After 17 hours fast, only mild ketosis

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ShepR
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Re: After 17 hours fast, only mild ketosis

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AnnaM wrote: Sat Jul 02, 2022 1:58 pm Maybe talking on the phone with her siblings would help? And the churches are open now, with masks. I know the zoom gets tedious. Do check out one of the Doctors listed on Dr Bredesen's website at Apollo Health Co. They will have other ideas for you.
Good luck, and know that you are doing an incredible job for her!
Best,
AnnaM
Anna, not sure I answered your previous comment. I thought I did, but maybe not. I am so not understanding this platform.

This reply is just to say "Thank You" for your input. I heard you.
We did over a year of weekly zoom meetings with her sibs. Then she didn't want to do it anymore. It take a lot of cognitive energy to have a 44 person meeting. And when the sibs would go off on a tangent or get into private jokes, she was feeling left out of it. So I can understand. What she needs is one to one with people who understand her condition and accept her where she is, while talking directly to her about her issues, and patiently, lovingly, giving her time to respond. Sigh.

That's not going to happen in a group zoom yoga class. So I have engaged her yoga teacher for one-on-one strength training starting on the 13th for 2x per week. And I am encouraging her 2 friends to engage more. If we move to Atlanta, she has old friends who may still be around and willing to engage. We lived there for 12 years and came to Boston in 2006.
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Re: After 17 hours fast, only mild ketosis

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ShepR wrote: Mon Jul 04, 2022 2:47 pm Please say what is the BBB you refer to. Thanks. [how the BBB regulates Glucose Transporter density.]

I will take your advice, and implement more fat, and try and get the carbs down. A lot depends on what she is willing to eat. Some time back I made fat bombs. They are refrigerated after mixing, then cut into squares. I could add a fat bomb to each of her 2 meals / day, while eliminating fast carbs, and only occasional complex carbs. Yes, build up calories and ketones. Sadly, I have to focus on downsize and move in 60 days. It will mean less attention to diet for that 2 months.
BBB = Blood Brain Barrier. The brain is isolated from the rest of the body and its blood supply - only certain things are allowed in (glucose, ketones, etc.). The walls of the blood vessels that feed the brain make up a good portion of the BBB. There are mechanisms in the walls to allow a particular substance into the brain. Glucose Transporters are one type that facilitates the entry of glucose into the brain. Sometimes these things have locks and requires the help of something else like insulin, but not these particular ones; if glucose comes in contact with one, it is allowed in. The more of these transporters, the closer the brain's glucose levels will be to the blood glucose levels. If the body is not able to maintain relatively even blood glucose levels, then as a last resort, glucose transporters are removed from the BBB, and the glucose level in the brain will become a lower fraction of blood glucose level. Let's say the brain wants a level of 80, but your blood glucose goes up to 200, then the density of glucose transporters in the BBB reduce until the peak is something that the brain can handle, say it cuts by 1/2 and your highs are now only 100 inside the brain. That protects the brain from neuron burnout, but what happens when your blood glucose goes down? Say you get it down to 120. That means inside the brain, it is only 60. Neurons don't have enough fuel and eventually start to have problems. Ketones have their own way to get through the BBB and can help during these low periods. But best to keep your glucose peaks down.

Out of curiosity, what do you put into your fat bombs?
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Re: After 17 hours fast, only mild ketosis

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mike wrote: Mon Jul 04, 2022 7:25 pm
ShepR wrote: Mon Jul 04, 2022 2:47 pm Please say what is the BBB you refer to. Thanks. [how the BBB regulates Glucose Transporter density.]

I will take your advice, and implement more fat, and try and get the carbs down. A lot depends on what she is willing to eat. Some time back I made fat bombs. They are refrigerated after mixing, then cut into squares. I could add a fat bomb to each of her 2 meals / day, while eliminating fast carbs, and only occasional complex carbs. Yes, build up calories and ketones. Sadly, I have to focus on downsize and move in 60 days. It will mean less attention to diet for that 2 months.
BBB = Blood Brain Barrier. The brain is isolated from the rest of the body and its blood supply - only certain things are allowed in (glucose, ketones, etc.). The walls of the blood vessels that feed the brain make up a good portion of the BBB. There are mechanisms in the walls to allow a particular substance into the brain. Glucose Transporters are one type that facilitates the entry of glucose into the brain. Sometimes these things have locks and requires the help of something else like insulin, but not these particular ones; if glucose comes in contact with one, it is allowed in. The more of these transporters, the closer the brain's glucose levels will be to the blood glucose levels. If the body is not able to maintain relatively even blood glucose levels, then as a last resort, glucose transporters are removed from the BBB, and the glucose level in the brain will become a lower fraction of blood glucose level. Let's say the brain wants a level of 80, but your blood glucose goes up to 200, then the density of glucose transporters in the BBB reduce until the peak is something that the brain can handle, say it cuts by 1/2 and your highs are now only 100 inside the brain. That protects the brain from neuron burnout, but what happens when your blood glucose goes down? Say you get it down to 120. That means inside the brain, it is only 60. Neurons don't have enough fuel and eventually start to have problems. Ketones have their own way to get through the BBB and can help during these low periods. But best to keep your glucose peaks down.

Out of curiosity, what do you put into your fat bombs?
Mike thanks a bunch for your wonderfully detailed explanation.

My fat bomb recipe is called "Nora’s Nut Ball Snackers", and I got the recipe from a book by Nora Gedgaudas - Primal Body, Primal Mind.

Here is her recipe (BTW she is a high fat/ low carb guru, so she reluctantly published this recipe to help people get through the carb cravings):

The ingredients I used are numbered - (I wanted to put them in bold face, but don't know how to do it. Pasted from Word Doc, but boldface was removed by system)

Nora’s Nut Ball Snackers, I hope these aren’t my only legacy.

You’ll need the following ingredients:
1) One regular, 16-oz jar (roughly) of almond butter or any other nut butter that you prefer (other than peanut or cashew butter). Stir surface oil in well!
2) 10 oz or more (a very rough approximation) of organic nuts (e.g., almonds, pecans, macadamia nuts, Brazil nuts, pistachios), preferably presoaked and dried. Use a food processor to grind or chop to the desired consistency and chunkiness.
3) Handful of organic sesame seeds or chia seeds (great source of mucilaginous fiber to help “keep that train rolling”).
4) Organic shredded coconut (as much or as little as you like).
5) Alcohol-free (glycerin-based) vanilla extract, or crushed or powdered organic vanilla beans.
6) One full brick (room temperature) of KerryGold butter (decidedly a key ingredient). You can also try grass-fed ghee. (For an outstanding organic and fully grass-fed ghee, go to www.pureindianfoods.com). Green Pasture (www.greenpasture.org) also makes a butter pecan–flavored butter oil that I have found to be a lovely and nutritious addition to this recipe. If you cannot have butter or want a nut ball that keeps better at room temperature, you can use organic cocoa butter instead. Works great!
You can add any of these optional ingredients.
Organic coconut flour (Bob’s Red Mill makes a good one): Add for additional yummy coconut flavor or better binding.
7) Organic coconut butter: You have to taste this stuff to believe it!
Stevia: For added sweetness, if needed or desired.
8) Organic cacao nibs (Dagoba brand has quality ones): Add chocolaty flavor without adding sugar. Also, cacao nibs have roughly twice the antioxidant content of green tea!
9) Organic, unsweetened cacao powder can also provide some lovely decadence for people fancying that chocolaty flavor.
A scoop of Garden of Life–brand Super Seed: A delicious, gluten-free, sprouted and fermented seed-based fiber product with a touch of cinnamon. This is a particularly effective ingredient for turning those nut balls into a regularity-enhancing experience. Plus, it tastes great!
Whatever floats your boat (and happens to be low carb).
Blend the above ingredients in a bowl thoroughly, then spoon out in little balls onto wax paper on a plate or tray. An alternative and timesaving method is to simply pour the mixture into a pan evenly, then chill and cut into squares or bars (effectively changing the name of this recipe into Nora’s Nut Squares or Bars). Refrigerate for a good hour, or until they firm up.
If you want to take the nut balls with you, you might consider placing them in a small portable cooler. You could also individually wrap them in wax paper to secure them (if they can’t be refrigerated) so that they don’t get all over everything if they melt.
Prepare your taste buds to be seriously dazzled! And kids love them.

Primal Body, Primal Mind
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Re: After 17 hours fast, only mild ketosis

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How about getting a second opinion? You have so much data and are doing so much. I wonder if a doc specifically trained in ReCODE might see something that your FM doc is missing.

An example might be Lyme disease, which my son has. We have found that the doc who spends her whole day dealing with this complicated disease simply knows more about it than the doc who is educated about it but does not practice in it full-time.
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Re: After 17 hours fast, only mild ketosis

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ShepR wrote: Mon Jul 04, 2022 11:53 pm 1) One regular, 16-oz jar (roughly) of almond butter or any other nut butter that you prefer (other than peanut or cashew butter). Stir surface oil in well!
2) 10 oz or more (a very rough approximation) of organic nuts (e.g., almonds, pecans, macadamia nuts, Brazil nuts, pistachios), preferably presoaked and dried. Use a food processor to grind or chop to the desired consistency and chunkiness.
3) Handful of organic sesame seeds or chia seeds (great source of mucilaginous fiber to help “keep that train rolling”).
4) Organic shredded coconut (as much or as little as you like).
Quite the recipe! That jar of Almond Butter has around 170 g of carbs. The other items also have carbs. - How many fat bombs do you make from one batch? Have you tested her sugars with the CGM after eating one when fasting? Might be a good idea...

If she is okay with butter, then how about cream cheese? I can't do it, but my wife will just eat a chunk of butter sometimes. I put whole fat whipping cream in my coffee - no carbs. I start my day with fat. If I'm hungry at night, I will zap some and drink it by itself. My wife also like these - https://eatingevolved.com/collections/c ... 8776841310 with 1 gm net carbs. She says it does not raise her sugars. It also has some MCT. She puts them in the freezer, and makes a satisfying snack. You would want to test with the CGM to see how your wife responds.
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Re: After 17 hours fast, only mild ketosis

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mike wrote: Tue Jul 05, 2022 11:47 am
ShepR wrote: Mon Jul 04, 2022 11:53 pm 1) One regular, 16-oz jar (roughly) of almond butter or any other nut butter that you prefer (other than peanut or cashew butter). Stir surface oil in well!
2) 10 oz or more (a very rough approximation) of organic nuts (e.g., almonds, pecans, macadamia nuts, Brazil nuts, pistachios), preferably presoaked and dried. Use a food processor to grind or chop to the desired consistency and chunkiness.
3) Handful of organic sesame seeds or chia seeds (great source of mucilaginous fiber to help “keep that train rolling”).
4) Organic shredded coconut (as much or as little as you like).
Quite the recipe! That jar of Almond Butter has around 170 g of carbs. The other items also have carbs. - How many fat bombs do you make from one batch? Have you tested her sugars with the CGM after eating one when fasting? Might be a good idea...

If she is okay with butter, then how about cream cheese? I can't do it, but my wife will just eat a chunk of butter sometimes. I put whole fat whipping cream in my coffee - no carbs. I start my day with fat. If I'm hungry at night, I will zap some and drink it by itself. My wife also like these - https://eatingevolved.com/collections/c ... 8776841310 with 1 gm net carbs. She says it does not raise her sugars. It also has some MCT. She puts them in the freezer, and makes a satisfying snack. You would want to test with the CGM to see how your wife responds.
Mike, thanks for the reply.

I try and stay away from heavy loads of cow milk products. Why? Because of all the food sensitivities, she was slightly sensitive to casein. So we use cream, and cream cheese on occasion, but I am wary of it for her. We are definitely in trade-off land.

We last did the Nut Ballers in March and I had not yet started the CGM. I plan to make another batch and give her 2 squares a day. One with each meal, or else as a snack, but she hardly ever has the appetite for snack.

RE the almond butter 170g carbs. The recipe makes over 20 squares. So that would be about 8g per square. When I started this project 2 years ago. All I had was a keto book and Bredesen's book. I didn't know anything yet. So I followed the Bredesen advice, and his advice was MODERATE amount of carbs, and 2-3oz protein with meals. That is why he called it keto-flex as differentiated from keto (I thought at the time). I looked up macros for keto and carbs were strictly under 30g, and the way I interpreted Bredesen's book I took his carbs to mean under 70g. I may have misunderstood that, or Bredesen may have thought that was enough to do it. And it may have been enough for MOST people. But some people have a harder time with ketosis.

BTW here is my actual recipe and method:

Nora’s Nut Ball Snackers

This is the recipe I used. The result was roughly 20/2”x2” squares. They are both incredibly kind of sweet and salty at same time.

Ingredients:
1) One - Trader Joes Salted 16-oz jar of almond butter
2) One – Nutiva, Coconut Manna, 15oz
3) 2 oz Walnuts + 2oz pecans (chopped fine in a blender)
4) 1 - 4oz stick – Kate’s salted butter (soft at room temperature)
5) 4oz - Navitas Organic Cacao Butter – (it comes as a solid, so I put it in a bowl and steamed it)
6) 2 oz - Terrasoul Cacao Nibs (ground fine in a coffee grinder. Fine like espresso or Turkish ground coffee. Even a paste would be good)
7) 6oz – Unsweetened organic shredded coconut
8) 1 Tsp – Vanilla Extract
9) 2 Packets – Truvia

Method:

Grind the Cacao nibs to almost a paste (otherwise you will get little bits that are too hard to chew), set aside

Grind the nuts in a blender to the consistency of kosher salt, and set aside

Use a large mixing bowl. Set the mixing bowl on top of a double boiler so that the bowl warms gradually

Add the Cacao butter, and salted butter to the bowl, when the cacao butter has started to liquify, add the salted almond butter, and the coconut manna, then the dry ingredients, the shredded coconut, and nuts, then the vanilla flavoring, the cacao nib paste, and the Truvia.

By then, you can remove from the heat and start mixing the ingredients with a hand mixer. The coconut manna may be hard to break down then you would get isolated lumps in the squares, so I suggest mixing and mixing to make sure it has a very smooth consistency.

Prepare a glass or pyrex baking pan (mine was 9x13x2.5), by applying butter to bottom and sides, so the squares won’t stick.

Pour the well mixed batch into the Pyrex Baking pan. Refrigerate until it firms up. Cut into squares. I got 20 squares that were 2”x2” approximately. I wrapped each square in saran wrap and stored in the refrigerator. They will keep for a long time.
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Re: After 17 hours fast, only mild ketosis

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ShepR wrote: Tue Jul 05, 2022 12:59 pm [RE the almond butter 170g carbs. The recipe makes over 20 squares. So that would be about 8g per square.
Yes, but that is just the almond butter. I'm guessing the total will be double that. She would be getting ~32 g of carbs a day from 2 "fat" bombs. The object is to increase fat and reduce carbs, and instead you are adding both. But everyone responds differently to carbs, and you need to test her with the CGM (without any other food, preferably fasting) to see what the fat bombs do to her sugars.
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Re: After 17 hours fast, only mild ketosis

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mike wrote: Tue Jul 05, 2022 1:27 pm
ShepR wrote: Tue Jul 05, 2022 12:59 pm [RE the almond butter 170g carbs. The recipe makes over 20 squares. So that would be about 8g per square.
Yes, but that is just the almond butter. I'm guessing the total will be double that. She would be getting ~32 g of carbs a day from 2 "fat" bombs. The object is to increase fat and reduce carbs, and instead you are adding both. But everyone responds differently to carbs, and you need to test her with the CGM (without any other food, preferably fasting) to see what the fat bombs do to her sugars.
Agreed. I will test with the CGM. Baseline w/o food in fasting mode, then just the fat bomb, then take readings every half hour. Got it.
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Re: After 17 hours fast, only mild ketosis

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ShepR wrote:You said: "I second Mike's suggestion to have fewer carbs and more fats at night. Plenty of research out there that says we humans have some pretty strong circadian rhythms when it comes to calorie source: primarily carbohydrate-catabolic mode earlier in the day and primarily lipid-catabolic mode later in the day."

I really don't get the significance or even the meaning of this. Please expand on it a little? Thank you.
Catabolic means breaking down food for energy. It just means that our bodies are on a daily cycle where we're primed to burn carbs earlier in the day better than later, and our bodies switch over to burn more fat in the evening.

Wondering why you are only feeding your wife 2 meals per day. Personally, I tried 2 meals per day and just can't get enough calories in before I get full. To keep weight on, I eat 3 times within my window.

Could you keep her eating window the same, but add some nutrient dense foods in the middle?
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