14 Ways to Tell if Keto Is Working for You Besides Weight Loss

 

Based on keto transformation pics on social media, it would be easy to think this very low-carb way of eating is used for just one thing: weight loss. And no doubt, the before and after pictures of people who’ve lost substantial amounts of weight are amazing. But low-carb and ketogenic diets are good for so many other things besides changing the size of your body. Some of these—like lower blood sugar, lower triglycerides, and lower blood pressure—can be shared via pictures of glucometers, home blood pressure cuffs, or printouts of your latest bloodwork. But what about the things we can’t see? What about all the great stuff keto does that you can’t capture in a picture? A picture speaks a thousand words, but what about the great things keto does that you can’t take a picture of? 

People use keto for fat loss, but what if you: 

A) Don’t want or need to lose weight, but you’re dealing with a laundry list of troubling health issues? 

B) Do want to lose body fat but you’re stuck in a stall and the scale hasn’t moved in a while? 

Well, if B is your issue, check out this article I wrote on how to stay motivated during a fat loss stall, and then grab a copy of my book, The Stall Slayer, to help break that stall. (I also encourage you to just stay off the scale altogether for a while.) 

 

Either way, here are 14 ways to know that keto’s working for you that have nothing to do with weight.

Is Insulin Messing with Your Skin?

Question: Is there anything in the body insulin doesn’t affect?

Answer: From what I’ve seen, no.

If you’re new to my blog or are a newcomer to the science of the clinically therapeutic effects of dietary carbohydrate restriction, you might think of insulin mostly as a blood sugar hormone. People with diabetes have blood sugar that’s too high, so they take insulin to bring it down. Simple, right? Not quite.

I’ve written in past posts that reading and learning I’ve done over the past few years has led to me to the perspective that lowering blood sugar is among insulin’s least important effects. (In fact, insulin isn’t even required to lower blood sugar at all. Your body can do that just fine without insulin…even in someone with type 1 diabetes. Type 1 diabetics do need insulin, just not solely for the purpose of lowering blood sugar. Details on all this here.)

I’ve written articles about insulin as a major factor in the development of gout, migraines, Alzheimer’s disease, PCOS, erectile dysfunction, benign prostatic hyperplasia (BPH, a.k.a. enlarged prostate), Parkinson’s disease, and more. The short list of things we know for certain are damaged by chronically elevated insulin and/or blood glucose (BG) includes the liver, kidneys, eyes, cardiovascular system (heart muscle and blood vessels), ovaries, the brain and nervous system. At this point, knowing what I now know about insulin, I don’t need someone to explain to me why insulin would affect any particular organ, gland, or tissue system; I need them to explain why it wouldn’t.

With this in mind, is it possible insulin is affecting your skin? You can’t see a fatty liver, polycystic ovaries or an enlarged prostate gland from the outside; you need special tests to determine for sure whether you have those. But what about acne, skin tags, psoriasis, and other things we can see just by looking at someone? Could insulin be playing a role here, too?

Tl;dr: If you want a brief summary of this article, read this. And if you have a few extra minutes and want to read one paper that will give you an enormous amount of insight into this topic, read this one. But if you come to my blog because you enjoy digging into the meaty details, stay here and keep reading. 

The PCOS Post: Hormonal Havoc From Hyperinsulinemia

As I mentioned in the previous post, I’ve been plugging away this blog since 2012. It’s hard to believe it’s been seven years, but even harder to believe that in all that time, I’ve completely neglected the topic of polycystic ovarian syndrome (PCOS). I’ve written a ton about insulin, glucagon, thyroid hormones, digestion, cancer, and more, but not one word about PCOS, except for a brief mention in this post. This is a glaring omission, because PCOS is a huge issue for reproductive aged women these days, and, no surprise if I’m writing about it here, it’s intimately tied to chronic hyperinsulinemia and metabolic dysregulation.

A while back I wrote about the effect of elevated insulin on men’s hormones, explaining the concept of a “male equivalent to PCOS,” and I didn’t realize that I hadn’t even yet written about actual PCOS. I don’t know how such a huge gap has existed on my blog for so long, but this is being corrected right now. Whew!

I’ve seen online in various places women saying that they’re at increased risk for type 2 diabetes or metabolic syndrome because they have PCOS. It’s actually the other way around: chronically high insulin (basically metabolic syndrome, whether you know you have it or not) is the main driver of PCOS. The reason so few women who have PCOS are aware of this is … surprise, surprise … most doctors are clueless about insulin’s many functions unrelated to blood sugar and they never bother measuring insulin levels.

Women with PCOS are often given unhelpful and condescending advice.  There is a lot of "blame the victim" that goes on with this condition. I sincerely hope this post does not come off that way. That is the very last thing I intend. I have only one goal here: to provide information. Information that can be empowering to women who have PCOS. If you are living with this condition and you feel disappointed by the help you've gotten from healthcare professionals so far, please know that you can take control. You have more power than you might realize. I hope what follows here is helpful.   

This is a long post (some of you are rejoicing now and others are groaning), so grab yourself a beverage of choice, a bag of pork rinds or some string cheese, and happy reading!

The Personal Fat Threshold Concept

Hey Kids!

It’s been ages since I’ve posted what I would call a “real” blog post. Something meaty and educational. Something you can really sink your teeth into. The last one was way back in August, when I wrote about whether protein is bad for the kidneys. (Hint: it’s not.) I’ve posted a few things since then, but nothing all that substantial. I’m glad to say today’s post makes up for lost time, because it is LONG. So grab yourself a cup of coffee or tea (or...*gag*...broth, if you must), put your phone on silent, and dig in.

I’m excited to share this with you. So excited, in fact, that I’ve been procrastinating on writing this for no less than 6 months. In looking at the folder of blog post drafts on my computer, I started jotting down notes for this in July 2018. The reason I kept putting it off is that I knew this was going to be a LONG post—massively long, even for me. But then I gave a talk on this topic at a keto event in Canada in December, so I finally had to organize my thoughts and put them together coherently. Once that was done, I figured it would be easier to get this written, since I could just flesh out the details of what was on the slides. Don’t kid yourselves, though. This still took four days to write and edit. (It’s much faster to talk and show images on slides than it is to type everything out in detail in a blog post!) Nevertheless, I’ve wanted to write this for a long time, so here we finally are. And the benefits a blog post has over a talk is that you can read this at your leisure, click on whatever links you’d like to explore further, and go as deeply down any of those rabbit holes as your heart desires. And to any of you who are happy at such a long post and who prefer reading to watching videos, I’m with you. I started my YouTube channel to bring my message of Keto Without the Crazy™ to a wider audience, but I, myself, prefer reading.    

One of the things I love most about writing my blog is sharing with you, my beloved readers, the fascinating and important things I learn as I deepen my understanding of human metabolism and physiology. The reason they call it “commencement” when you graduate with a degree in something is that it’s the start of your education, rather than the end of it. This has certainly proven true for me since getting my M.S. in nutrition.

One of the most intriguing things I’ve come across recently is the concept of the personal fat threshold. I don’t know who first coined this term, but it appears to have been Roy Taylor and Rury Holman, in their 2015 paper, Normal weight individuals who develop type 2 diabetes: the personal fat threshold. Other researchers wrote about the concept long before this paper, but I think Taylor & Holman were the first to use the phrase personal fat threshold. (Their paper is the first place I ever saw it in print, anyway. A researcher named Keith Frayn wrote some outstanding papers on the same topic years before without using the term. I cite his work liberally throughout this post. If you’d like to read the full text of any of the key papers I cite here, feel free to email me and I’ll send you a copy.)

Gout: Is it Meat, or Metabolic Syndrome?

I’ve never experienced a gout attack, but if common graphical representations are to be believed, it feels like there are shards of broken glass embedded in your joints, or like someone’s holding a flamethrower on full blast and aiming it right at your big toe. For whatever reason, the big toe seems to be the joint that suffers the worst in gout, but the condition can manifest in other joints as well.

Conventional medicine holds that animal proteins and alcohol are major triggers for gout, so typical advice for those who suffer from gout is to reduce consumption of alcohol and animal protein—red meat and seafood, in particular.

Part of the rationale for these recommendations is that gout results from an abnormal accumulation in the blood of a compound called uric acid. At high blood concentrations, uric acid can crystallize and be deposited in the joints, and these uric acid crystals are responsible for the pain, swelling, and other fun stuff that comes along with gout. And a major source of uric acid is the metabolism of purines, which are nitrogen-containing compounds found in proteins (and other substances). Some foods are higher in purines than others, hence the recommendations to eliminate or reduce red meat and seafood in the diet. Beer is also high in purines, and other plant foods are sources of purines as well.

But uric acid is a normal compound in the body. It’s not solely a metabolic waste product; it performs important functions as well. So we don’t want to get rid of uric acid entirely, and we certainly don’t want to eliminate protein from our diets.

So if the body normally produces uric acid, what’s really the problem in gout? Does the body produce too much uric acid, or is the uric acid not cleared away properly?

If it’s the latter, and the problem isn’t with overproduction, but rather, with impaired clearance, how is uric acid cleared from the body, and what impairs this?

Well, to cut right to the chase, the kidneys filter excess uric acid out of the blood so it can be excreted in the urine. And what impairs the kidneys’ ability to do this? Insulin. Yes, dear readers, our old friend insulin strikes again. (I mentioned this insulin and gout connection way back in the insulin series.) Alcohol also reduces the kidneys’ ability to excrete uric acid, so there might be some truth to cutting back on alcohol if you have gout.  

Mankind has been consuming animal proteins for a long time now, and gout is a relatively new disease. Well, “new” since about 300 years ago, which is when more accounts of it started being recorded. At that time, it occurred mainly among wealthy people—the people who could afford to eat rich meats and drink alcohol. But something else these “refined” individuals could afford that most common folk couldn’t, was sugar. Refined sugar.  ;-) 

Interesting, huh? 

Typical old-school representation of gout: a demon shooting fire at the toes.

Notice what appears to be a wealthy looking man eating what might be a meatball, and there’s alcohol on the table.

So what’s the real deal with gout? Is it caused by meat, or metabolic syndrome--that is, chronically elevated insulin?

Read all about it in my latest post for the KetoDiet Blog: Is Gout Caused by Red Meat or Metabolic Syndrome?  I think you’ll find the details interesting, and what’s really fascinating is that a few studies have shown that diets that are higher in protein can actually reduce uric acid levels and frequency of gout attacks—provided that the diets are also lower in carbs. Nice, huh?

If you or someone you know suffers from gout, and you think you’ve been relegated to a life without steaks and red wine (perish the thought!), check out the post to learn why it’s not meat, but rather, chronically high insulin, that causes gout.

As a personal aside, I have a friend who suffers from gout, and he’s a vegetarian. No red meat, but lots of fruit, fruit juice, and grains. And fructose, via its effects on the liver, can be a huge contributor to hyperinsulinemia and gout.

If you’d like to learn more, Georgia Ede, MD, has a fabulous post that covers all of this as well—gout, meat, insulin, alcohol, and fructose, and it’s a highly recommended read: Got Gout but Love Meat?

Also, the must-read book, Good Calories, Bad Calories, by Gary Taubes, originally included a chapter on gout, but it didn’t make it into the version that got published. Fortunately, this “lost chapter” is available online and it’s another educational read on the connections between insulin, fructose, and gout: Gout: The Missing Chapter from Good Calories, Bad Calories

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Does Protein Harm the Kidneys?

Hey kids! My previous blog post laid waste to the myth that a high protein intake is harmful for bone health. This time, it’s my great pleasure to decimate another “high protein is bad for you” thing. Today, it’s kidney function. Many of you have been eagerly awaiting this post. Here’s hoping I don’t disappoint.

Even if you’ve accepted that everything we thought we knew about saturated fat and cholesterol in our diets was almost completely wrong, and you’ve been following a low-carb or ketogenic diet confidently for fat loss, migraines, GERD/acid reflux,  reversing type 2 diabetes, reducing insulin needs and evening out blood sugar for type 1 diabetes, or for some other health issue, maybe there’s still some lingering fear in the back of your mind that the protein you’re eating—especially animal protein—is bad for your kidneys.

We’ve heard this over and over from just about everyone with an agenda to discredit the efficacy of low carb diets. Now, mind you, low carb diets are not, by definition, high in protein, but in walking away from sugars, grains, beans, and starchy vegetables, many of us find that, compared to our former high-carb life, our protein consumption does increase, whether in absolute grams, as a percentage of total calories, or both. Not to mention the growing carnivore movement, where people are eating only animal foods. For these folks, protein consumption almost certainly increases compared to a standard Western diet, and likely even compared to if/when they were following a ketogenic diet.

So with all this in mind, it’s important that we set the record straight about the influence of dietary protein on kidney function.

Is There a Male Equivalent to PCOS? (a.k.a. The Detrimental Effects of Hyperinsulinemia on Men's Health)

 

Insulin has gotten a bad reputation in the low carb and keto communities. But insulin isn’t a bad thing. Too much insulin, too often, is a bad thing. If you ask people whose homes are threatened by wildfires whether lots of rain would be a good thing, you’ll probably get a very different answer than if you ask people whose homes have just been destroyed by hurricane floods. Water is not a problem; too much or too little water is a problem, and it’s the same with insulin.

So I’m not trying to demonize insulin. I wrote an 8-part blog series detailing the gnarly and nefarious effects of chronically elevated insulin (soon to be 9 or 10 parts -- new posts coming soon!), but the operative phrase there is chronically elevated. In and of itself, insulin isn’t a problem. (Just ask a type 1 diabetic.) The bad stuff happens only when insulin is too high, too often. Now that that’s out of the way, on with the show!

We know for certain that PCOS (polycystic ovarian syndrome)—which is “is the most common endocrinopathy of reproductive aged women affecting 6-10% of the population,”—is driven primarily by chronic hyperinsulinemia. (Incidence may be as high as 18% among certain cohorts when different diagnostic criteria are used, putting the number of women affected worldwide at around 10 million.)

“Hyperinsulinemia associated with insulin resistance has been causally linked to all features of the syndrome, such as hyperandrogenism, reproductive disorders, acne, hirsutism and metabolic disturbances.” (De Leo et al., 2004)

In fact, the causal link (not just an association!) between hyperinsulinema and PCOS is so well-known (and so powerful) that metformin—best known as a diabetes drug—is among the frontline pharmaceutical interventions for PCOS. Keep this in mind as you read about the men’s issues here.

Facial hair, acne, oily skin, mood swings, weight gain, menstrual irregularities, and infertility are not the only signs and symptoms of PCOS. These signs & symptoms are driven by the underlying hormonal disturbances, which include: elevated insulin, increased adrenal androgen synthesis (more testosterone and/or DHEA), decreased sex hormone binding globulin (SHBG), increased luteinizing hormone (LH), and decreased follicle stimulating hormone (FSH). And while the stereotypical PCOS patient is overweight or obese, as many as 50% of women with PCOS are not overweight or obese. (Remember, chronic hyperinsulinemia leads to obesity in some people, but not all. There are millions of people walking around with a “normal” body weight, but sky-high insulin levels.)

Since men produce all of these hormones as well, could there be a male equivalent of PCOS?

You bet your bald spot there is!

Let’s take a look at three different areas where chronic hyperinsulinemia has adverse effects on men:

• Early onset androgenetic alopecia (a.k.a. male-pattern baldness)
• Erectile dysfunction
• Benign prostatic hypertrophy (BPH) – enlargement of the prostate gland