The complex adaptability of the human body truly amazes me, and the level of misunderstanding most of us have about it is even more astounding.
Growing up in the 70's and 80's, and seeing the growth of the fitness trend parallel the growth of obesity, one would think we'd have some clue about why people are both getting fatter and exercising more. Its been roughly 50 years since the high carb diet became the default recommendation of the USDA, and its obvious its wrong. But what's worse, is it seems because so much of our understanding of the human metabolism is based on studying people eating the "Standard Western Diet," much of that is wrong, too.
Its been nine months since I began eating a high fat, very low carb diet and the changes just keep coming as my body continues to adapt. My strength and stamina have gone up, my waistline shrank months ago and has stayed put. My body fat hovers around 10%. I recover from workouts amazingly fast, my morning HRV is consistently ideal even after hard workouts, my mental focus is the best its ever been, and I generally feel great.
I stopped measuring blood sugar and ketos on a regular basis a while ago. Now I only do so when I have good reason to think I may have slipped out of ketosis.
Earlier this week I attended a bartender's dinner hosted by a spirit company, at one of Atlanta's premier restaurants. I'd have been a fool to pass up the astoundingly good free meal, the company of friends and colleagues, and free top shelf booze. I've been to my fair share of industry dinners over the past 5 or so years, and I know what to expect when being wined and dined. Intent on maintaining my ketosis, I knew what I would and wouldn't eat or drink. If I had stuck to that plant, I wouldn't be writing this now.
After sampling a range of liquors, we were treated to a five course meal with cocktail pairings. To say it was delicious really doesn't do it justice. The problem was it was so good, my mouth wanted more when my stomach was begging me to stop stuffing it!
I had planned to taste the samples, since I know how alcohol effects ketosis. No problem. I planned to take a few sips of the cocktails, out of politeness and professional curiosity, but not too much to keep my sugars down (plus it looks good at these things not to get drunk). Again, no problem. I planned to avoid the starches, like the house made Hawaiian rolls that smelled amazing, and which everyone eagerly devoured. I managed that. I skipped some of the appetizers and sides, while enjoying the meat and fish and veggies. I was doing good.
Then came the desserts. Well, that's when my plan went wrong. Everything else had been so good, and there was chocolate involved, and I didn't have any keto friendly chocolate waiting for me at home and...
Yeah, one bite to taste turned into a healthy portion of both desserts.
Sure I had knocked myself out of ketosis, I decided to check the next morning. Ketones are usually lowest right after waking, so I waited about an hour without eating, then tested both blood sugar and ketones.
Months ago, when I began this journey, my fasting blood sugar first thing in the morning was usually between 70 and 80 mg/dl. An hour after getting up, it was 105. Yep, I was out of ketosis. Except I wasn't. A few seconds later, my keto meter told a different story, reading 0.9 mmol/L, well into ketosis.
What? How can that be? With blood sugar that high, I had to be out of ketosis! With Ketones that high, my blood sugar should be much lower?
Over the past couple days I've gotten similar results each morning, so I did some googling.
It turns out, this is a known phenomenon: Physiologic Insulin Resistance or adaptive glucose sparing.
Diabetics are insulin resistant. Their cells don't listen too well to the insulin hormone, so the pancreas keeps pumping out more and more to clear glucose from the blood, creating a vicious cycle.
When someone is very highly sensitive to glucose, a very small amount of insulin can trigger the cells to clear glucose from the blood very efficiently. This is one of the many benefits of sustained ketosis. It retrains the metabolism to work better.
Part of the metabolic process of waking up is increasing cortisol, which triggers gluconeogenesis, the process of making glucose out of non-glucose in the liver. This is why we do not need to eat any carbs at all, our body can manufacture glucose for those processes that require it through gluconeogenesis. In effect, waking up should cause a spike in blood sugar, even though you haven't eaten in hours.
Sugars in the blood trigger insulin, which tells the cells to suck up the sugars and store them. Someone on a Standard Western Diet, whose body is used to getting sugars from food, might not be well adapted to gluconeogenesis. So their blood sugars don't rise as much.
Someone who has been in ketosis for a sustained period would be better at this, and thus see a spike first thing in the morning. The exact opposite of what is seen on a Standard Western Diet.
Based on what was thought to be normal, your blood sugar should be lowest upon waking, and raise when you eat breakfast. Then drop between meals, and raise again each time you eat, until your last food of the day. After which it would decline overnight until the morning again.
After long term keto adaptation, it seems to be highest upon waking, then declines through out the day as your cells use it or absorb it to replace spent stores.
With the continuing findings of how much better the human body seems to operate on a low or no carb diet, this new model of blood sugar should change the whole way we look at what used to be considered "normal."
If effect, our understanding of normal has been based on looking at a poorly adapted and unhealthy population. For the first time we're seeing a growing number of healthy individuals and their markers are very different. They don't fit the base line at all!
Besides fasted blood glucose, Keto Adapted people have slightly higher resting heart rates, but are also more fit which goes against "normal." They are also all over the board for cholesterol and blood lipids, but display fewer symptoms of heart and cardiovascular disorders, which flies in the face of how we understood cholesterol until recently. They shed fat while eating what many still consider unhealthy amounts of fat. Despite low relative blood sugar levels, they don't experience symptoms of hypoglycemia. All these and many other common keto observations show that our understanding of our own bodies is very wrong.
But that's the beauty of science, its never perfect, always evolving. New data, leads to new understanding and new questions we didn't even know to ask before.
