The Ketogenic Diet — Far From a Fad 

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,
  • depression,
  • anxiety,
  • psoriasis,
  • diabetes,
  • hypertension,
  • 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?

ketogenic diet recipe

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
  • Heartburn
  • Non-alcoholic fatty liver disease
  • Sleep disorders
  • Autism
  • Fibromyalgia
  • Migraines
  • Acne
  • Gum disease
  • PCOS

Here are a few of the most common conditions we treat successfully at Whole Body Health with the ketogenic diet.

Weight Loss

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.

Cancer

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.
3www.westonaprice.org

13 replies
  1. Nancy
    Nancy says:

    What an awesome read. Well written, Kristen. At first, I may have been skeptical of this diet and the fasting but am now a believer. The last 5 days my blood sugar testing has been the most consistent numbers ever. Then there is my weight-loss – I am in clothes sizes, I haven’t been in since my 20’s. So thanks for turning me into this diet along with 2 fantastic supporters of mine – Mark and Chris McCoy!!

    Reply
  2. Kim Dunne
    Kim Dunne says:

    Awesome blog, Kristen! Anxious to read this aloud to Mike and hopefully there’ll be other listening ears hanging around…. i.e. stubborn pre- and teen kids who love their carbs! Thanks for wrapping all this all up into one convenient article.

    Reply
  3. SP
    SP says:

    So I’m confused what a typical daily menu would look like. The thought of eating spoonfuls of butter and coconut oil is kinda gross to me. What do you eat to get 70-75% fat?

    Reply
    • Kristen Sutherland
      Kristen Sutherland says:

      Although some of our patients do resort to eating spoonfuls of coconut oil :), cooking with fats like coconut oil, butter, and avocado oils are easy ways to ensure the 70-75% fats. So cooking your meats and veggies in high quality fats would boost our fat intake easily. We also recommend adding coconut oil and butter to your coffee and/or tea daily. For dairy intolerant patients I often recommend coconut milk yogurt which is super high in good fats and has high probiotics. We actually have a lot of dairy intolerant patients and they do very well on the ketogenic diet.

      Reply
  4. Lisa Parketny
    Lisa Parketny says:

    Wow ! Love it ! My son Christopher has educated me on this way of eating, and you have taught me so much more ! He has lost 45 lbs on this eating plan ! I have slowly moved from limiting processed foods, to eating paleo- ish and now for January have gone LCHF – keto . I have lost 10 lbs in 4 weeks, having Hashimoto’s I have been gaining weight no matter what I tried ! I am learning more strategies and how to stick with it, my only carb downfall – I miss bread ! Lol ! Again, thanks for the info, I look forward to learning more !

    Reply
  5. Chrissie
    Chrissie says:

    Hi Kristen, seeking a bit of advice? I have been on a ketogenic diet for the last 6 weeks to help with severe migraines and I have not suffered one migraine in this time! Amazing results. I feel heaps better but I am not loosing any weight and I still feel very tired. I clearly have metabolism issues, the migraines were a symptom of this it seems. Over the last 5 years since birthing my son I have suffered very low energy, weight gain, cellulite and severe migraines. Thyroid results come back as normal but they are just checking T4’s. Keto is definitely helping but wonder if there is more I could do, anything you might suggest? Love the website and articles, really insightful and inspiring. THANK YOU

    Reply
    • Kristen Sutherland
      Kristen Sutherland says:

      Congratulations on the good work thus far! Our hormonal system is a delicate balance and can take some time to heal. While you have removed a large stress on your body (yeah!), I often find that it can take time for our endocrine system to balance itself following chronic stress. Keep up the good work and give your body time. They say for every year you have suffered from a condition, give yourself at least 1-2 months to heal. I often recommend my patients to do salivary hormone tests if we continue to stay at a plateau. Good luck and Keto-on!! 😊

      Reply
  6. Donna Thomas
    Donna Thomas says:

    Hi, my husband has not been officially diagnosed with non-alcohol fatty liver disease or autoimmune hepatitis yet but it is looking that it is headed that way because he just spent days in the hospital where they found that he has hepatospleenomegaly, esophageal and gastric varices, 2 ulcers, and a polyp. yes my husband is overweight so he knows that losing weight is a must but since he is a big sweet eater losing weight is a challenge for him. I have been told that being on a Ketogenic diet would help me as well since I have Ehlers-Danlos syndrome hypermobility/MACS/POTS and I’m currently eating gluten free so would a keto diet help us both.
    Thanks

    Reply

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