The Ketogenic Diet: Part 2

In The Ketogenic Diet (part 1) that I wrote a month ago, I tried to give an overview. In this blog, I would like to clarify a few concepts and share some more research.  Let’s start by defining the different ways the term ketosis has been used. The following are terms that the researcher, Jeff Volek, PhD, outlined in a recent webinar series.

Ketosis: hepatically (liver)-derived energy containing substances derived from fatty acids that provide fuel to nearly every cell in the body

Nutritional Ketosis: the process of accelerating production of ketones through restriction of carbohydrates

Keto-Acidosis: A dangerous side effect of Type 1 Diabetes

Keto-Adaption: a health promoting process of shifting to using predominately fat for fuel

These clarifications are important because there is an “optimal ketone zone” for your brain and muscles to achieve peak performance and it is approximately 1.0-3.0 mmol/L of ketones, as measured in the blood.   Light nutritional ketosis is between 0.5mmol/L and 1.0 mmol/L.  For comparison, in states of ketoacidosis, blood ketones can be greater than 10 mmol/L.

Many patients have asked me if they need to measure their ketone levels and I will typically say no, unless they are not seeing the results they desire.

Here are the common signs that you are in keto-adapted state:

Weight Loss: short-term and long-term

You may notice more weight loss initially, however, I tell most patients to aim for 1 pound of fat loss per week. The appropriate caloric intake and percentage of macronutritients that you require will vary, and meeting with one of our registered dieticians at CentreSpringMD can be very helpful.

Increased Energy and Mental Clarity

You may feel some initial lethargy, however, it will pass in a few days. Ketones have a neuroprotective/anti-oxidant affects and enhance mitochondrial production and energy production in the hippocampus, a part of the brain involved in learning and memory. Ketones also inhibit the excitatory effect of glutamate on brain cells by increasing GABA (an inhibitory neurotransmitter), which decreases excitotoxicity and neurodegeneration

Loss of Cravings

I noticed that by 3 pm I wasn’t searching the office for my little piece of dark chocolate anymore! This may be due to alterations in leptin (the satiety hormone), insulin, cortisol, estrogen, Neuropeptide Y (stimulates appetite), and hormones in the gut that control appetite like GLP-1 (Glucagon-like-peptide-1), CKK (Cholecystokinin) and PYY (Peptide YY).

Reduced Pain /Inflammation

Interesting research has shown that Beta-hydroxybutyrate is more than a metabolite produced in ketosis. It has been shown to have an effect on cell-signaling and gene expression affecting anti-inflammatory pathways. It also suppresses oxidative stress, which leads to cell death.

Interestingly, there is also new research, published this year in the International Union of Biochemistry and Molecular Biology, that the metabolic changes induced by ketosis can have the same effect of calorie restriction on longevity! Sign me up for that!

Other interesting research has shown that ultra-endurance athletes as well as other professional athletes in keto-adapted states outperformed their equals that follow higher carbohydrate based diets. This has been a common question among the athletes that I see at CentreSpring, since there has been a long-standing thought that athletes require a high carbohydrate diet for peak performance.

In the study published in Metabolism 2016, it was shown that ultra-endurance runners in a keto-adapted state achieved peak fat burning more than two times their counterparts on a high carb diets and 90% of their fuel was derived from fat! The higher carb based athletes derived 50% of their energy from fat and 50% from glycogen.  The most fascinating data, however, was that the keto-adapted athletes were able to maintain normal glycogen levels during exercise and post recovery despite their low carbohydrate intake (approximately 10% of their total macronutrients).

So, as you can see there are many benefits to being in a keto-adapted state. If you have questions about the ketogenic food plan, need to lose weight, improve your energy, suffer from conditions rooted in inflammation or are just interested in living a long and disease-free life, make an appointment with any of the providers at CentreSpringMD.