Hi.  wow I'm impressed as well.  It's not totally perfect, but certainly 
readable. 
Maria Chapman
[email protected]

"The weak can never forgive. Forgiveness is the attribute of the strong." - 
Mahatma Gandhi

On 08/03/2013, at 5:37 AM, Anne Robertson <[email protected]> wrote:

> Hello everyone,
> 
> My StandScan Pro arrived today and I'm really impressed! Below my signature 
> I've pasted two scans, the first one using the mains adaptor with the 
> StandScan Pro, and the second one using the battery. These are double-pages 
> and the two are not the same.
> 
> Cheers,
> 
> Anne
> 
> The Art and Science of Low Carbohydrate Living quished (because m p pie then 
> returned to a 'balanced,,_ -~ relin.
> diet), along with many of its associated metabolic benefits '~ainterla% 
> Parallel in time to the popularity of VLCDs, Dr. Robert Atkins promoted a 
> less energy-restricted approach to a ketogenic diet. His focus Was on keeping 
> carbohydrate intake low enough to induce ketosis, but not to severely limit 
> (or even count) calories. To achieve this, he advised individu.
> als to eat protein and fat to satiety while keeping dietary carbohydrates low 
> enough to maintain positive urine ketones. It was his view that this diet, 
> including vegetables, limited fruit, and vitamin supplements, could be 
> followed by the individual outpatient without close medical SUpervi.
> sion unless there was a pre-existing complicating condition like diabetes or 
> hypertension. For most patients, however, the Atkins diet tended to be only a 
> temporary sojourn into nutritional ketosis, whether for want of sweets or 
> want of approbation from their friends and doctor.
> n
> ,
> owever, in these parallel few decades of the VLCD and Atldns diet, hundreds 
> of studies were done, and we learned a great deal about carbohydrate 
> restriction. Among these lessons are many which can contribute to the safe 
> and sustainable use of carbohydrate restricted diets going forward.
> Counting Calories vs Carbs It was Dr. Atkins' contention that when most 
> carbohydrate was removed from the diet, heavy people lose weight more 
> effectively than by classic balanced calorie restriction. The mechanism was 
> (and remains) hotly debated. Claims of reduced metabolic efficiency during 
> nutritional ketosis remain unproven. Among other points against this is the 
> fact that Steve Phinney's bike racers produced the same power output in 
> testing 0~ a stationary bike using the same oxygen consumption after adapting 
> to the Inuit diet compared to their test on a high carb diet[23], leaving 
> little room for metabolic inefficiency in this group of subjects.
> But this argument over the mechanism of weight loss is an acaderoic 
> straw.man, In study after study, over the first 3-6 months, people r~a" 
> ClinicaIUse°fCarb°hydrateRestricti°n: VeryL°wCal°rieandLowCarbohydrateDiets 
> donaized to a low carb diet eaten to satiety lose more Weight and more body 
> fat than those assigned to a low fat, calorie restricted diet. A credible 
> mechanism to explain this is not hard to find - carbohydrates in our diet may 
> offer a short-term sense of increased energy, but they offer little in the 
> way of functional satiety.
> ~e best example of this effect was reported by Dr. Guenther Boden[45] in an 
> inpatient study of obese type-2 diabetics. After a week of eating a balanced 
> diet to satiety, the subjects were given a low carbohydrate diet consisting 
> of most of the same foods, with the exception that they were asked to limit 
> their total daily carbohydrate intake to 20 grams. Over the next two weeks, 
> their spontaneous nutrient intakes were carefully measured. Interestingly, 
> the subject's average daily energy intake dropped from 3100 to 2100 Calories, 
> and this was all due to the 'missing' carbs.
> Despite having the choice to eat more, the protein and fat intakes of these 
> subjects remained relatively constant. And despite this 1000 Calorie per day 
> deficit, their reported hunger, satisfaction, and energy levels did not 
> change appreciably. What did change was their diabetes control - dramatically 
> for the better. For more on this topic, see Chapter 15.
> But this study was just 2 weeks long. What happens in the longer term? Well, 
> the process of full metabolic adaptation to a low carbohydrate diet takes up 
> to 6 weeks, so for the first few months, we would expect wellbeing and 
> function to get better. But after many months and a major degree of weight 
> loss, it is a normal response of the human body to try to limit its losses. 
> This is typically achieved by eating more, but what? If dietary carbohydrate 
> intolerance led to the choice of a low carbohydrate diet at the outset, why 
> lift that restriction? In particular, why add back calories that promote fat 
> storage but do not provide functional satiety? Accepting that protein is good 
> for us only in moderation, the answer is fat (see Chapters 2 and 16). How 
> much fat should you add as you approach Weight maintenance.~ The simple 
> answer: "let satiety rule", 163 1~9
> 
> 
> -- Made with Prizmo.
> 
> Scan 2, using battery
> 
> The Art and Science of Low Carbohydrate Living Ketones - To Measure or Not As 
> noted m" Chapter 1, nutritional ketosis is defined by ser-um keto ranging 
> from 0.5 up to 5 mM, depending on the amounts ^€ ~. aes ~'~ uletary car.
> boh#rate and protein consumed. In most people, the Combined intake of 100 
> grams of carbohydrate and 100 grams of protein will drive seruna ketones well 
> below 0.5 mM. While there is nothing magical about hay.
> ing circulating ketones above this threshold level, it does have the practi.
> cal value of providing the brain with a virtually limitless, fat-derived fuel 
> source. This alternative fuel is eminently more sustainable, particularly in 
> the insulin resistant or carbohydrate intolerant individual.
> Within a few days of starting on carbohydrate restriction, most people begin 
> excreting ketones in their urine. This occurs before serum ket0nes have risen 
> to their stable adapted level because un-adapted renal tubules actively 
> secrete beta-hydroxybutyrate and acetoacetate into the urine.
> This is the same pathway that clears other organic acids like uric acid, 
> vitamin C, and penicillin from the serum.
> Meanwhile, the body is undergoing a complex set of adaptations in ketone 
> metabolism[99]. Beta-hydroxybutyrate and acetoacetate are made in the liver 
> in about equal proportions, and both are initially promptly oxidized by 
> musde. But over a matter of weeks, the muscles stop using these ketones for 
> fuel. Instead, muscle cells take up acetoacetate, reduce it to 
> betahydroxybutyrate, and return it back into the circulation. Thus after a 
> few weeks, the predominant form in the circulation is beta.hydroxybutyrate' 
> which also happens to be the ketone preferred by brain cells (as an aside, 
> the strips that test for ketones in the urine detect the presence of 
> acetoacetate, not beta-hydroxybutyrate). The result of this process of ket0" 
> adaptation is an elegantly choreographed shuttle of fuel from fat cells to 
> liver to muscle to brain.
> In the kidney, this process ofketo-adaptation is also complex, over ti#, 
> urine ketone excretion drops off, perhaps to conserve a valuable enerf/ 
> substrate (although urine ketone excretion never amounts to very na#Y wasted 
> calories). This decline in urine ketones happens over the s~e 164 
> clinicalUseofGarbohydrate Restricti°n: Very L°wCalorieandLowCarbohydrateDiets 
> time-course that renal uric acid clearance returns to normal (discussed 
> beloW) and thus may represent an adaptation in kidney organic acid metabolism 
> in response to sustained carbohydrate restriction.
> These temporal changes in how the kidneys handle ketones make urine ketone 
> testing a rather uncertain if not undependable way of monitoring dietary 
> response/adherence. Testing serum for beta-hydroxybutyrate is much more 
> accurate but requires drawing blood, and it is expensive because it is not a 
> routine test that doctors normally order.
> A non-invasive alternative is to measure breath acetone concentration. 
> Acetone is produced by the spontaneous (i.e., non-enzymatic) breakdown of 
> acetoacetate. Because it is volatile, acetone comes out in expired air, and 
> its content is linearly correlated with blood ketone levels. A number of 
> businesses have developed prototype handheld devices to measure breath 
> acetone, but at the time of this writing, nothing practical is on the market.
> But whatever test is used, the key question is why do it? Many people are 
> able to initiate and follow a low carbohydrate diet just fine without ever 
> measuring ketones. Others, however, find an objective measure of nutritional 
> ketosis to be reassuring. In some clinical settings, ketone testing is used 
> as a measure of'diet compliance'. While this may be useful in the short term 
> to keep patients on track in a strictly regimented dietary program, it begs 
> the question of how that individual's diet will be managed long term. For 
> this purpose, the handheld breath acetone monitors under development hold 
> some promise as a guidance tool put into the hands of the individual striving 
> to find the right levd of carbohydrate intake for long-term maintenance.
> Biochemical changes (uric acid, acid/base, dectrolytes, cholesterol 
> mobilization)
> There are often dramatic but wholly predictable changes that occur in blood 
> chemistry values upon initiation of a low carbohydrate diet. As a result, and 
> also due to the very limited food intakes of people following very low 
> calorie diets, most clinics using them do routine blood tests over the first 
> 165
> 
> 
> -- Made with Prizmo.
> 
> 
> Sent from my iPhone
> 
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