Ketogenic Nutrition

In this post I’m going to talk about ketogenic nutrition and why it’s useful for some people and not necessary for others. First, here are some brief guides to ketogenic diets:

• Dr. Emily Deans: Your Brain on Ketones

• Dr. Joaquin Perez-Guisado: Arguments in Favor of Ketogenic Diets

• Joseph Arcita: A Guide to Ketosis

• Dr. Michael Eades: Metabolism and Ketosis

The body goes into a state of ketosis when carbohydrate intake is restricted below a certain level. This is not to be confused with ketoacidosis. It’s an important point to make, and it seems like every low carb book is contractually obligated to make that distinction. Ketogenic diets are used in these major scenarios:

• Epilepsy – Ketogenic diets have been used for nearly a century in treating pediatric epilepsy. Going into ketosis can reduce the frequency and severity of seizures for some patients. The fifth edition of the book Ketogenic Diets by Dr. Eric Kossoff is scheduled to be released soon and includes more information on the subject.

• Cancer – Research conducted by Dr. Thomas Seyfried shows that malignant brain tumors are unable to rely on ketone bodies for energy. This makes brain tumor cells more vulnerable. I wrote about the topic further in my posts Ketogenic Diet Treatment of Brain Cancer and Can Ketogenic Diets Cure Cancer?

• Weight loss – The books by Dr. Robert Atkins promote ketosis as a way of resetting the body’s metabolism and jumpstarting the weight loss process. Some people have had success with this method, while others have had less success.

• Diabetes – A group of researchers showed that a low carbohydrate ketogenic diet allowed patients with type 2 diabetes to lower the amount of medication they required. Ketogenic diets can also reverse diabetic nephropathy.

• Migraine - Dr. Larry McCleary is a neurosurgeon who also discusses the ketogenic diet as a treatment for migraine in his book The Brain Trust Program.

• Alzheimer’s Disease – So far, there haven’t been many tests of using ketogenic diets for treating Alzheimer’s disease. One of the only experiments I know of comes from Dr. Mary Newport, who tested coconut oil on her husband. This is just a test involving one person, but if Alzheimer’s is actually a form of Type 3 diabetes that involves blood sugar abnormalities, then maybe ketosis could help improve brain function in patients with Alzheimer’s disease. Don Matesz studies the evidence further in his post Meat is Medicine.

Tim Ferriss recently introduced ketogenic nutrition to a wider audience. He references data from bariatric physicians Drs. Michael and Mary Dan Eades, who are major figures in the world of low carb nutrition. Ferriss mentions in his book The Four Hour Body that the cyclical ketogenic diet made him look incredibly lean and muscular and was the only diet that increased abdominal vascularity for him (where you can see veins popping out on a person’s body, as many bodybuilders demonstrate).

Science writer Gary Taubes recently posted his blood test results. He has very good numbers while eating lots of fat and very little carbohydrate. After reading books like The Great Cholesterol Con, though, I’m more skeptical of conventional lab measurements. Measuring indicators that relate to blood clotting seems like a more promising way of preventing heart disease.

After reading all of this information about ketogenic nutrition, I was really gung-ho to give it a try. Then I found out that while ketogenic diets are useful for people facing specific medical problems, they probably aren’t necessary for most people. Lipid researcher Mary Enig says in her book Eat Fat Lose Fat that ketosis can lead to nausea, fatigue, dizziness, and abnormal heart rhythms.

Other good information comes from the following two bloggers, who skeptically examine low carb diets as well as the standard American diet:

Anthony Colpo – a trainer and independent researcher who really knows his way around the scientific literature

Evelyn Kocur - a blogger with a scientific background who also knows how to analyze nutrition studies in detail

These writers seem to lean more towards paleolithic nutrition. The paleo diet is gaining plenty of backing from physicians and researchers. You can search for the word “paleo” in my blog archives to find some posts where I discuss the scientific rationale behind eating like early hunter-gatherers. In a nutshell, paleo researchers argue that the human genome hasn’t really changed all that much in the past 100,000 years and human beings still function best on foods that match the ones used by early humans.

I think there will still be some variation between people from different ethnic backgrounds, which is where the field of nutrigenomics comes in. One of the results included in my DNA test from 23andMe focused on nutrition. It said that people with SNPs (single nucleotide polymorphisms) similar to me will lose weight on a high fat diet but not a high carb diet. The impact of different foods on gene expression is one of the most exciting areas of science.

The following search string for PubMed is a good way of keeping up with research on ketogenic nutrition and ketosis:

ketogenic[title/abstract] OR ketosis[title/abstract] OR ketone[title/abstract] OR ketones[title/abstract]

Those search results look pretty overwhelming at first glance. The good news is that you can then adjust the search further, such as by using PubMed’s limits feature to limit the results to studies in humans for example. If you use Google to find results for “searching PubMed” or “using PubMed” you can find lots of helpful guides to searching PubMed and narrowing down searches.

Updated 12/11/2011

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