This one's super sciencey (as in, it's an actual journal article), but has a fascinating rundown of all kinds of things a ketogenic diet might help cure or prevent: Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets, from: European Journal of Clinical Nutrition, June 2013.

Also very sciencey, and it focuses on psoriasis ... but since that's an inflammatory condition, the findings are probably largely applicable to rheumatoid arthritis and other diseases as well: Diet and psoriasis: experimental data and clinical evidence, British Journal of Dermatology, October 2005 - older, so I'd love to see a follow-up! (Unfortunately, you pretty much need to be at a research library to get access to that one for free. Many university libraries will let you access articles even if you are not a student, though!)

Finally, there's some interesting work being done on putting together an "inflammatory index," to score foods based on their likelihood of increasing inflammation. This should be of interest to anyone with inflammatory arthritis, but also to people at risk for diabetes, heart disease, and certain cancers. A lot of the articles about it are available for free on PubMed! Here's one.

Here are my notes, based mostly on that middle article and a couple of official psoriasis and arthritis webpages, in case it's helpful:

• “Low-energy” (low cal) diet with periods of fasting -> good
• Alcohol -> bad
• Sugar -> bad
• Vegetarian diet -> good
• EPA (omega 3’s) -> good
• omega-6’s -> bad, unless combined w/ 3’s (so skip the grapeseed oil)
• Fatty fish -> good
• Carrots, tomatoes, fresh fruit -> good
• Green veggies -> good
• Beta-carotene -> good
• Vitamin C -> good
• Vitamin E -> good
• Selenium -> good

Suggested eating habits for people with arthritis (not all is relevant to IP, but good to have in mind during maintenance):

• Eat fish, especially salmon, mackerel, tuna - fatty fishes
• Whole grains without gluten (ideally no added sugars)
• Greens - spinach, kale, broccoli, and collard greens (maybe all cruciferous veggies?)
• Soy milk, tofu, edamame
• Low-fat dairy*
• Peppers*
• Tomatoes* - lycopene
• Beets
• Ginger + turmeric
• Garlic + onion (quercitin)
• Extra virgin olive oil
• Berries (esp. raspberry, blueberry, strawberry)
• Tart cherries - 1 cup of juice or 1.5 cups cherries per day
• Olivenol supplement helped some people
• Vitamin D & fish oil - lots
• One drink per day correlated with fewer rheumatoid arthritis symptoms in one study
• Consider vegetarianism; avoid high-fat red meat

* Unless you have a sensitivity to it; dairy and nightshades can cause inflammation in some individuals

Anyway, that's kind of a huge brain dump. I'm interested in the articles other people have found about the science behind IP! Or inflammation. Or related topics. Basically, gimme your science!

Bonus article (just an editorial, by a guy who seems pretty smart but doesn't list any credentials anywhere), making a case for calling Alzheimer's "type 3 diabetes." Cutting down sugar may help our brains--who knew?

Thanks for the links, magpie.

We seem to have a lot of discussions about exercise--cardio vs. strength-training--and it turns out IP has a video about it. I can't link the video, but I can link the articles/book they talked about, and I can give you a summary.

Here are the three articles they linked:

• Weighing the evidence on exercise, NY Times
• Resistance vs. aerobic training on VLC diet, (journal article in PubMed)
• The Slow Burn Fitness Revolution (book)

TLDR: Strength training is good, may build extra muscle, will definitely help you keep muscle, and will lead to a measurably higher basal metabolic rate (BMR) after the diet, which will make maintenance easier. There was also no indication given in the video that strength training would have an impact on IP (though I would still be inclined to have the extra raspberry jelly or blueberry pomegranate drink on the day I lifted). Cardio, on the other hand, is tricky: if you get too close to your maximum heart rate (as in, you are out of breath due to exercise), there's a chance your body will rob your muscles to get enough energy, and that will decrease your muscle mass and BMR over time.

If you haven't heard of BMR, that is how many calories it takes for your body to be alive--if you just stay in bed all day, how many calories your body burns, just breathing and staying warm.

"VLC" = "very low calorie"
"VLCK" = "VLC ketogenic"

I ran across an interesting study that I wanted to share, in case others are interested: Comparison of a very low-calorie-ketogenic diet with a standard low-calorie diet in the treatment of obesity

The diet they were using, PronoKal, has a lot in common with Ideal Protein, but it's lower-calorie (600-800 kcal/day, as opposed to our 850-1000) and has more phases. Their phase 1 is just packets and veggies, no meats (don't start doing this with IP; their packets are probably also formulated differently!), and their reintroduction of foods is much more gradual; their phases 2 & 3 look a lot like IP phase 1, and they have something like 8 phases.

One note: this was arguably a sponsored study, since the PronoKal people gave their foods to the authors free of charge. That doesn't invalidate the results, but it does, uh, temper them somewhat.

I'm going to pull out the quotes that are interesting to me.

"The main finding of this work is that, compared with a standard low-calorie diet (LC diet), a VLCK diet was significantly more effective in inducing loss of body weight, and that the weight loss was mainly related to the loss of fat mass."

"Interesting enough, when evaluated at one year follow-up, the VLCK diet group showed than more than 88 % of the patients presented a reduction of initial body weight higher than 10 % and that lean mass was well preserved."

"The VLCK diet method was found to be superior to the standard LC diet, and the average weight loss of 20 kg that was measured in this study was higher than the weight loss that has been observed with most of the anti-obesity drugs that have been studied"

Still, the thing I find interesting about this study is that the folks on PronoKal did better than the folks just counting calories, even after their calorie intake was increased. It reads to me like the study took a year, and I think a more interesting result would be for the study to look at them a full year later, to see who maintained and who didn't. I doubt that I will, but if I find that the authors followed up, I'll add that to this post.

One other pull-quote, and my commentary: "The dropout rate in this study was similar to that expected in any program with obese individuals" - you, you fat-hating jerks.

Anyway, the study isn't entirely without problems, but it's nice to know that there are people out there studying ketogenic diets. (I still haven't found a good source for the idea that ketosis helps reset the body fat set point, though.)

This is amazing magpie. I love facts. Thank you for taking the time to share.

ALL diets lose SOME lean mass (muscle included). It is an unavoidable element of weight loss.

Loss from cardio is variable, dependant on the individual and the choices they make.

In the 3 months I've been under the guidance of a nutritionist/bodybuilder at the Army Wellness Center, and monitored on their bod pod, I have seen two different results based on my own change of fueling related to running. For information, I am WAY over 75% of my maximum heart rate.

Jan 21 - Fat Mass 67.638 Fat Free Mass 115.325
Feb 20 - Fat Mass 55.769 Fat Free Mass 113,866
Mar 20 - Fat Mass 54.107 Fat Free Mass 115.273

So, as you can see ... my fueling method was incorrect when I first began Couch to 5K and I *did* lose lean mass. Once I started reading up on the principles of retaining lean mass I began losing fat again, and regained the loss (could also be helped with the strength training three times a week to balance it out).

One thing I can tell you is that the cardio is removing the inches, compared to the strength training toning up the underlying muscle.

Is it worth a slower loss on the scale? That's for an individual to decide, but cardio muscle retention *can* be done - even by an amateur like me.

Agreed. The fact that they leave out is that ALL diets lose a percentage of lean mass, regardless of whether they are anabolic (dietary fueled) or catabolic (fat fueled). It is an unavoidable factor of the way hormones work in the body.

This is why non-catabolic diets recommend exercise to supplement the reduction in calories. IP and other ketogenic diets often do not allow for optimal loss with the caloric/carb intakes being pruned back to minimal levels that allow maintaining good health, which is why coaches do not recommend exercise. It would mean calculating the individual changes on a per person basis and very few clinicians/coaches have that amount of time to spend tailoring a program for the individuals they see.

Strength training breaks down muscle, but refueling with protein, very light carbs and BCAA's allows them to be rebuilt with some growth factor thrown into the equation.

If you want the better quality research check out the Sports and Athletics trials and studies.

Don't be a hater. Not their fault if they prejudge us all, based on those who "play" at diets. Blame the quitters!


Couple of links that I found interesting:-

Keto Adaptation

Keto Lessons Learned in 17 months

Keto Adaptation versus Low Carb Limbo

Video of Anabolic versus Catabolic Metabolism

Here's an interesting short one with a few things about insulin resistance...

http://www.huffingtonpost.com/2015/0...ushpmg00000063

Interesting article in the Globe & Mail about the new Brazilian Food Guide...
What a different way of looking at it (from Canada & US food guides)

http://www.theglobeandmail.com/life/...ticle17496796/

Article on WebMD about the latest 'fat loss' medication - Contrave.
A compromised study and very unethical actions by the manufacturer. Yikes! Just goes to show how the scent of money from desperate obese people can sway the regulatory agencies...
http://www.webmd.com/diet/obesity/20...-safety?page=1

Liana

Excellent.

This would be FANTASTIC advice here in the US too...one always has to consider socioeconomics though and the severe lack of access in some areas to fresh goods.

That is so true... there are some real 'food deserts' in the inner cities... where the only 'grocery' within walking distance or feasible bus ride is the 7-11 with a wilty apple, or a bag of Doritos and a Slurpee going for the same price. Oversimplification, I know, but not far off the mark.