The Ketogenic Diet: A 10,000 Foot View
Listen Here Amigos Y Amigas
So what actually happens to Your Energy Production Process?
A Closer LOok
Because of how our diets have evolved. We’re genetically wired, in glucose abundant conditions, for our brains to first look to convert glucose to pyruvate as the main substrate for ATP production in the krebs cycle. However, we can thank our ancestral homo sapiens for going through some pretty tough times…hard winters, limited sustenance and extended periods of starvation. During those periods, our bodies proved to be tremendously resilient, and made key adjustments to our energy production process to ensure our survival. The key adaptation to the krebs cycle was the ability to turn fat stores and fatty acids into ketone bodies (a.k.a ketones) that can be used instead of glucose to produce ATP. Studies actually prove that the reason we can live 40 or more days without eating is precisely because of this adaptation. After about 3 days our blood sugar (glucose) stops falling and the levels of ketone bodies in our blood surpass levels of glucose which signals a full shift into burning fat. And it makes evolutionary sense – because in times of starvation your body kicks into survival mode – burning muscle to get to it’s glycogen stores would result in a withering away effect; so it’s logical to turn to fat stores.
The IMportance Of Going Against The Grain
Now, not to digress too much, but I can’t help but draw parallel to other industries. Why is it that the consumers (you know, “we the people”) can dictate expectations and really be in the driver’s seat for seemingly every product, service and piece of information we consume regardless of industry except when it comes to our medical, health and performance matters? In the fields of business and technology the internet and information age have broken down barriers, increased transparency and created a “golden age” of innovation and possibility that has benefitted the consumer and profited the corporations or providers. Constant interactions with companies and their products, services, information, etc. has been enabled through digital adoption. While it’s a great opportunity for providers of products, services, information, etc. it’s also an obvious shift in power…companies today are at the mercy of sophisticated consumers who dictate their own expectations and have elasticity of demand. Put simply, the consumer is all powerful and dictates expectations. The same phenomenon has forced financial services companies to invest billions in designing customer experiences and touchpoints that are benchmarked against seemingly unrelated eCommerce companies like Amazon or data and consumer tech companies like Google, Apple, etc. Why? Because the “best-in-class” experience in one industry has become the experience demanded by the consumer in any industry.
We believe that medical, healthcare and performance related industries are slow to change for a number of reasons but, in short, are inherently more sensitive and complex as far as the consumer is concerned. What we’re excited to see, and it’s what makes the concept of the Ketogenic Diet so relvant, is thousands of individuals being empowered by research groups, businesses and organizations who have decided to “go against the grain” by challenging age-old guidelines in health & performance where we’ve traditionally bowed down to the powers that be. The wheels are turning and momentum is building. Take for example the National Academies of Sciences, Engineering and Medicine (NAESM) who published a report bashing the broken process behind the Dietary Guidelines for Americans, which we’ve been brainwashed with for so many years. Remember the food pyramid? Yep, garbage…And those DGA are what have created society’s fat phobia, until recently…
A number of studies surfaced lauding the benefits of a high-fat/low carbohydrate diet and this time they’re armed with teeth. One of the more groundbreaking:Associations of Fats & Carbohyrdate Intakes with Cardiovascular Disease and Mortality, mainly because of the size and scope of the study. The efforts spanned 10 years and included 18 countries helping provide scientific, data-backed responses for many of the criticisms that predecessor studies were subject to.So with all of the talk about the health benefits of a high-fat/low-carb approach and their efficacy for preventing chronic disease and dysfunction, now is as good a time as ever to discuss the Ketogenic Diet: one of the more popular low-carb/high-fat approaches of the times. Some of the claims include: fat loss, detoxification, metabolic reset, mood consistency, eliminating brain fog, improved focus and even the potential to reverse type II diabetes. The concept of fat adaptation is a game-changer for the future of our health & performance and it is near and dear to the core of a ketogenic diet. A high fat approach is not for everyone and needs to be evaluated on an individual basis, taking into account genetics, medical background and family health history just to name a few. More importantly, the diet truly is best suited for folks who enjoy details. Anyone who doesn’t tell you this is selling you on something! We highly recommend doing your own due-diligence. A great place to start is Dr. Peter Attia’s Eating Academy,specifically his article: Ketosis – advantaged or misunderstood state? (Part I)
- The goal of a ketogenic diet’s very low-carb, high-fat nutritional approach is to get your body burning fatty acids (fats) as fuel instead of glucose (sugars).
- Further reading on the biological and chemical processes impacted is encouraged. A good place to start is: Dr. Peter Attia’s Eating Academy and Dr. Joseph Mercola (author of Fat for Fuel)
- A high-fat, low-carb approach has been a popular way to combat certain chronic diseases in the past; popularity has exploded as of late thanks to very promising research that comats many of the shortcomings of related predecssor studies. For example, Association of Fats & Carbohydrate Intake with Cardovascular Disease and Mortality.
tHE hyPE: wHY i DECIDED TO gO kETO
Later in life, the same habits and desire to self-experiment stayed with me in the midst of a demanding career. But with stressful, complex client problems to solve, the truth is my nutrition was less of a priority. Early on I was able to wake up and hit the gym before an 11, 12 or 13 hour work day and even get off the subway to hit the pool on the way home while I was training for triathlons. During those days I compensated for de-prioritizing my focus on nutrition with much higher levels of activity in my outside of the office hours. Needless to say, carbohydrates and the concept of fueling up with pasta, NY bagels or even the occasional grain was still part of my repertoire.
It wasn’t until I suffered my second back injury (herniated L4/L5 and S1) while training for the upcoming triathlon season that I had to adjust my focus back to optimizing nutrition. A demanding career often means limited time to exercise but a bad back sidelines you completely. During my recovery, I decided to largely eliminate carbohydrates and really investigate/experiment with optimizing my diet and performing well sans-carbohydrates. I largely eliminated 95% or more of the carbohydrates in my diet..or so I thought. Compensating for the cut in carbohydrates, I filled the void with copious amounts of protein, moderate dietary fat, and on top of what I would later learn was far too little greens, vegetables, etc.
Looking back, I was completely missing the mark on two key considerations of a low-carb approach and it severely impacted my performance. First, I wasn’t privy to the concept of Gluconeogenesis, where over-consumption of protein actually results in production of glucose…may as well have been eating carbohydrates. Second, I was no where near a state of fat adaptation that put me in a position to utilize the added dietary fat I was taking in with the new approach. In the mornings I’d rip down a bulletproof coffee, expecting to be in the zone until afternoon, only to find myself tired and hungry by 11am, latest. I also didn’t notice any obvious improvement to my ability to focus (a lauded benefit of Bulletproof Coffee that I later confirmed is very real). To compensate for a lack of energy, I’d drink 6 to 8 cups of coffee or more a day and really pressed deeper into the realm of natural cognitive boosters and Nootropics – a.k.a. “Smart Drugs” – which is a topic for another post.
In April 2017 I decided to transition into something new professionally. I’d be understating things if I said I was desperately in need of some mental and physical detoxification and a new challenge and health & performance goal. It was the perfect time for me to dive full force into Keto and I did so for two primary reasons. First, I really needed to “recycle” some fat and go after what I believed to be real detox…not the fancy (bullshit) “juice cleanses” people go on. Second, I really tried everything under the sun to get my focus and cognitive performance back after a lengthy period of operating on burnout mode. I wanted to see if I could get consistent and get rid of brain fog.
I have to thank Tye Jensen and his team at Epibolics for providing me with a good baseline for understanding the importance of fat adaptation. Tye and his team specialize in the reversal of Insulin Resistance and providing expert guidance on the supplement industry. Tye co-authored IR14, a 14 day metabolic reset that takes a ketogenic approach to resetting your body’s insulin response and setting the foundation for future health and nutrition goals. Please go check out IR14, it’s what got me started on “phase 1” of my journey with the ketogenic diet, and is one of the most user-friendly guides I’ve encountered.
tHE hYPE: wHY i dECIDED TO gO kETO
- Adam has been a lifelong self-experimenter where health & performance variables are concerned. After a career change, it was the perfect time to experiment with the ketogenic diet and see if the hype was real.
- Primary motivation for trying the diet: 1) detox aspects of fat “recycling”; 2) restore focus and mental acuity, cognitive function and eliminate brain fog.
- A great starting point for testing the waters with the Ketogenic Diet, or simply laying a foundation for health, is the IR14 guide put together by Tye Jensen and his team at Epibolics.
wHY yOU'RE pROBABLY mEASURING wRONG (OR NOT AT ALL) AND THE gLUCOSE TO kETONE iNDEX (gki)
Persona 1 – The Seasoned Vet: Fanatical about his/her diet and highly knowledgeable about nutrition. More importantly, highly knowledgeable about the impacts of specific food groups on their ketotic state. Even more specifically, they’re experienced with ketosis and understand how specific foods and food types have a unique or individualized impact on their ketotic state – levels of glucose, ketones, etc. These folks are borderline obsessed with and understand the importance of fibrous greens and vegetables taking up close to 70% of each plate. These are the folks who know what it feels like to be in ketosis, and can get away with not measuring.
Persona 2 – The Self Experimenter: Meticulous by nature and detail oriented, he/she falls in love with tracking, measuring and monitoring their progress; He/she uses a food log or mobile app to jot everything down and observes how ingesting certain food groups, types,etc. can impact their ketotic state. Many of these folks can be new to the diet or may have been doing it for years. They understand that dietary needs evolve over time and there is also potential for your body to change the way it reacts to certain nutritional elements. That said, they never miss a day of tracking and monitoring progress. These folks measure BOTH ketones and glucose levels and they do it the most accurate way – via the blood.
Ketosis is often defined as a state in which your body is producing “sufficient” levels of ketones. Notice how there’s no mention of glucose or comparing ketone levels to glucose? A common mistake people make, including myself, is deciding to measure only for ketones and I believe it’s because the glucose aspect is glossed over. The whole intent of the diet is to normalize levels of blood glucose and shift toward burning fat. How can you do that by measuring only one variable? The truth is, if you’re Persona 1, you may be able to get away with it. But for other folks, it’s really important to be accurate especially while you’re adjusting to ketosis and learning how it impacts your individual biology. Three different “ketone bodies” are present in the body and each correspond to a method for measurement. However, one way is much more accurate and it also happens to be the only way you can kill two birds with one stone and get a reading on both Glucose and Ketone levels…
- Betahydroxybutyrate (BHB) is present in the blood and measured via a glucometer. I fall in the bucket of Persona 2, so I want accuracy, and I use the Precision Xtra by Abbot Labs to monitor both glucose and ketones.
- Acetoacetate is present in the urine and measured via urine strips. I started out measuring with these, as do most, but by all accounts they’re rudimentary and sub-par as far as accuracy is concerned.
- Acetone is present in the breath and measured via a “breathalyzer” like test. I’ve never tried these, and they seem like the less popular option, so the verdict is out on these. If you have experience with this, share your thoughts.
So why do I say that for most people it’s dangerous to either not measure at all, or measure inaccurately? Purely because if you simultaneously have elevated levels of glucose with elevated levels of ketones, you’re most likely going to be feeling like your in ketosis and experiencing some of it’s benefits. The same logic applies to people who use Exogenous Ketones to get some of the therapeutic benefits of ketosis without the effort of adapting your body to produce them naturally. However, going off the feeling alone, you won’t notice the high levels of glucose and you certainly won’t be optimizing your ketosis efforts. In this scenario, it actually may be dangerous to be consuming high levels of dietary fat when you’re body is not optimally fat adapted. I came to this conclusion when researching a study done by Dr. Thomas N Seyfried on the Glucose Ketone Index Calculator (GKIC)  which he developed as a tool for monitoring the therapeutic efficacy of the ketogenic diet for brain cancer patients. The same comparison, called the Glucose Ketone Index (GKI), can be used for those folks who want to compare the simple ratio of blood glucose to blood ketones. Obviously, you want this number to be low…
- Measuring with ketone strips or a “breathalyzer” is simply not adequate. Especially if you’re not Persona 1, someone who fanatically monitors diet and understands how variables impact your individual ketotic state.
- Ideally, you’ll be consistently measuring and monitoring BOTH Ketone and Glucose levels in the blood to optimize the benefits of ketosis and eliminate any potential risks.
- The GKI is a good way to compare blood glucose to blood ketones; striving for a lower ratio to ensure optimal benefits.
- Check out the log I created for the last few days of my “Phase 1” of ketosis: Nutrition, Blood Glucose and Blood Ketone Log. I plan to expand on this and add/alter some variables for “Phase 2”.
cOMMON mISTAKES - i mADE 'eM SO yOU cAN aVOID 'eM
- Not Measuring Properly – Subject of the first observation. To reiterate, some of you don’t have to measure. But I think most should, and should do so through the blood for optimal accuracy.
- Over-Consuming Protein – If you get lazy on this diet the food can get really boring; it makes it very easy to find some meat and cheese in the fridge or make a protein shake because they’re seemingly low-carb. What most people don’t realize is that over-consuming protein actually spikes blood glucose and can kick you out of ketosis through a process called Gluconeogenesis .
- Failure to Get Comfortable With Uncomfortable Amounts of Fibrous Vegetables – on this diet greens and vegetables are key for two primary reasons. First, they fill up youre plate and keep you full. Second, and more importantly, fibrou vegetables are the primary souce of whole food nutrients and dietary fiber. Many critics question where to get nutrients and stop digestive issues. Veggies are the answer, amigo! So get comfortable with massive portions of veggies and large beds of greens underneath your fats and proteins.
- Believing In Cheat Days – To be clear, I’m actually not guilty of believing in cheat days, but I did have a wedding and a bachelor party over the last six months where I was obligated to stray. But for those of you familiar with a cheat day per week it will serve you well to forget about that idea. Why? Because it is a process to shift into ketosis. A cheat day can set you back anywhere from a few days to more than a week depending on the person. Who the hell wants to voluntarily suffer through the “keto flu” again? Not I. Plus, allowing for cheat days increases the probability that you quit the diet altogether.
- Limiting Exercise – Especially in the early stages where you’re transitioning into ketosis, exercise will help expedite the process of producing ketones and buring fat as fuel. I personally noticed that my ketone levels would fluctuate significantly on days or extended stretches where I controlled my diet but failed to exercise, even after being in nutritional ketosis for weeks on end.
- Cognitive Performance: I believe there are three primary ways to improve you’re cognition, i.e. your ability to focus, learn and perform better upstairs. First, via supplementation like prescription drugs or Nootropics a.ka. “Smart Drugs”. Second, through shocking your physiology – a really hot steam room or a freezing cold ice bath really primes your mental awareness. Nothings shocks your system like an ice bath or cold shower. Finally, through nutrition. And by this I mean the natural whole foods we eat and the overall approach to what we consume. The ketogenic diet has proven to help me cut through brain fog and operate much truer to form than any other approach I’ve taken.
- Consistent Energy and Mood: most of you probably experience peaks and valleys of energy throughout the day. Well, it’s because of the foods your eating and crashes your brain experiences when glucose levels rise and fall. The same rise and fall, believe it or not, can also have an impact on your mood. Because fat is the most abundant and efficient energy source in the body, it also creates the most consistent “feeling” mentally and physically when your operating on it.
- Cravings & Appetite Suppression: One of the most noticeable changes on the ketogenic diet is the profound reduction and eventual elimination of food cravings. I love food just as much as the next person. On weekends visiting home or after a week of consistenlty working out, I’d always crave (and feel like I deserved) about 24 chocolate chip cookies. I would literally crave sugary or high carbohydrate foods. And I spent wasted time and energy fighting internal battles to stop myself from raiding the cabinet. Two weeks into ketosis and those cravings were eliminated. It’s research-baked and proven that fat and a ketogenic approach help suppress appetite and crush cravings. Check it out: How Ketosis Helps You Lose Weight Through Suppressed Appetite.
- Fat Loss & Detox: Previously mentioned, I started the Keto journey using an amazing guide called IR14, produced by Epibolics. The protocol outlined in IR14 helps get you into ketosis quicker through gradual stages of Intermittent Fasting. Likely propelled by IM, I lost a ton of extra water weight in my first month of ketosis. During months 2 to 3 I lost what may seem like a trivial amount of weight, approximately 5 lbs., but my physique began to become more chiseled and defined than it had been in years. Unfortunately I can’t speak to the detox aspect matter of factly, but I do know that I lost fat, and felt better than I have in years.
- Easier Morning Routines: How many of you enjoy worrying about what to make for breakfast? Or even lunch? My morning routine is so much more efficient because it involves either: a) drinking water and brewing coffee during intermittent fasting periods; or b) drinking water and brewing bulletproof coffee to get a healthy source of fat and energy that makes me forget about food and start focusing on being productive well into the afternoon. On the weekends, I’ll replace either option with a high-fat/low-carb meal like overeasy eggs and bacon.
Plans for Phase II
- Impact to Exercise – although I had fairly consistent activity levels during the last round, I want to experiment with the type, duration and intensity of my workouts. I did not do very much traditional aerobic activity (“cardio”) outside of super-setting body weight exercises like pull ups and push-ups with jump rope…a concept called cardio-acceleration. I’d like to examine how the ketogenic diet impacts my anaerobic and aerobic activity differently.
- Targeted Ketogenic Diet (TKD) – as I ramp up activity levels the option of targeting increased carbohydrate intake around workout times is an option if you’re hitting a wall. I may try this out. Learn more here.
- Diversifying My Diet – I’m someone who actually prefers the monotony and repetitiveness of eating a few basic meals. It’s one less decision that I have to make. For the times that I want to switch it up, I’m reading these two books: The Keto Diet: The Complete Guide to a High-Fat Diet by Leanne Vogel, and Quick & Easy Ketogenic Cooking: Meal Plans and Time Saving Paleo Recipes to Inspire Health and Shed Weight by Maria Emmerich.
- Exogenous Ketones – the goal of ketosis is to get your body to produce ketones naturally, inside of the body or “endogenously”. Ketones introduced externally from outside of the body are also becoming popular, used by people who want to get the therapeutic effects of ketosis without all of the hard work. Or simply to help them transition into ketosis. I plan to test some of the claims made by many people about this specific product by KetoSports, called KetoBlitz.