154 comments

  • caleb-allen 2 days ago ago

    Of note from the "Acknowledgements" section:

    > K.C. is a director of TdeltaS Ltd., a company spun out of the University of Oxford to develop products based on the science of ketone bodies in human nutrition.

    • stubish 2 days ago ago

      So, an specialist with ketones published a study related to ketones.

      • reedf1 2 days ago ago

        So, a specialist with ketones published a study related to ketones; which they stand to benefit monetarily from.*

        That doesn't necessarily mean the research is suspect in itself - but there is a reason we need disclosures like this.

        "Competing interests: The intellectual property covering the manufacture and use of the ketone ester is owned by the University of Oxford and the NIH and is licensed to TdeltaS Global Inc. K.C., as an inventor, receives a share of the royalties under the terms prescribed by each institution. K.C. is a director of TdeltaS Ltd., a company spun out of the University of Oxford to develop products based on the science of ketone bodies in human nutrition."

        • bonoboTP a day ago ago

          On the other hand, in the counterfactual case the reverse critique would also be possible: if he's so sure about his science claims, why doesn't he put his money where his mouth is?

    • briansm a day ago ago

      Bit ironic when the path to ketosis is fasting (i.e. not using products).

    • passwordoops 2 days ago ago

      Thought it looked too easy and clever just from the abstract

  • kirykl 2 days ago ago

    Doing keto long enough however, your kidneys might wear out before your brain

    • 3abiton 2 days ago ago

      It depends how you do it. My current approach relies on intermittent fasting for 18 hours (save it for coffee and salty water), and accasional 24-36 hours fast (approx every 6-8 weeks). Not a keto diet, but helps with training Ketons.

      • nandomrumber 2 days ago ago

        What salt are you using?

        • moi2388 2 days ago ago

          I use my tears when I see a cake I’m not allowed to have

          • penguin_booze 2 days ago ago

            We now have a new demonstration of autophagy.

          • wyclif a day ago ago

            I laughed, but in all seriousness I too was interested in the amount of salt he's using for this.

            • commandlinefan a day ago ago

              Not OP, but I do a 36-hour fast once a week. I drink black coffee and water, but I mix one very small salt packet (probably no more than 1/2 tsp) in with one 8-oz glass of water around noon for "lunch". For the most part, that does well enough to stave off the next-day side effects.

            • QuantumGood a day ago ago

              I keep tiny containers around to pick some up with the touch of a wet finger a few times a day. Helps me experiment with how much keeps the keto flu at bay. Also frequent MCT oil from a squeeze bottle.

      • random3 2 days ago ago

        why salty water? does milk/cream in coffee make it not fasting?

        • eptcyka 2 days ago ago

          Anything that kicks off your metabolism will make it not fasting.

          • aydyn 2 days ago ago

            Last I read, the evidence that fasting is beneficial beyond the caloric restriction is controversial at best. I would like to see you back up the claim with strong evidence.

            > A Systematic Review and Meta-Analysis of Randomized Clinical Trials

            >"despite these short-term benefits, FBS did not show superior long-term outcomes compared to CCR."

            https://pubmed.ncbi.nlm.nih.gov/39458528/

            • al_borland 2 days ago ago

              From what I’ve read fasting is more of an intervention for metabolic issues, helping to reduce insulin levels more dramatically. The study you linked to seems to support this.

              > However, FBS improved insulin sensitivity, with significant reductions in fasting insulin

              The issue, and why I think we’ve seen several high profile fasting advocates stop, is because they weren’t metabolically unhealthy, but were on extreme fasting protocols as if they were.

              The way I read it, if you’re significantly overweight and have high insulin levels (type 2 diabetes or pre-diabetes), fasting can help get things under control quickly. However, once a person has regained metabolic flexibility and health, moving to something more balanced is likely a good idea. Just avoiding going back to a lifestyle that leads to chronically high insulin levels. Some amount of fasting probably makes sense, as has been practiced by most major religions in some form for thousands of years, but not to the same extreme as during the intervention.

              • jvanderbot a day ago ago

                There's entire books about this, and how insulin resistance / insulin "overdoses" are implicated in most metabolic disorders and obesity (above and beyond CI/CO energetics) and how Alzheimers is kind of just type 3 diabetes.

                Try Outlive (very good) and Obesity Code (not bad so far - I'm 3 chapters in).

            • lm28469 2 days ago ago

              Losing weight is only a bonus for me, you could lose weight by following a diet that exclusively consists of eating a cube of sugar every XX minutes if you wanted to. Where fasting shines is that it helps control hunger and energy levels. A normal person in the west is basically always in a fed state (bf, lunch, snack, dinner) to the point it's hard for most people to differentiate thirst from hunger from boredom.

              • jvanderbot a day ago ago

                I noticed this right away when I was fasting occasionally. I couldn't remember the last time I felt hungry! And after a bit, it was easy to differentiate "Primed to eat" from "Actually hungry", as well. We're creatures of habit.

                • xeromal a day ago ago

                  Part of the reason I do ramadan as a non-muslim. There's something powerful in restricting your flesh for a period of time every year to reset things.

              • aydyn a day ago ago

                That is fair, there's a mental component that is hard to measure. For me, eliminating carbs from meals was much easier than fasting.

            • _Algernon_ 2 days ago ago

              From the same article abstract:

              >However, [fasting-based strategies] improved insulin sensitivity, with significant reductions in fasting insulin (-7.46 pmol/L, p = 0.02) and HOMA-IR (-0.14, p = 0.02)

              • aydyn a day ago ago

                You can expect different modes between fasting and caloric restriction. You might even consider one mode "better", but what is missing is any evidence that it leads to difference in outcomes.

                • _Algernon_ a day ago ago

                  For a healthy individual it might not make a difference, but increased insulin sensitivity may help in (pre-)diabetics for instance.

                  >Studies have shown intermittent energy restriction to be efficacious in preventing and managing prediabetes and DM, with remarkable improvements in the metabolic and cardiovascular biomarkers of individuals with DM.

                  https://pmc.ncbi.nlm.nih.gov/articles/PMC9534344/

            • commandlinefan a day ago ago

              I've seen conflicting evidence that fasting triggers autophagy as well - I've seen some that suggest that it starts after just 18 hours and some that you'd have to fast for a week before you'd actually see autophagy kick in.

          • 3abiton 2 days ago ago

            > Anything that kicks off your metabolism will make it not fasting.

            That's the key part. Black coffee is key. I also sometimes go with tea or fruit infused water.

            • wyclif a day ago ago

              What kind of salt to water ratio do you use, just out of curiosity because I've been doing intermittent fasting for a while now.

          • random3 2 days ago ago

            Isn’t a caloric deficit implicitly fasting though? Guessing there’s number of calories / time formula there.

            • zargon 2 days ago ago

              Any time you eat calories, you're not fasting.

              • tossandthrow 2 days ago ago

                In some paradigms they consider it fasting up to 300kcals a day.

                In some paradigms you are not even allowed to drink water and call it fasting.

                The word fast means multiple things.

              • Bender a day ago ago

                That is certainly the purist view. I just came off a 3 day fast and in that time I had some Benfotiamine, B-50 complex and Magnesium. Despite having zero calories and zero insulin impact they do have an impact on the bodies metabolism so a purist would also say I broke my fast but I reject that reality. Some of the times that I have fasted longer 5 to 7 days I also had Krill Oil (5 calories) and that also would break the fast according to purists. 5 calories are not going to shut off fat burning when I am in a 2700+ calorie/day deficit by BMR. When I actually break my fast I can feel the changes in the gut, mood, Ghrelin production, etc... Admittedly I am basing this entirely on a gut feeling. Either way my end goals are accomplished burning some fat, improving my overall feeling of wellness, improving my sleep, improving my vision so it works for me.

        • mistrial9 a day ago ago

          > does milk/cream in coffee make it not fasting

          almost certainly yes, that breaks the fasting .. milk specifically is fed by mothers to their young to gain weight a.k.a. not fasting

          • markus_zhang 10 hours ago ago

            Wondering is there anything else I can put into coffee without breaking the fast? Thanks.

        • XorNot 2 days ago ago

          The milk in coffee is a pretty substantial number of calories, particularly if you have a programmer coffee habit.

    • throwcarsales 2 days ago ago

      I hear this from barely healthy people all the time. Omg you're having too much lemon juice, too much salt, too much meat, too much butter, too much stinging nettle tea, skipping too many meals, on and on and on. Yet anyone I finally convince to eat like be literally changes their entire life so positively their entire world view and opinions about the medical field and government changes. Oh yes I'll worry about my kidney because I've stopped ingesting health destroying chemicals in basically all mass food, and focused on beef and fasting.

      • fransje26 2 days ago ago

        Did you know that if you replace coffee with water in the morning, you can remove up to 95% of what little joy you had when you woke up?

        • al_borland 2 days ago ago

          I only recently tried coffee for the first time in my 40s. I didn’t understand the appeal, but I suppose it’s an acquired taste.

          What I’ve seen over the years from occasionally being around coffee drinkers in the morning didn’t look like joy. It looked like addicts, unable to function and singularly focused, until they acquired coffee in the morning. When outside of their normal environment with quick and easy coffee, this seemed like an annoying burden to deal with.

          I had a caffeine addiction from soda when I was in high school, which I broke in college. It led to chronic headaches if I didn’t have enough. In high school I didn’t put 2 and 2 together to know why I was getting the headaches and my dad was trying to push to take me to a neurologist.

          Nothing about my experience with was joyful, nor has it looked like joy when someone wakes up in an unfamiliar city and is frantically looking for the nearest cup of coffee before they can talk about anything else. I’ve seen this from multiple people on multiple occasions.

          • j1elo 2 days ago ago

            Those people were addicts, and not by a bit but deep into it. They should first realize their condition and then apply measures to get out of the hole. I bet they also had very poor sleep quality (regardless of length).

            Like crack addicts longing for their dose, I've also seen people not able to work as functional adults until they get their precious morning coffee shot, and when on holidays their company ends up becoming a burden, not able to improvise, not able to stay in uncommon situations without a coffee brewer nearby for a couple days.

            I'm a coffee drinker, and I take it around 2 to 3 times a week. To be honest, it takes effort to reach those addiction levels; I don't think it can happen without taking coffee every. single. day., which seems way too much honestly. Like "needing to drink hard alcohol every day seems odd"-levels of wrong.

            • jvanderbot a day ago ago

              Coffee addict here. Like any addiction, the ritual is the scaffolding on which the whole thing is built. Sure, I'd get a headache or be groggy without it at first, but having an excuse to sit and sip a warm beverage for 15-30 minutes has become a peace-creating space for myself to think and prepare. When I go on vacation, it's much less important or pressing, because that ritual is broken. There are seldom adverse effects in those situations when avoiding coffee.

              There's nothing about this that requires coffee, but habits require primers and repetition, and starting coffee is that primer, and the socially accepted aspect of it maintains those boundaries so it can be repeated. When we go on vacation, it all goes away.

              I used to smoke cigarettes as a young kid, and 90% of the reinforcement of that was the ritualistic work smoke break where you sat and bullshitted with coworkers or friends outside for 15 minutes. Without that, the habit broke easily because smoking didn't actually reinforce or be reinforced by anything joyful.

              It is easy to look down ones nose at coffee drinking, but the core tie is rarely some crippling physical addiction so much as a ritual that is itself enjoyable, and we all have those. Any guidance on breaking addiction usually centers on the rituals you've created around your substance.

            • al_borland a day ago ago

              > when on holidays their company ends up becoming a burden, not able to improvise, not able to stay in uncommon situations without a coffee brewer nearby for a couple days.

              Exactly. This is why it was so memorable. They made their coffee problem my problem as well. Suddenly the entire morning was a frantic search for coffee. It’s not exactly the vibe I’m going for in the morning.

          • npteljes a day ago ago

            Same with alcohol too.

            >I didn’t understand the appeal

            My personal appeals are the anticipation of the next dose, and the initial rush I get from it. I feel smart, motivated, and capable during this rush.

            Aside from this, I think the smell is great and I really like it cold, with a lot of milk. I quenches my thirst like nothing else.

          • LoganDark 10 hours ago ago

            > What I’ve seen over the years from occasionally being around coffee drinkers in the morning didn’t look like joy. It looked like addicts, unable to function and singularly focused, until they acquired coffee in the morning. When outside of their normal environment with quick and easy coffee, this seemed like an annoying burden to deal with.

            It's shocked me that this view isn't more common. Caffeine dependence often looks like addiction to me too, and I honestly don't think it should be as normalized as it is. People should know what they are getting into before they get hooked on the stuff.

            I'm personally somewhat dependent on ADHD meds, but at least I've known that and made an informed decision. If I stop them suddenly, it takes me around a week to return to normal-ish levels of energy, but other than that I don't have any headaches or pain or anything. I think for me that's more than acceptable.

        • npteljes a day ago ago

          I like this saying a lot, but I have found the opposite by experience. I stopped drinking coffee recently, and frankly, I found that coffee didn't add much positives to me, aside from the feeling of looking forward to drug myself. The evaluation of its effects after ingestion is bleak - my mood improved after 10 minutes for like 30-60 mins, then I was back to my normal feelings. I sweat a lot more, was more jittery, and much more irritable throughout my entire rest of the day. Which I didn't even know about, since I have been taking caffeine daily for 20+ years now.

      • circlefavshape 2 days ago ago

        So how many people have you finally convinced to "eat like be"? And what age are you?

      • rexpop 2 days ago ago

        > the medical field and government

        Nothing about industries that have captured legislature?

        Bayer/Monsanto (pesticide exposure, water contamination, cancer risk), Tyson Foods (antibiotic resistance, air and water pollution, respiratory illness), American Crystal Sugar Company (obesity, diabetes, heart disease), Koch Industries (pollution, weakened environmental standards), ADM (antibiotic resistance, pollution), Bunge Ltd (antibiotic resistance, pollution), Nutrien (fertilizer runoff, water contamination, cancer risk), Corteva (pesticide exposure, water contamination, cancer risk).

        • carlmr 2 days ago ago

          This is so on point, the big money in ag is pushing a lot of these conspiracies. If that's your argument for your diet, it's a shaky one.

          I will go that far to admit I don't know what's the healthy diet in the end, because there's too much industry influence anywhere you look.

          • BobaFloutist a day ago ago

            Are eggs healthy this week?

            We do seem to be in a pretty persistent anti-carb phase of diet culture, I wonder when we'll go back to low-fat.

          • aydyn 2 days ago ago

            Beyond things that are provably carcinogen and specific genetic deficiencies its just calories. Every diet looks better compared to the standard American slop, but when tested against reducing caloric intake, every diet looks like the null distribution.

            Dont be fooled. Just eat sensibly in amount and composition.

            • al_borland 2 days ago ago

              The composition of those calories impacts hormones in the body. Hormones do matter. If for nothing else, making it easier or more difficult to actually stay within that caloric budget.

      • jajko 2 days ago ago

        Swinging from one extreme to another without a good research to back it up, always a sign for a good long term move for sure. But its good, please do some research on your body for the rest of mankind, we thank and salute you. I just hope you get your meat consistently in standards that pretty much surpass what we consider "bio" in say EU or Switzerland in most aspects.

        You know, there is some middle ground. In southern Europe, people have consistently healthy diets without resorting to such extremes, while eating food that tastes massively better than what a general US consumers buy / are willing to spend money on.

        I just returned from 1 week vacation in Italy, thats always a trip to a small universe of healthy gourmet food. That experience is unfortunately not very transferable outside country borders but can serve as great inspiration - ie pasta ins't very healthy unless cooked al dente, then it becomes much better for the body.

        • daerogami a day ago ago

          > ie pasta ins't very healthy unless cooked al dente, then it becomes much better for the body

          That sounds absurd. I think you have been lied to.

          • donkers a day ago ago

            Al dente pasta has a lower glycemic index than more cooked pasta (which logically makes sense), thus it can be better for you in that context.

      • drawfloat 2 days ago ago

        The government?

        • somenameforme 2 days ago ago

          The FDA claims a sedentary 40 year old man needs 2400 calories a day, the same as a 17 year old incidentally. [1] Or that everybody just needs 50g of protein a day. [2] Then there's the fat vs sugar food pyramid nonsense that led to more than half a century of health degradation.

          [1] - https://www.fda.gov/media/112972/download

          [2] - https://www.fda.gov/food/nutrition-facts-label/daily-value-n...

          • Broken_Hippo 2 days ago ago

            That 2400 number?

            It is an average. A guideline. And most countries give an average or range. And the US isn't the highest here: The official recommended averages I found after moving to Norway were higher than in the US and much more reasonable to keep to. (I'm female, my averages are lower).

            That doesn't mean that the food pyramid is a good thing or that we've been giving good health advice. It also doesn't mean that our health advice is all that good now. We know more than we did before, but nutrition science seems tricky to do and even trickier to communicate well with the general public in ways that most people can follow. And that's before the disinformation from business interests and dealing with outright scams and lies.

            • jvanderbot a day ago ago

              Here's the thing: It may be that 2400 calories would take the average 40 year old male and only have him continue the socially acceptable weight gain of a few lbs a year. Or maybe the average (already overweight) male would maintain his weight at 2400 calories.

              But in any sane world, that's like the 90th percentile of calories required when consumed with a carb-heavy american diet and I'd argue almost no sedentary person requires that much. Just plugging in the basal metabolic rate numbers gets something well below that.

              • magicalhippo a day ago ago

                Norwegian Institute of Health has a calorie calculator[1] based on scientific studies.

                For a 40 yo male, 180 cm (5' 10") high and weighing 80 kg (176 punds), it spits out 1800 kcal at complete rest.

                That then gets multiplied by a factor of 1.4-1.5 if you're a sedatary office worker, resulting in around 2400-2500 kcal.

                This number is for maintaing weight. I used the calculator to find my 500 kcal deficit to lose weight, and based on my actual losses it seems quite accurate.

                [1]: https://nhi.no/skjema-og-kalkulatorer/kalkulatorer/diverse/b...

                • jvanderbot a day ago ago

                  I ran similar numbers and experiments over and over. In the end I found composition and "starting weight" matters quite a lot. https://jodavaho.io/tags/diet.html

                  You can easily go +/- 5-10 lbs at my height, just by choosing carbs over protein or fat, and it's not "Fat loss" or body composition, it's water weight associated with converting carbs to something your body can use.

                  Then a fast day drops you another 5-10 lbs for opposite reasons + burning glycogen stores. And that >10% swing in body "weight" is just noise on the calorie estimates if you plug it directly into such a calculator.

                  (as an example, if I choose 2000 calories of carb-heavy foods, I will weigh more, increasing my calorie "budget" to maintain weight b/c I eat more carbs, producing a higher weight, further increasing my calorie "budget", etc etc).

                  I can find 2200 for my 2 meter height, or 2500, or 1800, depending on input weight, and since input weight varies by day, and by caloric intake (due to food weight, water weight, and weight gain), it's not reliable to say the "average" person is healthy with 2400 calories. Because perhaps that person should be eating different foods or have 10 lbs less bodyfat to begin with!

                  I find you have to reverse-engineer it given what you know to be a healthy weight including muscle and fat composition.

          • eisen_matrix 2 days ago ago

            2400 calories is very rational number, considering that Americans eat around 3800 on average.

            • somenameforme 2 days ago ago

              The 3800 number was from the media misunderstanding/misrepresenting the data. The 3800 is calorie availability, not consumption. With calorie availability you take absolutely all food produced/imported and then divide by the population size. There's no reduction for waste, spoilage, inedibility, etc. [1]

              Americans aren't eating anywhere near 3800 calories on average. 2400 calories is already a massive amount of food. That's 15 100g servings of chicken breast (cooked weight) for some baseline of what it means in terms of healthy food. Obviously lots of people are eating lots of junk that makes it easy to bring up the consumption, but it's still nowhere near 3800 on average.

              [1] - https://www.ers.usda.gov/data-products/food-availability-per...

              • BobaFloutist a day ago ago

                Using unseasoned cooked chicken breast as your proxy for healthy food is...less absurd than using grapefruit would be, but not as much as you might think.

                At least add like a quarter teaspoon of olive oil, an eighth of a cup of whole grain rice, and a side of like some sweet potatoes with its own seasoning or something.

                Straight chicken breasts is like the meme level of what celebrities have to eat to maintain their figure, not what a reasonable human diet looks like. Chicken thighs with the skin on are reasonably healthy.

              • SamPatt 20 hours ago ago

                2400 is a massive amount of food ... for some people. This is why averages are pointless as recommendations.

                I'm 6'3", 200 lbs, I lift and I run - I would be in a caloric deficit at 2400 calories.

                My wife would be in a huge surplus.

            • carlmr 2 days ago ago

              I thought you were pulling numbers out of your magic hat.

              It seems true. Sorry for doubting you.

              https://www.usatoday.com/story/news/health/2024/10/14/weight...

              I guess the 2400 for middle aged people is not that far off if in the 60s the average was right around there and people were healthier.

              • undefined 2 days ago ago
                [deleted]
              • jvanderbot a day ago ago

                I'm about to say something that is easy to dismiss as bullshit, so feel free to, but you're right, people were healthier in terms of weight in the 60s, and right around that is when we changed dietary guidance to be carb-focused, low fat, etc. Since then, obesity has skyrocketed. The book Obesity Code covers this.

                As sibling comments have pointed out, 3800 is availability, not consumption, so it's not an indicator of how much people do eat, just how much they could eat.

                • aaronbaugher a day ago ago

                  You can see it if you watch any US documentary filmed before the late 70s that shows ordinary people in the street. They're much fitter, and exercise for weight loss wasn't really a thing yet; people didn't jog. That's not far enough back that everyone was a farmer or laborer; there were plenty of fairly sedentary office workers. They also weren't starving; it was a prosperous time. They were generally eating meat-and-potatoes diets with plenty of animals fats (I have a 1960s barbeque cookbook that tells you to put a pat of butter on pretty much everything). And obesity wasn't a problem.

                  And since we started letting the government tell us how to eat healthy, not only has obesity skyrocketed, but so have diseases connected with it.

                  • carlmr a day ago ago

                    My parents were vegetarians in the 80s, also no weight issues. I don't believe it's carbs or seed oils or any of the modern scapegoats. Since they were eating plenty of that. They even had cake.

                    I think it doesn't matter what you eat as long as it isn't super processed. The one thing that's changed a lot in the 90s is more and more convenience food.

                    • jvanderbot a day ago ago

                      "processed" is also a modern scapegoat, unfortunately.

                      But all three are correct, I think: Food has gotten more laden with sugar, seed oils, and carbs because it's processed to be that way after we tried to go Low Fat for so long.

                      A conscientious vegetarian is probably eating damn near an ideal diet by avoiding all that.

                      • carlmr 16 hours ago ago

                        But they were eating plenty of seed oils, and sugar in cake, and loads of bread.

                        So mostly carbs, but with a lot of fiber. It just goes counter to the current trend in major ways. I looked through the old cookbooks. The biggest difference is no processed foods. And maybe less microplastics.

                        • jvanderbot 11 hours ago ago

                          It's hard to really appreciate how many calories are added to things like bread, just by virtue of changing the recipe to be more "USA tasty" (e.g., sugary). My EU friends always commented on how sweet everything is in USA, even store-bought bread. If we didn't do that, when we started reducing fat, everything would taste like hardtack. But 200 extra sneaky calories a day + insulin spikes from the refined carbs, and here we are - all fat.

                          • carlmr 7 hours ago ago

                            That's true, "bread" in the US is atrocious. I recommend flour, water, salt, yeast. Amazing book if you want to get into home baking.

            • ahartmetz 2 days ago ago

              3800 on average?! What the hell. Makes me wonder why Americans aren't even more overweight than they already are.

          • J_Shelby_J 2 days ago ago

            Hey man, we really need eight potatoes a day, ok.

        • ultrarunner 2 days ago ago

          The government shapes diets both through guidance (food pyramid, “plates”, etc) and regulation. For example, a major criticism revolves around farm bill payouts that incentivize corn production, leading to cheap fructose that finds its way into everything.

          • rexpop 2 days ago ago

            Where does the buck stop, in this matter?

            • ethbr1 2 days ago ago

              Removing Iowa as the first state in the primary season.

    • LPisGood 2 days ago ago

      Live long enough and you turn to dust I guess.

      • Terr_ 2 days ago ago

        I aspire to the "One Hoss Shay" approach. [0] Nothing is unnecessarily overbuilt, so everything works perfectly for a hundred years... then it all collapses to dust simultaneously. :P

        [0] https://www.gutenberg.org/files/45280/45280-h/45280-h.htm

        • irrational 2 days ago ago

          That was nearly my great-grandfather. Completely healthy until he was 103. Didn’t need glasses, walked without support, lived alone, completely there mentally and had a fantastic memory. Then he got shingles which affected his throat so eating was painful. He was dead two weeks later. Went from completely healthy to dead practically overnight.

          • wyclif a day ago ago

            Many people don't realise how evil and terrible shingles can be, thinking "oh it's just itchy skin." No. It is much, much worse than that, and it's very painful as well.

      • uoaei 2 days ago ago

        Joni Ernst already proved just how unpopular this line of rhetoric can be.

        • esseph 2 days ago ago

          Well humans don't seem to really learn anything that spans more than a generation or two, so there's plenty of time.

          • thatcat 2 days ago ago

            That's just the current culture, plenty of historical society's were more stable.

            • esseph a day ago ago

              Ah, well, we will never see that again short of a Carrington event.

              Technology is moving faster than any human or our societies can keep up with, and that is compounding over and over again.

        • pstuart 2 days ago ago

          It's not the fact that we turn to dust -- we all understand that; but denying healthcare because you're gonna die anyway is messed up.

          • throwcarsales 2 days ago ago

            You have to deny healthcare at a certain point because there will always be resources you could throw at someone to extend life span. Where do you stop? We already have the means to help people live longer than we do but don't do it for everyone because how are you going to pay for that at scale? Or do you mean you just want healthcare paid for at the level that you in particular believe it should be?

            • XorNot 2 days ago ago

              You're acting like DNRs don't exist.

              People aren't hanging around consuming more and more healthcare for diminishing outcomes. Instead they're suffering long term or permanent problems from the US denying prompt, proven interventions.

              The problem you're talking about doesn't exist.

            • uoaei 2 days ago ago

              You're not wrong. Ultimately the discussion boils down to whose values are we prioritizing by allocating society's resources. In the interest of supporting a culture of agency and self-determination the society should* be supporting the decisions of those most affected first.

              * I hate the word "should" but in this case we are already contextualized within an implied value system so it is used in a simple determinative manner.

            • pstuart a day ago ago

              It's effectively agreed upon that "heroic measures" while approaching EOL are both a bad use of funds and also of questionable value to the patient.

              That said, the OP context was about denying healthcare to "the poors". Period. It has nothing to do with the slippery slope of "lost causes".

              Bear in mind that the OP's political party is stridently against any sort of public health care options, and that's what is driving her stance.

    • AstroBen 2 days ago ago
    • snthpy 2 days ago ago

      That has been a concern of mine. What is the latest on that?

      • ycombinete 2 days ago ago

        I'm not sure what the stats are, but my anecdote is that two family members who did long term keto have both developed permanent renal problems in their 60s. They can now eat only very little protein.

        The one person's Dr. told her that the main issue is that she was eating way too much protein. Which might mean she wasn't doing Keto quite right. But I don't know enough about the diet myself to say for sure.

        • snthpy 2 days ago ago

          Thanks, that's very interesting.

          I was concerned about that and had my liver checked a couple of years ago but it might have been too early then. I'll brush up on that.

          • M0x20M1 2 days ago ago

            The kidney is the organ that deals with the nitrogen waste from proteins.

        • rxtexit a day ago ago

          My guess would be this is just nonsense.

          No one has an eating too much protein problem. The average person has a sitting on their ass problem that leads to all kinds of health issues, especially when combined with a too many calorie problem.

          There is absolutely no evidence that long term high protein consumption leads to these things.

          • aaronbaugher a day ago ago

            My anecdote is that I was diagnosed with stage 3 kidney disease, likely as a result of years of very high blood pressure. Four years later, using medication to get the blood pressure down to near-normal, and following a high-fat/keto diet, my kidneys were operating perfectly in the normal range. (I didn't tell my doctor about my diet, because I needed him to prescribe the BP meds and didn't want him nagging me about diet. One mention of "healthy grains" was enough.)

            The "your kidneys will fall out" nonsense has been circulating since I first started hanging out on alt.support.diet.low-carb in the mid-90s. Probably since Atkins first published his book. It's superstition.

    • NotGMan 2 days ago ago

      That's a myth.

      Also high protein consumption is not a problem for kidneys.

      There was a lot of bad science, this "protein is bad for the kidneys" comes from people who already had kidney issues from other reason beforehand, not from healthy people.

  • casenmgreen 2 days ago ago

    I'm not sure I understand the method.

    Is it correct that the study looked at the effect of a single (large) dose of ketones, rather than ongoing consumption?

    As I understand it, dosage was 0.395g per kilo of body weight (so about 27g for 70kg subject), and that was it - with measurements of brain activity before and after.

    No indication of duration of effect?

    I Googled and have found a product on Amazon, which is asking about 30 USD for that dose, which would make daily 900 USD a month (!)

    • casenmgreen 2 days ago ago

      Been looking into this.

      Looks like blood concentrations peak about 30 mins after ingestion, then back to normal after about 120 minutes.

      No info about how this relates to effects or duration of effects on cognition.

    • ImHereToVote 2 days ago ago

      You can make your own ketones by downing some MCT oil. Cheap AF. Just have to be somewhat fasted.

  • Kiyo-Lynn 2 days ago ago

    I initially tried keto just to lose weight. But to my surprise, after about three weeks, I started feeling much clearer mentally, and overall just lighter, like something had lifted.

    Back then, I thought it was just a coincidence. Now, reading this paper, I’m starting to think it might really have something to do with how the brain gets its energy.

    • jvanderbot a day ago ago

      Have you heard of "Carb comas?" You're missing those now. And it's quite a relief.

  • anonzzzies 2 days ago ago

    What are those supplements as I find a keto diet impossible to maintain.

    • bionhoward 2 days ago ago

      MCT oil could be one option because it’s a shorter chain saturated fat with a number of carbons divisible by 2,

      I forget the reason this is better for ketogenesis than longer chain triglycerides, Google answers didn’t seem like what I had learned about it.

      Avoiding high glycemic index carbs (sugar, dairy, starch) is a big factor. Also, water: beta oxidation of fat to make the ketones, is a hydrolysis reaction

      https://en.m.wikipedia.org/wiki/Ketogenesis https://en.m.wikipedia.org/wiki/Beta_oxidation

      > Ketone bodies are not obligately produced from fatty acids; rather a meaningful amount of them is synthesized only in a situation of carbohydrate and protein insufficiency, where only fatty acids are readily available as fuel for their production.

    • marstall a day ago ago

      they used this product in the study - looks like subjects were geven about a 1/4-1/3 of the large bottle they sell, which is around $40 https://ketone.com

  • cmiller1 a day ago ago

    Absolutely terrible science, the conclusion is a bunch of mechanistic speculation passed off as causal inference, just more keto bro grifters trying to pretend to be scientists.

  • adaisadais 2 days ago ago

    Can someone give me a TL;DR?

    • tom_ 2 days ago ago

      If you're worried about your brain, reading the entire article might be good exercise for it.

      • jader201 2 days ago ago

        So is that the TLDR of the article?

        /s

    • aldanor 2 days ago ago

      Keto diet makes your brain use ketones instead of glucose for fuel which results in slower brain aging when you're 40-50.

      • bravesoul2 2 days ago ago

        I wonder is keto on then off better or always on.

        On then off might let you get more variety in.

        • moi2388 2 days ago ago

          Variety is the spicy of life, and all things in moderation.

        • aldanor a day ago ago

          It's like asking if on and off cocaine is better than always off... sugar being a sort of cocaine-like thing for the brain.

          One thing to note here is that ketosis may be achieved by diets less strict like MAD etc.

    • BennyH26 2 days ago ago

      TLDR;

      • As people get older, their brain connections start to break down faster in midlife (around 40–60 years) because brain cells don’t use sugar as well. • Giving the brain a different fuel called ketones can help keep those connections strong during this middle‐age window. • This suggests that helping the brain get fuel in midlife could keep it healthier and slow down memory problems later on.

      You can ingest ketones on their own (generally expensive supplements), but this article is more interesting in that a ketogenic diet (very low carbs) may have similar benefits.

    • undefined 2 days ago ago
      [deleted]
    • _Algernon_ 2 days ago ago

      The article has an abstract. That is the tldr

    • ivape 2 days ago ago

      Here's my regular Claude prompt:

      5 bullet points, make sure I fully understand everything in 5 bullet points:

      (My deliberate buzzfeedification of the Internet)

      ---

      - Brain aging isn't linear - it follows an S-curve with key milestones: onset ~age 43, fastest decline ~age 61, then plateau.

      - Insulin resistance drives it - metabolic problems (high blood sugar) appear first in midlife, before vascular or inflammatory issues.

      - Neurons can't use glucose but could use ketones - gene analysis shows aging brain regions have high insulin-dependent transporters but also ketone transporters.

      - Ketones reverse aging effects, but only ages 40-60 - ketone supplements significantly helped younger/middle-aged brains but did nothing for 60+ year olds.

      - There's a critical intervention window - the 40s-50s appear to be when neurons are stressed but still saveable, suggesting early metabolic treatment could prevent dementia.

      • xk_id 2 days ago ago

        Against site rules to post generative text

        • selcuka 2 days ago ago

          Where does it say that? Besides the GP clearly discloses that it is LLM-generated.

          • ed 2 days ago ago

            It doesn’t. At least not in the guidelines or FAQ (links at the bottom of the site)

        • falseprofit a day ago ago

          If it isn’t, it should be. No one asks in a forum because they want to hear from an LLM.

  • xeonmc 2 days ago ago

    You can also get ketones in nail polish removers.

    • refulgentis 2 days ago ago

      Well, yes, but not in a way that is particularly helpful. :)

      This isn't as funny or faddish or odd as it sounds at first blush.

      It's a well-recognized and effect help with epilepsy. My sister went on such a diet growing up and it helped. No more 20 minute seizures.

      • ndesaulniers 2 days ago ago

        [flagged]

        • K0balt 2 days ago ago

          FWIW I definitely noticed a downturn in my feeling of well being when I stopped huffing acetone.

    • greesil 2 days ago ago

      [flagged]

  • 1Sebastian 2 days ago ago

    [dead]

  • throwaway984393 2 days ago ago

    [dead]

  • bethekidyouwant 2 days ago ago

    “Ketones, whether produced endogenously through fasting or low-carbohydrate/high-fat diets or administered exogenously as a supplement, have been shown to improve age-related cognitive decline (23–25) and to restore insulin-resistance-induced deficits in axonal conduction velocity” - Another win for the gym bros

    • dottjt 2 days ago ago

      As someone who has been weight lifting for the past few years and previously was really into keto diets, one thing I've realised is that carbs are simply necessary in order to have the energy to push very heavy weights. Fat just doesn't give you the required energy to do so.

      With that said, if you're only pushing moderately heavy weights or if you're a beginner and you're starting out with low weights, then it usually can be done.

      Though the compromise is usually to eat high carb/low fat on workout days, and low carb/high fat on rest days. Fasting as well helps a ton.

      • nkozyra 2 days ago ago

        Carbs are extremely helpful for strength, but there's a middle ground between ketosis and the standard American diet.

        Most who lift and do low carb time their carbs before and after workouts for specifically this reason. Some also do carbs before bed.

        But the rest of the day is close to no carbs. This still works. You can get < 100g of carbs a day and not have strength and energy negative impacts.

        • dottjt 2 days ago ago

          > Most who lift and do low carb time their carbs before and after workouts for specifically this reason. Some also do carbs before bed.

          This is exactly what I do. I have a have a pre-workout carb meal to try and compensate.

          Though one interesting thing I've noticed is that I've intentionally had to eat carbs as my body fat percentage has decreased. Otherwise I feel very low energy (though to be fair, I think part of it is that I'm still very active on my rest days, usually doing 20 - 30k steps). I think with higher body fat my body could simply burn that fat for energy, whereas that surplus simply isn't there.

          • cosmic_cheese 2 days ago ago

            > I think with higher body fat my body could simply burn that fat for energy, whereas that surplus simply isn't there.

            It’s anecdotal, but I believe I’ve experienced similar effects. During my teenage years and for most of my twenties, my body fat percentage was low because I chronically under-ate (mostly just due to bad habits, though there was a financial component too at one point) and was pretty thin. Energy peaked and valleyed quite a bit with the after-lunch crash being the worst.

            After I started working out and adjusted eating habits to accommodate that, my baseline weight jumped 20lbs or so. Some of that was muscle, but body fat percentage increased too. Since then energy levels have been much more even throughout the day, even during periods where I wasn’t working out (e.g. during pandemic lockdown) and I think it’s because there’s always a bit of fat to burn where there hadn’t been before.

        • ludicrousdispla 2 days ago ago

          I would rewrite your last sentence as:

          You can get < 100g of carbs a day and not have negative impacts to your strength and energy.

      • anon291 2 days ago ago

        Meh. I agree keto is too much ,but a standard 'low carb' diet is closer to how we should be eating instead of the carb heavy diet that is typical. You don't need THAT many carbs to feel energetic. But yeah some is nice

        • Marsymars 2 days ago ago

          It’s kinda tough to get a good baseline of what people are talking about without real numbers - like I’d personally rate my carb consumption as “moderate” - I don’t eat meat so it’s tricky to meet my Calorie needs by cutting out rice and increasing my bean consumption. OTOH the added sugars in my diet are practically zero.

          • anon291 a day ago ago

            I eat a handful of grains a day. Sometimes I make an exception for oatmeal. Anymore, is too much for me. I don't eat added sugar regularly.

            > I don’t eat meat so it’s tricky to meet my Calorie needs by cutting out rice and increasing my bean consumption.

            Other than eggs and dairy, there is really no good vegetarian protein source. That's my personal opinion. Vegetarian protein comes with a variety of issues.

          • 7e 2 days ago ago

            White rice has a higher glycemic index (GI) than sugar (sucrose).

            • simmerup a minute ago ago

              Because sugar is half fructose which is processed in the liver when over eaten. Insulin doesn’t come into it for fructose

            • BobaFloutist a day ago ago

              Yeah and a peeled potato has a dramatically higher glycemic index than straight fructose. Glycemic index is an interesting metric, but it's far from the end-all be-all, especially if you aren't diabetic.

              • anon291 a day ago ago

                A peeled potato is similarly bad for you if eaten in the same density as rice in Asian cuisines. The typical Asian dish is served with the equivalent of 3-4 potatoes of rice.

            • Marsymars a day ago ago

              Yeah, that kinda underlines my point, that without actual numbers, even “moderate rice and no sugar” isn’t particularly meaningful. (FWIW, I don’t eat white rice or other non-whole-grains.)

            • anon291 a day ago ago

              I first understood this when I noticed that by avoiding white rice for lunch, I was more energetic in the afternoon. Unfortunately, in Indian culture, it's very common to eat rice at every meal and the corresponding sugar drop is a huge contributor to brain fog / lethargy, as well as the extremely high levels of insulin resistance (and pot bellies) commonly found amongst most Indians. I had to undo a lot of my childhood programming to get out of the constant consumption of rice. Rice is fine sparingly and in moderation, but not in the way it is commonly consumed across asian cultures.

        • arvinsim 2 days ago ago

          I wonder if that is really true globally. You can't really escape carbs in some cuisines like Asia and some of them are really doing just fine.

          • unnamed76ri 2 days ago ago

            See: The China Study. They are apparently doing much better than the west.

            • anon291 a day ago ago

              Yes this is because they walk. It really has nothing to do with food if you're at the activity level of the typical American (which is zero, to be clear).

        • dottjt 2 days ago ago

          What you're saying makes no sense without context. You say "we" but someone who's extremely active vs extremely sedentary are going to require different macros to compensate.

          • anon291 a day ago ago

            You can get energy from fat. No human on hacker news except for elite athletes are running multiple miles per day continuously in the way our ancestors may have. And honestly, you still don't really need sugar for that as your body adapts.