I’m sure you have heard of the Ketogenic diet by now.  One minute, mainstream media loves it, the next minute, they say it might be one of the most harmful diets on the planet.

What is the truth?

What is the Ketogenic diet? 

A normal ‘recommended’ diet is 45-65% carbohydrates.

Low carbohydrate diets are broken down into 3 categories.

• Moderate carb = 26-45% of daily calories (kcal)

• Low carb = < 26% of kcal or < 130 g of carbs daily*

• Ketogenic (very low carb) = < 10 % of kcal or < 50 g of carbs daily*

(* based on a 2000 kcal diet)

IMPORTANT – someone who adopts a ketogenic diet is aiming for ketosis.  This is NOT the same as ketoacidosis.  Ketoacidosis is a result of poorly managed diabetes that causes a low pH in the blood and is life-threatening (coma and/or death).

Is the Ketogenic Diet always a high-fat diet?

No.  

Historically, fat was the primary ingested fuel source. But fat is already plentiful in our bodies, and used by our heart, organs, and possibly most important – our brain.  When fat is the primary fuel source the need for our pancreas to produce insulin to regulate glucose (carbohydrates) decreases dramatically.  This is why the ketogenic diet had historically been the treatment method of choice for T1D (Type 1 Diabetes) and epilepsy.

However, science has shown us that using fat as a primary source does not need to be the only way to achieve ketosis.  

Many of those who achieve ketosis, do so with a protein-heavy diet.  Theoretically, a high-carb diet can achieve ketosis, as long as there is a significant caloric deficit.  The problem with attempting to achieve ketosis with a carb-dependent diet is the hunger returns quickly (glucose is quickly digested), it does not provide the high level of satiety protein does, and therefore does not force the body to convert to using only ketones for energy.

What is ketosis?

Ketosis is a process where the body uses ketones for energy. This process takes from a few days to a few weeks, depending upon the amount of carbohydrates used prior to transitioning. When carbohydrate (glucose) intake is limited, as outlined above, blood sugar levels fall and subsequently maintain a solid baseline, while AT THE SAME TIME free fatty acids are released from fat stores (adipose and visceral) and  ketone levels rise. Ketones now become the primary source for fueling the body’s needs. Additionally, ketones are a very stable and a limitless source of energy.

Is the Carnivore diet ketogenic?

Yes.  

While the carnivore diet seems like a slam dunk for attaining and maintaining ketosis, it does have it’s potential pitfalls.  Vitamin C (found only in plants) deficiency can have serious ramifications. 

Scurvy is the name for a vitamin C deficiency. It can lead to anemia, debility, exhaustion, spontaneous bleeding, pain in the limbs, and especially the legs, swelling in some parts of the body, and sometimes ulceration of the gums and loss of teeth.

What are the benefits of a ketogenic diet?

• Clearer thinking

• Stabilized blood sugar

• Reversal of T2D and decreased need for insulin in T1D

• Improved insulin sensitivity

• Combats cancer (cancer thrives on sugar/carbohydrates)

• Thyroid function improves*

Follow this logic:

Reducing overall sugar intake inherently reduces sugar cravings. Reduced sugar cravings leads to less consumption of excess sugar.

Reduce sugar (carbs) intake causes a lower demand for insulin (less stress on the pancreas) 

Fewer fluctuations in insulin can create a lower demand for T3 (the active form of thyroid hormone).  

*When free fatty acids are used for energy in the form of ketones, T3 is needed less to deal with carbohydrate metabolism.

A lower T3 level is associated with a protein-sparring effect (muscles are not used as an energy source).

BUT . . . 

The question you must ask: Do you feel good with lower T3 levels?  It is not only about lab values.

Keto and kids

Research literature shows that this diet is healthy for kids, with an emphasis on autism, epilepsy, and diabetes.

Not only is it healthy, but some data also suggests it is the parents who actually resist the diet and the kids do great!

As far as autism is concerned, they have shown that there is a strong gut-brain connection, and by balancing the gut microbiome with a low carbohydrate diet, children with autism have had a dramatic improvement in social skills.  Look into the Specific Carbohydrate Diet for more details.

What about exogenous ketones?

Exogenous ketones are supplemental ketone bodies generally found in pill or powder form.  It may be packaged as Ketone Beta hydroxybutyrate (BHB).  The thought behind taking this is to make up for a higher-than-normal carb meal when someone has already established ketosis.  Does it work?

The scientific literature reports that when blood work is done, ketones are present in those who took exogenous ketones.  Does that mean they are in ketosis?  Not necessarily.

Ketosis is a function the body is in because of the diminished amount of carbohydrates eaten.  I would argue true ketosis occurs in the absence of exogenous ketones.  

What about athletes and ketosis?

Endurance athletes have been known to tap into ketosis for the efficiency of their event.  There is emerging data that the ketogenic diet can be for strength athletes when protein is the primary macro.  Protein is the driving force for building muscle while increasing fat loss.  In this article, the authors explain away the myths (with science) about building muscle while in ketosis. It is not only possible to gain muscle with a low carbohydrate diet, in some cases the gains are greater than with a traditional diet.