Un­der­stand­ing the Keto Diet

Q: Ev­ery­one is talk­ing about this new keto diet. What is it? And should I try it?

Amazing Wellness - - CONTENTS - — Z. Lawson, Phoenix

Ev­ery­one is talk­ing about this new diet. What is it? And should I try it?

A: Let’s just get this out of the way, shall we? The keto diet is a high-fat diet.

Those who ad­vo­cate for ke­to­genic (keto) di­ets ba­si­cally sug­gest that we re­ject the di­etary guide­lines of the past 40 years and em­brace fat—yes fat, the one macronu­tri­ent we’ve been try­ing to avoid for decades. They’re sug­gest­ing that we turn the con­ven­tional wis­dom about high-carb, low-fat di­ets on its prover­bial ear. They’re telling us that the foods we were taught were great—ce­re­als, breads, whole wheat pasta—are ac­tu­ally not, while the foods we were told were not good—an­i­mal prod­ucts and fats—ac­tu­ally are.


First, some def­i­ni­tions. The “keto” in ke­to­genic refers to ke­tones (also known as ke­tone bod­ies), which are a byprod­uct of fat me­tab­o­lism. When lots of ke­tones show up in your urine, you can be pretty sure you’re burn­ing fat, be­cause that’s where ke­tones come from. Ke­tones are a won­der­ful meta­bolic fuel for the heart, the brain, and the mus­cles. Your body makes ke­tones all the time; it just doesn’t make that many of them, since it has plenty of glu­cose (sugar) around to use for pri­mary fuel.

And that is the real pur­pose of the ke­to­genic diet in a nut­shell: to get you to burn fat, rather than sugar.

Here’s how it works. When you go on a very low carb diet—re­strict­ing carbs to 20–50 grams a day—your body’s sup­ply of con­stant glu­cose (from carbs) is sud­denly cut off. Since there’s less sugar in the blood­stream to fuel your mus­cles, your body turns up the ke­tone-pro­duc­tion ma­chin­ery, burn­ing more fat and mak­ing more ke­tones. When the ke­tones in your blood, urine, or breath rise to a cer­tain level, you’re said to be in nu­tri­tional ketosis. A diet that gen­er­ates that amount of ke­tones is known as a ke­to­genic diet.


The keto diet isn’t all that new—it’s been around since the be­gin­ning of hu­man­ity. Dr. David Perl­mut­ter, the in­te­gra­tive neu­rol­o­gist, says that ketosis is the orig­i­nal—and most op­ti­mal—state of me­tab­o­lism. It’s al­most cer­tain that our hunter-gather an­ces­tors spent most of their time in ketosis, since carbs (as we know them)

just weren’t on the cave­man menu. Cave­men would have had to be­come ef­fi­cient fat-burn­ers just to sur­vive.

Even keto diet books aren’t new. The first com­mer­cial keto diet, called “Let­ter on Cor­pu­lence,” was pub­lished in 1863 by an obese English un­der­taker named Wil­liam Bant­ing, who lost 52 pounds in about seven months eat­ing mostly meat and fat. And, of course, Dr. Robert Atkins in­tro­duced ketosis to Amer­ica as part of his orig­i­nal Atkins Diet in 1972. Atkins found that nu­tri­tional ketosis forced his most stub­bornly obese pa­tients to start burn­ing fat. In the ab­sence of car­bo­hy­drate, their bod­ies had no other choice. So for many peo­ple—though cer­tainly not all—the re­sults of be­ing in nu­tri­tional ketosis can feel a lit­tle like a mir­a­cle.

High-fat, low-carb di­ets were the stan­dard rec­om­mended med­i­cal treat­ment for obe­sity (and di­a­betes) in the first half of the 20th cen­tury, but they fell out of fa­vor be­gin­ning around the 1950s and 1960s. Di­etary fat suf­fered a re­ver­sal of for­tune in the public eye and was grad­u­ally de­mo­nized. It, along with choles­terol, was blamed for heart dis­ease and tied to obe­sity. Health or­ga­ni­za­tions be­gan rec­om­mend­ing low-fat (high-carb) di­ets, a move that ul­ti­mately led to the Di­etary Guide­lines and the an­tifat rec­om­men­da­tions we’ve been liv­ing with for the bet­ter part of 40 years. And we all know how that’s worked out.


One of the main rea­sons the ke­to­genic diet is so pop­u­lar to­day is that it lit­er­ally causes your body to switch from sug­ar­burn­ing to fat-burn­ing. Which is great, when you think about it.

Your body only can store about 1,800 calo­ries of glyco­gen, the stor­age form of carbs. But you can store about 80 gazil­lion calo­ries of fat. So if you could

ac­cess that fat, and make it your main source of fuel, you would have an in­ex­haustible sup­ply of en­ergy, you’d be burn­ing fat (and los­ing body fat), you’d be de­priv­ing can­cer cells of their fa­vorite food (sugar), and—the­o­ret­i­cally, ac­cord­ing to many ex­perts and a fair amount of re­search—both your heart and your brain would work bet­ter. As the leg­endary ul­tra-marathoner and ex­er­cise phys­i­ol­o­gist Stu Mit­tle­man once told me, “If you want to burn fat, you’ve got to eat fat.” Our meta­bolic goal is to be­come a bet­ter but­ter burner.

This changeover from a glu­cose-based fuel sys­tem to a fat-based fuel sys­tem is like chang­ing from low-oc­tane gas to diesel. It even has a name, thanks to Dr. Fred­er­ick Sch­watka, a U.S. army lieu­tenant and med­i­cal doc­tor. Sch­watka and his team went on an Arc­tic ex­pe­di­tion and be­gan eat­ing the na­tive Inuit diet—very high in fat, very low in carbs, es­sen­tially keto. They no­ticed that once they be­came what’s now be­ing called “keto-adapted,” they had bound­less en­ergy.


In re­cent decades, we’ve seen in­creases in the in­ci­dence of di­a­betes, obe­sity, heart dis­ease and Alzheimer’s. In­sulin re­sis­tance is a com­po­nent or a fac­tor in ev­ery one of these con­di­tions. And when in­sulin re­sis­tance is a fac­tor—as it so fre­quently is in meta­bolic dis­eases—ke­to­genic di­ets can be ben­e­fi­cial.

Since ke­to­genic di­ets are high in fat (and mod­er­ate in pro­tein), they don’t jack up blood sugar. When blood sugar isn’t el­e­vated, the de­mand for in­sulin is sig­nif­i­cantly re­duced. When in­sulin is re­duced, it isn’t con­stantly bom­bard­ing the cells ask­ing them to take in more sugar. Now the cells start to re­lax, and be­come more in­sulin-sen­si­tive (as op­posed to re­sis­tant). Emerg­ing re­search sug­gests that keto di­ets can re­verse in­sulin re­sis­tance, and this may well turn out to be one of the ke­to­genic diet’s great­est con­tri­bu­tions to health.

The keto diet is known to be ef­fec­tive for child­hood epilepsy and is an ac­cepted treat­ment at hos­pi­tals across the coun­try like Johns Hop­kins. The Navy—in con­junc­tion with re­searchers at the Univer­sity of Tampa—are ex­per­i­ment­ing with keto di­ets for Navy Seals.

And let’s not for­get weight loss. As Atkins dis­cov­ered, folks with the most stub­born cases of weight loss would lose weight when they were in ketosis.

If you want to try go­ing keto, here are a cou­ple of things to know:


ONE. Some peo­ple just can’t get into ketosis. Don’t worry if you turn out to be one of them. You can still get a whole lot of ben­e­fits just eat­ing low carb! ✜ DON’T GO “KETO” AT MCDON

ALD’S. A keto diet is not a rea­son to con­sume junk foods. Use high-qual­ity fats such as co­conut oil, Malaysian palm oil, grass-fed but­ter, ghee, MCT oil, or av­o­cado oil, and high-qual­ity pro­tein like 100 per­cent grass-fed beef and wild sal­mon. ✜ A KETO DIET IS NOT A HIGH

PRO­TEIN DIET. Di­etary pro­tein is made up of amino acids, and some of those amino acids can con­vert to sugar in the body, so too much pro­tein can knock you out of ketosis. Though there’s some de­bate in the keto com­mu­nity about this, most peo­ple rec­om­mend high-fat/mod­er­ate pro­tein rather than high­pro­tein/mod­er­ate fat. ✜ CON­SIDER “FLIRT­ING WITH KETO

SIS.” Don’t get too ob­ses­sive about be­ing “in ketosis.” Just aim­ing for ketosis—by eat­ing a high-fat/mod­er­ate pro­tein/ very low-carb diet—will get you a lot of ben­e­fits. ✜ WHAT I JUST SAID DOESN’T AP­PLY

TO EV­ERY­ONE. There are some very weight-loss-re­sis­tant peo­ple who will just not drop weight (body fat) un­less they’re in deep ketosis. So maybe the les­son here is that ev­ery­one’s dif­fer­ent—don’t get locked into any­thing too rigid. Just ex­per­i­ment to see what works for you.


High-fat di­ets can be low in fiber so I rec­om­mend a daily fiber sup­ple­ment, which will also help keep your mi­cro­biome happy. I also rec­om­mend 2-4 grams of EPA-DHA, the two omega-3s you get in fish oil. Most peo­ple don’t get enough mag­ne­sium, and many peo­ple elim­i­nate a lot of good mag­ne­sium-heavy foods when they’re cut­ting back on carbs, so I rec­om­mend a daily dose of mag­ne­sium. Then there’s vi­ta­min D—in the 2,000 IU to 5,000 IU range, de­pend­ing on your lev­els, which are eas­ily tested. (Al­most any rep­utable brand will do, as long as it’s in the vi­ta­min D-3 form—chole­cal­cif­erol).

I think ev­ery­one on a keto diet—or re­ally, any eat­ing plan—should still take a multi. A high-qual­ity mul­ti­ple with clin­i­cally mean­ing­ful doses of nutri­ents in the cor­rect forms is go­ing to plug all the holes in your mi­cronu­tri­ent in­take.

While all ke­to­genic di­ets have the same pur­pose—to get you into nu­tri­tional ketosis— there are mul­ti­ple ap­proaches to get­ting there. Look around and see what fits you best. There are keto pro­grams es­pe­cially tai­lored to women, per­for­mance ath­letes, re­sis­tant weight loss. There are even pro­grams that in­cor­po­rate a tech­nique called “carb cy­cling,” where you in­ter­rupt pe­ri­ods of keto di­et­ing with a “carb feast.”

No diet is per­fect for ev­ery­one or ev­ery sit­u­a­tion. But the keto diet is a pow­er­ful tool that can achieve a lot of things when it’s done cor­rectly.

Take a high-qual­ity multi to fill any mi­cronu­tri­ent gaps

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