What is Ketogenic Diet?

The Diet doctor tells us that “The “keto” in a Ketogenic Diet comes from the fact that it makes the body produce small fuel molecules called “ketones”. This is an alternative fuel for the body, used when blood sugar (glucose) is in short supply. Ketones are produced if you eat very few carbs (that are quickly broken down into blood sugar) and only moderate amounts of protein (excess protein can also be converted to blood sugar).

A Ketogenic diet requires that 50 to 70 percent of your food intake come from beneficial fats, such as coconut oil, grass-pastured butter, organic pastured eggs, avocado, and raw nuts (raw pecans and macadamia nuts are particularly beneficial). One of the fastest ways to prevent nutritional ketosis is by consuming sugar or refined carbohydrates. 

The Brain Utilizes Ketone  Bodies as fuel

The ketogenic diet is designed to make the brain switch from its normal glucose metabolism to ketone body metabolism. Unlike most other cells in the body, the brain can only use glucose or ketone bodies, a product of fat metabolism, as a fuel. The brain switches to ketone body metabolism when there is a shortage of glucose. Carbohydrates are the main source of glucose. Protein can convert to glucose but is primarily used for body maintenance and repair.

The Keto Diet causes the need for ketogenesis

Moreover, the central nervous system requires glucose as an energy source and thus following a ketogenic diet will cause the need for an alternative energy source which is derived from the overproduction of acetyl-CoA namely ketone bodies. Ketone bodies are made up of acetoacetate, B-hydroxybutric acid and acetone.

This whole process occurs in the matrix of liver and is called ketogenesis. Under normal diet, the concentration of ketones bodies is less than 0.3 mmol/l and ketone bodies will not be used as an energy source by the central nervous system until this concentration reaches 4 mmol/l, similar to the glucose concentration. At that point, ketone bodies are then used as a source of energy by the tissues.

Health benefits of The Ketogenic Diet

The ketogenic diet decreases blood glucose levels

Managing carbohydrate intake is often recommended for people with type 2 diabetes because carbohydrates turn to sugar and, in large quantities, can cause blood sugar spikes. If you already have high blood glucose, then eating too many carbs can be dangerous. By switching the focus to fat, some people experience reduced blood sugar.

The Keto Diet may prevent Type 2 diabetes

That’s why people who decide to follow a strict ketogenic diet start to see positive changes to blood sugar and insulin levels. Some people even claim that the keto diet can reverse or prevent Type 2 diabetes altogether.

When following the ketogenic diet, your calorie intake should be 80% fat and 20% proteins/carbs. According to the Ketogenic Diet Community, “The diet mimics aspects of starvation by forcing the body to burn fats rather than carbohydrates.” It essentially brings individuals to a state of ketosis, where your body processes fat – rather than carbs – for energy. When the liver converts fats into ketone bodies, they replace glucose as the body’s primary source of energy.

The ketogenic diet deprives cancer cells of their energy supply

With ketogenic diets, lowering carbohydrates will reduce your levels of glucose, the fuel that feeds cancer cells. This will put your body into ketosis and will assist in depleting cancer cells of their energy supply.

The ketogenic diet doesn’t mean you should load up on saturated fats, though. Heart-healthy fats are the key to sustaining overall health.

The Keto Diet improves insulin sensitivity

Another potential benefit of the ketogenic diet is that it is thought to improve insulin sensitivity. Prediabetics and diabetics are often referred to as “insulin resistant” because their muscle, fat, and liver tissues do not respond properly to insulin. When the pancreas can’t meet the body’s need for insulin, excess glucose builds up in the bloodstream, contributing to diabetes and other medical conditions.

Ketogenic diet improves exercise performance

Starting on a ketogenic diet can influence your exercise performance in multiple ways, both positive and negative. During the first 1-2 weeks (the “adaption period”), you will most likely see a decrease in energy and athletic performance across the board while your body adjusts to the new diet. This is perfectly normal and should NOT be a cause for concern or make you abandon the diet. Your exercise performance will improve after you have adapted to the diet.

It is important to mention that there are several variations of the ketogenic diet. Some variations recommend eating less than or equal to 30 grams of carbohydrates per day and do not quantify other macronutrients, like, protein and fat. Whereas the standard ketogenic diet is more specific.

ketogenic diet reduces seizures in children

We have solid evidence showing that a ketogenic diet reduces seizures in children, sometimes as effectively as medication. Because of these neuroprotective effects, questions have been raised about the possible benefits for other brain disorders such as Parkinson’s, Alzheimer’s, multiple sclerosis, sleep disorders, autism, and even brain cancer. However, there are no human studies to support recommending ketosis to treat these conditions.

The Keto Diet decreases the risks for health disease

Studies of obese individuals following a ketogenic diet show a different outcome. According to a study in the fall 2004 issue of “Experimental & Clinical Cardiology,” a ketogenic weight-loss diet can decrease the risks for heart disease in obese individuals. It is unclear why the original ketogenic diet and the weight-loss version have different effects on cardiac health. Obesity could be a greater risk factor for heart disease than a high-fat diet. Alternatively, the lower calorie content in the weight-loss diet could prevent the dietary fat from negatively affecting the heart.

The Keto Diet causes weight loss

Achieving weight loss is one of the earliest strategies used for the management of type two diabetes and the prevention of diabetic complications. Moreover, there is a positive correlation between ketogenic diet and weight loss. In fact, according to the study done by Sahama et al., which compared the efficacy of ketogenic diet and that of low fat diet, it showed that the ketogenic diet are 3 times more effective in weight loss than the low fat diet.

One of the reasons for such weight loss is the excessive fatty acid metabolism in the presence of ketone bodies. Another possible reason for weight loss using ketogenic diet might be the hunger-reduction caused by the hypothalamus, yet the main mechanism is still elusive since ketone bodies have shown to act both anorexigenically and orexigenically.

Disadvantages of the Keto diet

I am a big fan of the ketogenic diet and many of my patients have had huge success on it. Having said that, it’s not necessarily for everyone. This should be looked at as a long-term strategy, not a short one. Some people simply find the dietary restrictions too difficult to commit to. Since yo-yo dieting is bad for everyone, and can be downright dangerous for diabetics, you should only begin the ketogenic diet if you feel you can stick to it.

The Ketogenic diet may cause diabetic ketoacidosis

Ketoacidosis occurs when the acidity in the blood increases. Diabetic ketoacidosis is a life-threatening condition caused by very high blood sugars and a deficiency of insulin in insulin-dependent diabetics, a very different state from ketones produced by a fat-burning metabolism on a low-carb, high-fat diet.

The ketogenic diet is quite safe and even beneficial for diabetics. However, there is sometimes a chance a patient can develop diabetic ketoacidosis. Anytime you change your body’s primary energy source from carbohydrates to fat, your blood becomes flush with those ketones we talked about. And anytime there are too many ketones, there is a potential risk for developing ketoacidosis. However, this is most likely to occur in those with type 1 diabetes. It can still happen in individuals with type 2 diabetes, although is it quite rare.

The keto diet requires careful monitoring

The ketogenic diet seems straightforward. Unlike a typical low-calorie diet, however, a high-fat diet requires careful monitoring. In fact, you may start the diet in a hospital. Your doctor needs to monitor both blood glucose and ketone levels. This is to make sure that the diet isn’t causing any adverse effects. Once your body adjusts to the diet, you may still need to see your doctor once or twice a month for testing and medication adjustments.

If you’re on the ketogenic diet, be sure to test blood sugar levels throughout the day to make sure they are within their target range. Also, consider testing ketone levels to make sure you’re not at risk for DKA. The American Diabetes Association recommends testing for ketones if your blood sugar is higher than 240 mg/dL. You can test at home with urine strips.

Final Thoughts

A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow. It can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects. This is probably because it’s so hard to stick with that people can’t eat this way for a long time.

It is important to remember that “yo-yo diets” that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months try to embrace change that is sustainable over the long term.

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