What is the ketogenic diet?
The ketogenic diet is a low carbohydrate, high fat diet. The mechanisms at play are quite complicated but it is well worth understanding. First, it is important to understand that the body uses glucose as its primary fuel source. Glucose is a sugar molecule that is produced when the body digests carbohydrates (carbs). Glucose is absorbed in the gut and is used as a primary fuel source for muscles, the brain and most organs in the body. Excess glucose in the body is converted and stored as glycogen. Glycogen can be stored in the body for several days and can be used as a fuel source when glucose is not readily available.
The carbohydrates that break down into glucose are common place in the typical North American diet. Bread, Pasta, sugary sweets and drinks all contain significant levels of carbohydrates. By restricting carbs from your diet, you are effectively cutting off the body’s supply of glucose. In the absence of glucose, the body begins to metabolize the stored glycogen until you eat carbs and the whole cycle repeats. The carbs you eat are metabolized, and the glycogen stores are replenished. This elegant system generally allows the body to enjoy a steady uninterrupted supply of glucose. But what then happens when the body runs out of its glycogen stores? This is where the magical story of the ketogenic diet begins.
Calling all Ketones!
Here is where things get interesting. In the absence of glucose, and stored glycogen, the body switches its metabolic state and begins using a new fuel source. This metabolic state is called ketosis and the fuel source is aptly named ketones, or ketone bodies. Now bare with me and take this next step slowly as it is really important. Ketones are produced in the liver through several different pathways. The first pathway and the pathway that makes the diet so appealing for those looking to lose weight, is through the metabolism of the body’s own fat store. This process is known as ketogenesis and mainly occurs in the mitochondria of liver cells. Fatty Acids stored in the body are broken down in the liver into ketone bodies which can then be used by the body as a fuel source.
The body can also convert ingested fatty acids into ketone bodies. Oils such as medium chain triglycerides (MCT oil) or coconut oil are easily metabolized and converted into ketone bodies. Additionally, you can also ingest ketone supplements such as those containing beta-hydroxybutrate. These supplements are easily absorbed and provide a direct source of energy with minimal energy lost due to metabolism. This is extremely important to understand as it is a common error to eat too much fat while on the ketogenic diet. Fat has a caloric value that must be considered if you are trying to lose weight. If you eat thousands of calories of fat you will not lose weight, in the same way that you do not lose weight by eating high caloric carbs.
The process of restricting carbs, depleting glycogen stores and then producing optimal amounts of ketone bodies in the liver can take several weeks to occur (even months). This process is known as the keto adaptation period and can be quite unpleasant. It is almost as if the body still craves glucose and even with all these new ketone bodies readily available, the body hasn’t been optimized to use them as fuel. During the keto adaptation period many proponents of the ketogenic diet report symptoms that are collectively known as the “keto flu”. These symptoms include headaches, brain fog, irritability, fatigue, sugar cravings and many others. Luckily the symptoms generally subside, and when fully adapted one can expect to feel much better than they did on a carbohydrate based diet. Sticking through the keto adaptation period is the most difficult part of the diet.
The ketogenic miracle?
When your are fully adapted and your body is fueling off ketones you can expect to feel quite different than when on a carb based diet. While most people enjoy steady weight loss (assuming fat calories are optimized for weight loss), the most striking change may occur in the brain. The ketogenic diet is able to help regulate the conversion of glutamate to GABA in the brain. Higher levels of GABA, and conversely lower levels of glutamate, help reduce excess firing of neurons in the brain and this is experienced as a reduction of “Brain Fog”. As such, many people use the ketogenic diet to reduce brain fog, increase mental acuity, improve memory and improve focus. It appears that the imbalance of glutamate to GABA acts like a type of inflammation in the brain. The ketogenic diet can be thought to then reduce the inflammation which results in improved cognition.
Study’s show that the ketogenic diet may also help or even prevent Alzheimer’s and Parkinson’s disease. In both of theses diseases it appears that brain glucose uptake becomes impaired which mean’s that the brain becomes less efficient at using glucose as a brain fuel. Ketones however seem to not suffer the same impairment and become a more efficient fuel source for the glucose starved brain. This glucose impairment begins to happen years if not decades before the traditional symptoms of the diseases become visible. The question remains as to whether or not the ketogenic diet could be used to prevent the brain from ever becoming glucose impaired which possibly might prevent the disease all together. Studies are underway to answer this very question.
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Studies also show that the ketogenic diet may also help kill cancer cells. Cancer cells by nature require glucose to divide and cannot switch to ketones as many other cells do. Cancer cells also require glucose to rid themselves or harmful reactive oxygen species. In the absence of glucose, the cancer cell dies as it is not able to rid themselves of the reactive oxygen species. Studies are currently underway at research centers such as John Hopkins to show the efficacy of using the ketogenic diet as an adjuvant to traditional cancer treatments. Other studies at John Hopkins are showing that excess glucose uptake may even cause cancer!
Other possible therapies
The ketogenic has also shown to be an effective therapy for preventing epileptic attacks. It has been shown to have possible therapeutic benefits when used to treat auto immune diseases such as Multiple Sclerosis, ALS, Lupus and various skin disorders. It seems the potential benefits are endless.
How to get started
The ketogenic diet appears to have a significant positive effect on health and should be seriously considered as long term solution to a variety of health risks. All the miracle benefits associated with the ketogenic diet leaves one to ponder if this is truly the optimal state for the human body. Perhaps thousands to millions of years ago before the advent of agriculture, our ancestors lived primarily in this state and only came out of ketosis when they could find an abundance of fruit. It makes sense that our body evolved to use both ketones and glucose as fuel sources.
This article will not go into the details of how to get stated with the ketogenic diet. There are many resources that you can look through including this great website ruled.me. Good Luck! and please leave your comments below, would love to hear from you on this topic.