As a functional medicine doctor working at a busy integrative medical practice, and as a mom, I too can fall short when it comes to following my own advice.  Recently, I decided to “doctor” myself and took a good look into my own health due to increasing fatigue. In addition to our basic lab tests, I decided to get a NutrEval as well (one of the more a comprehensive tests we offer). In the end, I made the decision to try a ketogenic diet.

After having a baby a little over a year and a half ago, I wanted to shed a few pounds and was seeing great success in some the patients I had placed on a keto diet. The more research I read, however, the more interested I became in the additional health benefits.

If you take your health seriously and follow research on different types of food plans, you will come across conflicting advice as to what plan offers the greatest health benefits. My position at this stage of my career is that it isn’t so important to identify the healthiest food plan to follow, but rather what it the healthiest food plan for you as an individual. Depending on your existing health, activity level, goals and moral position, the food plan that may be the best for you may not be the best for another. One point that cannot be refuted however is that sugar and an overabundance of carbohydrates can cause a host of negative affects on weight, insulin regulation and inflammation.

Medical Conditions that would benefit from a ketogenic diet:

• Parkinson’s Disease
• Type 2 Diabetes
• Alzheimer’s
• Hyperlipidemia
• Epilepsy
• Obesity
• Traumatic brain injury
• Cancer
• Acne
• Arthritis
• Cardiovascular Disease
• Fibromyalgia
• Chronic Fatigue
• Multiple Sclerosis

What is the ketogenic diet anyway?

The Ketogenic diet is a very low-carbohydrate diet plan that was originally created by researchers at Johns Hopkins Medical Center for patients with seizures.  Researchers discovered that avoiding intake of all foods for a brief period of time, including those that provide carbohydrates, helped reduce the amount of seizures patients experienced. Interestingly, they also discovered other positive effects on body fat, blood sugar, cholesterol and hunger levels.

Most of us can’t fast for long periods of time and so, the ketogenic diet essentially tries to mimic the benefits of fasting through a strict restriction of carbohydrates. When someone does that, they put their body into a metabolic state called “ketosis” where they are utilizing ketones from fat for fuel rather than glucose.  Ketosis occurs when the liver breaks down fat into fatty acids and glycerol, a process called beta-oxidation. The three ketone bodies produced during this process are acetoacetate,  beta-hydroxybutyrate and acetone. This usually takes 3-4 days when you are under 20 grams of net carbs per day. Net carbs are the total carbohydrates minus the grams of fiber. Others will use 50 grams of total carbs as the goal to stay under.

What do you need to know before you begin?

To be precise about the calculations, I suggest patients get body composition testing. We offer the InBody test at CentreSpringMD. Once you know your estimated Basal Metabolic Rate (the amount of calories needed for basic life sustaining functions) you can figure out the percentages of macronutrients you should have in your diet. You can also track your fat loss which is more important than tracking your BMI or weight.

Once you know your BMR, the total caloric intake can be calculated based on your activity and goals for weight loss. There are many online calculators to help you figure out these calculations or you can see one of our Registered Dieticians at CentreSpringMD to help you.

Macronutrient Ratios in terms of calories on a ketogenic diet:

• 60-75% of calories from fat
• 10-30% of calories from protein
• 5-10% of calories from carbohydrates

Another quick way to calculate your minimum protein needs would be to take your weight in pounds and multiply by 0.6. Your maximum protein needs would be calculated by multiplying your weight in pounds by 1 (for intense athletes). Depending on your activity level your protein needs will vary.

Once you know the total calories for each macronutrient category, you need to divide by 9 for the total grams of fat and 4 for the total grams of carbohydrates and protein per day.

One word about protein…

There is a cell signaling pathway called mTOR (Mammalian or Mechanistic Target of Rapamycin) that was discovered when researching a drug called Rapamycin, hence the name. It is the key-muscle building mechanism in all mammals. When mTOR is stimulated by eating large amounts of protein, cellular and mitochondrial autophagy is suppressed. This prevents your body from effectively cleaning out debris, repairing damaged DNA and activating intracellular antioxidants and heat shock proteins.

When mTOR is activated it causes cells to grow and proliferate. This is in part why a ketogenic diet is beneficial in cancer patients.

So, my advice is to consume slightly larger amounts of protein on days of strength training and drop it to lower levels when it isn’t needed for muscle repair.