Change This…and Increase Energy, Lose Fat and Prevent Disease
If I told you, that by changing one thing in your life you could increase your energy, improve your mental and physical performance, lose fat weight, prevent chronic conditions such as diabetes, cardiovascular disease and neurodegenerative disorders such as Alzheimer’s would you be interested? I would guess that most would. And as with any dietary change and implementation there are nuances that need to be respected and understood for safe implementation. You should always consult with a knowledgeable physician or practitioner. The research-based information presented in this article is about a foundational lifestyle change that will help you improve your life.
What is Ketosis?
Ketosis is a metabolic state that occurs when our body utilizes ketone bodies from fat as its primary source of fuel for the production of energy. This occurs naturally when we implement a very low carbohydrate, moderate protein, and high fat diet. It also occurs during states of fasting or rare modern day events of starvation.
Your diet is the foundation for the source of fuel your body will utilize. Most individuals in today’s world utilize glucose from carbohydrates and protein (gluconeogenesis) as the primary source of fuel for the production of energy; let’s call them “sugar burners”. By changing to a ketogenic diet your body over time, can begin to use ketone bodies from the fat stored in your body or from dietary sources, as its primary fuel making you a “fat-burner.” Both of these states are normal metabolic states for your body; the benefit of fat burning is our focus.
Through adaptation in Paleolithic times our body utilized both glucose and ketones as sources of fuel depending on what was available. Glucose was the primary source of fuel during times of carbohydrate (plant) availability. Ketones were utilized during times when animal protein and fat were available or during winter when lack of food brought on times of fasting/starvation. During times of foraging or hunting our Paleolithic ancestors relied heavily on the body’s ability to convert stored fat into usable ketone energy. Sugar burning and fat burning states are both natural physiologic responses to changes in our environment (our diet); however in today’s society with the industrialization of our food and the standard American diet, we have become sugar burners for extended periods of time, forgoing the positive benefits of being fat burners.
Of interest in the prevailing data and research are the positive therapeutic effects of ketones or ketone bodies on our metabolic processes and the resultant discovery that ketones are the preferred source of fuel for the production of energy (or ATP) by the heart, brain and muscles.
That bears repeating….our heart, brain and muscles thrive on fat burning.
In order to create ATP or energy our body can utilize glucose, amino acids or fatty acids. However, utilizing fatty acids makes the process of energy production more efficient and more productive for our heart, brain and muscles.
Getting into a state of ketosis and relying on ketones as the primary source of fuel has demonstrated numerous benefits including but not limited to sustained energy, improved metabolism, weight loss, increased satiety/decreased hunger, hormonal balance, improved labs such as cholesterol, increased athletic performance and decreased inflammation. Some of these beneficial effects of ketosis are attributed to the balancing of glucose and insulin response as well as the removal of certain problematic foods.
The Ketogenic Diet
I must reemphasize a point I stated earlier in the introduction. Any implementation or change in diet should be under the supervision of a knowledgeable physician or practitioner. There are many nuances that are important to understand and can make the difference between you succeeding in this type of lifestyle change or have you fall flat on your face. In this section I am providing some general guidelines that help most people get to a state of ketosis, but each person must carefully track their implementation and results closely because minor mistakes can prevent you from reaching this most beneficial state.
You have to be very strict with the types of food you eat in order to effectively implement a ketogenic diet and get yourself into a state of ketosis. Depending on your current state of health it may take weeks to months before you reach ketone production significant enough to see the benefits listed above. Your due diligence and patience is of the utmost importance. Each individual is different and may need to tweak these general recommendations in order to gain the health-enhancing benefits of getting into a state of ketosis.
From a macronutrient (carbohydrate, protein and fat) perspective total carbohydrates should be less than 50 grams per day. This can be difficult initially because of the amount of carbs we typically consume but with some close monitoring of your consumed carbohydrates you can be successful. The other key to getting into ketosis is consuming moderate amounts of protein 0.70-1.0g/kg of body weight per day. That would equate to approximately 38-54 grams of protein per day for a 120lb person and approximately 63-90 grams of protein per day for a 200lb person. Finally and of maximal importance is the consumption of fats. Most individuals have been conditioned to believe that all fat is bad or that consuming high amounts of fat can create cardiovascular problems or contribute to the development of disease. This ketone producing or fat burning diet emphasizes consuming high amounts of healthy fat, such as avocado, coconut oil, olive oil, saturated fats from naturally raised animals and fish; as well as butter from naturally raised cows. Some people may even be able to consume other dairy products, such as cheese or raw milk with no problem, while it may be a barrier for people with sensitivities to dairy.
The most effective measuring tool for determining whether you are in a state of nutritional ketosis is either monitoring the blood ketone, beta hydroxybutyrate, or the breath ketone, acetone. These measurement tools are accurate and can be found online. For the sake of cost the breath analysis seems to be more affordable.
Data from animal and human studies has demonstrated an increase in cognition, memory, and mental performance when people are in a mild ketotic state (blood ketone reading of approximately 0.5 millimolar and higher). An ideal blood ketone reading of 1.0-3.0 millimolar is very beneficial and clearly demonstrates a state of ketosis. When fasting, ketones can reach a level of 5-7 millimolar or higher.
Disease Prevention with Ketosis
Since the early 1900’s the high fat, low carbohydrate diet was the primary go-to prescription for conditions such as type 2 diabetes and epilepsy. Yet in today’s world it is hardly thought of as an option in the treatment of chronic disease despite clinical evidence.
Type II Diabetes
If thinking back to our ancestral diets, often referred to as Paleolithic diets, it is impossible to know exactly what they were consuming, however it is safe to assume that it was plants, animals, fish, seeds and nuts. It is certain that it was not what the majority of Americans or Mainer’s consume today, the standard American diet, consisting of highly processed, high carbohydrate, low nutrient dense foods. By implementing a ketogenic diet we stop the insult of foods that elevate glucose, hemoglobin A1C and insulin, which are present in insulin resistance/type 2 diabetes, and we provide an environment within the body for utilization of the alternative source of fuel, ketones.
The implementation of the ketogenic diet can help a great deal with weight loss by switching a person from being primarily a sugar burner to a fat burner. Many of us have excess fat storage secondary to our excessive carbohydrate consumption. Turning on your body’s ability to burn fat is advantageous for weight loss because we are finally able to burn our excess fat stores.
The bacteria in our gut play an important role in our health and weight management. Studies have demonstrated that a change to a ketogenic diet promotes a proper ratio of intestinal bacteria that when imbalanced can contribute to the development of increased weight gain and obesity. This is just another factor to consider in your choice of a ketogenic diet to help with your weight loss goal.
One study out of John Hopkins examined 600 patients who had a history of 20 seizures a day. After implementation of a ketogenic diet close to one third had complete reversal, one third had a reduction in occurrence of seizures and the other one third experienced no effect. Close to 67% of the patients in the study demonstrated improvement. If a drug had that effect it would be considered a blockbuster.
One of the interesting things to consider is that as medications became a staple to treat illness this ketone dietary approach took a back seat and today it is almost completely unheard of in conventional medicine. However, I believe with the rise of functional medicine, this diet will see resurgence. Educated physicians and practitioners will begin to recommend the ketone dietary approach because of its superiority in addressing some of the foundational problems in our standard American diet.
Ketosis vs. Ketoacidosis: Warning to Insulin Dependent Diabetics
Ketosis and Ketoacidosis are not one in the same. Ketosis occurs when moderately elevated levels of ketones occur simultaneously with LOW blood sugar. Ketoacidosis occurs most often in patients who are insulin dependent diabetics. When these individuals have elevated levels of glucose and do not have the proper amount of insulin present in the body to shuttle the glucose into the cells for the production of energy, the body begins to break down fat into ketones as an alternate source of fuel. In this state of elevated blood sugar paired simultaneously with extremely elevated ketones (>20 millimolar) the result is ketoacidosis, a dangerous metabolic state that can result in coma or death.
This is not to say that insulin dependent diabetics cannot improve with a ketogenic diet. Some can, it is just critical that they do so under observation of a physician who understands the differences in the biochemistry of ketosis vs. ketoacidosis and can implement a plan that is safe and effective. Switching to a low carbohydrate diet can result in better regulation of blood glucose as well as reduce the requirement of insulin.
Ketosis is a natural, inherent evolutionary process that occurs in our body and makes sense due to our body’s large amount of stored fuel as fat, our body’s small reserve of carbohydrate (glycogen), and our bodies limited storage of protein. When implemented and monitored properly a ketogenic diet and developing a state of Ketosis can be a great approach to improving your overall health both with prevention of disease and enhancement of health.
Your Health Detective,
Dr. Rudy Mueller DC IFMCP