Information and benefits of the Ketogenic Diet
What Is Ketosis?
Ketosis is a natural metabolic state that allows the body to burn fat (dietary and stored body fat) as a primary fuel source instead of glucose/glycogen.
The body enters the metabolic state of ketosis when it is depleted of its glycogen (stored form of glucose in the muscles and liver). Stored body fat will then begin to be metabolized for energy. The bi-products of metabolized fats are known as ketone bodies or simply ketones.
There are different types of ketones that are produced, there are Aceto-Acetate, Beta-Hydroxy Butyrate and Acetone. Aceto-Acetate is the first ketone that is produced, it is produced from Acetyl-Coenzyme A in the liver, and once they leave the liver they will convert into Beta-Hydroxy Butyrate. Beta-Hydroxy Butyrate is a hydrophilic salt that enters the cells of the body very easily to create energy. Beta-Hydroxy Butyrate is then reconverted into Acetyl-Coenzyme A once the energy has been produced. The Acetyl-Coenzyme A then re-enters the Citric Acid Cycle, also known as the Krebs Cycle and will be used to create more energy.
Acetone is created when there is enough ketones circulating in the body, the excess Aceto-Acetate spontaneously destroys themselves into Acetone and is excreted via the breath and urine. We do not yet know the true purpose of the Acetone ketone body.
Aceto-Acetate and Beta-Hydroxy Butyrate are the ketones used for energy by the muscles, organs and the brain. A Standard Ketogenic Diet comprises of high fat, moderate/adequate protein and ultra-low carbohydrate.
This diet promotes the process of ketosis over time. Over this period of time, the body will adapt to function without glucose and will increase its efficiency to metabolize fat for fuel. This process is known as fat-adaptation.
The Ketogenic Diet & Oxidative Stress
When creating mitochondria/energy, we create reactive oxidant species or oxidative stress. This is stressful to the body as well, this causes glutathione secretion and other substances just to neutralize these free radicals.
According to the journal of neuroscience, ketosis enhances cellular respiration in the mitochondria, it uses the oxygen more efficiently reducing excess oxygen circulating and oxidizing cells. This reduction of oxidative stress in turn reduces overall stress on the body, resulting in a reduction of cortisol which will reduce gluconeogenesis which will reduce blood glucose levels which reduces insulin secretion.
The Ketogenic Diet & Stress
When carbs are consumed and digested, glucose levels in the blood stream will rise and to restore normal blood glucose levels, the body will release insulin and the insulin will put this glucose in the muscles and liver as glycogen as stored energy. When glycogen storages are full, excess glucose is transformed into fat.
The body creates a hormone called glucagon which releases glycogen from the muscles and liver back into the blood stream to keep the blood glucose supply levelled. This causes a constant oscillating cycle causing stress within the body. This rapid increase and decrease causes the body to secrete cortisol, a stress hormone. When the body is in ketosis, insulin levels are mostly at baseline due to the absence of glucose in the body which prevents the stress cycle. Ketosis also has a positive effect on stress within the mind. Ketones have the ability to create a balance between GABA (Gamma Amino Butyric Acid) and Glutamate. GABA causes the mind to feel calm, sharp and mentally focused, it reduces stimulation and promotes relaxation.
Glutamate in excess can cause brain fog and it promotes stimulation. But ketones have the ability to convert excess glutamate into GABA to obtain homeostasis. This balance causes the mind to function optimally. When the GABA and Glutamate are out of balance, excess cortisol is produced, which will increase fat burn, but will increase visceral fat which increases insulin resistance and will raise inflammation and increase appetite. Cortisol also breaks down protein into glucose (Gluconeogenesis, the liver also has this ability) and can remove you from ketosis.
The Ketogenic Diet & Metabolic Flexibility
Metabolic flexibility is the ability for your body to efficiently switch from 1 type of fuel for another type of fuel. The 2 fuel types the body uses are glucose and fat.
As most people’s diets consist of high amounts of carbohydrates based on the Standard American Diet (SAD), our bodies have become efficient at burning glucose but at the expense of metabolizing fat at a decreased efficiency.
When on a properly formulated ketogenic diet, carbohydrates are restricted, protein intake is defined adequately based on the individual’s lean body mass and activity levels and the remainder of the calories consumed come from a variety of fats.
When the body is deprived of glucose, it will deplete the glucose stored in the muscles and liver, known as glycogen first. When the glycogen is depleted, the body will begin to look for another source of fuel. The body will begin to burn fat, but not optimally at first because the genes have been adapted to burn carbohydrates efficiently at the expense of being able to burn fat. There is an adaptation period which varies upon the individual. This adaptation can cause brain fog, nausea and low energy levels for the individual. This is commonly called the “Keto-Flu”. This occurs because the body is in transition from burning glucose to burning fat and the body is looking for energy that has been completely depleted and the energy that is available (body fat) isn’t burning optimally to support normal energy levels requirements.
The body hasn’t developed the necessary levels of enzymes to breakdown fat and the mitochondria isn’t utilizing the ketones being produced at the cellular level efficiently just yet. Also the “Keto-flu” can occur in individuals because the body becomes efficient at flushing out minerals, especially sodium. So it is very important to increase/maintain sodium levels to approximately 5 grams/day.
Sodium is approximately 40% of the weight of salt. The other main minerals to consume are Potassium and Magnesium.
Over a certain amount of time, again this will vary upon each individual, the genes will adapt to metabolize fat at a higher rate of efficiency. Energy levels will gradually increase and stored body fat will be used as a source of fuel.
This phase is called keto-adaptation and can be achieved in a matter of weeks. The full spectrum of keto-adaptation can take several months or years for certain individuals.
The Ketogenic Diet & Appetite Control/Reduced Cravings
Ketosis affects blood sugar in a positive way. A diet high in carbohydrates triggers sugar cravings as carbohydrates is the macro nutrient that spike your blood sugar levels the most. The body then secretes insulin to regulate your blood glucose levels and places the glucose into your cells. Once the insulin has done its job, your body will crave carbohydrates again to elevate your blood glucose levels.
These ups and downs will be continuous when consuming a diet high in carbohydrates. Over time, when lowering carbohydrate intake, blood glucose levels will stabilize, the crashes will cease and so will the carb/sugar cravings.
When eating, a hormone called cholecystokinin (CCK) is secreted to stimulate the release of digestive enzymes and bile from the pancreas and gallbladder. It is secreted into the intestinal tract by the enteric nervous system (known as the gut nervous system) that communicates directly with the brain. The enteric nervous system is sometimes referred as the 2nd brain and it communicates directly with the hypothalamus.
When full and levels of CCK increase, the enteric nervous system tells the brain it’s time to stop eating because CCK primarily tells the body to start producing digestive enzymes and to produce bile. When it comes to digestion, the body doesn’t like to multi-task and if it’s time to digest the body wants to stop consuming.
CCK also slows down the emptying of the stomach content. When full, the body doesn’t want to evacuate the stomach content in the intestinal tract immediately making digestion much too difficult. CCK slows down this process.
The ghrelinergic cells in the gastrointestinal tract produce ghrelin, a neuro peptide hormone, also known as a hunger hormone, that has the ability to communicate directly with the brain and is secreted when the stomach is empty.
In general, when dieting or restricting calories, there is an increase in ghrelin levels. According to the European Journal Study of Clinical Nutrition, when in ketosis, there is a decrease in ghrelin production. This decrease in ghrelin will cause the body to crave less food.
The Ketogenic Diet & Mitochondria Biogenesis
Mitochondria Biogenesis means creating new mitochondria, or creating new energy.
Our cells contain powerhouses that are responsible for creating mitochondria. These powerhouses create ATP (Adenosine Triphosphate), which is the energy currency in the body.
Many illnesses, such as cancer, diabetes and auto-immune diseases all start with a breakdown of mitochondria which then further cascades into other chain of events which leads to the illness. Mitochondria is under constant resistance from a variety of reasons like heavy metals in the diet, poor lifestyle choices, pollution, chemicals, toxins, uncontrolled stress, radiation, viruses, microbes, refined sugars, GMO’s and even over exercising. These all over create free radicals that damages the mitochondria production. Free radicals make the cell membrane unstable and damage the mitochondria. This is also known as oxidative stress because it involves oxygen. This oxidative stress has a damaging effect on various parts of the cell, like the membrane, DNA and genes.
Antioxidants and phytonutrients help in neutralizing these free radicals. A properly formulated ketogenic diet enhances mitochondrial function and a reduction of the creation of free radicals. But it is still important to consume a variety of antioxidants and phytonutrients to balance out the damages being created from the environment & lifestyle and the damages being created naturally as a byproduct of mitochondrial production.
90% of energy is created from mitochondria. NADH, a coenzyme, (Nicotinamide Adenine Dinucleotide Hydride, a powerful form of vitamin B3, known as Niacin) is used by enzymes embedded in the inner cell membrane to generate ATP.
Oxygen arrives and combines with highly charged particles that are a direct result of the CREB CYCLE, consumed nutrients get converted into NADH (Positively charged) then the NADH crosses through the cell membrane and mixes with negatively charged liquid in the cells creating energy. ATP is created, used and then turns into ADP (Adenosine Diphosphate, the uncharged version of ATP), ADP is then combined with phosphate which then creates ATP. This process is known as Oxidative phosphorylation.
The ketones created allow the energy making process in the mitochondria to go much faster, smoother, and creating more heat.
The Ketogenic Diet & Cholesterol
On a ketogenic diet, your body adapts and becomes efficient at burning fat as a primary fuel source, these fats start to breakdown into fatty acids where they will be mobilized in the blood stream and they will be used as fuel. High levels of cholesterol on a ketogenic diet is linked with weight loss.
As these fats start to breakdown, we begin to see an increase in lipids in the blood and an increase in cholesterol levels. As the triglycerides are broken down into fuel, the cholesterol remains in the blood stream and doesn’t get burned for fuel. It travels in the blood stream waiting to get recycled by the liver. This is neither positive nor negative, it is just elevated and is an indication the body is using more fat for fuel.
This increase is temporary. Once the body’s composition has been altered and at a plateau, cholesterol levels will go down. HDL (High Density Lipoprotein) and LDL (Low Density Lipoprotein) are not cholesterols, they are lipoproteins, which means this is where the cholesterol goes into, and it’s a transport vehicle that delivers the cholesterol to the body.
The function of LDL, the so called “bad cholesterol” is to delivers fat nutrients to the body. The function of HDL, the so called “good cholesterol” is to pick up waste particles or unused cholesterol that was previously delivered by the LDL and bring it back to the liver so it can be recycled.
LDL is not bad and is necessary. It does oxidize easier than HDL and this oxidation changes the state of the lipoprotein. LDL oxidation occurs with the consumption of sugars/refined carbohydrates and even excess iron in the diet. Excess iron oxidizes LDL rapidly as LDL responds negatively to iron. It triggers a very specific inflammatory response on kynurenine, a metabolite of tryptophan and is used in the production of Niacin, the B3 vitamin. Kynurenines are on the LDL particle and respond to iron and allow the oxidation process.
Iron is one of the major causes of LDL oxidation. LDL has different particle sizes, they are pattern A and pattern B. Pattern A is large & fluffy and this is the state LDL should be in. This state of LDL delivers nutrients and fat soluble antioxidants to the cells. They fight off free radicals that would normally oxidize them. Pattern B is small & dense and doesn’t have the room inside to carry nutrients and antioxidants. Because they are so small, they can travel into the endothelium layer of the arteries and buildup over time.
According to the Journal of lipids and Archive of internal medicine, they have found that a well formulated Ketogenic Diet dramatically increases the amount of pattern A particles and decreases the amount of pattern B particles. Although an increase will be noticed, the ration between pattern A and pattern B will change. This increase is not artery clogging but a sign that more fats are being delivered.
The problem is when an LDL pattern A particle combines with a free radical, it causes a chemical reaction that causes it to be sticky and causes them to aggregate and build up in the arterial walls. This not only causes clogged arteries, but also triggers more inflammation causing narrowing of the arterial walls. With oxidized LDL, it inhibits the production of nitric oxide, a signaling molecule which dilates blood vessels, raises blood supply and lowers blood pressure.
The presence of oxidized LDL creates plaque, swollen arteries and a reduced ability for blood vessels to relax. The plaque can further be divided into 2 types, stable and unstable. Stable plaque can stick to the arterial walls, but the body can adapt by building around this plaque. The cells adapt, the walls adapt and the arteries get bigger. When LDL combines with free radicals, it creates unstable plaque. The main issue with unstable plaque, is when it doesn’t have good structure, it can break free, clog a vessel or artery causing a stroke or heart attack.
Oxidized LDL can contribute to a fatty liver. The LDL cells get enveloped with white blood cells and end up going in the liver and they envelope the other white cells present in the liver that are normally there to fight off pathogens making the liver function below capacity creating future problems. Diabetes, heart disease and other metabolic syndromes all start with free radicals and inflammation, not with the consumption of fat.
The Ketogenic Diet & Fatty Liver Disease
Fatty liver disease is also known as hepatic steatosis or just steatosis. This is when the liver is inflamed with triglycerides and develops fatty tissues. This occurs when you have more fat than your liver can process and metabolize. Excess carbohydrates, especially fructose since it goes directly to the liver and it cannot be metabolized as energy by the organs and muscles.
Refined sugar is 50% glucose and 50% fructose, High-Fructose Corn Syrup (HFCS) is usually 55% fructose, but can be as high as 90%. Fructose does not spike blood glucose levels and does not trigger an insulin response but has an immediate effect on triglycerides.
A well formulated ketogenic diet decreases Intrahepatic Triglycerides (IHTG). Triglycerides are the building blocks of free fatty acids, which are then used as fuel for energy. When the body is fat adapted, the triglycerides are awaiting to be converted into free fatty acids circulating in the blood stream to be used as fuel. When on a high carb diet, the excess of triglycerides that are not being used will be stored in the liver.
If we decrease the amounts of IHTG, we decrease the amount that are standing by ready to become free fatty acids. This decrease is a pre-cursor of a non-fatty liver. This happens because of the reduction in fasting glucose and fasting insulin levels. When there is a restriction in carbohydrates, this will cause insulin levels to drop and insulin sensitivity increases and blood glucose levels lower. This cascade is what contributes to preventing/reversing fatty liver disease.
When insulin sensitivity is restored and optimized, our bodies will have the ability to use carbohydrates more efficiently when consumed and will make them less likely to stay stagnant in the blood stream to contribute to fatty liver disease. This is also an important factor in managing/reversing type 2 diabetes.
The Ketogenic Diet & Skin Disorders
Acne is usually a high androgen situation. High levels of androgen can increase oily skin and can promote acne if it’s too high. The trigger for androgen is insulin. Cortisol, a stress hormone, can also increase insulin levels which can lead to an increase of androgen.
Some people can develop skin issues in times of high stress because of the cortisol, insulin and androgen relationship.
A well formulated ketogenic diet will have a high amount of healthy fats. This increase of healthy fats will help with essential fatty acids which will be beneficial for the skin. Introducing intermittent fasting with a well formulated ketogenic diet is a very powerful combination to promote healthy skin. Intermittent fasting will improve the gallbladder, the gallbladder is pear-shaped and is located beneath the liver. This period of not consuming food will give the gallbladder a chance to recharge & recycle the bile.
Bile is a fluid that comes from the liver and then stored into the gallbladder via the common hepatic duct and releases it via the common bile duct into the duodenum, where the bile helps in the digestion of fats.
With intermittent fasting, there will be more bile available and more fats will be extracted from food and will extract more vitamin A for the skin. Vitamin A is a key vitamin for clearer skin.
The Ketogenic Diet & PCOS (Polycystic Ovarian Syndrome)
Insulin resistance is the primary cause of PCOS (Polycystic Ovarian Syndrome). There is usually high levels of androgen and irregular/no menstrual cycles happening. Some symptoms of PCOS are:
• Facial hair
• Deep voice
• Belly fat
• Hair loss
• Male pattern baldness
• High blood pressure
• Ovarian cysts/follicles
A female with a lean body mass gets the majority of her estrogen from the ovaries. When body fat is elevated, the fat cells will create estrogen also. Both types of estrogen are structurally identical.
The difference however is that the ovaries will listen to the rest of the body when deciding to make estrogen or not. When the ovaries produce the estrogen, the hormone levels are regulated based on the time-of-the month, pregnancy, nutrition and brain function. The ovaries factor in signals from your brain, adrenal glands, the uterus and stress levels.
The fat cells will produce estrogen nearly all the time. They do not factor in the above signals, estrogen is produced in an unregulated manner, the higher the body fat percentage, the more estrogen is produced by the fat cells. An over-abundance of estrogen leads to abundant androgen. This is what will cause PCOS. PCOS is also known as type 2 diabetes for ovaries. Normalizing insulin levels is the only way to reverse PCOS.