Barbara and I have been on a ketogenic diet for about six months, and we are absolutely amazed at the results. I’ve lost inches. She’s lost inches. And we’re both full of energy.
To tell you the truth, the diet wasn’t even that difficult to configure or stay on. From our perspective, it wasn’t restrictive at all.
In this series of posts, I’ll tell you why we’re doing keto. You see, not everyone does it for the same reasons. Barbara and I have some similar goals, but at the same time, we have some very different reasons for going keto. I’ll also detail how we configured our macronutrients (carbs, fats, and proteins), our experiences with it, and some practical things we learned that you must do if you’re going to do this diet.
I’ll also answer questions like:
- Do I have to check my ketones every day?
- How much fat can I eat?
- Will too much protein throw me out of ketosis?
- Can I still lift heavy on this diet?
In today’s post, though, let’s take a 10,000-foot view of the ketogenic diet.
The Ketogenic Diet Is Hot
The ketogenic diet seems to be the newest fad diet. However, doctors have used it to treat epilepsy for over 100 years.
Today, nutrition experts are recommending the diet as a healthy way of eating. Several leading researchers like Doctors Westman, Phinney and Volek have written best selling books showing how the keto diet can be used to treat a number of physical ailments and also provide a healthy diet for millions of people.
Even longtime primal lifestyle blogger Mark Sisson recently released a “how to” book on the keto diet (it’s excellent by the way). And if you browse Amazon’s nutrition bestseller list, you’ll see several keto cookbooks there.
The keto diet is hot — no question about it. But what exactly is it?
What Is A Ketogenic Diet?
Simply put, a ketogenic diet is a diet that puts your body into a state of nutritional ketosis. Wow, that didn’t tell you a lot, did it?
Okay, let’s make it simpler. Nutritional ketosis is a condition where your body uses fats and ketones rather than carbohydrates (glucose) as an energy source. This metabolic state happens when your intake of carbohydrates is sufficiently limited to the point where your liver begins to convert fat tissue and dietary fats into organic compounds called ketones. These ketones can be used for energy in other parts of your body especially your muscle and brain.
Contrary to what has been taught for decades fat and ketone metabolism is a much more efficient source of fuel for your body than carbohydrates. Here are a few reasons why:
- Carb metabolism produces more reactive oxygen species (free radicals) than fat. The less of those disease causing free radicals floating around your body the better.
- Ketone body metabolism produces more ATP (energy) within mitochondria and less damaging free radicals.
- Less free radicals mean less tissue inflammation
- Energy-wise fat yields more bang for your buck. Carbs yield 4 calories per gram while fat yields 9.
- Carbs are burned more quickly than fat. Therefore, if your diet consists of predominantly carbs you will need to continually eat carbs to continue fueling your body. However, since carbs are broken down into glucose, constant consumption of glucose will spike your blood glucose levels. In turn, this will signal the constant secretion of insulin which can lead to insulin resistance and subsequent disease. Fat on, the other hand, doesn’t induce insulin secretion.
Mark Sisson compares the burning of carbs to fat as burning kindling as compared to a slow, long burning log. You’ll get quick heat from the kindling but the log will keep you warmer a lot longer.
Switching To Fat Burning
A keto diet causes your body to switch from burning carbs for energy to fat. This fat comes from two possible sources. One is from the fat you consume. The other is from your own stored fat reserves. Yes, that’s that dreadful stuff hanging around your belly and thighs. In the process of fat burning, ketones are produced.
So far, we have seen three very important aspects of a ketogenic diet. First, your carb intake is kept low. Second, fat is your body’s primary fuel. And three, in the process of fat metabolism, ketones are made in the liver.
I would like to add here that being on a keto diet does not mean that your body can be fueled by any dietary fat. It’s strictly limited to healthy fats (no processed industrial seed oils, margarine, etc.).
Let’s take a look at why someone would want to go on this
insane, healthy diet.
Reasons For Going On A Ketogenic Diet
There are some good reasons for going on a ketogenic diet. Some are better than others. You’ll see what I mean later on.
Traditionally, a ketogenic diet has been used to treat epilepsy. Doctors find that it has a remarkable ability to lower or even eliminate seizures in epileptic children. See Charlie’s story.
Physicians believe it’s the ketones that produce the amazing results in epilepsy, but they’re not sure how.
Possible Management Of Other Diseases
Many people are experimenting and finding success with the ketogenic diet for conditions such as:
- Parkinson’s disease
- Alzheimer’s disease –— There have been several studies done showing the positive effects of increased ketone levels and improvement in memory and cognitive abilities in individuals with Alzheimer’s Disease. See here, here and here. Researchers are not sure why they see improvements among patients with Alzheimer’s Disease when on a ketogenic diet. One theory is that Alzheimer patients often have impaired glucose metabolism in their brains. Therefore, energy from ketones is more efficient. Two other reasons are the possibility of reduced hyperinsulinemia and reduction of inflammation.
- Multiple sclerosis
- Type 2 and type 1 Diabetes
- Cardiovascular disease (CVD)
An important note here is that some of the above conditions such as Type 2 diabetes, Alzheimer’s Disease, CVD, PCOS, as well as gout, hypertension, erectile dysfunction, benign prostate hyperplasia/hypertrophy (BPH), vertigo, tinnitus, and Ménière’s Disease seem to be driven by hyperinsulinemia.
Since a ketogenic diet is extremely low in carbohydrates, insulin levels should fall. Thus the success of the keto diet for these conditions may be more related to lowering insulin and not necessarily to the higher ketone levels.
This means that if you were using the diet to solely correct hyperinsulinemia, you wouldn’t have to go crazing trying to constantly check your ketone levels. You could actually go out of ketosis and still derive health benefits by lowering insulin levels. In which case, you may not even really need to be on a ketogenic diet but simply an adequate carb restricted diet.
Reduction Of Inflammation
Inflammation is not always a bad thing. It’s our body’s way of responding to pathogens, tissue damage, and irritants so that our body can heal itself.
However, when inappropriate chronic inflammation gets out of hand, disease can occur. Chronic inflammation has been associated with several diseases such as Rheumatoid Arthritis, MS, Alzheimer’s Disease, some cancers, cardiovascular disease, type 2 diabetes, Parkinson’s Disease, hypertension and, obesity.
The Ketone Inflammasome Connection
In 2002, researchers discovered that a structure within human cells called an inflammasome is responsible for initiating the cascade of inflammatory effects. When an inflammasome recognizes a threat such as toxins, bacteria, viruses or even too much glucose, it binds to caspase-1 and triggers the release of cytokines. These small proteins continue to mediate the inflammatory process.
However, if an inflammasome (there’s only one per cell) remains abnormally activated, then cytokines can run wild causing a chronic inflammatory state and even some of the diseases I mentioned above.
Are you with me so far? Good. Here’s where it gets interesting.
Researchers are now doing studies to see if targeting the NLRP3 inflammasome can help in reducing chronic inflammation and thus disease.
Researchers believe that modulating the NLRP3 may help in the treatment of type 2 diabetes, metabolic syndrome, and insulin resistance, rheumatoid arthritis, epilepsy, and some neurodegenerative disorders such as Alzheimer’s Disease, ALS and, MS.
So you might be saying, “What does all this have to do with the ketogenic diet?” There is evidence that one of the ketones produced by a ketogenic diet, beta-hydroxybutyrate (BHB), can reduce inflammation by modulating the effect of the intracellular NLRP3 inflammasome.
Researchers from this study came to these conclusions about BHB,
These findings provide insight into immunological functions of metabolic signals such as BHB and suggest that dietary or pharmacological approaches to elevate BHB, without inducing the generalized starvation response, holds promise in reducing the severity of multiple NLRP3 mediated chronic inflammatory diseases.
Here is another study suggesting the same effect of BHB on the NLRP3 inflammasome and inflammation.
Okay, since, a ketogenic diet increases the ketone (BHB), and BHB reduces the activation of NLRP3, then it’s possible that increased ketones in the body can reduce the chronic inflammatory response associated with the above conditions.
On to the next reason people go on a ketogenic diet.
Fat Loss On A Ketogenic Diet
A big reason individuals go on a ketogenic diet is for its ability to promote fat loss. Here’s the rationale.
Since a keto diet is extremely low in carbohydrates, insulin levels will drop dramatically allowing fat to be released from fat cells. Now, because you are not burning carbs for energy but fat, excess fat stores can be used for energy. Thus, you lose fat and weight.
This process is in accord with the hormonal theory of weight gain that suggests obesity is primarily due to the prolonged over secretion of insulin.
The Hormonal Theory Of Weight Gain
After you consume refined carbs and sugar, your digestive process converts them into glucose. This glucose then enters your bloodstream.
When your body recognizes the glucose in your blood, your pancreas secretes insulin which removes glucose from your blood and transports it to cells for immediate energy. If the cell has sufficient energy, the cell will convert the excess glucose into glycogen or fat as a store for future energy needs.
If you continue to over-consume carbs, insulin will continue to pack glucose into muscle and fat cells where if it’s not needed for energy, it will be converted to triglycerides (fat). This means you get fatter.
If you continue to over-consume carbs for a long time (I’m talking about years here), insulin will stay chronically high which will have the effect of locking fat into cells. This means you get even fatter.
If insulin stays chronically high, your cells may develop a resistance to insulin. This can lead to all kinds of problems like type 2 diabetes, obesity, and metabolic syndrome. If insulin resistance continues long enough, your cells may resist the effect of insulin to store glucose. This means that excess glucose may end up in your liver. Eventually, your liver will convert the glucose first into glycogen and then into fat and then presto chango you have fatty liver disease.
This is a simple explanation of the hormonal theory of weight gain. If you’re a biochemistry nerd like me and want to discover the detailed science behind the theory, see this excellent series of posts by Amy Berger of Tuitnutrition.com.
Now here’s something I mentioned before. If you have insulin resistance, type 2 diabetes, or metabolic syndrome, then a ketogenic diet will help with these medical conditions. But since the goal here is to reduce insulin levels by reducing carb intake, the thing that’s making you better is carb restriction, not ketones.
As they say over at Ketogains.com, if your goal is to lose fat you’ll want to chase results, not ketones. This means that your success will be measured by inches, pounds, blood glucose, and insulin numbers.
So if you want to use a keto diet to lose fat, you don’t have to go crazy making sure you’re producing at least 0.5 mmol of ketones per day. However, if you’re concerned with the adverse inflammatory effects caused by hyperinsulinemia, you may want to make sure you’re in ketosis.
The Elimination Of Brain Fog
Many people who go on a keto diet say they experience increased clarity of thinking. While this evidence is anecdotal there are two scientific theories which may support the claim.
This study shows that ketosis increases the production of glutamine synthetase. Therefore ketosis increases glutamine synthetase which reduces ammonia in the brain which reduces brain fog.
An imbalance between the neurotransmitters glutamate and GABA within the brain can cause neurodegeneration. This study showed that ketosis can bring these two chemicals into balance by clearing glutamate and increasing GABA. This is also a proposed reason why a keto diet works for epilepsy.
Now, if you want the ketone benefit of a ketogenic diet, there are some important things to know.
How Can You Tell If You’re In Ketosis?
Keto diet experts Dr.s Phinney and Volek state that a person reaches a state of nutritional ketosis when the concentration of ketones in your blood is at or above 0.5-3.0 mM. Here’s the rub though. The only way to know that you are absolutely in ketosis is by using a special meter that tests your blood.
This is somewhat invasive as it means you have to draw some blood from yourself similar to what a diabetic does when they check their blood glucose levels. Personally, I have never done this nor do I plan to.
A less accurate way to tell you’re in ketosis is by using a urine strip. However, this will only tell you that you have some excess ketones but not how much. More on ketone levels later.
How Do You Get Into Ketosis?
Dr.s Phinney and Volek recommend eating <50 grams of carbs and a moderate amount of protein daily to achieve nutritional ketosis. However, these recommendations can vary according to the individual. Others keto advocates recommend that net carbs (carbs – fiber) be kept to a maximum of 30 grams.
Some people can achieve ketosis with slightly more carbs though others may need less. Also, individuals may not see ketones in their blood immediately. For those who have not already been on a low-carb high-fat diet, it may take 1-2 weeks for ketosis to begin.
Protein and fat intake are variable, depending on the goal of the dieter. I’ll go into more detail later on what comprises a well-formulated ketogenic diet (macronutrient and micronutrient content).
Going Into Ketosis Without Consuming Fat (Fasting)
If you consume no food, you will eventually burn up your stored glycogen reserves. Once this happens, your body will then turn to its own stored fat for fuel. This will eventually produce ketones. This is one goal of those who practice prolonged fasting.
Increasing Ketones Through Supplements
There are supposedly two ways to increase your ketone levels with supplements.
- Consume exogenous ketones. I haven’t had experience with these and I don’t know how effective they are.
- Consume MCT (medium chain triglyceride) oil. MCT oil is broken down directly into ketones in the liver. I do take MCT oil, and I’ll give more on my experience with that in an upcoming post.
Who Shouldn’t Be On A Ketogenic Diet?
If you have any kind of debilitating disease you should always consult with your doctor before beginning a diet. That being said some individuals should be cautious before entering into a keto diet.
- Pregnant women, women who are breastfeeding and children. Because of the differences in caloric intake necessary in these populations a strict keto diet might be contraindicated. See here, here and here.
- Type 1 and Type 2 diabetes. Type 1 diabetics must be careful of going into ketoacidosis. Since a keto diet increases ketones this is a concern. Type 2 diabetics must be cautious on any low-carb diet because the limitation of carbs in conjunction with insulin-lowering medications can cause hypoglycemia. See here.
- Hypertensive Individuals. Low-carb diets are effective for lowering blood pressure. Therefore people who go ultra low-carb and are on antihypertensive meds should guard against low blood pressure. See here.
There it is. I know I promised you a 10,000-foot view of a ketogenic diet, this was more like a 5,000-foot view. And, yes, I know there are still a lot of unanswered questions. I’ll get into our use of the keto diet next time.
P. S. If you’re looking for low-carb recipes, get a copy of Barbara’s newly released eBook Bursting With Flavor: 50 low-carb and gluten-free recipes designed to delight your taste buds. This isn’t just any cookbook. It’s filled with her tastiest and healthiest recipes. You’ll be able to walk into your kitchen excited to easily cook a new meal each day.
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