Ketosis & Kidney Failure
Ketosis happens when your body resorts to fat for energy after your stored carbohydrates have been burned out. It often occurs when people fast and exercise. But most commonly, ketosis occurs in people who eat low-carb, high-protein diets, which are also called ketogenic diets. There’s some evidence that ketosis can tax your kidneys, leading to kidney stones and low blood pressure. In diabetics, a variant of ketosis can be fatal. However, a small but growing group of health professionals say ketosis is not the poison you’ve been lead to think it was, and it may be better for you than high-carbohydrate eating. Your specific dietary habits are best advised by your healthcare provider or nutritionist. Video of the Day Ketosis happens when you get a buildup of a substance known as ketones, or ketone bodies in your blood. They are released when your body’s carbohydrate stores run out and you have to break down fat stores for energy. Dieters tend to deliberately cause ketosis because it makes you feel less hungry. However, ketosis also makes you feel tired and sluggish, because as "Medical News Today" reports, ketones aren’t the most efficient source of energy, especially for your brain. Ketosis can also harm your kidneys. Annually, more than 100,000 people are diagnosed with kidney failure in the United States, reports the National Institute of Diabetes and Digestive and Kidney Diseases, or NIDDK. The condition is marked by the inability of your kidneys to do their job of eliminating wastes. One treatment for kidney failure is dialysis, a draining and lengthy artificial blood cleansing process. Another option is a kidney transplant. The NIDDK states that the cost of care for patients with kidney failure reached close to $32 billion in 2005. The federal government sub Continue reading >>
Top 14 Low-carb & Keto Fears (and Whether You Should Be Worried)
It is not at all uncommon that people are skeptical of a low-carb diet in the beginning, especially since we’ve been flooded with bad high-carb, low-fat advice for decades. Of course, we don’t want any unsubstantiated fears of the past get in the way of people reaping the benefits of a low-carb diet. So here’s a short Q&A explaining why most of these fears are nothing to worry about. We also want to make low carb simple, and this includes being very upfront and honest about potential problems and how to handle them. Some problems actually can occur on low carb, and it can be very helpful to know what they are and what can be done about them. Here are the most common fears about low carb, and whether they are true or false. Does a low-carb diet cause high cholesterol? Low-carb diets tend to improve the cholesterol profile by increasing levels of the “good” HDL cholesterol, and decreasing levels of harmful triglycerides. These are both good changes, associated with improved health. Regarding the “bad” LDL cholesterol, most people experience no significant changes on low carb. However, some people can lower or (more often) increase LDL levels somewhat. Note that studies show that at least people over 60 years of age tend to live longer with higher LDL levels. Taken together, studies show that low-carb diets generally improve risk factors for disease, including cholesterol. For a small minority of people however, cholesterol may go up abnormally high on an LCHF diet. In those situations it could be worth adapting the diet to normalize the cholesterol levels. The bottom line: Low-carb and high-fat diets on average improve the cholesterol profile and reduce most risk factors for disease. The effect of this has been demonstrated in a 2010 study that showed a redu Continue reading >>
Kidney Function And Lchf
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Does anyone have issues with kidney function and still successfully follow the LCHF regime? Although I am not being treated as such!, i.e. dialysis, I've been told my kidneys do not work at full capacity and have deteriorated significantly over the last couple of years. I am a little worried about what I have read about ketosis affecting the kidneys. Is it just a case of drinking lots of water? Should I take the issue up with my gp or renal consultant? I've followed a ketogenic diet for around 2 years or so and I too have CKD and take Ramipril daily,My eGFR level has improved slightly on this diet,all I would add is don't go mad with eating protein and concentrate more on getting your calorific needs from fats and veggies etc. Thank you for this advice. I have only been on the LCHF diet for 2 days so far. Already my blood sugars have stabilised so that's a good start. So far my diet has consisted of eggs, bacon, burgers, broth, cheese, double cream, nuts and berries. I dont feel at all hungry most of the time. Of course its too early to tell if there is any weight loss. So far I have not had any negative feedback re this diet although I saw my dietician yesterday and she wouldn't endorse it douglas99 I reversed my Type 2 Well-Known Member Thank you for this advice. I have only been on the LCHF diet for 2 days so far. Already my blood sugars have stabilised so that's a good start. So far my diet has consisted of eggs, bacon, burgers, broth, cheese, double cream, nuts and berries. I dont feel at all hungry most of the time. Of course its too early to tell if there is any weight loss. So far I have not had any negative feedback re this diet although I sa Continue reading >>
Diabetes, Kidney Damage, And Ketogenic Diets
Take a look at this PBS video sent to me by one of our readers – and try not to punch your monitor near the end: So close … Okay, let’s focus on the positive for now. I was delighted to hear one of the on-screen experts explain that high glucose levels appear to cause repeated injury to the kidneys. Well-meaning people have tried to warn me over that a “high protein” diet is hard on the kidneys. Why? Because damaged kidneys leak protein. But that doesn’t mean protein is causing the damage. If your kitchen pipes start leaking water, do you assume the damage was caused by water? Of course not. The kidneys are damaged by excess glucose, and then they leak protein. I was delighted again to hear a researcher explain that ketones can be used as an alternate energy source by most cells in the body, and that on a ketogenic diet the body switches from being primarily a glucose-metabolizing machine to a fat-and-ketone metabolizing machine. As I like to explain it to people, you can be sugar-burner or a fat-burner. I find life as a fat-burner much more pleasant … more consistent energy, better mood, no more creeping weight gain, and no more ravenous hunger if I skip a meal. As I write this, I’m 23 hours into a 24-hour intermittent fasting day, and I feel fine. I was delighted yet again when the researchers speculated that removing glucose from the picture might help the kidneys recover, then discovered that putting mice on a ketogenic diet did indeed reverse the kidney damage caused by diabetes. Sure, it’s just a rodent study with results that may or may not apply to humans, but as the researcher said, it’s a proof of principle, an avenue to be explored. All right! Cool! Great story so far. I was anxiously waiting for the part where he suggests we try the same Continue reading >>
Clearing Up Kidney Confusion: Part Deux
Its funny how our mental state really affects how we write and what we are interested in. When I wrote the introduction to this piece I was just getting settled into our new place in Santa Fe, NM and was looking at over a month at home to work and write. Then a number of wacky events happened and Ive been home about 7 days out of the last month and Ive only made it about 70 pages into Kon-Tiki. Now Im home for 8 days and will then be gone for a project that will take me completely off the grid for nearly 3 weeks. No phone, emailnada. When I sat down to do this kidney piece it was with a mindset that I had a ton of time and could really sink my teeth into it. Now Im time crunched and anxious that I will get it done at all! Up front here Id like to thank Mat The Kraken Lalonde with his help on some literature for this piece. Any inaccuracies however are my own tomfoolery. If I wanted to cut to the chase I could boil this whole thing down to the following: 1-Dietary protein DOES NOT CAUSE KIDNEY DAMAGE. 2-Chronically elevated BLOOD GLUCOSE levels DO cause kidney damage. 3-Dietary fructose REALLY causes kidney damage. 4-Many kidney issues have either a hyperinsulinemic characteristic, an autoimmune characteristic, and or a combination of autoimmunity or hyperinsulinism. A standard, low-ish carb paleo diet can fix most of these issues. 5-For serious kidney damage a low-protein, ketogenic diet can be remarkably therapeutic. 6-If you get kidney stones that are from oxalates, reduce your green veggie intake (spinach for example) and have other types of veggies. 7-If you get kidney stones that are from urate salts, you are likely NOT following a low-ish carb paleo diet, you likely have insulin resistance and your liver is not processing uric acid. As much as Id like to leave it Continue reading >>
Is Ketosis Really Bad For You?
A patient recently asked me how bad being in nutritional ketosis was for her. I responded that the worse problem I’ve seen recently is the patient that broke his toe when he slipped on bacon grease. Are there risks with a ketogenic diet? Yes, but these usually only occur when you cheat or fall off the wagon. What problems can arise? Lets talk about them individually. First, as I stated above, make sure you don’t slip on bacon the grease. It really can be an issue if you’re not used to using increased amounts of fat in your kitchen. So, be prepared for how to cook and use fat. Grandma understood this well, we could learn a great deal from her if you ask her about using bacon grease. Second, let’s define the difference between ketosis and keto-acidosis and try to clarify the misinformation that is being spread around the blogosphere. A ketone is a molecule the body produces from the breakdown of fat (specifically triglycerides) and some proteins (amino acids). There are specifically three types of ketones: beta-hydroxybutyric acid, acetoacetic acid and acetone. If ketosis was “bad,” then why would our bodies produce these molecules? They are not bad, and in fact, multiple studies show that the body is often more efficient in weight loss, inflammatory reduction, bowel function, epigenetic influence and maintenance of lean body mass more effectivly when it functions on ketones rather than glucose as its primary fuel source. You can see these studies here, here, here and here. The body can only supply a limited amount of sugar or glucose for fuel. If you talk to runners, marathoners or triathletes, they will tell you that after about 45-90 minutes of continuous endurance exercise the glucose supply runs out and they will experience what is termed a “bonk” (ha Continue reading >>
Is The Keto Diet Safe? 10 Myth-busting Arguments For The Safety Of Ketosis
Is ketosis safe? The truth is that we can’t say for certain that it is 100% safe. Humans don’t understand everything under the branch of nutritional science and probably won’t for a very long time. As an individual, the only thing you can do is take a look at the research yourself and form your own conclusion. Personally, through the reading I’ve done and the experience I’ve had with the Keto diet, I’ve formed my own conclusion that ketosis is safe. Could I be wrong? Absolutely. But I could also be right. I’m willing to take that risk in order to follow a diet which could maximize longevity, well being and function. My personal conclusion shouldn’t matter to you though. You need to do your own research and come to your own conclusion. I’ve put together this post to organize all of the issues surrounding the safety of ketosis so that you can make your own decision. In trying to prove something to be safe there are two ways to go about it. Disprove the claims of danger Show evidence which may be correlated with safety This article will dispel the top 10 claims people make in an argument to label ketosis as dangerous. Like I said, the science on ketosis is still quite immature. The following data is not meant to 100% prove or disprove the safety of ketosis. It’s merely the information we have available today which can help us form a nutritional strategy we feel is best for ourselves. I’m not a doctor or a researcher. The following information is material I’ve collected in my attempt to feel confident following a Keto diet indefinitely. Most of it is sourced from doctors or authors although I have also included anecdotal accounts from experiences posted on message boards and Reddit. I know, much of the information here isn’t sourced directly from s Continue reading >>
High-protein, Low-carb Diets Explained
High-protein, low-carbohydrate diets, like The Atkins Diet, have been widely promoted as effective weight loss plans. These programs generally recommend that dieters get 30% to 50% of their total calories from protein. By comparison, the American Heart Association, the National Cholesterol Education Program, and the American Cancer Society all recommend a diet in which a smaller percentage of calories come from protein. Normally your body burns carbohydrates for fuel. When you drastically cut carbs, the body goes into a metabolic state called ketosis, and it begins to burn its own fat for fuel. When your fat stores become a primary energy source, you may lose weight. Some experts have raised concern about high-protein, low-carb diets. High cholesterol.Some protein sources -- like fatty cuts of meat, whole dairy products, and other high-fat foods -- can raise cholesterol, increasing your chance of heart disease. However, studies showed that people on the Atkins diet for up to 2 years actually had decreased “bad” cholesterol levels. Kidney problems. If you have any kidney problems, eating too much protein puts added strain on your kidneys. This could worsen kidney function. Osteoporosis and kidney stones. When you're on a high-protein diet, you may urinate more calcium than normal. There are conflicting reports, but some experts think this could make osteoporosis and kidney stones more likely. If you're considering a high-protein diet, check with your doctor or a nutritionist to see if it's OK for you. They can help you come up with a plan that will make sure you're getting enough fruits and vegetables, and that you're getting lean protein foods. Remember, weight loss that lasts is usually based on changes you can live with for a long time, not a temporary diet. Continue reading >>
Diets For Patients With Chronic Kidney Disease, Should We Reconsider?
Abstract Here we revisit how dietary factors could affect the treatment of patients with complications of chronic kidney disease (CKD), bringing to the attention of the reader the most recent developments in the field. We will briefly discuss five CKD-induced complications that are substantially improved by dietary manipulation: 1) metabolic acidosis and the progression of CKD; 2) improving the diet to take advantage of the benefits of angiotensin converting enzyme inhibitors (ACEi) on slowing the progression of CKD; 3) the diet and mineral bone disorders in CKD; 4) the safety of nutritional methods utilizing dietary protein restriction; and 5) evidence that new strategies can treat the loss of lean body mass that is commonly present in patients with CKD. Background When we published a Commentary on how dietary factors could affect the treatment of patients with complications of chronic kidney disease (CKD) in 2004, we relied heavily on results from older publications . There were two reasons for this decision: firstly, clinicians and investigators working on this topic were still reeling from the negative conclusion of the Modification of Diet in Renal Disease trial (MDRD), namely that dietary modification exerted only a minor impact on the progression of CKD . Secondly, there were too few hypotheses addressing how dietary manipulation could affect the development of CKD and its complications . We now revisit this topic because new insights have identified how dietary factors can overcome the development of CKD and its complications, including the progression of CKD. Notably, these insights can be largely traced to results obtained during rigorous studies of patients with CKD rather than intensive investigations of animal models, indicating there is clinical r Continue reading >>
How Does Keto//os Affect Kidneys And Liver And The Role In Metabolizing Ketones?
As with all medium chain triglycerides, the MCT powder portion of the product will largely be converted to ketones by the liver within a few short hours of consumption. MCT create a readily supply of Ketone production for the liver to use for ketones. The BHB-salt portion should simply be absorbed into the blood as ketones. The BHB supplies another source, which doesn’t require the liver to produce ketones. There is no reason that the ketones produced by the product will affect the kidneys or liver any differently than ketones produced from exogenous fats (such as when eating a ketogenic diet) or ketones produced from stored fats (such as when calorie restricting or losing weight). Exogenous ketone scientific literature does not suggest that either kidney or liver function is negatively affected by ketosis. The major role of the kidneys when it comes to ketones is to excrete excess ketones in the urine. This excretion will likely be highest during the first few days of keto-adaptation (either in eating the keto diet or consuming KETO//OS), but the body will retain more and the tissues will begin to preferentially burn the ketones as consumption continues. The liver is the major site of endogenous ketone production, so taking exogenous ketones with KETO//OS would provide another source besides the liver to make ketones. Remember, KETO//OS and exogenous ketones are a source of calories; so be sure to consider it in your daily goals. KETO//OS and exogenous ketone supplementation is not hard on the liver. Continue reading >>
The Keto Diet Is Gaining Popularity, But Is It Safe?
A new twist on extreme weight loss is catching on in some parts of the United States. It’s called the "keto diet." People promoting the diet say it uses the body’s own fat burning system to help people lose significant weight in as little as 10 days. It has also been known to help moderate the symptoms of children with epilepsy, although experts are not quite sure why it works. Proponents say the diet can produce quick weight loss and provide a person with more energy. However, critics say the diet is an unhealthy way to lose weight and in some instances it can be downright dangerous. Read More: What is the “Caveman Diet?” » What Is Ketosis? The “keto” diet is any extremely low- or no-carbohydrate diet that forces the body into a state of ketosis. Ketosis occurs when people eat a low- or no-carb diet and molecules called ketones build up in their bloodstream. Low carbohydrate levels cause blood sugar levels to drop and the body begins breaking down fat to use as energy. Ketosis is actually a mild form of ketoacidosis. Ketoacidosis mostly affects people with type 1 diabetes. In fact, it is the leading cause of death of people with diabetes who are under 24 years of age. However, many experts say ketosis itself is not necessarily harmful. Some studies, in fact, suggest that a ketogenic diet is safe for significantly overweight or obese people. However, other clinical reviews point out that patients on low-carbohydrate diets regain some of their lost weight within a year. Where It’s Helpful The keto diet was created by Dr. Gianfranco Cappello, an associate professor of surgery at the Sapienza University in Rome, Italy. He claims great success among thousands of users. In his study, more than 19,000 dieters experienced significant, rapid weight loss, few side Continue reading >>
Reversal Of Diabetic Nephropathy By A Ketogenic Diet
Go to: Introduction While intensive insulin therapy and other interventions slow the development of diabetic complications , there is far less evidence that these interventions reverse diabetic complications. For example, tight glucose control prevented the development of nephropathy (as indicated by proteinuria) in a rat model of Type 1 diabetes, but did not reverse nephropathy once proteinuria had developed . Thus there is a general consensus that diabetes is associated with progressive and cumulative processes that are much more amenable to retardation than to reversal. Nevertheless, from a clinical perspective, reversing pathologies associated with diabetes would be far more valuable than simply delaying their onset. We have proposed that both diabetic complications and age-related pathologies develop due to a progressive and cumulative effect of glucose metabolism that produces a bistable hysteretic effect on gene expression . In addition to glycolytic enzymes that would be expected to produce oxidative stress , glucose metabolism also induces a variety of molecular responses such as thioredoxin-interaction protein  and p65  that could plausibly contribute to nephropathy. Indeed, the latter induction is persistent, even after normalization of glucose, thus exemplifying glucose-induced hysteresis and its clinical correlate, metabolic memory, including in nephropathy . Furthermore, based particularly on detailed analysis of the hysteretic behavior of the lac operon , , we have hypothesized that sufficiently prolonged and robust reduction in glucose metabolism or molecular responses to glucose metabolism may reverse this bistable molecular state, leading to reversal of pathology . While examining basic mechanisms mediating molecular respo Continue reading >>
Is Ketosis Dangerous?
You may have heard from your doctor that ketosis is a life-threatening condition. If so, your doctor is confusing diabetic ketoacidosis (DKA) with nutritional ketosis, or keto-adaptation. First, some semantics. Our body can produce, from fat and some amino acids, three ketone bodies (a “ketone” refers to the chemical structure where oxygen is double-bonded to carbon sandwiched between at least 2 other carbons). These ketone bodies we produce are: acetone, acetoacetone, and beta-hydroxybutyrate (B-OHB). [For anyone who is interested, they are the 3 most right structures on the figure, below.] Why do we make ketones? For starters, it’s a vital evolutionary advantage. Our brain can only function with glucose and ketones. Since we can’t store more than about 24 hours’ worth of glucose, we would all die of hypoglycemia if ever forced to fast for more than a day. Fortunately, our liver can take fat and select amino acids (the building blocks of proteins) and turn them into ketones, first and foremost to feed our brains. Hence, our body’s ability to produce ketones is required for basic survival. What is diabetic ketoacidosis? When diabetics (usually Type I diabetics, but sometimes this occurs in very late-stage, insulin-dependent, Type II diabetics) fail to receive enough insulin, they go into an effective state of starvation. While they may have all the glucose in the world in their bloodstream, without insulin, they can’t get any into their cells. Hence, they are effectively going into starvation. The body does what it would do in anyone – it starts to make ketones out of fat and proteins. Here’s the problem: the diabetic patient in this case can’t produce any insulin, so there is no feedback loop and they continue to produce more and more ketones withou Continue reading >>
Does Ketosis Cause Kidney Damage?
The ‘Lean for Life’ program is mildly ketotic, and only for a brief portion of the program. It has not been associated with kidney damage or disease in individuals who have normally functioning kidneys. Concerns regarding undue stress on the kidneys are often aimed at very low carbohydrate, very high protein ketogenic diets. Few studies have shown any actual damage, however. (Note: Although the Weight Loss portion of the ‘Lean for Life’ program is mildly ketogenic, it is not considered to be exceptionally “high protein” for most individuals.) Dietary ketosis is among the most maligned and misunderstood concepts in nutrition medicine. Particularly among researchers who don’t actually treat patients, ketosis (the presence of ketone bodies in the urine) is often confused with ketoacidosis, which is a life-threatening build-up of ketone bodies due to muscle wasting and dehydration as in states of shock or uncontrolled Type 1 diabetes. In the Type 1 diabetic, the absence of insulin leads to a toxic build-up of blood glucose and an extreme break-down of fat and muscle tissue. This condition doesn’t occur in individuals who have even a small amount of insulin, whether from natural production or artificially administered. Whereas patients in ketoacidosis are closely monitored in Intensive Care Units, individuals in ketosis are amongst the healthy, active population. Dietary ketosis is a natural adjustment to the body’s reduced intake of carbohydrates as the body shifts its primary source of energy from carbohydrates to stored fat. The presence of insulin keeps ketone production in check so that a mild, beneficial ketosis is achieved. Blood glucose levels are stabilized within a normal range and there is no break-down of healthy muscle tissue. It would be diffi Continue reading >>
Are Low-carb Diets Safe For The Kidneys?
A new study eases long-term concerns regarding the potential adverse effects low-carbohydrate diets may have on the kidneys. Low-carb, high-protein diets—such as the Atkins diet—have been popular for years, but experts have long worried that these weight loss strategies may have harmful effects on a person’s kidney function or fluid and electrolyte balance. As far back as the 1970s, the American Medical Association even released an editorial labeling the Atkins diet "potentially harmful." “The belief among many experts was eating lots of protein could ‘rev up’ the kidneys, like an engine, and cause damage or failure over time,” lead researcher Dr. Allon Friedman, from the Indiana University School of Medicine, told FoxNews.com. “High levels of protein have also been known to change electrolytes in the blood in ways that could be harmful,” he added. However, in a study of 200 obese patients who participated in a low-carb, high-protein diet over a two-year period, Friedman and his colleagues did not find any noticeably harmful effects on kidney health or function compared to people who ate a low-fat diet instead. “We did not find that a high-protein diet led to any kidney-related problems like lower filtration rates, kidney stones or problems with blood electrolytes,” Friedman said. Based on the results, Friedman said high-protein diets appeared to be healthy from both a kidney and weight loss standpoint. “As long as the diet is sensible, the most important thing is weight loss, regardless,” Friedman said. “Other studies have suggested high-protein diets allow patients to lose at least as much weight as heart-healthy diets.” However, he warned that despite the encouraging results, these diets may not be safe for everybody. “We did not perfo Continue reading >>