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I do not cite most of my sources because I feel like it's more or less a waste of time, considering my target audience. If you don't believe me about something, Google it, and if that's not sufficient, let me know.

Pseudo-TL;DR typeface key: major points, takeaways, and general emphasis.

Saturday, April 2, 2011

The Ketogenic Diet


I briefly went over keto in my previous post, but I left a lot of loose ends, so now I'll give you an in-depth view of the diet.

King of the low-carb diets

A ketogenic diet resembles the "induction phase" of the Atkins diet, but with one key difference: you're not allowed to eat as much as you want as long as you keep your carbs low. A caloric deficit is still needed to lose bodyfat, even if you are fixing the core problem: insulin resistance. However, it will be easier to maintain a deficit- keto tends to have a hunger-blunting effect. Fullness from fat and protein kicks in a lot sooner from that than carbs, and satiety is increased dramatically in the absence of carbs, meaning you don't get nearly as hungry later on.

Dr. Atkins died at the age of 72, with exceptionally good cardiovascular health.
He slipped on ice and suffered severe head trauma and died a few days later.
His wife is still alive, as is his mom, who is 93.

But what is a ketogenic diet?

Your body has a "plan B" mode of metabolism that almost no one in the general public knows about. When your body runs out of stored glucose, and isn't getting enough from your dietary intake to keep up sufficient blood sugar levels, it switches over to plan B. "Ketogenic" means 'conducive to the generation of ketones.' What are ketones? Basically, the byproducts of fat metabolism (this is an oversimplification though). But ketones have a very important function: your brain can operate off of them in lieu of glucose! (As a matter of fact, following a ketogenic diet greatly reduces the frequency of seizures, if not stopping them altogether, in epileptics) Following a ketogenic diet almost flatlines your insulin levels and so can do wonders for improving insulin sensitivity. There are a myriad of other metabolic benefits too.

However, this is just prompts a long series of questions that involve biochemistry. These are all addressed extremely well in here, with a very good overview of keto as a whole (this post is great too). While the first link is very informative, and is definitely recommended reading beyond the biochemistry section, it might be a bit of information overload if this is still a new concept to you. I'll be giving you my own version, but keep in mind that these are awesome resources.

This is the basic idea of keto: eat a low percentage of Calories coming from carbs, a moderate percentage coming from protein, and a high percentage coming from fat, while keeping your overall caloric intake fairly low. (The protein/fat ratio has some leeway, but too much protein will prevent you from entering ketosis, which might make you feel like crap.) This will eventually put your body in a fat-burning state rather than a carb-burning one (I will go into excruciating detail on this in a minute). Burning so much fat (mostly dietary fat) produces a lot of ketones, eventually putting your body into a state of ketosis. This has a ton of benefits other than promoting insulin sensitivity, which you can read about in the previous link.



 Keto: eat bacon and lose weight.

Excess ketones are usually exhaled or urinated out. Naturally, your breath and urine are pretty good indicators of whether you are in ketosis, although you can still be in ketosis with the absence of these signs. So what are these signs, exactly? 'Keto breath,' which is often described as 'fruity,' and acetone in your urine, which can be detected with ketostix. Ketostix can be found at a pharmacy- they are used by diabetics (or anyone with messed up kidneys) to make sure that they don't go into ketoacidosis since their kidneys don't function as they should. When one's kidneys don't function well, one doesn't even have to eat a ketogenic diet to build up ketones in the blood to a dangerous, pH-altering level. Needless to say, if you are diabetic or have kidney problems, don't do keto without first consulting a doctor. You don't need to worry about ketoacidosis if you are eating a ketogenic diet and you have functional kidneys. Also, it is important to note that eating a ton of protein will not give you kidney stones or damage them in any way unless you have a pre-existing kidney condition. That is simply an unsubstantiated myth that has been spread around by ignorant, albeit well-meaning, people.

Acetone- a ketone. Ketostix detect these.

Achieving a state of ketosis is a multi-step process. That process starts with the depletion of your body's stored carbohydrate- glycogen.

A glycogen molecule. Ain't it pretty?

Glycogen is stored both in the liver and the muscles. When you don't eat carbs or don't eat at all, your body will use primarily its liver glycogen for energy and the maintenance of blood sugar levels. One gram of glycogen can 'hold' 2.5-3 grams of water. That corresponds to a lot of weight lost over a very short time frame if one goes low-carb. Many people don't recognize that weight loss does not necessarily correspond to fat loss, so they quit the diet, satisfied with the arbitrary number on the scale, and all that weight comes back in a day or three. Then they think the diet was simply a failure. This is silly and ignorant. Try to weigh yourself only once a week if you follow a low-carb diet, and know that the mirror is a better tool for gauging progress.

Now, back to glycogen-- aside from energy, it's used to keep your blood sugar from dropping too low. Your brain usually runs on glucose, and if there's too much or too little, it'll freak out. Insulin is used to lower blood sugar if it's high- this is why diabetics have to frequently measure their blood glucose levels. By the way, type 2 diabetes is simply an extreme insulin resistance which can usually be fixed.


One of the most famous mispronunciations ever.

When those hepatic stores of glycogen are gone, your body will start looking for another source of glucose: either protein or fat (in this case, a substitute for glucose). 

If you don't eat a lot of fat, your body will default to using protein. The process of converting protein to glucose is called gluconeogenesis. If you're not eating a lot of protein, that won't be sufficient, so your body will cannibalize your muscle protein to make up for that. This is bad for obvious reasons. Now it is probably worth mentioning here that a diet comprised almost entirely of protein does have some merit. You could say that a protein diet is keto's crazy half-brother. If there were such a thing as a 'healthy crash diet,' this would be it. It's not sustainable for much longer than a week or two assuming you're a sane person, and provided you take a multivitamin. The reason it works is that protein is very filling and so it's very easy to eat few calories without feeling like you're starving. Plus, protein is closer to 3 Calories per gram than 4 when it's all said and done, and eating so much will spare your muscle tissue from being cannibalized.

Chicken: the holy grail of lean meat.

However, if you hardly eat any carbs and you do eat a lot of fat, your body will notice and will accordingly start using it for energy, ultimately landing you in ketosis. Once in ketosis, your body will switch from glucose to ketones for brain food, and then your body won't care about your blood sugar is like, which virtually eliminates the risk of muscular catabolism (breakdown) for gluconeogenesis.

This is for all you visual learners.

There are 3 main variations of keto: the most common is the Standard Ketogenic Diet, or SKD. As the name implies, this is just straight-up keto for weeks on end. This is more for sedentary people. It seems like this is the only way to get into 'strong' ketosis: I think it has to do with the brain adapting to ketones completely. I have no experience with this variation of keto, though, so don't take my word for it.

The other two types of keto are known as the Cyclical Ketogenic Diet (CKD) and the Targeted Ketogenic Diet (TKD). These are for people who exercise- especially anaerobic exercise. That means weight-lifting and intense cardio, which are hugely beneficial to everyone-- I will talk about these in one of my upcoming posts, because there's a lot of ignorance and misconception surrounding them that I want to dispel. Now, anaerobic activity requires muscle glycogen. Glycogen is created from carbs. No carbs means you eventually run out of muscle glycogen, making anaerobic activity almost impossible. This is known as 'bonking.' You will know when it happens-- it sucks. There are two ways to prevent this from happening:

CKD allows weekly 'carb-ups' where you exit ketosis and eat a lot of carbs over the course of one or two days. This is my favorite version of keto because it allows you to satisfy any carb cravings you have in addition to making your favorite foods accessible. However, you have to be really careful to not get into the wrong mindset and overdo it, thereby sabotaging your progress. Cheat meals and carb-ups are there to keep you sane and happy, but you have to earn it. Lift weights and do short-yet-intense cardio if this appeals to you. The only downside is that you fill up your liver glycogen, so it takes a day or so to get back in to ketosis.


You may have seen this giant donut on Man vs. Food. I've actually had a part of this monster before. You can't binge on this for your carb-up, but you can have at least one of the regular-sized one.

TKD allows you to have small to moderate amounts of carbs before (if necessary) and after your workouts to immediately replenish muscle glycogen stores. However, this doesn't let you binge on carbs on the weekend, so it's not as enjoyable. The upside is that the carbs shouldn't cause you to exit ketosis.

Putting it all together
Keto is the proper way to do a low-carb diet: it switches your body to a fat-burning mode, meaning that your energy levels shouldn't decrease-- in fact, it could very well increase your energy levels if you are an insulin-resistant individual. It has the potential to do wonders for your health. The science behind it is proven, even if it isn't embraced by the public quite yet. It can allow for cheat meals, given you've earned them, making it easier to stay on the narrow path. Finally, it puts a new perspective on how you view carbs, preventing you from abusing them again when you stop following the diet, allowing you to go back to a relatively normal and healthful diet without gaining your weight back.

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