketosis may maintain low levels improving satiety yet again.
6/11

Another aspect may be related to decreases in desire for hyperpalatable food.

In this study, jci.org/articles/view/… it was demonstrated that circulating glucose modulates neural stimulatory and inhibitory control over food motivation ...
7/11

The study suggests that this "glucose-linked restraining influence is lost in obesity"

Meaning that a diet that improves glycemia, particularly postprandial might reduce the risk of overeating.

VLCKD have consistently been demonstrated to significantly improve gylcemia
8/11

Lastly, the unique neurologic effects seen w/ketosis may also be increasing satiety through neuro inhibitory effects. ketones, like the anti-convulsant topiramate have a complex MOA. Both are inhibitory, both are satiety inducing, both appears to work by increasing Gaba ...
9/11

Relevant studies on this topic
Topiramate - ncbi.nlm.nih.gov/pubmed/11440351
Ketosis - ncbi.nlm.nih.gov/pmc/articles/P…
10/11

Summary:
Ultimately it appears that LC/VLCKD appear to work through the following mechanisms
-Protein, Thermic Effects
-Peptide YY
-CCK
-Ghrelin
-Improved Glycemia
-Neuro Inhibitory Effects

LC/VLCKD diets are unique & may be specifically helpful in obesity, diabetes, BED

11/11

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