Merits of a Ketogenic (Fat-based) Diet, Part 2

Merits of a Ketogenic (Fat-based) Diet, Part 2

This is part two of the abbreviated content from my lecture Merits of a Ketogenic (Fat-based) Diet, January 2019. This article will cover:

  • Benefits of ketogenic diet against cancer, diabetes, cholesterol-related risk factors for heart disease, and hormone imbalances 
  • Benefits of ketones for athletes
  • Ketone supplements (exogenous ketones)

Part three of this article, coming soon, will cover the "how-to" of a ketogenic diet and trade-offs.

    Although many people may not be aware of the benefits or specifics of a ketogenic diet, fortunately, the number of medical studies about ketogenic diets is growing and the benefits are impressive when stacked against other diets.

    Cancer and Ketogenic Diet

    There is preliminary evidence that the ketogenic diet may aide attempts to slow down cancer growth or eliminate tumors.  Because some types of cancer cells rely on glucose to survive, they cannot survive on a very low carbohydrate diet. Therefore, a person can be on a fat-based diet and burn ketones and fat for energy and cancerous tumors may cease to grow or become smaller (1).  Case studies on patients with advanced brain cancer, for example, suggest that the ketogenic diet has the potential to slow down cancer growth when coupled with conventional treatments (2). Careful monitoring is required to ensure that protein intake levels are around 15% of calories, typically, so that protein is not converted to glucose (which might undermine the ketogenic diet).

    Diabetes and Ketogenic Diet

    The ketogenic diet has been extensively studied for its effectiveness in reversing and controlling the following parameters for diabetic individuals:

    • glucose
    • triglycerides
    • weight
    • insulin

    An early study of ketogenic diets and diabetes found it lowered fasting insulin levels (a good thing!) (3). Follow-up studies found ketogenic diets decreased fasting insulin levels when compared to moderate- and low-fat diets in overweight individuals with elevated lipids (4,5). When taken further to compare the ketogenic diet to a low-fat diet plus conventional drugs, the ketogenic diet performed better on numerous measures relating to diabetes (6). Furthermore, numerous meta-analyses demonstrate (7, 8):

    • Very low carbohydrate diets are beneficial for overweight people with Type II diabetes
    • Ketogenic diets help Type II diabetic individuals most when compared to other equal-calorie diets (such as low-fat).

    Heart Disease and Ketogenic Diet

    It may be hard to let go of the belief that a meat and fat-based diet including a diverse array of vegetables may actually reduce one's risk for heart attack or stroke. However, studies demonstrate just that. A ketogenic diet does this by improving the numbers of large fluffy LDL particles  and reducing the number of small, dense LDL particles that increase our risk for disease and death (9, 10). The ketogenic diet when compared to a low-fat, high-carbohydrate diet has also been shown to improve HDL numbers, causing a significant increase in the numbers of this protective cholesterol (11). This translates to a healthier cardiovascular system for many. If you are at risk for heart disease, I would suggest careful monitoring such as with the Spectracell Cardiometabolic Panel coupled with dietary changes in order to see which dietary approach is best for you.

    Hormone Imbalances and Ketogenic Diet

    Part one of this article discussed how foods high in glucose lead to hormonal imbalances for men and women. In men, we typically see a reduction in testosterone and an increase in estrogen from too many carbohydrates prompting too much insulin. In women, we see an increase in estrogen and a drop in progesterone such that the ratio is not optimal.  Since the increased level of insulin is one of the underlying causes of hormone dysfunction, then it follows that reducing carbohydrates will help restore hormone function.  I find this to typically be the case for many individuals in our consulting practice. In cases of PMS, PCOS, infertility, heavy bleeding and menopausal symptoms, helping a person adopt a healthy but low or very low carbohydrate diet will bring about noticeable improvements in hormones and symptoms.

     Athletic benefits of ketones

    Ketones provide numerous benefits to athletes, particularly endurance athletes doing aerobic activities. Studies with athletes, particularly cyclists, demonstrate that ketones (12):

    • Improve endurance
    • Decrease muscle protein breakdown
    • Reduce blood lactic acid levels
    • Reduce oxidation and inflammation
    • Reduce fatigue

    Athletes that require frequent explosive bursts of energy (such as extreme HIIT) may not find the ketogenic diet to be ideal due to their need for glucose. This is one role for a ketone powder supplement or exogenous ketones.   The ketone powder may be mixed with water or another liquid to supply ketones desired without having to follow a ketogenic diet.  Generally, I think fit adults would find a ketogenic diet helps with endurance, especially for pro-longed aerobic activity.

    Ketone powders

    Ketone supplements (called exogenous ketones) are typically not needed on a ketogenic diet but they may be used to help a person get into ketosis more easily, such as when you are just starting. The GO BHB ketones are the best quality available on the market. There are some ketone supplements that have been shown to be ineffective and excreted in the urine without being burned for energy. I suggest the Cyrene Labs Keto-FX powder or the Keto-Nootropic powder by Designs for Health (we carry both products, the first is available on our webstore, the latter is available through phone order only). These can be helpful for those who like intermittent fasting but need a boost during the fasting phase as well. For example, my husband drinks the Keto-FX shake in the morning as his breakfast and then eats his typical (non-ketogenic) lunch and supper.  

    Stay-tuned for the third part of this article that will cover the practical aspects of a ketogenic diet.

    1. Liberti and Locosale. 2016. The Warburg effect: How does it benefit cancer cells? Trends Biochem Sci Mar;41(3):211-218
    2. Schwartz et al 2015. Treatment of glioma patients with ketogenic diets: report of two cases treated with an IRB-approved energy-restricted ketogenic diet protocol and review of the literature. Cancer Metab 3:3
    3. Boden et al. 2015. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Annals of Internal Medicine. Mar 15;142(6):403-11.
    4. Noakes et al 2006.Comparison of isocaloric very low carbohydrate/high saturated fat and high carbohydrate/low saturated fat diets on body composition and cardiovascular risk. Nutrition and Metabolism Jan 11;3:7
    5. Volek et al 2009. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids Apr;44(4):297-309
    6. Yancy et al 2010.  A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss. Archives of Internal Medicine.Jan 25;170(2):136-45
    7. Ajala et al 2013. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. American Journal of Clinical Nutrition. Mar;97(3):505-16
    8. Snorgaard et al 2017. BMJ Systematic review and meta-analysis
    of dietary carbohydrate restriction in patients with type 2 diabetes. Open Diabetes Research. 5.
    9.Wood et al 2006. Carbohydrate Restriction Alters Lipoprotein Metabolism by Modifying VLDL, LDL, and HDL Subfraction Distribution and Size in Overweight Men. Journal of Nutrition. 136 (2):384–389
    10. Westman 2006.  Effect of a low-carbohydrate, ketogenic diet program compared to a low-fat diet on fasting lipoprotein subclasses.  International Journal of Cardiology 10 (2): 212–216
    11. Bueno et al 2013. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. British Journal of Nutrition 110(7):1178-87