People choose to make changes to their dietary routines for a number of reasons. Some want to lose weight, others want to improve athletic performance, and sometimes we are forced to make changes based on a medical diagnosis or condition.
Starting anything new for the first time naturally involves a bit of unease. With so many facets to wellbeing, starting a new diet—especially one as provocative and ever-evolving in new research as a ketogenic diet—might make you feel the same way.
It’s very easy to tell someone “just eat better” when talking about weight loss. However, this type of simple-minded attitude towards dieting does a disservice to the complex topic of full-body health and to those who make the conscious choice to improve it. It can also be damaging psychologically because making drastic dietary changes isn’t easy for a lot of people so they might feel bad about themselves if they fail.
When making any lifestyle change, it’s important you have all the information available. Maybe you’ve heard of the keto diet and want to give it a try. We’re here to help make the seemingly complex topic digestible, and provide resources to help you make the best decision when adopting keto for your health and wellness goals.
You may think that the coffee or energy drink you're sipping on is what gives you the energy to make it through the day.
While it may feel as if you have wings after downing one of these tasty beverages, the reality is that you only think you have energy based on how caffeine interacts with receptors and neurotransmitters in your brain.1 The actual physiology behind how our bodies derive energy from food sources is a lot more complex and can’t be bottled.
The body’s main source of energy is derived from a molecule called adenosine triphosphate (ATP).
It is considered the body’s “metabolic energy currency” and approximately 30 kilojoules (kJ) of free energy is released when one phosphate molecule is cleaved off per mole (an SI unit equivalent to 6.022 x 10^23 of a particle) of ATP broken down (more on that soon).2 A kilojoule is a unit of energy, similar to a calorie, which we use to determine how much energy we derive from food (1 calorie = about 4 kilojoules).
The body’s specific concentration of ATP is tightly regulated in order for the body to maintain a number of physiological processes such as cell signaling, macromolecule synthesis, cell structure, and muscle contractions working efficiently.3,4,5
You may have heard the phrase “counting your macros” tossed around online. But what exactly is a macro?
Macros, short for macronutrients, are energy-providing nutrients that your body needs in ample quantities in order to generate ATP and ensure proper growth and development.
The essential macronutrients are protein, carbohydrate, and fat. Water, fiber, and alcohol are also technically classified as macronutrients. However, water and fiber do not provide energy and alcohol is classified as “non-essential.”
During times of energy surplus—usually after a high carbohydrate or high fat meal—the body stores energy-generating substrates derived from macronutrients to be mobilized when energy demands are high (i.e. during exercise).6
Although a ketogenic diet focuses on eliminating most of one macro—carbs—while compensating with an increase in dietary fat, it’s still important to understand how the body uses all three major macronutrients to maintain homeostasis (a state of equilibrium for every day, normal body functioning).
Understanding macronutrient ratios is important to successfully attain all of the benefits of a ketogenic diet. We’ll get into more detail on this later on but as you read on, it’ll be good to keep in mind the basic principles of keto macros and the rational behind it: moderate protein (prevents the body from naturally synthesizing glucose, something that can be done with protein), low carb (causes the body to utilize all stored carbs), and high fat (promotes endogenous fat utilization).
Protein is the key macromolecule that provides the body with structural support and is also a key player in signaling cascades that regulate a number of biological processes.7
The building blocks of protein are molecules known as amino acids, which play a role as intermediates in a number of metabolic processes.
There are 21 amino acids common to all forms of life on earth. Of those, humans are unable to synthesize nine of them, making them “essential” to be obtained via the diet, while another six are considered conditionally essential.8
Branched-chain amino acids (BCAAs) are a sub-group of essential amino acids which include leucine, isoleucine, and valine. Not only do BCAAs promote a number of signaling pathways involved in protein synthesis / turnover, but they also have a role in glucose and fatty acid metabolism.9 Furthermore, they are able to cross the blood-brain barrier and provide substrate for the production of neurotransmitters and cerebral protein synthesis.10,11
But protein’s primary biological functions revolve around building muscle mass / promoting protein synthesis, leading to increased strength and / or aiding in muscle repair and recovery.
The main player in stimulating protein synthesis is a signaling protein mammalian (or mechanistic) target of rapamycin, or mTOR.
When protein rich food is consumed, the amino acids that are released, specifically essential amino acids, are able to directly stimulate mTOR. This causes an increase in signaling that promotes muscle protein synthesis and turnover.12
BCAAs, specifically leucine, are able to both activate muscle growth as well as prevent muscle protein breakdown following strenuous efforts as when exercising.13 Therefore, the consumption of protein is essential for maintaining lean muscle mass.
When protein is broken down, its primary purpose is to be converted to usable energy via the process of deamination (removal of an amino group) so that the amino acids can enter the Krebs / Citric Acid (TCA) Cycle to generate ATP.14 Protein catabolism provides about four calories (roughly 17 kJ) of energy per gram.
However, because protein is essential to maintaining the structural integrity of a number of tissues, the body does not readily utilize protein for energy. Rather, energy is primarily obtained from the breakdown products of carbohydrates and fats first and, as a last resort, is obtained from protein as a means of self-preservation to avoid muscle wasting.15
With regards to a ketogenic diet, it should be noted that it is NOT a high protein diet. It is important to eat a moderate amount of protein, as too much protein in the diet can be converted to glucose via a metabolic process known as gluconeogenesis and knock you out of a fat-burning state.
Carbohydrates are the sugars and starch found in a number of foods—they’re the body’s primary physiological energy source.
Carbohydrates have numerous physiological roles. Chiefly among them is supplying energy to cells as sugar molecules known as glucose which are stored in muscle tissue and the liver as glycogen chains.16 Carbohydrates, particularly a carbon-based molecule known as ribose, provides structure for ribonucleic acid (RNA) and deoxyribonucleic acid (DNA)—both important components of our genetic machinery.17
Since stores of ATP are limited in the body, it needs to be resynthesized from a breakdown of molecules, such as macronutrient substrates, from adenosine diphosphate (ADP), adenosine monophosphate (AMP), or inorganic phosphates. The production of ATP from glycogen (the storage form of glucose molecules) involves a multistep process called glycolysis.18 The end product of glycogen breakdown includes molecules which facilitates the continued generation of ATP for sustained activity.
Carbohydrates are also an essential energy source for the body. Typically, carbs are classified into one of two categories: complex or simple carbohydrates.19
Complex carbohydrates are composed of long(er) glycogen chains than simple carbohydrates.
Because the chains are longer, they also take longer to breakdown and therefore provide longer lasting energy than simple carbs. Examples of complex carbohydrates include fiber rich foods like brown rice, oats, but also refined foods like whole-wheat bread. Simple carbohydrates include micronutrient rich fruits, milk, but also sugary drinks and candy.
There is also the consideration of a term called “net carbs.” Net carbs, sometimes also referred to as digestible carbs, refer only to the carbohydrates, both simple and complex, that are absorbed as individual glucose units.
Since the body can only absorb individual glucose molecules rather than complex glycogen chains, some carbohydrates—like fiber and alcohol—can’t be broken down chemically or are only partially absorbed. A net carb calculation subtracts fiber from the total carbohydrate count, simply accounting for those that are ingested.
Carbohydrates have an energy content of four calories/g of carbohydrate (or about 16.7 kJ/g). The advantage of eating carbohydrates is that the energy is released quickly for use. However, we’ll see in the next section, that there’s another macronutrient that provide more energy “bang for their buck.”
Nutritionally, when we talk about fats, we’re often referring to molecules of glycerin with three chemically bonded fatty acid tails attached. These form molecules called triglycerides that are essential for a number of important biological functions.20
Fats are the most energy-dense macronutrient (and, therefore, the most efficient at storing energy). They’re also are used to maintain hair and skin health, regulate body temperature, and, most importantly, comprise the outer “shell” of cells (lipid bilayer); therefore fats are an important structural and maintenance molecule in the body.21,22
The two main types of triglycerides that you may recognize are called saturated and unsaturated.
Saturated fats have hydrogen bonds attached to every carbon atom where available, thus “saturating” the molecule.23 These types of fats are usually solid and room temperature and have a higher boiling point than unsaturated fats.
Due to their supposed correlation with increased risk of cardiovascular disease, saturated fats have often borne the brunt of concern with regards to being detrimental to health. Recent studies, however, have shown this to be inconclusive.24
In fact, saturated fats derived from medium-chain triglycerides (MCTs) have been shown to offer a number of health benefits such as increased energy, mental clarity, reducing food cravings, and better engaging the body’s burning fat processes.25,26
Unlike saturated fats, unsaturated fats are more likely to be liquid at room temperature. This is due to one or more of their carbon-carbon double bonds causing a kink in the fatty acid chains (melting temperature decreases as double bond number increases). These types of fatty acids can be further classified as either monounsaturated fatty acids (a single double bond) or polyunsaturated fatty acids (multiple double bonds).
Monounsaturated fats are a staple of what is considered a “Mediterranean” diet— one that is high in vegetables, fruits, whole grains, beans, nuts and seeds. Food products high in monounsaturated fats, such as olive oil and peanut oil, have been shown to improve not only cholesterol profiles (lower LDL and potentially increase HDL) but also lower risks associated with diabetes, neurodegenerative diseases, and cardiovascular diseases.27
Polyunsaturated fatty acids, often referred to as “good fats,” are found in foods like salmon, avocados, and seeds and are rich in omega-3 and omega-6 fatty acids, which have been shown to have holistic benefits for cardiovascular and neurological health.28,29
Among the polyunsaturated family are two essential fatty acids: alpha-linolenic acid (omega-3 fatty acid) and linoleic acid (omega-6 fatty acid).
These are considered essential because they cannot be synthesized from other smaller fatty acids or molecules and are required for a number of biological processes including cellular function, signaling and inflammation responses.30,31
Furthermore, all other fats required by the body can be synthesized from these essential fats and / or any other fat including the other non-essential omega-3s and omega-6s we hear about, namely eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and arachidonic acid (AA).
With regard to absorption, unlike carbohydrates, which are absorbed from the bloodstream and transported through to muscle via the aid of insulin (released when we eat carbs and protein), fats are absorbed without insulin in the intestines before transport through the blood.32
MCTs in particular are more easily taken up by the intestines than long-chain triglycerides because they do not require energy or bile salts to be digested and / or stored.
Unlike the four kcal/g energy content of proteins and carbohydrates, fat has an energy content of nine kcal/g (~37.7 kJ/g), making it an excellent reservoir of stored energy and the underlying premise of why a ketogenic diet may be an effective long-term health option for some.
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Low-carbohydrate diets have become a popular dietary strategy for weight loss. This is due to the fact that there can be a marked loss of initial weight and, if adhered to properly, a healthy and consistent loss of weight as time progresses.
You may have heard of one of the most popular, and hotly debated, low carbohydrate diets: the ketogenic diet.
But what exactly is a ketogenic and how does it differ from other low-carb diets?
Low carbohydrate diets operate on the principle that, by minimizing or removing carbohydrates from the diet, the body’s natural metabolic processes will switch to use fat as a primary source of energy.
This is where the term “burning fat” originates; it may ultimately result in fat mass loss.33
There are different levels of low-carbohydrate diets, from moderately low carbohydrate intake to very low intake as seen in a keto diet.
Moderately low carbohydrate diets typically keep daily carbohydrate consumption to under 100g net carbs. A diet that falls under this category could be the Paleo diet, which encourages the consumption of whole foods that our Paleolithic ancestors would have foraged for.
Both a Paleo and keto diet discourage excess consumption of processed sugar (like those found in sodas and cakes), but the Paleo diet allows the consumption natural sugar sources from foods like fruits and honey.
Low carbohydrate diets, like the Atkins diet, recommend an intake no greater than 50g net carb These carbs, depending on diet, are sometimes slowly reintroduced and / or increased as weight loss goals are met.
Many people confuse a ketogenic diet for being a version of the Atkins diet.
This assumption stems from both keto and Atkins being extremely low carb. But keto is far stricter on carbohydrate consumption: about 20g - 50g net carbs or ~5% - 10% of daily caloric intake.
Not only does a ketogenic diet have a lower total carb intake than Atkins, but it also maintains that low carbohydrate state in order to keep your body in a state of ketosis. Furthermore, an Atkins diet suggests higher protein intake to compensate for the lack of carbs, whereas a keto diet increases fat intake (from healthy sources like avocados and salmon) to make up the difference.
Low-carbohydrate diets have been shown to potentially have a number of health benefits. These include (but aren’t not limited to) controlling appetite / reducing cravings, enhancing memory and neurological health (especially with regards to epilepsy), reducing inflammation, and lowering blood pressure / risk of heart disease, and lowering high blood sugar / treating type 2 diabetes.34,35,36
Normally, a ketogenic diet is described as high-fat diet (70% - 80%) with very low-carb (< 5% - 10%) and moderate protein (10% - 15%) intake.
The idea behind a ketogenic diet is to consume the appropriate ratio of macronutrients in order to switch the body’s primary fuel source from carbohydrates to fat. This helps achieve a state of ketosis: a metabolic state by which the body derives its energy from the products of fatty acid breakdown knowns as ketones.
The production of ketones occurs via a process called ketogenesis (hence the term “ketogenic” diet).
In order for the body to utilize fat, whole body and liver stores of the carbohydrate-derived substrate, glycogen must be significantly depleted.37 The simplest way to achieve this is through the restriction of dietary carbohydrates, hence why a ketogenic diet advocates for < 5% - 10% of daily caloric intake coming from carbohydrates.
Through the elimination of glycogen, the body activates a series of metabolic pathways that free fatty acids from adipose tissue (body fat) and breaks them down to ketone bodies (or ketones). Ketones are water-soluble molecules that contain a chemical structure known as a ketone group and are produced during low carbohydrate diets, but also during periods of prolonged intense exercise or fasting.38
The continual production of ketones results in ketosis, the body’s metabolic “fat-burning” state.
When fatty acids are freed from adipose tissue (typically when blood glucose is low), they circulate to the liver where ketones are produced. These ketone bodies then enter the energy-generating Krebs cycle, leading to the eventual production ATP for energy.
After starting a ketogenic diet, it usually takes about 2 - 4 days for the body to burn through its glycogen stores and enter into ketosis. After a few weeks on the diet, you’ll likely be “fat adapted,” and your body will begin to efficiently burn fat as its primary substrate for energy.
It should be noted that ketosis is not the same as ketoacidosis, which you may have heard used interchangeable when talking about ketones.
Ketoacidosis is a medical condition that is characterized by high levels of circulating ketones in the blood as well as high blood sugar.39 This wouldn’t be possible on the keto diet, in which high ketone levels are usually a result of low levels of glucose in the blood.
Ketoacidosis is sometimes called diabetic ketoacidosis (DKA) because it’s a condition most commonly seen in type 1 diabetics as a result of their inability to produce insulin.40 Low levels of insulin are also a metabolic signal for increasing fatty acid catabolism, hence the increase in circulating ketones even when a normal western diet (roughly 60% carbs, 30% protein, and 10% fat) is being consumed.
This combination of increased blood glucose (which isn’t taken up from the blood due to insulin’s absence) and elevated ketone levels results in a highly acidic blood pH that can be very detrimental to your health.41
It is also sometimes seen in alcoholics where alcohol abuse severely depletes liver glycogen stores, causing an increase in ethanol metabolism which blocks the production of glucose (i.e. gluconeogenesis).42
The mitochondria (which is “the powerhouse of the cell” or where metabolic energy is generated) is the organelle in the cell where ketone bodies are broken down for use as energy-generating substrates.17
AcAc is what is considered a “true” ketone due to the fact that it is the only ketone body with a chemical structure called a “keto” group—one carbon double bonded to an oxygen molecule and two other carbons bonded to hydroxyl (double bonded to an oxygen + bond with a hydroxide molecule).
BHB and acetone technically do not follow this chemical structure.
BHB and acetone are also derived from AcAc when catabolized for energy. There is little AcAc found in the blood since it’s considered to be less stable than BHB and acetone. In order to get energy from AcAc, it must either enter circulation for delivery via bloodstream transport (which, due to its instability, is rare), undergo a series of enzymatic reactions (primarily in the liver) that reduces it to the more stable BHB which enters the TCA cycle for energy production, or it can be reduced spontaneously (i.e. no enzyme) to form acetone.44
When on a ketogenic diet or fasting, blood ketone levels of BHB increase proportionally to fat utilization.
Normally, the ratio of circulating BHB to acetoacetate is about 1:1. However, on a ketogenic diet (or when fasting), when fat is being used as the primary metabolic fuel source, this ratio can rise up to 6:1.17
As for acetone, you may have heard of it as a key chemical component of commercial products, such as nail polish remover. However, there’s definitely more to acetone than merely cosmetic value.
It has seen use as a potent solvent in the medical field, specifically in its ability to help dissolve fat and aid in tumor detection in lymph nodes.45 It’s easy to think of acetone as the ketone outlier because it’s the least abundant ketone and not utilized as fuel (since it is technically a “waste product” resulting from the enzymatic breakdown of AcAc).
However, the breakdown to acetone allows for an easy route for determining whether or not one is in a state of ketosis.
Acetone is normally present in the blood and urine, which means that small blood prick samples or pH sticks can help detect ketone levels relatively accurately. Acetone is also exhaled through the lungs, hence why some people on a ketogenic diet have a distinctive “keto breath.”
The hardest part of starting a keto diet is just that—starting!
A typical ketogenic diet is all about adhering to a strict range of macronutrient ratios that allow the body to remain in ketosis: 70% - 80% of calories from fat, 10% - 15% from protein (20% - 25% if on a more liberal keto diet), and < 5% - 10%% from carbohydrates.
These proportions are great for those of us who are analytical thinkers, but for most, it is a difficult thing to imagine without a plate of food in front of us.
Macro-tacking health apps or keto calculators are great tools to employ that can help you see what and how much of each macronutrient the foods you’re eating contains. This can then help you plan out strategies on which foods to eat and keep you on track with your goals, especially for those special occasions when you go out to eat. Being social can be part of a keto lifestyle!
Remember, the goal of a keto diet is to ideally consume less than 50g net carbs per day if on a 2000kcal per day diet. This is admittedly difficult for some right off the bat. Don’t be discouraged! It’s OK to take your time.
Starting slow is a great way to ease your body into this metabolic shift while refining your keto meal plan.
Before becoming a full blown keto-master, it could be a good idea to start limiting intake. Try going under 75g net carbs per day and slowly working your way down over the course of a few weeks in order to hit that ketosis sweet spot.
Remember, it’s a marathon, not a sprint. You want to be able to not only maintain your eating habits for the period you’re on the diet, but also apply its benefits towards a long term lifestyle change.
In order to compensate for a reduction in carbs, we’ll need to offset this with foods low in carbs and higher in fat.
Just to be clear, by fat, we mean a focus on consuming “good fats” rich in omega-3 and omega-6 fatty acids for added health benefits.
When starting a ketogenic diet, your focus should be on incorporating as many whole foods as possible that are packed with both macro and micronutrients (vitamins, minerals, and antioxidants). Not only do you have more control over what is in your meals this way, but also it avoids any unwanted processed ingredients.
If time hinders your ability to cook meals (we get it—life is busy), quick and easy keto shakes and smoothies are a delicious and nutritious way to incorporate nutrients into your diet when you’re on the run. These can keep you on track with your keto dieting goals. This can be accomplished through a combination of whole foods and a number of supplements that are keto friendly.
We recommend opting for good quality protein or collagen powders, in order to bolster the protein profile of the drink. MCT oil is also a great way to incorporate good fats into a smoothie or shake, especially ones high in C8 caprylic acid. This is a type of MCT that has been dubbed the most ketogenic due to its ability to be converted into ketones quickly.
Also, don’t be afraid of eating “too much” fat!
Remember—the focus of fats on a ketogenic diet should come from healthy sources like avocados, almonds, and coconuts. Consuming more fats when in ketosis not only results in more energy but also in increased feelings of satiety (we’ll touch on that more in the health benefits section below).
Here’s a list of foods to consider that are low in carbs and / or high in fat:
And don’t worry, just because you start on a ketogenic diet doesn’t mean you have to be on it forever to get the benefits. Once you figure out how easy it is to get into ketosis, it’ll be a cinch to come back to it when you need that extra boost in your health and wellness journey.
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In fact, many people do cyclical dieting—strict dieting for a set period of time followed by a more “relaxed” diet—to either kickstart a state of ketosis or to metabolically “reset” to better obtain the benefits that are found with a ketogenic diet.
However, a full-blown keto diet may not be for everyone, either due to the restriction being too stringent or their lifestyle requires a different balance of nutrients (i.e. athletes). And that’s totally fine. The good news is that there are other ways to get the benefits of ketones without fully committing to a ketogenic lifestyle.
In addition to cyclical dieting, some people in the keto community incorporate periods of moderate fasting (i.e. intermittent fasting) to kick start getting into ketosis. A short 16 - 36 hour fast will deplete muscle glycogen stores faster than a keto diet alone and can help you become “fat adapted” quicker.
Lastly, another avenue some may find beneficial in exploring is the consumption of exogenous ketones. Exogenous simple means “obtained from an outside source.”
In this case, we’re referring to ketones that can be consumed via a supplemental means or that can be consumed as a precursor to ketone production.
The benefits of supplemented exogenous ketones, such as H.V.M.N. Ketone Ester, is that one is able to maintain carbohydrate stores in the body while also having circulating ketones in the blood to use for energy. While more research still needs to be done in this area, it is a promising avenue of dual energy-generating systems working to benefit athletes looking to boost performance.
Drastically reducing carbohydrates is probably the trickiest part for most people to adjust to, because it is a pretty big shock to a system that is designed to get most of its fuel from carbohydrates and glycogen.
Here’s a list of higher carb foods to avoid:
The last item above highlights an especially important consideration: be sure to read nutrition labels as a lot of items can contain hidden ingredients.
You’d be amazed at how many premade and / or so-called “healthy” food items have hidden sugars, starches or other flavoring ingredients that could potentially knock you out of ketosis.
To reduce the temptation to eat these, it may be best to eliminate them from your pantries entirely. Out of sight, out of mind, right?
The only real “restriction” of a ketogenic diet is the limit on the amount of carbs you can consume. Otherwise, a ketogenic diet is actually really flexible.
There’s no need to deprive yourself of foods or over complicate things with calorie counting. All you need to be able to do is keep track of the macronutrient profile of the foods you eat to ensure fat is being used for fuel.
When you consume a standard carbohydrate diet or a high carb meal, excess carbs are stored in the liver and muscle as glycogen, which is also bound with water molecules at a rate of 2g - 3g water per 1g of carbohydrate.46 Obviously as you deplete carbohydrate stores, you store less water, making you more prone to dehydration, and it can also flush out a lot of electrolytes from the system.
The dehydration from the loss of bonded water is also something that can easily be overlooked on a keto diet. This can easily be alleviated by drinking more water.
Not only will drinking more help remedy hydration, it will also help your kidneys if you happen to consume extra protein. Keep in mind that moderate protein intake is key for a ketogenic diet— roughly 0.5g of protein per pound of body.
Not only can a keto diet dehydrate you, it can also flush out key electrolytes, specifically potassium, sodium, and magnesium, which are beneficial for mental clarity. A common “side effect” of the first few days on a keto diet is what is called the “keto flu.”
It is a general feeling of lethargy, mental fogginess and general “flu-like” symptoms that are due to your brain having to switch from carbohydrates to ketones for energy. Replacing lost electrolyte can be as easy as spiking a beverage of choice with electrolyte supplements, drinking bone broth (high in collagen—a protein found in connective tissues), or by simply adding some extra salt to your food.
And lastly, the best companion to any diet (and a great lifestyle choice in general) can be exercise. Combining exercise and its benefits with the health benefits of a keto diet will not only leave you feeling more confident and happy, but it may also help you drop weight you’re looking to shed faster.
For most, the biggest benefit they’re hoping to gain from starting a ketogenic diet is to lose weight. But there are a number of other health benefits to a keto diet that you may not have been aware of.
Here we’ll touch on a few key research-backed benefits of a ketogenic diet to encourage you along your health journey.
On a ketogenic diet, fat becomes the driving macronutrient from which your body gets its energy, as opposed to carbohydrates. As mentioned above, in order to obtain the energy, fat (or adipose tissue) needs to be broken down.
So, naturally, the amounts of fat mass will likely decrease on a ketogenic diet as energy requirements from fat increase.
A 2002 study looked at body composition changes associated with a low-carbohydrate diet over the course of six-weeks. The authors concluded that, “carbohydrate-restricted diet resulted in a significant reduction in fat mass and a concomitant increase in lean body mass in normal-weight men.”34
This is important to note because muscle is not only responsible for strength and contraction but also helps regulates the uptake of energy-generating molecules and their utilization.47
Muscles store molecules used for both short-bursts of energy (in the form of creatine phosphate) as well as long-term energy use—namely in the form of glycogen (chains of glucose stored in muscle).
Glucose uptake into muscle is regulated by the presence of insulin. Interestingly enough, the authors of the aforementioned study attributed the loss of fat mass / increase in muscle mass observed in those on a ketogenic diet at least partially to a reduction in circulating insulin concentrations.”34
Insulin is the primary hormonal regulator of blood glucose (sugar) uptake into muscle cells.
Since a ketogenic diet focuses on a lower intake of carbohydrates, insulin secretion and effectiveness is able to be better managed as a result of decreased “glucose spikes” from high-carbohydrate foods.
For those who are diabetic, insulin is either not produced in sufficient quantities by the pancreas (type 1 diabetes) or the receptor proteins on muscle cells become “resistant” to insulin (type 2 diabetes) due to overstimulation from high circulating blood glucose levels. In both scenarios, without proper management, glucose is unable to get into cells, remains in the bloodstream, and results in damage to blood vessels and other organs.
Research on ketogenic diets have been shown to benefit diabetics by specifically improving insulin sensitivity.
A 2005 study in type 2 diabetics showed that, at least in the short term (two week dietary intervention), a ketogenic diet not only improved insulin sensitivity by 75% but also decreased plasma triglyceride and cholesterol levels decreased by 35% and 10%, respectively.35
More research is presently needed to see what the long-term effects of a keto diet are, particularly on blood sugar level management.
In addition to insulin, you may have heard the term “ghrelin” mentioned when talking about diet and appetite but might not have any clue as to what it is.
Ghrelin is a hormone that is produced in the gastrointestinal tract. It regulates appetite by acting on the hypothalamus and reward-centers of the brain.
When stimulated, this leads to increased food intake and a promotion of fat storage.48 Interestingly, ghrelin also stimulates the release of growth hormone from the pituitary gland, which actually works to break down fat and build muscle.49
In a 2018 study the ingestion of a ketone ester drink (the predecessor to H.V.M.N. Ketone Ester) following an overnight fast significantly lowered blood ghrelin levels. This resulted in a controlled level of perceived hunger as well as a decreased desire to eat.36
As we mentioned above when talking about properties of ketones, these substrates of fatty acid breakdown have the ability to cross the blood-brain barrier and have seen clinical applications in a number of beneficial models regarding neurological protection in disease states such as Alzheimer’s, Parkinson’s, and Epilepsy.
Interestingly, a ketogenic diet was initially developed to help control seizure episodes in individuals who suffer from epilepsy.
A multicenter study carried out by researchers from Johns Hopkins University found the frequency of seizures in children (n = 51; aged 1 - 8 years old) with epilepsy who were prescribed a ketogenic diet decreased to over 50% in over half of the children over the course of a year on a ketogenic diet. Ten percent of the children even went seizure-free for the whole year.50
With regards to neurological protection, migraines are severe headaches that affect ~15% of adults in North America and Western Europe.51
A 2014 study investigated the efficacy of the ketogenic diet in preventing migraine flare ups and found that frequency, length, and reliance on medication decreased significantly in those in the cohort who consumed a keto diet.52 However, when transitioning off a keto diet, symptoms worsened which indicates further research needs to be done to further elucidate the diets efficacy on migraines in the long term.
Preliminary research also indicates that a ketogenic diet may also provide protection in elderly adults at risk of developing Alzheimer’s.
Following a six-week intervention period where individuals were given either a high or low carbohydrate diet, the researchers unsurprisingly observed a reduction in weight, waist circumference and blood glucose levels as a result of low carb intake. However, verbal memory performance was also observed to be significantly improved in the low-carb subjects.53
The authors concluded that the findings “indicate that very low carbohydrate consumption, even in the short term, can improve memory function in older adults with increased risk for Alzheimer's disease [and that] further investigation of this intervention is warranted to evaluate its preventive potential and mechanisms of action in the context of early neuro-degeneration.”
There’s no doubt that the ketogenic diet has been one of the most talked about diets in recent years. And while it may not be a strategy for everyone to adopt, there is ample evidence as to some of its more well touted health benefits.
As with many things in life, you get out of it what you put in. If you’re able to put in the time, planning, and dedication to stick to the keto diet plan as well as incorporating other healthy practices such as exercise, there is no reason why you should not absolutely crush your goals.
We hope this overview has equipped you with enough knowledge to feel confident in starting your own keto diet adventure.
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