You may have heard the term fat-burner. By consuming limited carbohydrates, the body begins using fat for energy. This is a normal physiological process. Fat is more satiating so if keto is done properly people tend to need to eat less but feel full.
What I see often see in clinic is people who don’t eat enough protein. Keto tends to help with this because you start by tracking your protein intake. Protein has higher nutrient density than other foods. It also more satiating for this reason. When people are low in protein they are also low in essential micronutrients as well. This can cause cravings and a hunger that seems to never end.
Blood Sugar Dysregulation
Keto is stabilizing stabilizing for blood sugar. Those with insulin resistance or hyperglycemia can benefit from a ketogenic diet. Just to be clear, metabolic ketosis is what we are talking about. Don’t confuse this with ketoacidosis, an acute condition that can occur to diabetes.
Both conditions involve ketone production but the second happens because insulin is unavailable at the cellular level. This dangerous condition produces much higher levels of ketones and is a medical condition that looks much different than metabolic ketosis. Blood sugar dysregulation is very common. I see it almost daily in my practice.
If you have followed my work you’ll know how important blood sugar regulation is for maintaining physiological homeostasis ranging from hormones to brain health.
Epilepsy & Neurodegenerative Diseases
We have known for a long time that a ketogenic diet has excellent outcomes for certain conditions. Drug resistant epilepsy is one especially when used in children. The side effects of seizure drugs have some of the worst side effects. Using diet to avoid long-term use has changed the lives of epilepsy patients. Other neurodegenerative diseases like Alzheimer’s and Parkinson’s also show promising results.
This is an area that requires more research however we’ve know of anecdotal evidence where cancers disappear with extended metabolic ketosis. Interestingly the method used to detect cancer uses a radioactive form of glucose. This reflects the fact that cancers use more glucose than normal tissues.
Patients with recalcitrant gastrointestinal issues like SIBO (small intestine bacterial overgrowth) and IBD (like Crohn’s and Colitis) tend to benefit from a lower starch diet. In many cases keto or intermittent fasting provides symptom relief so people are doing this intuitively. Keep in mind that simpler sugars (monosaccharides) are sometimes easier for these people to tolerate. Fruit is a better source of simple sugar than processed foods which are what some people reach for when they are in pain but require energy. Energy from fat can be a good solution that is actually helping with recovery from the infection or inflammation.
Protein is the best place to start. Most organisms do not overeat protein. We have a hard-wired cut off point for protein because of how satisfying it is. If you don’t get enough protein, you’ll try to find nutrient minimums by eating larger amounts of other foods that likely don’t have as good a nutrient profile.
The next step is to limit carbs to 20-30 grams per day. There are tools to help you learn how to do this that I go into below. Once you get started it becomes just a new way of eating. In the long-term carb cycling can be better for gut health. This means choosing a day or two a week where you increase carbs. By including some of the resistant starches and prebiotic fibres you replenish the beneficial bacteria.
The last step is to fill the rest of your energy needs with healthy fats. For gut health use a variety of fats, not just saturated fats. I’ll talk more about who benefits from “a mediterranean keto diet’ in a follow-up article. Basically everyone benefits from consuming adequate amounts of EPA/DHA from fish and MUFA (monounsaturated fatty acids) from olive oil & nuts.
We know humans can thrive on any macro nutrient ratio. There is evidence of populations like the Inuit thriving on a fat-based diet. This is also true of a high protein or a high carbohydrate diet. We are highly adaptable! This is not one-size fits all, meaning any diet needs to be individualized & will change depending on activity levels, stage of life, lifestyle etc.
I’ve trialed a few different tools for tracking macronutrients. Initially these make it much easier to get a sense of what you are eating. MyFitnessPal is a popular one that many of my patients use. I prefer Cronometer. It give you a sense of your micro and macronutrients and is easy to use. Check it out and let me know what you think!
In the next couple articles I’ll address who should be cautious when trying a ketogenic diet and why electrolytes are so darn important!