This is part one of the abbreviated content from my lecture from January 2019, Merits of a Ketogenic (Fat-based) Diet. This article will cover background information about the benefits of the diet:
- What is a ketogenic or fat-based diet?
- What are some of the benefits?
I will publish parts two and three of this article soon which will cover additional benefits for health issues and athletes plus practical aspects of the diet like what to eat and how to avoid common pitfalls on the diet.
Introduction
A ketogenic diet is a diet that uses fat, rather than carbohydrates, as it’s primary source of energy. As a result, the diet promotes the metabolic formation of ketone bodies within the body.
When people are on a ketogenic diet, using fat as fuel, they typically report these benefits:
- It becomes easier to access fat stores to burn them off (this means weightloss typically)
- Less hunger (fat and protein are more satiating)
- Steady supply of energy
- Greater sense of being alert and focused
Because carbohydrates, in contrast to fats, create blood sugar swings, they may create other symptoms for people that make it difficult to have steady energy and focus. Carbohydrates can also make it impossible to overcome cravings and lose weight for some.
Carbohydrates as fuel
Glucose, which is broken down from carbohydrates to provide fuel in the body, has these benefits:
- It can be used by every cell in the body (not all cells can use fat, for example)
- It produces energy quickly (so it can be important for athletes and people that require a big burst of energy frequently.
Glucose does not burn as "cleanly" or efficiently as fat or ketones as a source of energy. When glucose is burned, more free radicals are created. This can increase oxidation in the body, thus accelerating inflammation and aging.
Many illnesses stem from blood sugar problems related to carbohydrates in the diet. Eating too many carbohydrates for an individual, even healthy carbohydrates, will lead to an influx of glucose in the bloodstream. This will have the chain reaction of increasing advanced glycation end products (AGE's) that promote aging and disease. AGE's are a new area of research and appear to be one of the primary causes of heart disease.
The carbohydrates (rice, breads, sweet potatoes, sweeteners, etc) also prompt the production of triglycerides which convert the glucose to fat for storage. Have you ever eaten a plate of pancakes and then needed to lie down on the couch? This reaction is a sign you ate too many carbohydrates for you and must rest so your body can use it's energy to store them as fat by making triglycerides (this is not a good thing for most of us!).
Next, after glucose hits the bloodstream, cholesterol increases and the small, dense LDL particles increase and the beneficial HDL decreases. This puts us at higher risk for heart disease as well. Furthermore, the increase in glucose causes testosterone to drop for men and causes progesterone and estrogen to shift in women. Yes, eating those yummy dates or cookies can lead to heart and hormonal problems for some due to the sugar.
Also, aging cells in the brain appear to lose their ability to burn glucose which can play a big role in those individuals with cognitive decline eating a high or moderate-carb diet.
Fats and ketones as fuel
In contrast to glucose (from carbohydrates), ketones represent a quality source of fuel for the brain, especially. It turns out ketones are a more efficient and "cleaner" fuel for the brain than glucose or fat. Ketones produce fewer free radicals when burned. Therefore, you might say the ketogenic diet is a better anti-aging and anti-inflammatory diet than others.
Following a ketogenic diet does require diligence to food choices. It may require testing ketone levels in urine or blood (something you can do at home). Because ketones have a diuretic effect on the body, many people on a ketogenic diet will need to focus on electrolytes and hydration to stay healthy. This can be especially important in those concerned with bone health. These topics will be discussed more in part two of this article.
There are some sources on the internet that say that the ketogenic diet is not appropriate for those with thyroid problems. They state that this is because insulin is required to assist in one of the three ways that thyroid hormone T4 is converted to T3. After reviewing this information, I do not agree that the ketogenic diet should be avoided by those with thyroid conditions in general. I think instead that someone with a thyroid condition should be self-aware and not be too restrictive with calories on a ketogenic diet. If this is done, I do not observe or anticipate issues with the ketogenic diet for most individuals. It is also important to realize that food is just one of the important fuels for thyroid health. Sleep and sunlight and stress-reduction are equally, or perhaps more important. Finally, realize that no diet is right for everyone and that one should practice self-awareness on any diet. Blood tests may be used to monitor your changes on the ketogenic diet if you are unsure of how it is effecting you.
Here is a list of conditions generally understood to be helped by the ketogenic diet:
Epilepsy
Type 2 Diabetes
Type 1 Diabetes
High Blood Pressure
Alzheimer’s disease
Parkinson’s disease
Chronic Inflammation
High Blood Sugar Levels
Obesity
Heart Disease
Polycystic Ovary Syndrome
Fatty Liver Disease
Cancer
Migraines
I would also add that I've seen it help in improving sleep issues.
A ketogenic diet is high-fat, moderate-protein, and low-carbohydrate. A common example of caloric intake would be: 70% healthy fat, 15-25% healthy proteins, 5-15% green vegetables. This is the caloric breakdown, but not what percentage is covering the plate. For example, in the picture in this article, you'll see the majority of the plate is filled with vegetables, then fish, with the pesto and salad dressing comprising the fat calories.
The greatest benefits from the ketogenic diet are due to the ketones produced. Ketones, short for ketone bodies, are produced in the liver when fat is burned for energy. When a person begins a high fat and very low carbohydrate diet, the liver will begin to burn fat stores for energy and then ketones are created. The ketones are called BHB, acetoacetate and acetone.
These ketones are picked up by the different tissues from the blood stream and used to burn energy. The brain particularly will make use of the ketones at a high rate as will the heart, kidneys and skeletal muscles. Ketones may also be used to form long-chain fatty acids in the brain which help with brain repair and protection.
Ketones first gained medical attention in their effectiveness at stopping seizures in epileptic children. There are numerous ways the ketones work to protect the brain from seizures but one interesting study in 2005 Science Daily demonstrated the ketogenic diet alters genes in the brain and therefore stabilizes nerve cells to not have seizures.
Ketones appear to act as an anti-oxidant in the brain (1). They also maintain aging brain cells that have lost the ability to burn glucose for energy and appear to protect the brain from strokes, Alzheimer's and Parkinson's. Ketones can increase the production of BDNF (brain-derived neurotrophic factor) that facilitates higher thinking, learning and memory (2). If you are at risk for cognitive-related issues with aging, please take a serious look at this diet for you as it can have profound benefits as discussed in Dr. Bredesen's book, The End of Alzheimer's.
Stay-tuned for part two of this article which will include:
- Benefits of ketones against cancer, diabetes, and heart disease
- Benefits of ketones for athletes
- Examples of a fat-based diet
- How to measure ketones
- How to balance trade-offs of the diet
Sources:
1. Prins, 2008. Diet, Ketones, and Neurotrauma. Epilepsia
2. Sleiman, et al. 2016. Exercise promotes the expression of brain derived neurotrophic factor (BDNF) through the action of the ketone body β-hydroxybutyrate. eLife