For decades, food guides have provided diet advice designed to promote people’s overall health. We’ve all seen the graphics depicting pyramids of recommended food or the sectioned plate indicating what percentage of each food group should be on our plates, but is the evidence behind these guidelines solid? Evidence suggests that people are following the guidelines but plans like following a ketogenic lifestyle are gaining popularity. If so, why are we all getting fatter despite this? Since the 1970’s we have been taught to avoid fat, especially saturated fats. However, this meant that we increased the carbs in our diet from < 40% in the 1960’s to over 50% today.

However, increased consumption of carbs, especially refined, highly processed ones, like sugars and flours, have led to obesity and diabetes. Even regular exercise cannot avoid obesity over time. You cannot outrun a bad diet – meaning a diet laden with carbs! Despite guidelines to the contrary, fat and red meat have not been shown to be harmful. Advice to avoid them has been harmful, however! More and more evidence suggest that dietary fat is essential to keep our insulin levels down and mobilize our own fat stores. Carbs stimulate insulin encouraging more fat storage and preventing fat burning (regardless of how much exercise we do!!)

This is what we know. Reducing calories or increasing exercise may cause temporary weight loss, but inevitably your body “catches on” and simply adjusts its metabolic rate to compensate. Reduce calories by 30%, and your body slows its metabolism by 30%! Also, low-fat, high-carb diets aggravate this fact as the carbs stimulate insulin, especially with advice to eat 3 meals and 2 snacks and effectively, “graze” all day. On the other hand, low carbohydrate diets have been compared to low fat diets in over 60 trials. Low carb diets have proven superior to low fat diets, with sustained weight loss for up to 2 years. Turns out high fat, moderate protein diets are very satisfying, and in fact, we tend to eat 200-300 fewer calories per day. However, as our body feels satisfied, it doesn’t reduce its metabolic rate so, we lose weight. In fact, on high fat diets, our metabolic rate and ability to oxidize fats increases as much as 3-fold, especially in athletes.

What are low carb diets? Currently on our standard western diet we consume 250-300 grams of carbs per day. Low carb diets begin at less than 150 grams per day. However, weight loss and reversal of so-called “insulin resistance” (creating by long-term high insulin levels by modern diets laden with carbs) requires much lower carb intake. Such people need very low carb diets (20-30 grams per day) which means consuming up to 70% healthy fat in your diet. This induces nutritional ketosis. When your body doesn’t ingest sugar, then insulin levels fall, fat can be liberated and sent to the liver to be turned into ketones. Brain, heart and our muscles actually prefer ketones as fuel. Our organs get lazy burning sugars. However, sugars are a very short-term fuel. This is why we “hit the wall” in endurance exercise and need to replenish our short term sugar supply. Modern athletic training techniques are emphasizing “keto-adaptation” of performance muscles to enable more sustained endurance.

Despite the various health benefits of the low-carb ketogenic diet, a substantial amount of critics claim the high fat diet is unhealthy. In today’s epoch of lazy ketoer’s, these criticisms are not without credence. As Paul Jenkins MSc, eloquently explains in his article about the ketogenic diet: “Contrary to popular keto-belief, lard, cream, cheese and butter, although keto-friendly, are a far cry from being health foods. They will not enhance your health. These foods are loaded with saturated fat and if included in to your diet, should be used sparingly.” If you intend on following a low-carb, high fat ketogenic diet to lose weight and improve your health, it is important to pay attention to the quality of foods that you eat, irrespective of their carbohydrate content. As Jenkins points out, eat foods that promote good health.

What is keto-adaptation?

Changing from regular sugar-based metabolism to a high-performance fuel, like ketones, does require time. It can take weeks or several months of commitment to switch metabolism. Early on, there is often a loss of performance due to withdrawal from sugars and starches. Further, because your muscles and brain aren’t quite sure what to do with this “high-test” fuel, much of it is wasted in your urine pulling salt, water and magnesium with them. Consumption of extra sodium and (sugar-free) sport electrolyte drinks lessen these symptoms and get you ever closer to that keto-adapted state! When keto-adapted, MVO2 increases.

It’s important to note that individual responses to the diet may vary, and the long-term effects are still an area of ongoing research. Here are some potential benefits of the ketogenic diet:

  1. Weight Loss: One of the primary reasons people adopt the ketogenic diet is for weight loss. By drastically reducing carbohydrate intake and increasing fat consumption, the body shifts into a state of ketosis, where it burns stored fat for energy.
  2. Improved Blood Sugar Control: The ketogenic diet may help stabilize blood sugar levels, making it potentially beneficial for individuals with insulin resistance or type 2 diabetes. By reducing carbohydrate intake, the diet can lower blood glucose and improve insulin sensitivity.
  3. Increased Satiety: High-fat and moderate-protein meals on the ketogenic diet can promote a feeling of fullness, potentially reducing overall caloric intake and aiding in weight management.
  4. Enhanced Mental Clarity: Some individuals report increased mental clarity and improved focus when following a ketogenic diet. The brain can use ketones, a byproduct of fat metabolism during ketosis, as an alternative fuel source.
  5. Potential for Cardiovascular Health: Some research suggests that the ketogenic diet may improve markers of cardiovascular health, including reducing triglycerides and increasing levels of HDL (“good”) cholesterol. However, long-term effects on heart health are still being studied.
  6. Therapeutic Use for Epilepsy: The ketogenic diet has been used for decades as a therapeutic intervention for epilepsy, particularly in children with drug-resistant epilepsy. It can help reduce the frequency and severity of seizures in some cases.
  7. Potential Anti-Inflammatory Effects: Some studies suggest that the ketogenic diet may have anti-inflammatory effects, which could be beneficial for conditions associated with inflammation.

Is Nutritional Ketosis dangerous?

The short answer…NO! Many confuse this natural biologic state with a dangerous disorder called diabetic ketoacidosis. Ketone levels are 10’s of times higher than in the natural low carb state. In fact, breast feeding infants start life in nutritional ketosis, and children, whose brains are still developing, and can benefit from ketones for brain development flip into ketosis much easier than adults do. The ability to switch to ketone as fuel, in times of starvation, is likely one of the major reasons that humans survived often tough evolutionary conditions since appearing on this planet!

There is one proviso to the above. There is a lot of good information on low carb lifestyles available, but, there is also a lot of questionable material on the internet. If one consumes too many carbs with the new high fat diet, then weight may actually increase, and keto-adaption will not occur. Seeking out knowledgeable health coaches or trainers, knowledgeable in low carb lifestyles and ketoadaption, is a wise strategy.

Finally, note that we use the term low-carb lifestyle deliberately. Unlike low-fat, calorie restricted diets, this is meant to be a life-long way of eating for weight management, enhanced performance and disease management and prevention. Done properly, it is very satisfying. It requires learning new recipes, but fortunately, fat is very satiating and worth the effort! Be prepared to not be hungry, to lose cravings, to recover more quickly from intense exercise, have more energy, more focus and simply be healthier.

Barbara O’Neill, RN, COHN (c), MBA, Certified Health Coach
Blair O’Neill, MD, Interventional and Preventative Cardiologist, Medical Advisor, Ketocule Health Coaching

Disclaimer. As with any change in diet, it is important to consult with your physician and ensure that your needs are being adequately met.