dr roth ⓀⒸ Profile picture
Jul 25, 2020 17 tweets 6 min read Read on X
#T2RevFoodCGM #keto #CGM #ketoAF

A thread on two diets with differences in WHAT and WHEN to eat.

Low-fat, three meals plus snacks (my HistoricDiet™)

vs

Low-carb, 4 hour TRF (time restricted feeding)
There is a lot of chatter on social media debating whether a low-carb/keto diet can improve health, and perhaps prevent certain disease. Much of this chatter turns out to be covert vegan disdain for consuming animal products, which confounds any discussion of the real question:
Does consuming less carbohydrate improve health and prevent or reduce the severity of long term chronic disease? We can't really know for sure given the prohibitions against conducting RCTs to find out. IRBs won't approve such trials. Subjects would never actually comply.
We can't lock up people to control what they eat and how they live for long periods. But can we agree that higher glucose levels, and especially spikes, on a #CGM chart are indicative of exposure to hyperglycemia, and that chronic hyperglycemia is detrimental to health?
Can we also agree that wild fluctuations in glucose (high or low) are also indicative of exposure to hyperinsulinemia, and that chronic hyperinsulinemia is detrimental to health?
This (n=1 anecdotal) evidence suggests consuming an ordinary SAD diet is worse than a #LCHF/#keto diet for controlling blood sugar (and insulin) levels—both average and peak. Those hypoglycemic crashes I observed (from glucose bolus for OGTT/Kraft tests) were absent this time.
Approach: See if I can maintain a relatively flat CGM plot of similar shape and BG level on my HistoricDiet™—a carb-rich low-fat SAD 5-a-day plan compared to my normal #ketoAF TRF diet. These two days were isocaloric at ~2590 kCal. Judge for yourself:
First, the baseline #ketoAF TRF diet, eating as I was told NOT to for 40 years: Image
Next, the HistoricDiet™, eating as I was told to for 40 years: Image
What do you think the long term effects are of the latter? I know, I was there for decades. I'm 70lbs lighter now. On one Rx for HBP (working on getting off that) instead of seven Rx medications. I sleep well now, no longer with a CPAP machine. I no longer have gout, asthma.
I have energy. I no longer want to just give up living.

I discovered it is quite difficult to eat one meal a day of high carb choices; too soon, you feel stuffed yet still crave nourishment.

The HistoryDiet™ fails for me. The #CGM curve reveals an objective and grim truth.
I have learned from my look back on what (and how) I used to eat.

Historically, I ate three meals a day, plus several snacks. Presently, I eat once or twice a day.

Historically, I fasted for about 8 hours a day (while I slept). Presently, I eat during a 4 hour window.
Historically, I consumed a low-fat, low protein diet. The rest were so called healthy carbs. No sugar-sweetened sodas. I avoided saturated fats b/c they clog your arteries.

Presently, I consume <20g of carbohydrate a day, moderate protein, the rest healthy fats. No PUFAs.
Historically, I gained weight over the years and was hungry a lot when I tried to lose weight.

Presently, I don't get hungry because of what & how I eat.

Historically, I got sick and fat and took seven Rx at a time.

Presently, on a beta blocker for mild HTN, working on that.
Historically, I ate a *healthy* diet, and before I changed diets, my labs were awful.

Presently, many say my diet is harmful. Yet at my last lab check, by lab numbers are healthy. Don't be swayed by #LDLBS!

Presently, my CAC is ZERO.
Historically, I didn't have a #CGM to monitor blood glucose, to see how what I ate, and when I ate affected glucose levels. Presently, I do.

What a difference technology and social media have made on my health. If you're thinking about trying a low-carb, keto diet, do it. /fin
I neglected to edit the percentages, the grams are correct: Image

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More from @mrc314

Mar 3
Ten years ago this week, I quit heavily drinking alcohol cold turkey and quit eating carbs. I weighed 256lb (I'm ~5'11'"), waist:hip was 1.16, and waist:height was 0.7, trigs were 393. I had gout, depression, hypertension, anxiety, asthma, zero energy, metabolic syndrome, 1/n
and couldn't walk from my garage to my shed and back. I was on 7 prescription drugs and several OTC. I was miserable and was planning on not making it to age 56. After decades of ADA/AHA/DGA-approved low-fat, five-a-day, healthy whole grain, limit saturated fat, eat the 2/n
rainbow, moderation required, seven meals a day, your body needs sugar, willpower-driven, breakfast is the most important meal of the day eating I was totally wrecked. 3/n
Read 16 tweets
Nov 22, 2023
Looking … Image
Looking … Image
Still looking … Image
Read 5 tweets
May 19, 2023
Many times over the decades (since 1974), I've been right where I am today: At a low, nearly optimal weight after a fairly profound weight loss. Before 2014, I reduced weight via calorie restriction and willpower. It's a miserable process rife with hunger and (unknown to me Image
at the time, negative metabolic and physical changes). After 2014, when I went lower carb, I could still restrict calories, but with a higher protein, higher fat, lower carb diet, there was much less hunger. But my weight still yo-yoed because when I wasn't consciously
restricting calories to lose weight, I still didn't really understand how to eat. The difference between today and all the prior instances is that I finally know how to eat: when to eat and when not to, what to eat, and why. I look forward to meals (strange, I know, for
Read 6 tweets
May 18, 2023
Nutrition for Precision Health, powered by the All of Us Research Program

"The goal of the NIH Common Fund’s Nutrition for Precision Health, powered by the All of Us Research Program, is to develop algorithms that predict individual responses to food and dietary patterns."
1/3
The objectives of the study are:

1. To examine individual differences observed in response to different diets by studying the interactions between diet, genes, proteins, microbiome, metabolism and other individual contextual factors
2/3
2. To use artificial intelligence (AI) to develop algorithms to predict individual responses to foods and dietary patterns

3. To validate algorithms for clinical application

I don't see any corporate sponsors. Boy, are they in for a surprise!

Site:
commonfund.nih.gov/nutritionforpr…
3/3
Read 7 tweets
Apr 26, 2023
Cardio:

Looks at lab report — LDL-C 270 (350 last time), LDL-P 2504 (3421) — and recites should be <100 and <1000. Says nothing about HDL 77 or TRIG 69 or LP-IR <25). Freaks out. I can tell this report colors everything else he says, and how he says it. 1/n
"Your CAC was abnormal." (17 this time, zero three years ago). Then adds, but anything less 100 is lower risk. "Your carotids are worse this time." Then adds but the % occlusions are not very accurate. Recommends a statin, plant-based diet, avoiding SFA, yada yada. 2/n
So I asked about CCTA to look for soft plaque. He says one is not necessary b/c I am symptom-free and I easily passed my stress test two years ago. It's really hard to tell whether the calcified plaque and "worsening" carotid stenosis is serious (take drugs) or not 3/n
Read 6 tweets

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