Ketogenic Basics

Introduction Video

This video from Dr Eric Crall who discusses the ketogenic diet in detail, from how it works, the benefits of living in a state of nutritional ketosis, and the paradox of eating coconut oil, butter and beef to keep heart disease risk low.

I was raised during the 80’s and I am afraid of eating fats?

Your not alone I was raised during this generation and we has been indoctrinated into the low fat generation so covertly we all just got confused and went along with the flow.

For a history of the low fat movement to see why we are here this video lecture given by professor Tim Noakes should put everything into perspective.

What triggers ketosis in the body?

Let us not complicate things: “A Ketogenic Diet is one in which a diet is sufficiently low in carbohydrates to cause the body to produce ketones” – Some Info

When you reduce carbohydrates down, fats first enter lipolysis (about 50-150g of carbs/day).

But this is still not ketogenic and is still glucose driven but yes the body still use free fatty acids (FFAs) for energy but the brain is still using glucose, as the brain cannot utilize FFAs.

Here is where the magic happens when you reduce the carbs low enough (under 50g people tolerance differ from person to person mine at the moment is 37g) and the protein is low enough that Gluconeogenesis (GNG) can no longer generate glucose from proteins and fats to provide the body energy the body switches your bodies liver in creating ketones from FFA.

Nutritional ketosis averagely exists in the following macronutrient ratio:

This chart below shows the ratios where a well formulated ketogenic diet exists this chart uses calories and percentages on what can be tweaked this is a very rough chart showing how keogenic diets differ from Paleo etc.

Why Paelo isn’t Ketogenic – Source Youtube

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Source Dr. Stephen Phinney (Click YouTube Video)

What can I exactly eat?

Eat real foods don’t go for packaged food eat plenty of vegetables and moderate meats this is not a complete list as there are so many foods out there:

Eliminate: Sugary foods and beverages, grains (wheat, corn, rice, pasta, breads, cereals, etc.), legumes (soy and other beans), trans and partially hydrogenated fats (canola oil, sunflower oil), high-risk conventional meat and produce, and excess PUFA’s (instead, increase omega-3 oils).

Herbs, spices and extracts: Offer many health benefits and enhance enjoyment of meals.

Proteins / Fats: Meats, Baccon, Fish, Cheeses, Cream, Coconut Cream, Butter, Coconut Oil, Olive Oil, Sour Cream

Vegetables: Cauliflower, Spinach, Mushrooms, Asparagus, Lettuce, Celery, Broccoli, Cabbage, Capsicum, Zuchini, red onion

Fruits: Avocado, blue berries, black berries, strawberries

Nuts: Almonds, Peanuts, Macadamia Nuts, Pecans

Flours: Flax Seed, Almond Meal, Hazelnut Meal, coconut Flour, Lupin Flour

Additives: Xanthan gum

Drinks: Green Tea, Black Tea, Coffee, Diet Soft drink (Optimal to give up but I am not perfect)

Sensible indulgences: Dark chocolate, peanut butter, moderate alcohol, high-fat treats, lowcarb beer.

Your Macronutrients Breakdown

Its a good idea in the beginning to track the foods you eat with an app like my fitness pal to give you an idea on what your current caloric intake is.

And once you worked out your personal macros on a calculator tweaking your meals to work out how that looks in a day then it will become autonomic.

Wherever possible I recommend whole real foods eating plenty lots of vegetables moderate amounts of high quality grass fed meats and low carbohydrates.

Here are some good calculators in order of my personal preference.

http://ketogains.com/ketogains-calculator/

http://ketodietapp.com/Blog/page/KetoDiet-Buddy

http://keto-calculator.ankerl.com/

Carbohydrates

Keep carbs low do not count green veg and you can have 10g refined carbs separated every 5 hrs to avoid the insulin spike knocking you out of ketosis.

Proteins

Changes pending your height and gender but there are many schools of thought on min and max in this nutrient.

This article give a very good overview on working out your Daily Protein Requirement

There is normally no advantage to consuming more than 0.82g/lb (1.8g/kg) of protein per day to preserve or build muscle once you’re past the novice level as a natural trainee. This already includes a mark-up, since most research finds no more benefits after 0.64 g/lb.  Optimal protein intake decreases with training age, because your body becomes more efficient at preventing protein breakdown resulting from training and less protein is needed for the increasingly smaller amount of muscle that is built after each training session. – Source

But in saying this the number differs from source to source so between 1.4 -1.8g/kg  f protein per day should be safe starting point testing with a blood glucose monitor / ketone monitor will give you an indication on what level of protein you can support without going crazy as if your protein is too high then you can increase bad LDL particles and cause inflammation in the body as that excess protein turns into sugar and induces an insulin spike which when eaten in excess could knock you out of nutritional ketosis.

Ideally i find separating the protein meals over 3 meals will yield a high ketone level than consuming all the protein in 1 to 2 meals. (and i love the feeling of ketosis)

Fats

They are used to bump up the calories to the rest of your recommended intake please ensure you eat enough otherwise the body will not learn to use the FFA’s and/or you’ll start dropping weight.

Once adapted your body will be primarily running from fats the quality becomes extremely important and the correct ratio of foods with Omega 3s vs Omega 6s. While we need omega 6 in our diets the current trend of western food cooked in omega 6 oils the ratio is extremely skewed into high omega 6 ratio is known to inflammation in the body so for the most part it is better to eat meats that are grass fed and avoid unnatural processed fats like canola spreads.

This Paleo video shows why having a diet to high in omega 6s isn’t a good idea.

So eat healthy fats like coconut oil, tallow, olive oil, lard and many and many natural animal fats.

Adaptation length:

It takes around 4 weeks eating a ketogenic lifestyle strictly in order for blood ketones to reach the nutritional range 0.5 – 3.0mmol. Once adapted and eating this was for a while I find it takes me 5 days to re-enter nutritional range some people find it in 3 days.

In saying that wife surprised me and adapted into the nutritional range in only 4 days but has continued to increase so she hasn’t hit her homoeostasis level yet.

This chart shows the nutritional range that your blood ketones should be in to give an idea that your adapted:

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Source Dr. Stephen Phinney (Click for YouTube Video)

Measuring Blood ketones

I use the FreeStyle Optium Neo Blood Glucose and Ketone Monitoring device to measure my blood ketones.

Blood ketones are best measured on a fasted stomach in the morning (before breakfast, that is). here is how to interpret the result:

  • 0.0 to 0.4 -not considered “ketosis” and it is not uncommon for carbohydrate eaters to measure 0.2 in the morning
  • Between 0.5-1.5 mmol/L is light nutritional ketosis.
  • Around 1.5 – 3 mmol/L is what’s called optimal ketosis zoneValues of over 3 mmol/L aren’t necessary. That is, they will achieve neither better nor worse results than being at the 1.5-3 level. Higher values can also sometimes mean that you’re not getting enough food. For type 1 diabetics, it can be caused by a lack of insulin.

What benefits/changes when your body runs on ketone bodies rather than glucose:

More efficient at creating ATP than glucose. – Emily Deans, M.D. , Pubmed 2014 

What higher LDL levels on higher good fats is a good thing– Source A/Prof. Ken Sikaris

Weight Loss and the Ketogenic diet?

The ketogenic program has been used on children for over 100 years to help with epilepsy and if would be wrong on so many levels if the ketogenic program was for weight loss as those children would suffer severe malnutrition.

There have been people in the community that have been following a ketogenic diet for years chasing blood ketone numbers and can not figure out why their weight stall and frequently increase their fats —after the food is cooked in fat too, (eggs-already cooked in butter/cocont oil, steak/bacon–also cooked with fat, avocado, coffee) instead they blame cortisol and sleeping as the main culprit. (Not saying that isn’t a factor)

So to stress again The Ketogenic Diet is not a weight loss program even though its extremely hard to gain weight on higher fats for example Sam Feltham in UK blogged about his experiment of why he didn’t get fat eating over 5,000 calories a day not only that but he lost inches around his stomach if it was just about calories he would have gained almost 10kg.

This is the paradox of the calories in vs calories out method.

My brother is very similar to him metabolically and they just lean out and get thin on the ketogenic diet irrespective of the caloric intake.

Here is his graph of his 21 day 5,000 calories a day diet:

SamFDay21

Once your in a ketogenic state it is highly individual on how much weight you’ll naturally loose there is still so much for me to learn on this topic.

Dr Stephen Phinny’s approach about calories on adapting -> losing weight ->and maintaining – Source Youtube is key in understanding weight loss, but this may not be required for everyone, and I highly recommend eating at a maintenance level even before you consider Steve’s approach.

Keto Flu:

Keto flu is the name given to a set of symptoms some people experience when first starting keto. It’s not actually a flu and definitely not contagious, but it can become quite tiring.

Keto flu symptoms are very similar to that of your regular flu and normally last a day.

You may experience the some or all of the following symptoms:

  • headaches
  • fatigue
  • cough
  • runny nose
  • irritability
  • nausea

Many people who experience these symptoms in the beginning of their ketogenic diet will believe the diet is to blame and carbs are good after all.

But ironically, seeing these symptoms is a sign that you were very dependent on carbs!

Your body is going through withdrawal from a higher carbohydrate diet.

Solutions to Alleviate Keto Flu symptoms.

The main cause of keto flu is a lack of electrolyte balance as your body is working out the water balance drinking water is important but remember you will be flushing out electrolytes in your urine but the more the drink the better but its extremely important to replenish Electrolytes.

Keto Foods That Are High in Electrolytes

Sodium – salt, (stock) soup broth, bacon, pickles and sauerkraut

Magnesium– nuts, dark chocolate, artichokes, fish and spinach

Potassium – avocados, nuts, dark leafy greens like spinach and kale, salmon and mushrooms

Calcium – cheese, leafy greens, broccoli, seafood and almonds

Phosphorus – meats, cheese, nuts, seeds and dark chocolate

Chloride most vegetables, olives, seaweed and salt

FAQ:

I notice muscle cramping on a ketogenic diet

Magnesium, a mineral, activates over 76% of the enzymatic processes in the body and is especially critical for cellular respiration and mitochondrial function. Magnesium has to be available in order for the body to know when to switch on and off enzyme and hormone production, and it is important for muscle function and nerve transmissions as well. – LINK 

Get Magnesium from the above foods or supplement Magnesium and Calcium Supplements calcium by itself is a laxative If combined with magnesium slow down digestion and if in slow release matrix help.  – LINK

Are there risks of Impaired Kidney Function on a Ketogenic diet

“50 diabetics with protein loss from their kidneys from a ketogenic diet in the majority it got better or disappeared” – LINK

Can I do a Ketogenic diet without a Gallbladder?

“The strategy will be to spread the fat out as it is much easy to absorb emulsified fats than than liquid oil.” – Dr. Stephen Phinney – LINK

“What I tell patients without a gallbladder, you need to eat smaller high-fat meals more often so the liver can keep up with that. Become a grazer!” — Dr. Adam Nally- LINK

Will a ketogenic diet help my diabetes? 

Paul Smith wants his child to have the option of being a senior – Paul Smith – ‘Diabetes, Technology and Children’ 

Books to Read

If you wanting some good current education books to read and understand the science behind ketogenic diets I recommend the following from Phinney’s and Voleks “The art of Low Carbohydrate” series books, also the The poor, misunderstood calorie by Dr. William Lagakos Ph.D. gives a good overview on why the calories in food are not the same as those expended by the body.

9457375_orig The poor, misunderstood calorie: calories proper (Volume 1)

Click Here to see some information on Movies I have also found interesting.