As many of you know, I am a huge advocate of the Ketogenic Diet to help my patients reach their health goals. Whether they suffer from…
- weight loss,
- or even high cholesterol,
…the ketogenic diet can help many people turn their health concerns into success stories.
A patient recently told me the Ketogenic Diet made a list of 2016 top “fad” diets.
Needless to say, as someone who has helped heal thousands of people with this diet, my jaw was on the floor. This “fad” diet has been documented for thousands of years and is widely known for its ability to control epilepsy in children. I assure you, those who criticize the benefits of the keto diet don’t fully understand the role nutrition has in disease prevention and management.
Let’s shed some light on how the ketogenic diet started and why I firmly stand behind it.
A Brief History of the Ketogenic Diet
This “fad” diet dates back to 500 B.C., and whether or not you are a Christian, the idea of placing the body in a state of ketosis, or fasting, was mentioned in the Bible to treat “fits,” or seizures. Mark refers to this in the Bible when Jesus cures an epileptic boy.
The Ketogenic Diet began its rise to mainstream prominence in the early 20th century when an endocrinologist, Rollin Woodyatt, noted that water-soluble compounds, acetone and Beta hydroxybutyrate and acetoacetate, formed a ketone molecule in the liver when patients’ diets consisted of high fat and low carbohydrates. This molecule formation was dubbed the “Ketogenic Diet.”
H. Rawle Geyelin, an endocrinologist at the New York Presbyterian Hospital, used this Ketogenic Diet in his epileptic patients, presenting it to the American Medical Association in 1921 when he saw his patients symptoms resolve completely.
This was the preferred treatment for epilepsy until the 1940s when prescription medications made their way onto the scene. Doctors started using these medications in place of fasting and a Ketogenic Diet, which trickled down into less training for medical professionals to teach them how to properly manage disease through diet.
As the years passed, the Ketogenic Diet continued to be a thing of the past. Medications were more frequently used and, as you might expect, brought on a host of negative side effects, not to mention failure to control symptoms in a lot of children. If a child was placed on a medication and didn’t see symptoms resolve, the chance of the next drug working dropped to 10-15%.2
Children were subject to increased doses, medication changes, and poor symptom management during this time, which greatly affected their oxygenation and brain function. In 1997 a made-for-TV movie starring Meryl Streep named First Do No Harm told the story of a mother who was frustrated with the medical profession for withholding an alternative therapy for her son’s epilepsy. This movie put a spotlight on the Ketogenic Diet, bringing the concept of low carb back in the spotlight as a treatment for childhood epilepsy.
From an evolutionary standpoint, think back to our hunter-gatherer ancestors: Humans went into ketosis every winter when the cycle of food became less carbohydrate-laden. They used glucose when non-animal food was available; but during shortages, when their calories were mainly from animal foods/fats, ketones were their primary source of energy, thus sustaining them for long periods of time.
In 1879, Fredereick Schwatka, a U.S. Army Lieutenant, doctor, and lawyer, embarked on an Arctic expedition to look for records lost in 1845 by two Navy ships. With enough food to last him and the crew for one month, he found that eating plenty of animal fat would sustain him for many hours of strenuous walking, giving him adequate energy. This was one of the first documented understandings of how burning fat instead of carbohydrates was far superior, and became known as the “Schwatka Imperative”.1
Fast-forward back to the early twentieth century: Weston A. Price was a well-known Cleveland dentist and researcher who traveled to various parts of the globe to study the health of isolated, indigenous cultures. In his research, he found that the diets in these cultures, compared to the standard American diet, provided four times more fat-soluble vitamins, sourced primarily from animal foods such as butter, fish, eggs, shellfish, organ meats, eggs and animal fats.
What he discovered was that cultures who ate high-fat, low-cholesterol diets and more nutritionally dense foods had higher mineral absorption and protein metabolism, and were healthy, emotionally stable people free from disease. This finding is in sharp contrast to more advanced civilizations who were “displacing foods of modern commerce,” including sugar, white flour, pasteurized milk, low-fat foods, vegetable oils, and items filled with additives.3
What Exactly is the Ketogenic Diet?
To understand ketosis, we must first understand the role of insulin and glucose in the body.
Insulin is produced in the body in response to glucose/carbohydrate consumption. In modern diets, our body runs off of glucose for energy and therefore doesn’t need or use fat, causing your body to “store” excess sugar (glycogen) as fat in the liver and body. This can cause several health concerns including obesity, diabetes, hyperlipidemia, and fatty liver disease.
The Ketogenic Diet is a metabolic state when we consume low carbohydrate, moderate protein, and high fat, allowing the body to switch from using glucose as its primary fuel source to ketones (fat). This only happens when glucose isn’t available for fuel.
When the body produces ketones, the levels of beta-hydroxybutyrate (BHB) in the blood increase, which are synthesized in the liver, making it an energy source to be used by every cell in the body. When we look at the muscles, heart, liver and brain, ketones are a preferred fuel source, and higher carbohydrate diets are shown to actually cause a breakdown in their functioning.
So, when we break down fat, our bodies generate ketones that help us burn fat for fuel and provide more energy than when we use sugar/glucose.
Think of throwing gasoline on a fire: that’s carbs. We see an instant increase in the flame, but it burns quickly, dampening the fire shortly after.
Now throw on a nice big log that will burn slower, more consistently, and longer. That’s fat.
On a Ketogenic Diet, your body switches its fuel supply to run almost entirely on fat (i.e. “in ketosis”), thus decreasing blood sugar and insulin levels in the blood. When in ketosis for a long period of time, it becomes easy to access your fat stores and burn them, sometimes referred to as being keto-adaptive.
Can I get an Amen?! Say goodbye to those mid-afternoon crashes or naps and say hello to my little friend . . . ketones.
Ketosis vs. Ketoacidosis
Let me clear up a very common misconception: ketosis is very different from ketoacidosis found in diabetics, which is life-threatening.
Ketoacidosis happens when diabetics don’t have an adequate amount of insulin, so their body perceives it as starving and starts burning fat, thus ramping up ketone production for energy.
But, unlike non-diabetics who, in a state of ketosis actually see a lower glucose level, their blood glucose level remains too high and their beta-hydroxybutyrate (BHB) levels approach 20 millimolars. In a common individual using ketosis as a therapy, BHB levels measured less than 6.4 millimolars, with optimum levels around 0.5-3.0.1
But Wait: Isn’t the Ketogenic Diet Just the Atkins Diet?
Dr. Robert Atkins became popular in the 1970s when he promoted a low-carb diet that focused primarily on restricting carbohydrates, but didn’t map out the proper macro-nutrient ratios needed to get into ketosis.
Nutritional ketosis is low carb, moderate protein, and high fat, with an emphasis on testing your acetoacetate levels using a urine strip or your BHB blood levels.
So, Dr Atkins wasn’t far off with his recommendations, but he lacked the proper details to help maintain or increase nutritional ketosis in his patients.
This is a step in the right direction!
Benefits of the Ketogenic Diet
Now for the sonic boom! What can be achieved by maintaining a keto-adaptive lifestyle? Let me count the ways…
I could sit here and go on and on about the benefits of maintaining keto-friendly living, including but not limited to managing various conditions like:
- Irritable bowel syndrome
- Non-alcoholic fatty liver disease
- Sleep disorders
- Gum disease
Here are a few of the most common conditions we treat successfully at Whole Body Health with the ketogenic diet.
Ketogenic Diets work great to help shed extra pounds. The proportion of high fats allows for increased energy and greater satiety, which is a common reason why a lot of other diets fail. Being hungry and tired doesn’t make for a happy person and will absolutely allow for throwing in the towel early in the game. You can turn your body into a fat-burning machine by eating the right macronutrient portions and exercising regularly, giving your body and endocrine system the biggest gift you could give.
Diabetes Mellitus Type 2
Insulin wasn’t discovered until the early 1920s, and before that people’s blood sugar was maintained by a diet consisting generally of 70 percent fat, 22 percent protein, and 8 percent carbohydrates.1
The combination of a.) removing foods that cause high blood glucose levels and b.) reducing weight, drastically decreases the need for diabetes medications. When you’re consuming fat and producing ketones in the body, it further regulates blood sugar and prevents the drastic highs and lows commonly associated with high-carbohydrate diets.
Cardiovascular Disease and High cholesterol
We have been told ad nauseam that a diet high in saturated fats causes our arteries to “clog.” We believed Ancel Keys in the 1950s when he said that high-fat diets promote heart disease, a hypothesis that was never actually tested but was merely a prediction. But Dr. Jeff Volek and Dr. Richard Feinman published a study in 2005 showing that markers of metabolic syndrome and cardiovascular disease actually improved with carbohydrate restriction.
The proof is in the pudding: numbers don’t lie. We check our patients’ labs before they start and after six months on the Ketogenic Diet and the results are outstanding. I had one patient drop her triglycerides by over 350 points and cholesterol by 150 points . . . by eating nothing but saturated fat. Good cholesterol (HDL) levels rise, triglycerides lower, and inflammation reverses while on a Ketogenic Diet.
When looking at all chronic diseases, including heart disease, one thing they all have in common is high levels of insulin and inflammation. Insulin metabolism and dietary carbs, not saturated fats, drive up insulin and inflammation in the body. With inflammation comes oxidative stress, which is a driving force in heart disease.
Next time someone tells you that the eggs and bacon you ate for breakfast will give you a heart attack, please inform them that the bagel and cereal they ate is rapidly causing their body to break down, store fat, and increasing their risk of heart disease.
Alzheimer’s Disease and Dementia
Our brain needs fat and cholesterol to function; in fact it is made up of 25% cholesterol. Alzheimer’s is widely gaining notoriety as being “type 3 diabetes” caused by an insulin resistance in the brain. With increased inflammation and insulin levels in the body, the brain no longer has a sensitivity to insulin and cannot use glucose as a fuel source, causing mental decline.
When patients are put on a high fat, low carbohydrate, moderate protein diet, their brains use ketones as a source of energy, thus decreasing insulin levels and improving cognition.1
Sugar and carbohydrates further narrow the blood vessels in our brain, decreasing cerebral blood flow, which can cause premature aging, dementia, and significant mental decline.
In 1924, German Nobel Prize winning scientist Otto Warburg stated “the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar.”1
Cancer cells run primarily off of glucose. So when we starve the cancer cells of their fuel, we in turn can starve the cancer. Dr Schmidt and Dr Kammerer published a study on cancer patients in 2011 that showed 6 out of 8 patient treated with a Ketogenic Diet saw a decrease in the size of their tumor and improvement in their quality of life.1 This was their second study published with similar results.
Obviously, there is much more research needing to be done in this area. My hope is that doctors, scientists and patients continue looking into the reason of why in our society there are more and more people being diagnosed with cancer. Could it be a coincidence that in the past 30-50 years the standard American diet has been replaced with less nutritionally dense foods including high carbohydrate and processed foods? No coincidence there!
How to Become Ketogenic
In my time working with the Ketogenic Diet, I have learned many things about how the body works and how it flourishes when we feed it the highest quality foods. Not only in myself, but in my patients I see how effectively the body functions, the mind sharpens, the weight is managed, and disease lowered when carbohydrates are drastically reduced.
Another thing I can tell you is that not everybody has the same carbohydrate tolerance. The best way to start is by cutting your daily carbohydrates to 20-30 grams per day for a period of no less than 21 days, while frequently checking your ketone levels. After that you can slowly add in more carbs while continuing to monitor your ketone level.
Some people may eat 40 grams a day and still maintain ketosis, while others will need to go back to square one. For diabetics or those with insulin resistance, it would be difficult to maintain ketosis while consuming greater than 50 grams, while others who do not have insulin resistance may continue to make ketones.1
Some fats turn into ketones better than others, including short and medium chained triglycerides like butter, ghee, coconut oil and MCT oil. So if you’re having a hard time getting into ketosis, make sure your diet is full of these easily burned fats. The macros we follow in our office consists of 70-75% fats, 20% protein, and 5-10% carbs.
In the book, Keto Clarity, they have an acronym that I love to help with ketosis.
K – keep carbs low
E – eat more fat
T – test ketones often
O – overdoing protein is bad
Most importantly, listen to your body cues and make sure you are interpreting them correctly. Some of the time, hunger pangs are mistaken and are nothing more than your body needing more fat, boredom, or telling you that your thirsty. Eat when you are hungry, but don’t forget to feed your body good fats, water, and minerals (including pink Himalayan sea salt).
This is our opportunity to share with our friends and family how great being ketogenic can be! Let’s spread the word and let the results speak for themselves.
Keto-on my friends!!
1Moore, J., Westman M.D., Eric (2014). Keto Clarity, your definitive guide to the benefits of a low carb, high fat diet. Victory Belt Publishing Inc. Las Vegas, Nevada.
2Epilepsia. 2008. Nov; 49. Suppl 8: 3-5 DOL: 10.1111/j.1528-1167. 2008.01821.x History of the Ketogenic Diet. Wheless, J.W.