I did. In fact that was a great start, but once you reach a certain point (in having metabolic syndrome), the Keto+IF reaches diminishing returns. It did bring me down 18 inches on the waist. The gut and hypertension will remain. In fact, my hypertension actually went up. To go further requires either Metformin or Berberine. I opted for Berberine, but time will tell.
Congrats on your progress! I assume you still have metabolic syndrome (have you gotten your fasting insulin tested? What's a shame is most doctors test that, which is a $30 assay and the only way to calculate HOMA-IR or QUICKI IR estimates).
While I can't disagree w/ Metformin/Berberine being effective for glucose control, I personally don't think that they aren't great long term for the dysbiosis, B12-deficiency (for metformin) and toxicity (for Berberine) effects... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478780/
Most people that haven't long-term diabetic (eg, completely destroyed beta cells) should be able to get their health back in order via primarily dietary interventions, although it may require some detective work (conscientious dietary, blood work, body composition tracking).
I think waist:height ratio is definitely the best home measurement, but hopefully you're getting good supporting bloodwork as well, which can be very helpful in helping diagnosing problem areas. Also I found DXA and RER testing to be personally quite useful as well, especially for tracking progress on visceral fat (I took off 25% of my body weight off starting last summer). Good luck!
There's no best diet, there's just a diet that works for oneself. For me it's a ton of fruits (tomatoes, clementines,
.. depending on the season), vegetables (onions with leaves, spinach leaves, herbs, peppers, aubergines, carrots...) vapor-cooked or boiled in water, occasionally with some white fish, and some rice to 'cement' a bit that, some honey. No sauce and no waste or almost, no drugs (this diet is like a natural drug for me). Doing some exercise the weekend on a bike. My BMI is always around 18 (60/1.83^2)
Agreed. I am in a much worse state than you. Diet of any kind at this point sadly won't help me any more. Now I have to trick my metabolism into using glucose very inefficiently.
Adding 20-30mn HIIT sessions fasted right before breaking the fast may help also.
The hypertension may be related in some cases to sodium depletion causing aldosterone production (and cortisol and adrenaline) leading to fluid retention (and potassium excretion).
For this reason some people supplement themselves with sodium/potassium during keto or long term (72h optimally) water fasts.
Have you considered increasing your exposure to sunlight? It should help with the lowering of blood pressure through an increase in nitric oxide levels among other things.
Linking an article to with a brief overview, but there are many studies that can be found online.
Insulin resistance is related to inadequate protein, not excess fat per se. You may need more muscle, which is partly based on getting the right kind and amount of protein.
Egg whites are the most bioavailable protein. Humans can use about 98 percent of it. I used egg whites to good effect when one of my sons needed more protein for some reason.
The positive association between egg consumption and prostate and colon cancer that has been showing up consistently in studies since the 90s is concerning. I'm not sure the risk is worth it.
I eat eggs every day. Also spinach, onions, garlic, broccoli, sometimes wheat grass juice. Most of my protein is low quality soy from adv formula slimfast and I know that isn't great. Whey protein disturbs a wound in my stomach which I am still waiting to have doctors look at.
Awesome that it worked so well for you while it did. Tip for others who may try this: don't forget to lower your macros (and, in turn, calories) an appropriate amount as your weight drops. The same diet that maintains keto at 250 lbs won't keep you in keto at 190. For much, much more: https://peterattiamd.com/
Keto is the absence of carbs. So the same diet that maintains keto at 250 will keep you in keto at 190, since it is what you eat, not how much you are eating. But you are absolutely correct that one must change their caloric intake as they lose weight if they want to keep losing weight.
While on the surface this may seem true, this is actually totally false. For example, if you eat too much protein in one meal (even with no carbs) it will still throw the body out of ketosis. The science of staying in keto is way more nuanced than "no carbs" (which is nutritionally impossible, anyway). Again, read the blog I linked to if you want to know more.
You can drink 4000 calories of ethanol and not gain weight though! It's the only macronutrient with no storage form. From this was derived the infamous lean chicken breast and tequila diet. Biologically impossible to gain fat on that diet. Dietary protein is used as such, very little is converted into glucose and of that virtually none becomes lipids[1].
Never said it's healthy, but you will lose fat. If you're not keen on the ethanol poisoning aspect of the diet, you can substitute complex fibrous carbs like broccoli or some such and get similar results.
Of course if you really don't care about health you could poison yourself with Dinitrophenol. It's the fat burning drug. Literally. Users routinely die from their bodies cooking them to death.
The wording is a bit awkward, but if you re-read what he wrote, it's not what he's saying at all.
Because a ketogenic diet depends the amount of carbohydrate restriction that will cause your body to physiologically be generating ketone bodies (eg, say less than 20g of net carbs), even at a constant formulation that doesn't change (as your TDEE changes) you will still be in the same state of ketosis - eg, if you measured your mmol concentration of BHB, it would likely remain the same. However, your caloric deficit of course would change (and you would need to lower it to match that to maintain your rate of weight loss).
In your hypothetical example, if your TDEE were 2000kCal and you were able to eat and absorb 4000kCal of butter a day, you would gain weight (although slower than the expected 0.57lb/day due to increased TDEE; this expenditure change (up to +50%!) was shown in the Vermont State Prison overfeeding experiments in the 60s). But despite that, due to the complete lack of carbohydrates, this diet would definitely stimulate ketogenesis (and would do so regardless if your TDEE were a 2000kCal surplus or deficit).
Due to the complete lack of proteins, you would eventually start consuming some lean body mass to produce some of the glucose (a percentage of glucose would be provided by the glycerol molecule holding together each triglyceride) required by the brain (~30%) and RBCs. I'd expect a pure butter diet to have about the same physiologic effect on protein-sparing as an extended fast (eg, you'd probably last a couple months before eventually expiring).
Interested why you decided against metformin. Lots of people without DM or Metabolic syndrome are taking it for its apparent life extension effects (mostly unproven this far in humans). For diabetes, there's pretty solid evidence.
I work in this space tangentially and I had not heard of berberine before. What are you hoping to achieve with this supplement?
I don't think it's comparable. That link overstates the amount of evidence. Notably the only good trial didn't compare it to metformin. Three small trials and a meta analysis. There is decades of experience with and significant evidence for the efficacy of metformin.
Berberine can do that as well. You have to start off with small doses and let things adjust. I've been doing so many supplements for so long that it didn't really affect me much.
