Godot

Just plum dandy, thanks! I've found a large proportion of my time taken up with data analysis and applying for an academic position. I also don't really feel like posting much of late (ho-hum).
From a methodological perspective, I see a couple of points to rip this one on, but hey, that's just me. Personally, I'd really like to see the stats. Particularly impressive was the use of a 1-year dietary washout pre-study; this is usually neglected.

Got proof? I may just be being obtuse, but I have yet to see an appreciable distinction made between ketosis and ketoacidosis that didn't boil down to "because I say so".

JGL53

Godot, do we really have to let some Ayn Rand nutbar out of his cage to climb the nearest tree and shout over and over to you how "A = A" - until it f-f-f-finally sinks in?

Ketosis is ketosis. Ketoacidosis is ketoacidosis. Everyone agrees that ketoacidosis can be deadly. (As far as I know and as far as you've proven so far) there is no evidence (e.g., case study) that low carb dieting in a HEALTHY individual under a physician's care has ever led to ketoacidosis. There is no evidence that ketosis induced by low carb dieting is dangerous (Have you ever seen this headline in a newspaper: "Man Succumbs To Ketosis!"?).

Will Nuno or I have to spend a few hours researching this subject in all the relevant biochemistry textbooks, then post a series of links so that you can educate yourself on the subject?

Fuck that. Do it yourself.

Dune

-Again I want to leave clear that ketoacidosis ONLY happens in insulin dependednt diabetics,-

WRONG. It can occur in patients with insufficint levels of insuling secretion for any reason- not just diabetes. It can also occur in patients who are diabetic but not yet on insulin therapy.



-Ketoacidosis is not a concern for healthy individuals.-
I had a patient that would disagree with you. It is rare, agreed, but it can occur.
Besides- some patients do not realize they may be at risk, so caution is always advised. To make blanket statements like that is not only dangerous, its very ill informed.

Nuno-
Where are you getting your information? All you have provided is an assertion based on nothing but your word. Do you have medical training? Biochemical training?

-low carb dieting in a HEALTHY individual under a physician's care has ever led to ketoacidosis-
With those qualafiers, I would have to agree so far as I can tell. The big one there being UNDER A PHYSICIAN'S CARE. (thanks JGL53)

Ketosis is the creation of ketone bodies- ketacidosis is the accumulation of ketones to the point where the bodies buffer system can no longer handle the change in charge, and pH is lowered. So Ketosis can lead to ketoacidosis.
(biochemistry, mathews & Van Holt, 3rd ed) (physiology, berne, 4th ed)

A question about low carb high protien-
Couldn't this cause an exascerbation of gout?

ps418

Actually, I think the reference is correct. The trouble you're having is probably due to the fact that the reference refers to an abstract presented at a conference, rather than a research article, and was published together with all the other abstracts presented at the 1999 meeting of the Society for Adolescent Medicine. Indeed, it does not have a seperate cite in the journal TOC.

Sondike et al, 2000. Low Carbohydrate Dieting Increases Weight Loss but not Cardiovascular Risk in Obese Adolescents: A Randomized Controlled Trial. Journal of Adolescent Health 26, 91.

This is published in:

Abstracts of Research Presentations Presented at the Annual Meeting of The Society for Adolescent Medicine. Journal of Adolescent Health 26, March 2000, 82-100.


Patrick

JGL53

It most certainly can, especially in individuals with a previous history of gout.

Interesting that you should bring this up - I saw a really dumbass 'fat loss challenge' on network TV recently between six (6) individuals using various methods.

Interestingly, the guy using hypnosis came in second in total weight lost (the program didn't get into 'what' kind of weight). I think it was the Slimfast (TM) person or the "exercise alone" person who came in last.

The Atkins patient, who came in first , had a history of gout, and the diet (initially) brought it back. After consulting with the physicians at the Atkin's clinic, who changed his diet (added anti-gout meds, reduced the red meat, added more green leafy vegetables, I'm guessing), his gout cleared up and he went on, as mentioned, to lose the most weight of the six.

BTW, the patient was adament about continuing the diet - his attitude was "Fuck the gout - I going ahead with this because it is working to burn off body fat, and NOTHING else I've ever tried has worked".

This six person comparison was certainly not very scientific (Ha Ha Ha), but it did prove your suspection. It is obviously VERY important for a person with a history of gout to be under a physician's supervision when undertaking the Atkin's induction diet - not that such advice doesn't go for everyone doing the induction.

BTW, as for the Atkins diet inducing gout in persons with no previous episodes of gout - I've never heard of any. No doubt this could happen - especially if one eats just red meat, no vegetables, and does not hydrate properly . But, again, that's why we have health professionals - to advise lay persons on healthy lifestyle choices.

ps418

I got the 2 papers in the NEJM this weekend, and I need to correct a couple of errors I made.

1. Both Samaha et al and Foster et al used randomized group assignment.

2. Though HDL did increase in Foster et al, it did not increase in either group in the Samaha et al study.

3. Regarding the question of how HDL could increase on a high-fat diet, a perspective article in the same issue (Bonow et al) of NEJM states that "the rise in HDL cholesterol in the subjects following the low-carbohydrate diet (a change observed only by Foster et al.) may reflect a change in HDL subfractions that occurs with increased intake of saturated fats, and this change has not been shown to be beneficial. Thus, caution is urged about overinterpretation of this observation as a beneficial result of a low-carbohydrate, high-fat diet." This may be related to the fact that Foster excluded those on lipid-lowering meds, while "many" of Samaha's subjects were taking lipid-lowering medications .

Patrick

Godot

<sorry. double-post>

Godot

you are here aren't you?
As surprised as it may seem to you, I am fully cognisant of the differences between the two. The distinction has not been put forth in this discussion as of yet beyond "one is this, the other is not that". Doesn't make for a compelling argument if both terms aren't properly defined. Unless of course, you seem to think that defining a term as the antonym of another is correct?

Quote:

Will Nuno or I have to spend a few hours researching this subject in all the relevant biochemistry textbooks, then post a series of links so that you can educate yourself on the subject?

As I was merely asking for a definitional distinction to be made, I do not see a need for you to spend hours of your hard earned time to try and educate my poor, backwards self.
Besides, Nuno was making a broad-based positive claim. I felt like calling him on it. I'd be just as happy if he put a qualifier on the statement. Using words like "only" tend to make for dramatic statements, and I'm not certain that its use is entirely warranted in this situation.

Quote:

Fuck that. Do it yourself.

Temper, temper.


Patrick: thanks for the corrected citation. I'll check that one out.

nermal

C'mon, none of it was funny?
Sure the government put out the food pyramid, which was basically what Grandma would have recommended anyway. Nobody listened.
Sure, lots of low fat food has been sold. If I eat diet potato chips, I can eat the double quarter pounder with cheese without feeling guilty.
Americans consume the same amount of fat as 30 years ago? Maybe, but 30 years ago was probably some kind of benchmark point when people started eating in excess. Why not? 35 or so years ago, Americans began doing everything in excess.
Just look at serving sizes today. A kid in the 50's would have been shocked to see a Big Mac. "What, do I share it with 2 friends"? How about the 40 oz Big Gulp? Supersize those fries for ya?
Yeah, low fat food is the problem. It couldn't be so simple as we eat too damn much of everything!
The low fat craze was fundamentally no different than the Atkins thing. Don't tell me to eat healthy portions and exercise. Give me a gimmick if you can't give me a pill. I want to wake up skinny next week damn it! And I want to eat dinner for two doing it! I'm an American!

Hey--remember when you bought a bottle of Coke from a machine, and it was 8oz? Remember those days? Remember when there weren't no 2500 calorie, 80 gms fat TGIFriday dinner/appetizer combos? Weren't no Atkins diet then.

Ed

Nuno Figueira

Well, you most surelly must have a medical traning, judging from your arrogance and inahability to admit a mistake.

I get my info from medline and there's not a SINGLE case of ketoacidosis documented, still you present one case, which I seriously doubt was an healthy individual anyway as evidence, maybe you should present your astonishing findings to the scientirfic community.

CAn you show me asinlg edocumented case of ketoacidosis in a previously healthy individual? No you cant, because there isn't any.

The only thig ketosis and ketoacidosis have in common is the prefix "keto". That's it.

Show me the evidence, you're the one making the claims so the burden of evidence is lying on you. I've looked for it at medline and found nothing [deleted insult].