Babies Thrive Under A Ketogenic Metabolism
Some people, even some scientists who study ketogenic metabolism, have the idea that ketogenesis is somehow abnormal, or exceptional; an adaptation for emergencies only. We disagree. One reason we think a ketogenic metabolism is normal and desirable, is that human newborns are in ketosis. Despite the moderate sugar content of human breast milk, breastfeeding is particularly ketogenic. This period of development is crucial, and there is extensive brain growth during it. Although the composition of breast milk can be affected by diet , it is reasonable to assume that breast milk has always been ketogenic, and this is not an effect of modernisation. When the brain is in its period of highest growth, and when the source of food is likely to be close to what it evolved to be for that period, ketones are used to fuel that growth. If nothing else, this suggests that learning is well supported by a ketogenic metabolism. It is also consistent with the ability of ketogenic diets to treat a variety of seemingly unrelated brain disorders and brain trauma. Newborn infants are in ketosis. This is their normal state. Breastfeeding is particularly ketogenic (compared to formula feeding). Breastfeeding longer (up to a point) is associated with better health outcomes. This suggests the hypothesis that weaning onto a ketogenic diet would be healthier than weaning onto a high-carb diet. (Mark-up ours) Human babies are in ketosis Soon after birth, human babies are in ketosis, and remain so while breastfeeding . They use ketones and fats for energy and for brain growth. When this has been studied, in the first couple of hours after birth, babies aren't immediately in ketosis. There is a short delay . During that brief period before ketogenesis starts, lactate (confusingly not to do Continue reading >>
Hyperlipemia And Ketosis In The Pregnant Rat
Pregnant rats fasted on the 18th or 19th day of gestation developed hypoglycemia, severe ketosis, and hyperlipemia. The latter, which consisted primarily of triglycerides, was accompanied by increased plasma free fatty acids and accumulation of fat in the liver and kidneys. The effects of fasting were diminished by starting the fast earlier in pregnancy or by hysterectomy. Both ketosis and hyperlipemia were corrected by administration of insulin, tolbutamide, or glucose. The findings indicate that increased fat mobilization and ketosis in fasting pregnant rats are the result of insulin lack. It is suggested that the high priority of the fetuses for glucose reduced the maternal blood glucose concentration to a level too low to stimulate insulin secretion during fasting. Fasting did not alter the rapid growth of the fetuses. Pregnant rats fed ad libitum also developed hypertriglyceridemia if the diet contained fat. This hyperlipemia, unlike that in the fasted rats, was not due to increased fat mobilization and was unaffected by insulin administration. It is concluded that the fractional clearance of blood triglycerides is greatly reduced during late pregnancy. The comparative effect of anterior and posterior hypothalamic lesions on the development of sexual maturation of prepubertal female rats was investigated. Lesions by electrocoagulation were made in the medial hypothalamus of 45 rats at 25–26 days of age. Thirty-nine animals of the same age constituted the sham-operated and nonoperated controls. A hastened appearance of vaginal opening and first estrus, a significant increase in uterine weight, precocious ovarian luteinization, and premature sexual cycles were observed following both types of lesions. Sham-operated rats and animals with lesions in other parts of th Continue reading >>
Is Keto Safe For Pregnant Women?
Ketosis during pregnancy is a controversial topic. Health authorities and bloggers often praise low-carb diets for their ability to reverse infertility. But when it comes to low-carb during pregnancy, many of these same “experts” warn against the “dangers” of burning fat for fuel while pregnant. Most conventional medicine doctors would likely condemn this dietary choice as well. But is there any evidence to back up all of the fear mongering? The Evidence There are a few studies which on the surface seem to suggest possible complications with ketosis during pregnancy. Upon further investigation, however, they fall short of rational scrutiny. There aren’t many studies on pregnant women in ketosis. This likely due to the ethics and liability concerns involved with experimenting on vulnerable populations. It is important to note though that mountains of anecdotal evidence suggest that an intelligently formulated ketogenic is not only safe but may actually be beneficial to both mom and baby. Despite this, however, most mainstream doctors and media outlets have conflated ketosis with a dangerous condition called ketoacidosis and thus trumpet the dangers of keto during pregnancy. Ketosis vs. Ketoacidosis Much of the worry surrounding ketosis and pregnancy stems from a conflation of dietary ketosis with a dangerous metabolic state called ketoacidosis. Ketoacidosis happens to diabetics and involves extremely high levels of glucose and ketones in the blood. Ketoacidosis is very different from ketosis and should not be a concern for non-diabetic pregnant women. So is ketosis safe during pregnancy? The Keto Pregnancy Connection Far from being harmful, ketosis is actually a natural part of every pregnancy. In fact, pregnant women are able to enter ketosis 3 times more quic Continue reading >>
Guest Blog Post: Is It Safe To Go Low Carb During Pregnancy?
Today my friend and colleague, Lily Nichols, a fellow registered dietitian and certified diabetes educator, shares her insight on carbohydrate-restricted diets during pregnancy. This is a controversial topic that I believe deserves more attention and investigation, which Lily does brilliantly in the following article. Is It Safe to Go Low Carb During Pregnancy? With the wide adoption of low-carbohydrate diets, many people question if they are safe during pregnancy. While quite a few women use a lower carbohydrate diet to conceive (since they are especially useful for women struggling with infertility), most medical professionals discourage women from continuing this diet during pregnancy. I find it ironic that if you tell your doctor that you plan to eat low carb during pregnancy, they’ll say it’s unsafe, but if you say you plan to eat a diet based on fresh vegetables, meat, fish, eggs, dairy, nuts, seeds, and a little fruit, they’ll encourage you to stay the course. The controversy over the safety of low carbohydrate diets in pregnancy stems primarily from misconceptions around ketosis. It’s incorrect, but widely accepted, that ketosis during pregnancy is harmful to a developing baby. When I first dove into the research, I was shocked to find that studies on healthy, non-diabetic pregnant women (eating a “regular” diet) show a marked elevation in ketones after a 12-18 hour fast, which is akin to eating dinner at 8pm and having breakfast at 8am (or skipping breakfast entirely). What’s more interesting is that pregnancy actually seems to favor a state of ketosis. Compared to non-pregnant women, blood ketone concentrations are about 3-fold higher in healthy pregnant women after an overnight fast. And in late pregnancy, metabolism shifts to a state o Continue reading >>
What Is Ketosis?
"Ketosis" is a word you'll probably see when you're looking for information on diabetes or weight loss. Is it a good thing or a bad thing? That depends. Ketosis is a normal metabolic process, something your body does to keep working. When it doesn't have enough carbohydrates from food for your cells to burn for energy, it burns fat instead. As part of this process, it makes ketones. If you're healthy and eating a balanced diet, your body controls how much fat it burns, and you don't normally make or use ketones. But when you cut way back on your calories or carbs, your body will switch to ketosis for energy. It can also happen after exercising for a long time and during pregnancy. For people with uncontrolled diabetes, ketosis is a sign of not using enough insulin. Ketosis can become dangerous when ketones build up. High levels lead to dehydration and change the chemical balance of your blood. Ketosis is a popular weight loss strategy. Low-carb eating plans include the first part of the Atkins diet and the Paleo diet, which stress proteins for fueling your body. In addition to helping you burn fat, ketosis can make you feel less hungry. It also helps you maintain muscle. For healthy people who don't have diabetes and aren't pregnant, ketosis usually kicks in after 3 or 4 days of eating less than 50 grams of carbohydrates per day. That's about 3 slices of bread, a cup of low-fat fruit yogurt, or two small bananas. You can start ketosis by fasting, too. Doctors may put children who have epilepsy on a ketogenic diet, a special high-fat, very low-carb and protein plan, because it might help prevent seizures. Adults with epilepsy sometimes eat modified Atkins diets. Some research suggests that ketogenic diets might help lower your risk of heart disease. Other studies show sp Continue reading >>
Ketosis During Pregnancy
So I did a urine dip stick test and my ketones were really high (the second highest) and I also had elevated protein and bilirubin. I'm only 7 weeks pregnant and I've been very nauseous but no vomiting. I really can't stomach eating very much at all and I've lost 10 lbs in the last 3 weeks! With my daughter, I also had morning sickness but lost about 12 lbs over 3 months. The only difference between this pregnancy and the last is that I'm paleo now, and I wasn't with my daughter. I'm wondering if anyone else has had this? Should I be eating the most sugary foods I can manage? I'm not sure what to do. I haven't gone to the doctor about it yet, but I'm planning on making an appointment if things don't get better in a couple of days. Continue reading >>
Starvation Ketoacidosis In Pregnancy
Introduction: Starvation ketosis outside pregnancy is a rare phenomenon and is unlikely to cause a severe acidosis. Pregnancy is an insulin resistant state due to placental production of hormones including glucagon and human placental lactogen. Insulin resistance increases with advancing gestation and this confers a susceptibility to ketosis, particularly in the third trimester. Starvation ketoacidosis in pregnancy has been reported and is usually precipitated by a period of severe vomiting. Ketoacidosis has been associated with intrauterine death. Case report: A 22-year-old woman in her third pregnancy presented at 32 weeks gestation with a 24 h history of severe vomiting. She had been treated for an asthma exacerbation with prednisolone and erythromycin the day prior to presentation. She was unwell, hypertensive (145/70 mmHg) with a sinus tachycardia and Kussmaul breathing. Urinalysis showed ++++ ketones, + protein and pH 5. Fingerprick glucose was 4 mmol/l and ketones were 4.0 mmol/l. Arterial blood gas showed pH 7.27, PaCO2 1.1 kPa, base excess −23, bicarbonate 8.6 mmol/l and lactate 0.6 mmol/l. The anion gap was 20. Serum ethanol, salicylates and paracetamol levels were undetectable. She was fluid resuscitated but her biochemical parameters did not improve. She was intubated and underwent emergency caesarean section. A healthy boy was delivered and her acidosis resolved over the subsequent 8 h. Discussion: We believe this case is explained by starvation ketoacidosis. There was no evidence of diabetes mellitus or other causes of a metabolic acidosis. In view of the hypertension, proteinuria and raised urate the differential diagnosis was an atypical presentation of pre-eclampsia. This case illustrates the metabolic stress imposed by the feto-placental unit. It als Continue reading >>
Is Keto Safe During Pregnancy? Nutritionists Don't Recommend It
When you find out you're pregnant, a million questions pop into your mind. If it's your first pregnancy, two million questions pop into your mind. One of the most common questions about pregnancy is whether or not you can keep your diet the same as it was before pregnancy. This is an especially important question to ask if you've been on a low-carb diet such as keto. You need to know: is keto safe during pregnancy? According to the official keto website, the keto diet is a low-carb diet where the body produces ketones in the liver to be used as energy rather than carbohydrates. Much like other low-carb, high-fat diets, the keto diet promises significant results when it comes to weight loss. But can a diet that recommends 20 grams or less of carbohydrates a day help provide proper nutrition for you and your baby? According to nutritionist and health coach Erin Lorrain, the answer is no. Lorrain isn't a fan of the keto diet for regular women, let alone pregnant women. "The keto diet essentially tricks your body into thinking you're starving, causing your body to go into ketosis," Lorrain says. She goes on to explain that when you eat carbohydrates, your body produces glucose and insulin — two substances you need to survive. "Glucose and insulin help control your energy levels," Lorrain says. "And in order to maintain a healthy, balanced, diet, you should have healthy, balanced levels of glucose and insulin." This means you shouldn't survive solely on carbohydrates, but you shouldn't cut them out, either. Just like glucose is one of the main sources of energy for your body, glucose is a main source of energy for your growing baby, according to a study done by Yale University. The study goes on to state that to heavily restrict any source of energy during your child's dev Continue reading >>
Pregnancy Toxemia (ketosis) In Ewes And Does – 1.630
by S. LeValley1 (8/2010) Quick Facts… Pregnancy toxemia in sheep and goats is also known as pregnancy disease, lambing sickness and twin-lamb/kid disease. The principal cause of pregnancy toxemia is low blood sugar (glucose). Onset of the disease is often triggered by one of several types of stress including nutritional or inclement weather. The disease is most prevalent in ewes and does carrying two or more lambs or kids. The disease also affects ewes and does that are extremely fat or excessively thin. The best preventive measure is increased feeding of high energy concentrates and grains during the last month of pregnancy. Occurrence and Causes Pregnancy toxemia in sheep and goats has also been called ketosis, lambing/kidding sickness, pregnancy disease and twin-lamb/kid disease. It occurs in all parts of the world and is an often fatal disease occurring only during the last month of pregnancy. Death occurs in two to 10 days in about 80 percent of the cases. It most often affects ewes/does pregnant with twins or triplets and is characterized by low blood sugar (glucose). Economic losses because of the disease have been considerable and it is the most commonly occurring metabolic disease of sheep and goats. It is generally accepted that the basic cause of pregnancy toxemia is a disturbance of carbohydrate or sugar metabolism. In earlier phases of the disease, blood glucose concentrations are less than 30 and may be as low as 10 mg/100 ml (normal 40-60). Blood ketone bodies, on the other hand, are usually greater than 15 and occasionally may be as high as 80 mg/100 ml (normal 1-4). The free fatty acid content of the blood plasma also is increased, meaning that body fat is being broken down and used for energy. Since glucose is essential for proper functioning of the Continue reading >>
New producers of small ruminants often learn about pregnancy ketosis first time the hard way—with a dead dam, fetuses or both. This article explains the causes of pregnancy ketosis (a.k.a. toxemia) and more importantly—how to prevent it. Sheep and goat fetuses add 70% of their final birth weight in the last six to eight weeks of gestation. A singleton increases a dam’s nutritional requirements by 1.5 to 2 times maintenance in the last trimester. Multiple fetuses greatly increase energy demands on their mother: twins require 1.75 to 2.5 times maintenance requirements and triplets demand up to 3 times maintenance. Twins and triplets are common in some breeds of sheep and goats; quadruplets and even more are not uncommon in Boer goats, Finnsheep and Romanov sheep. Concurrent with a pregnant dam’s increasing nutritional needs, her physical capacity for feed intake is reduced by the rapid abdominal expansion of her pregnant uterus. Without managerial changes, the dam will be unable to ingest the calories needed to support herself and her fetuses, sending her into negative energy balance. Detecting a drop in blood glucose levels, her body’s regulatory systems will liberate energy from reserves stored as body fat. The release of stored energy will address her low blood glucose issues (remember the Krebs cycle?), but not without side effects: by-products of fat mobilization called ketone bodies can accumulate to toxic levels and suppress appetite. Without intervention and sometimes despite it, affected does or ewes may spiral downward in a fatal negative energy balance, taking their unborn fetuses with them. Besides multiple fetuses, health and management factors can predispose a pregnant ewe or doe to ketosis during pregnancy. For example, if there isn’t enough fee Continue reading >>
Is Low Carb And Keto Safe During Pregnancy?
When Carolina Cartier discovered she was pregnant with twins this past March, she never questioned whether she would continue eating a ketogenic diet. The 31-year-old Seattle area woman had been plagued by metabolic issues literally all her life: precocious puberty at age 3; polycystic ovarian syndrome (PCOS) by age 14; weight gain of 320 lbs (145 kg) on her 6 foot (183 cm) frame and pre-diabetes by her 20s. Her PCOS caused her ovaries to be enlarged and covered in cysts. She was told she was infertile and likely never able to have children. In August 2014, aged 28, her health was so poor that she went on medical disability from her job as a financial analyst. That first month off, however, she discovered and adopted the ketogenic diet. Between summer 2014 and February 2017, she lost 120 lbs (54 kg), experienced her first ever natural menstrual period that gradually established into a regular 28-day cycle; her blood sugar normalized and her ovaries reduced to 3.5 cm (< 1.5 inches) size. Her long-standing depression lifted. While she lost two early pregnancies at the start of 2016, likely because of poor egg quality, she knew she was getting healthier every day. Her positive pregnancy test in March 2017 was a happy surprise, as was the news soon after that she was carrying healthy twins. Except for a bout of extreme nausea and sea sickness for a week on a low-carb cruise early in this pregnancy, she has adhered to the ketogenic diet now through to 20 weeks of pregnancy and counting. She plans to continue this way of eating for the rest of her life. She feels great and looks wonderful; the twins in utero are thriving. “My life is transformed. Why would I even consider abandoning this way of eating when all of my positive health changes, and my pregnancy, I owe to this d Continue reading >>
Case Of Nondiabetic Ketoacidosis In Third Term Twin Pregnancy | The Journal Of Clinical Endocrinology & Metabolism | Oxford Academic
We provided appropriate management with fluid infusion after cesarean delivery. The patient and her two daughters survived, and no disabilities were foreseen. Alcohol, methanol, and lactic acid levels were normal. No signs of renal disease or diabetes were present. Pathological examination revealed no abnormalities of the placentae. Toxicological tests revealed a salicylate level of less than 5 mg/liter, an acetaminophen level of less than 1 mg/liter, and an acetone level of 300 mg/liter (reference, 520 mg/liter). We present a case of third term twin pregnancy with high anion gap metabolic acidosis due to (mild) starvation. Starvation, obesity, third term twin pregnancy, and perhaps a gastroenteritis were the ultimate provoking factors. In the light of the erroneous suspicion of sepsis and initial fluid therapy lacking glucose, one wonders whether, under a different fluid regime, cesarean section could have been avoided. Severe ketoacidosis in the pregnant woman is associated with impaired neurodevelopment. It therefore demands early recognition and immediate intervention. A 26-yr-old patient was admitted to our hospital complaining of rapid progressive dyspnea and abdominal discomfort. She was pregnant with dichorial, diamniotic twins for 35 wk and 4 d. Medical history showed that she was heterozygous for hemochromatosis. Two years before, she had given birth to a healthy girl of 3925 g by cesarean section, and 1 yr before, she had had a spontaneous abortion. Her preadmission outpatient surveillance revealed slightly elevated blood pressure varying from 132158 mm Hg systolic and 7995 mm Hg diastolic. Glucose and glycosylated hemoglobin were tested at 24 wk and were normal at 4.6 mmol/liter and 5.4% (36 mmol/mol), respectively. Urine analysis at the outpatient obstetri Continue reading >>
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7 Lingering Myths Everyone Should Know About Low-carb Ketogenic Diets
The public’s interest in learning more about the low-carb, moderate protein, high-fat, ketogenic diet is gaining momentum and is stronger than ever as evidenced by it being the #5 most Googled diet search term in 2013. Because this nutritional approach has scientific evidence showing it to be a powerful modality against most of the chronic diseases of our time, the curiosity about it comes from a variety of perspectives. From strong evidence for conditions such as diabetes mellitus (Type 2 diabetes) to cardiovascular disease, good evidence for issues like Alzheimer’s Disease to narcolepsy, and emerging evidence for a wide variety of other issues of great research interest including cancer, fibromyalgia, traumatic brain injury and so much more, there are compelling reasons to at the very least give this way of eating a try for yourself just to see how you do in your pursuit of optimizing your health. With the overwhelming flood of support for the new book on this subject written by me and my coauthor Duke internist Dr. Eric Westman called Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet (we are already in our fourth printing after just four weeks!), it seems many have already decided to do their own n=1 test of nutritional ketosis doing it in a methodical way making appropriate tweaks and changes along the way. But I’ve become increasingly concerned by the perpetuation of certain myths that continue to pervade the discussion about very low-carb, high-fat diets that is unfortunately turning some people away from even attempting to get into ketosis because of fear about what they have heard about it on the Internet. A number of these objections to very low-carb, high-fat ketogenic diets have been out there for many years without any sc Continue reading >>
Video: What You Need To Know About Keto And Pregnancy
Is eating ketogenic safe for a pregnant woman? Whether I would continue to eat high-fat, low-carb, ketogenic if I got pregnant tomorrow. There’s a lot of misinformation on the interwebs about whether a high-fat eating style is safe for pregnancy. Today, I’m sharing whether I would continue to eat high-fat, low-carb, ketogenic if I got pregnant tomorrow. I bust through some keto pregnancy myths, breakdown the ketogenic eating style that may respond best for pregnant ladies and share how to reduce water retention and all around puffiness throughout your pregnancy. A must-watch if you’re eating high-fat, or interested in eating high-fat, and plan to be pregnant at some point in your life. For video transcription, scroll down. Highlights… Why it’s widely accepted that ketosis is dangerous for pregnant women How many ketones a fetus needs to flourish 5 ways to slightly adjust a ketogenic eating style to work for your pregnancy Resources… Are you pregnant or planning to be? How will you approach your eating style while pregnant? Let’s chat about it in the comments… Hey, ladies. I’m assuming that the individuals watching this show today are going to be primarily women because today we’re talking about pregnancy and whether or not eating high fat is okay when you’re pregnant or eating more ketogenic. Congratulations if you are trying to get pregnant or you’re already pregnant. That is awesome. I am super happy for you. Maybe you are eating ketogenic or more fat fueled like what I outlined in my program or you’re eating more high fat and you’re wondering like, “Is this safe for the growing baby inside me?” First off, I can’t tell you what to do specifically but what I can do is share what I would do if I were in your position. Preparing for this Continue reading >>
My Low Carb Twin Pregnancy Journey
I realize this is much different than my regular food based posts, but none the less one that has raised many an inbox question. I just reached the halfway mark of my pregnancy with what we now believe to be two baby girls. We are so thrilled! We are expecting fraternal twins which means they are not identical. Basically two babies sharing the same birthday, but unique in every other way. We can’t wait to meet them! It was really funny and ever so slightly ironic that I had to test oodles of recipes for my recipe book in my first few weeks of pregnancy. YES! Nausea and new recipes… fun! But as they say, all is well that ends well. 1. WHY DID I CHOOSE TO CONTINUE WITH A LOW CARB LIFESTYLE DURING MY PREGNANCY? My family has been on a fully integrated low carb lifestyle for just over 18 months now. It is our new normal. It is our lifestyle. We cannot imagine feeling tired, emotional and hungry all the time anymore, so for me it made perfect sense to keep doing what is obviously working for my body. BUT the fact that I am also making decisions for someone else’s body… it made me ponder if I’m doing the right thing for them? I found confirmation after confirmation once I stopped reading pregnancy sites and shifted my research to what babies need for healthy growth. I devoted an entire chapter in my book to this. Basically, I looked at my entire nutritional regime and could not think of a time in my life that I actually ate a better amount of nutrients and less junk. I figured… our girls do not need junk like preservatives, colorants, enhancers, modified starches, hormone filled GMO Soy or GMO wheat. Sugar is void of any nutrients and really is the weakest form of energy so… not needed! I was shocked to see that most recommended pregnancy diets actually promoted Continue reading >>