Starting Out – Introduction to the Ketogenic Diet
In 1996 I started Ironmagazine Online, or “Ironmag.com” for short. It was the first bodybuilding online magazine of its kind with aspiring amateur writers from all over the world. As we kicked off, I had recently been introduced to the ketogenic diet and discussed it frequently on the Usenet (the first platform for discussions on the internet – before it became mostly a way of posting files and “pirated warez”). As I got into the research and discussed various strategies, I started to experiment on my own and documented everything at Ironmag, so the public could get a glimpse of what it would be like to go on the ketogenic diet and what results it would bring.
I tried several different styles of the Ketogenic Diet – including the Targeted Ketogenic Diet (TKD), the Cyclic Ketogenic Diet (CKD) and Dan Duchaine’s version of the CKD called Body Opus. The latter got me really good results, but it was a pain to follow due to the weekly refeeds of carbohydrates – tossing you in and out of ketosis every week.
I did these experiments on and off during 1997 to 1999, and back then, the ketogenic diet variations were almost exclusively a tool for fat loss – at least in the public eye. Only a few researchers and doctors used the ketogenic diet to treat epilepsy and autism. But the science was young, and the ketogenic diet was not really thought of as an alternative “lifestyle/long-term” diet or a diet to improve health markers or to treat disease.
It was simply used as an alternative to other diets to get you as shredded as possible.
A Quick Look at the Benefits and Drawbacks of the Ketogenic Diet
As a fat loss diet, the power of the ketogenic diet lies within the fact that it’s very satiating. The protein and fat bring high levels of satiety and will effectively blunt hunger. This makes long-term dieting and getting lean quite easy for most people – because once you are fat adapted, and you run more efficient on fats and ketones, your blood sugar is more stable and insulin production is low. There’s no “crashes” where you get sleepy after a big meal. Energy is constant. This hormonal environment makes it very easy to restrict calories and tap into your fat stores for energy. This also means that a ketogenic diet as a life-long diet is very easy to maintain.
For dieters, most common “trigger foods” (sweets, junk food, etcetera) are by nature eliminated on the ketogenic diet and once you’re adapted and your palate shifts, all cravings are gone. You also don’t run the risk to binge due to “re-feedings” or having planned “cheat days” with mentioned trigger foods (or similar carbohydrate/sugary foods). And yes, your palate will always adapt to what you’re eating on a continuous basis. On the ketogenic diet you will usually start to crave savory foods and vegetables (for the crunch and texture). The transition for our taste buds to change/deprogram usually take about 3 weeks – and once this have happened, sugary foods will taste overly sweet, to the point of being disgusting.
The drawbacks of the ketogenic diet are the limited source of food choices and the potential stomach upsets from pushing up your fat intake too quickly. Some people will find the transition into ketosis to be easy and enjoyable, while others will not and may feel really bad for several weeks. There’s also a concern with electrolytes, which is one of the reasons why many feel more miserable than necessary when jumping on the ketogenic diet. This is due to the big dump of water weight that happens when your body burn off most of its stored glycogen as well as loss of subcutaneous water from reduced inflammation. This dump in water weight will simultaneously flush away a lot of electrolytes. So it’s important to increase your intake of magnesium, potassium, and sodium (as in unrefined sea salt) during the first 1 to 2 weeks. We will cover all this and much more in this series.
The reason I got back into the ketogenic diet is the recent discoveries and ongoing research into its health benefits, especially the lowering of inflammation, as well as improved clarity and alertness due to our brain using ketones as its primary fuel. As an added bonus, a ketogenic diet makes your body inhospitable to cancer cells. While healthy cells can use ketones for energy, cancer cells can only use glucose and they literally starve to death on a ketogenic diet. This makes the ketogenic diet combined with fasting the best way to treat and reverse cancer.
If you’ve missed it, my recent experiments with the ketogenic diet are available here.
Defining The Ketogenic Diet and “Being in Ketosis”
The most common eating pattern in modern societies, three meals plus snacks every day, is abnormal from an evolutionary perspective. Recent and emerging findings from studies of both animal models and human subjects propose that intermittent energy restriction periods of as little as 16 hours can improve health indicators and counteract disease processes. Restricting the feeding window to allow for a longer window of fasting is known as Intermittent Fasting and it’s also an easy way to control energy intake and improve body composition. The mechanisms involve a metabolic shift to fat metabolism and ketone production, and stimulation of adaptive cellular stress responses that prevent and repair molecular damage. This also happens to a degree when you’re in ketosis, but the benefits of ketones and low stable blood sugar are not limited to a fasting window, you benefit from these effects as long as you stay in ketosis.
This is why Intermittent fasting protocols or days of fasting combined with the ketogenic diet has risen in popularity among those interested in fighting disease, inflammation and increasing our well-being and longevity. We will look into different approaches, their benefits and how to implement them in upcoming parts of this series. First however, let us define the ketogenic diet and being in ketosis.
A ketogenic diet is a very low carbohydrate diet where the body relies on fat for fuel rather than glucose from carbohydrates. In essence, it’s a low-carb, high-fat, and moderate protein diet.
When carbohydrates are restricted, for many people below 30 grams per day of net carbs (carb tolerance for ketosis varies for all individuals), and the body’s glycogen is depleted, the liver begins to create ketone bodies out of fatty acids to fuel the brain. These ketones can be measured with ketone strips on a blood glucometer. Being over .5mmol per liter is considered to be in “ketosis”. While ketones are the preferred fuel for our brain (which is why we feel better on a ketogenic diet), our brain still need a small amount of glucose; these small quantities can be synthesized from amino acids.
When in ketosis, our body switches to burning fat, rather than glucose, as our primary fuel. This state is called nutritional ketosis and is a fully normal and safe physiological state.
Protein: this is usually where we start
When defining a ketogenic diet, we already know that we have to limit and almost eliminate all sources of net carbohydrates. This leaves protein and fat. And protein is what we will look at first.
The amount of protein within the diet depends on the individual physical state and his or her goals. Usually 1.5-2.5 grams of protein per kilogram of lean body mass is adequate. More muscular bodybuilders, or people trying to get really lean while carrying more muscle mass than the average person, might go higher; in the neighborhood of 3 to 3.5 grams. However, consuming too much protein in proportion to total calories will probably lead to an increase in gluconeogenesis; a metabolic pathway that generates glucose from certain non-carbohydrate carbon substrates such as proteins, from breakdown of lipids (such as triglycerides), from glycerol (although not fatty acids); and from other steps in metabolism where pyruvate and lactate are produced.
In other words, consuming too much protein in proportion to your fat- and total caloric intake might make it harder to stay in ketosis.
This is why the original ketogenic diet used to treat epilepsy had a very high fat intake with at least 90 % of all calories coming from fat, as a very deep state of ketosis was required to control seizures.
For improved body composition and health, such deep levels of ketosis are not necessary, nor desired. A higher protein intake is necessary for both preserving and building muscle mass, as well as providing amino acids for enzyme- and hormone production.
With that being said, current evidence points to gluconeogenesis being driven by demand for glucose, not by the supply of protein. This means that as you get more and more fat adapted and your body’s need for glucose decrease, you could probably get away with a higher proportion of protein in your diet.
Still, it’s well documented that when going above a certain level of protein intake, ketogenesis declines, even in people who’ve been on a ketogenic diet for a long time. So regardless of the involved mechanisms, as a ketogenic dieter, you probably need to limit your protein intake. And keep in mind that it’s not necessarily the amount in grams that counts as much as the ratio of calories between protein and fats in your diet. Simply put, the higher your calorie intake, the more protein you can consume and vice versa. I would say that you would want at least 70 percent or more of your energy intake to come from fats. At 75 percent from fats, that would yield 150 g of protein at a calorie balance of 2500 kcal, but only 90 grams at 1500 kcal.
Another thing to keep in mind regarding protein is bioavailability and potential inhibitors contained within the source of the desired protein. Protein bioavailability depends on the type and relative amount of amino acids available within the protein molecule. There is quite a difference between the superior source of animal proteins compared to the inferior vegetable proteins.
In practicality, this means that if you rely a lot on vegetable protein sources such as pea protein, rice protein, chlorella protein, hemp seed protein, beans, etcetera; you need to take both protein bioavailability/quality, enzyme inhibitors, and antinutrients into consideration. On average, about 65 to 75 percent of vegetable proteins are absorbed and used by the body in contrast to 95+ percent in meat, eggs, fish, and milk-based protein powders. For example, one popular choice among the zombie population is soy protein. Problem is that soy is very rich in enzyme inhibitors, phytates, phytoestrogens (functions like estrogen within the body), and allergens (28 different proteins that bind to IgE antibodies) – and on top of all these health hazards, only 61 percent of the protein is bioavailable. It’s a terrible choice for many, many reasons.
Some vegetable sources, and especially seeds, nuts, beans, legumes and grains, also contain a lot of phytates (phytatic acid), which blocks absorption of important minerals such as zinc, calcium and iron. Phytates also reduce the digestibility of starches, proteins, and fats.
To get to the main point, if you largely get your protein from vegetable sources, this could easily mean that while you counted 130 grams of protein from reading nutrition labels and calorie tables, you might actually only absorb roughly 90 grams of protein – and thereby putting you at risk for muscle loss. It could also lead to lack of specific important amino acids, which could disrupt enzyme- and/or hormone production further down the road.
Since you can’t add potatoes, rice, grains or too much of the more carbohydrate rich vegetables such as peas, corn or lima beans, it’s quite difficult to follow a ketogenic diet as a vegetarian or vegan. You might have to rely on vegetable protein powders in such case. Best options are pea/yellow pea protein isolate, rice protein isolate or a combination of them.
In the next part we’ll look at the different types of the ketogenic diet. What the differences are and what they have to offer – so that you can choose the perfect approach for you.