I’ve been a nutritionist for many years but I still don’t even know how many types of diets there are out there. Almost every day we are hearing of a new “magical diet,” maybe even one that is actually really healthy and good for you. However, there is so much confusing information that it’s hard to know where to start.
One popular diet is called the ketogenic diet and it is characterized by very-high fat, low-carbohydrate, and low-to-moderate protein content. It was developed in the 1920s specifically for epilepsy patients that were not responding to drugs, but still today it is very much misunderstood.
The very low carbohydrate content in a ketogenic diet results in the body changing its fuel source from carbohydrates to fats. When the body makes this switch it also starts to produce ketones, also called the fourth macronutrient, and they act as another energy source for the body. The ketone bodies are produced in the liver and then utilized in other tissues as an energy source when hypoglycemia occurs in the body. There are three types of ketone bodies — acetoacetate (ACA), beta hydroxy butyrate (B-hydroxybutyrate or BHB), and acetone.
The ketogenic diet increases blood ketones and decreases blood glucose by simulating the physiological response to fasting, thus leading to high rates of fatty acid oxidation and an increase in the production of acetyl coenzyme A (acetyl-CoA). When the amount of acetyl-CoA exceeds the capacity of the tricarboxylic acid cycle to utilize it there is an increase in the production of the ketone bodies BHB and ACA, which can be used as an energy source in the brain.
One reason, for example, why the ketogenic diet can be effective in treating cancer is that normal cells in our body can readily use ketones as an alternate energy source so are unlikely to be adversely affected by reduced glucose, but cancer cells are much less flexible with their primary energy source and thus require glucose. So reducing the glucose in the body and replacing it with ketones can “starve” the cancer cells. Emerging research is showing that ketones can in fact do much more in the body, including significant benefits for Alzheimer’s and type 1 and 2 diabetes, increased cognitive performance, more effective weight loss, improved athletic performance, and much more.
The weight loss industry tends to see the ketogenic as simply a diet that is slightly lower in carbohydrates and higher in protein and fat, and as a result many low-carb products are claiming to be “ketogenic friendly”. Unfortunately most of them are not. A general lower carbohydrate diet, especially when consuming low glycemic index foods such as vegetables, a variety of fibers, limited starches and not consuming added sugar is probably a great way to start improving your health. Although seeing this as a ketogenic diet, and then adding lots of fats, is not only unsustainable but may also lead to weight gain. Nowadays there is a growing industry of ketogenic friendly low carb foods but please be extra careful to read the labels, not just looking at the nutrition facts but actually the full ingredient list. You may see lots of different types of fillers, artificial flavors, and not easy to understand or pronounce ingredients. Try to keep it simple and consume whole food sources as much as possible.
There are many different variations of the ketogenic diet which cause very different physiological effects, including modified Atkins, MCT oil ketogenic diet, ketone supplements, low glycemic index diet and intermitting fasting. A classical ketogenic diet will have a 4:1 or 3:1 ratio of fat to protein with minimal carbs and around 75% to 90% fat. Some of the benefits of a real ketogenic diet include:
• Decreased inflammation
• Healthy brain support / increased cognitive performance
• Increased energy
• Improved mood and preventing mood-swings
• Supporting weight loss by improving appetite control
• Improving performance, endurance and strength
• Increased longevity
• Supporting gut health
• Improved diabetes (type 1 and type 2)
• Preventing cancer, or supporting cancer treatment
• Promoting increasing lean muscle mass
• Helping to reduce visceral fat and decrease the risk of metabolic syndrome
• Benefits for aging, PCOS, Alzheimers, rheumatoid arthritis, the epigenetic effects on the gene expression, and much more.
So should we all be following a ketogenic diet? Absolutely not! Some people have certain conditions or different gene types that will not allow them to reach a safe state of nutritional ketosis. You may not need to go to the very far end, but I suggest that we all should eliminate or minimize the added sugars and refined carbohydrates in our diets, especially from sources such as baked goods, highly processed package foods, sugary drinks, and even diet drinks with artificial sweeteners. This will not produce ketones, however you will still see huge health benefits by doing it.
If you do decide to do a strict ketogenic diet then you need someone to guide you and teach you about the possible difficulties, and what down-sides you might encounter. A ketogenic diet is a very effective tool for preventing, treating and healing many diseases, however it can also be a long-term lifestyle for maximizing your health. With intermittent fasting, prolonged fasting, and a well formulated ketogenic diet it is crucial to give your body the correct macronutrient sources and types, and the timing is critical too. It all depends on your body’s needs and what you want to achieve.
So if you are try to improve your diabetes or want to lose some weight, most likely lower carbohydrates, moderate protein and moderate fat will be enough to achieve your goals. Although if you’re dealing with more serious types of type 2 diabetes, cancer, or Alzheimer or any other disease please be skeptical and do your research and work with a qualified practitioner.
References:
• “Benefits of The Ketogenic Diet”; https://healthangelwarrior.com/benefits-of-the-ketogenic-diet
• “History of the ketogenic diet”; https://pubmed.ncbi.nlm.nih.gov/19049574/
• “Ketones and Human Performance”; https://pubmed.ncbi.nlm.nih.gov/28599043/
• “Biomarkers, ketone bodies, and the prevention of Alzheimer’s disease”; https://pubmed.ncbi.nlm.nih.gov/25468143/
• “An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial”; https://pubmed.ncbi.nlm.nih.gov/28193599/
• “Nutrition Reviews”; https://academic.oup.com/nutritionreviews/issue/61/10
• “IN 1993 THE KETOGENIC DIET CURED CHARLIE ABRAHAMS’ EPILEPSY”; https://charliefoundation.org
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Ayda Ersoy is a nutritionist (Dip.C.N., Dip.S.N.); master trainer (CPT ACE, NCSF, CanfitPro); registered yoga teacher; founder, Health Angel Nutrition, Fitness and Wellness; and founder, SMS (Stability, Mobility Strength) Intuitive Training System.
