Discovering the Benefits of the Keto Diet: A Comprehensive Guide to the Ketogenic Diet

Information around ketogenic diets has spread through the internet at rapid speed, but most information centers on weight loss or why the newest trend can have consequences. When embarking on a ketogenic journey for health issues, there are going to be questions as to why and how a healing ketogenic diet can work for you. Here are a few frequently asked questions I receive within my practice.

Keto for beginners - understanding Ketogenic Diet

What is the keto diet?

The ketogenic diet, often referred to as the keto diet, is a high-fat, low-carbohydrate eating plan designed to shift the body's metabolism away from glucose towards fat metabolism. By drastically reducing carbohydrate intake, the body enters a state called ketosis, where it produces ketones from fat for energy.

What are the main rules of keto?

The main rules of the keto diet revolve around restricting carbohydrate intake while increasing the consumption of healthy fats and moderate amounts of protein. Typically, individuals following keto aim to keep their carbohydrate intake below a certain threshold, usually around 20-50 grams per day. Additionally, it's important to prioritize whole, nutrient-dense foods and avoid processed or high-carb items. Monitoring ketone levels and staying hydrated are also essential aspects of maintaining ketosis.

What foods you can eat to follow a keto diet?

On the ketogenic  diet, you can consume a variety of foods that are low in carbohydrates and high in healthy fats and proteins. This includes foods such as meat, fish, eggs, nuts, seeds, low-carb vegetables like leafy greens, and healthy fats like avocado and olive oil.

What foods are banned while following the keto diet?

Foods that are high in carbohydrates are typically avoided on the keto diet. This includes sugary foods and beverages, grains, starchy vegetables, most fruits, and processed foods containing added sugars or refined carbohydrates.

What meals can I have on a keto diet? Do I need an eating plan?

Ketogenic diet can be challenging for a beginner, but good news is that there are so many great normal diet recipes that require only small tweaks and can be easily adapted for a well-formulated ketogenic diet. Here are some of my favorite recipes for lunch dinner and dessert that your whole family will enjoy. 

If you're looking for some keto lunch ideas, this is one of my go-to chicken lunch recipes in times when I crave some comfort food.

For dinner -  this Keto Clam Chowder is to die for! We were so happy when my husband and I developed a recipe that was so tasty! 

This Gluten-free Pumpkin Pie recipe is one of our favorites! If you've never tried to make keto desserts, you'll find it surprising how good they can taste.

Is the keto diet really healthy?

It depends on various factors, including individual health goals and how the diet is implemented. While the keto diet has shown promise for weight loss and managing certain health conditions like epilepsy and type 2 diabetes , it may not be suitable for everyone. It's essential to ensure proper nutrient intake, monitor health markers, and consult with a healthcare professional before starting any new diet.

What ketone level is ketosis?

Ketosis typically occurs when carbohydrate intake is restricted, and the body begins to burn fat for fuel instead of carbohydrates. This usually happens within a few days of starting a ketogenic diet, although the timeline may vary from person to person.

How ketosis works?

Ketosis works by shifting the body's primary energy source from glucose to ketones, which are produced from fat metabolism. When carbohydrate intake is limited, insulin levels decrease, prompting the body to release stored fat for energy. The liver converts fatty acids into ketones, which can then be used by the brain and other tissues as fuel.

Why ketosis is healthy?

Ketosis may offer various health benefits, including improved blood sugar control, enhanced fat burning and weight loss, increased energy levels, and potential benefits for certain health conditions like epilepsy and neurodegenerative diseases. Additionally, some research suggests that ketosis may have anti-inflammatory and neuroprotective effects, although more studies are needed to fully understand its long-term health implications.

Advanced Keto - Main Mechanisms and Effects

There are a lot of studies that show people develop insulin resistance on high-fat diets over time. What do you make of this? What are the implications for being on a ketogenic protocol long term?

Most of this research is only on mice, and was not a well-formulated study of ketogenic diet on humans. The study done on mice was only 3 days and using vegetable shortening which we know causes insulin resistance.

There are many other studies that say the opposite. 

  • A 24 month study says "the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated."

    1. What’s actually happening is called physiologic insulin resistance or “adaptive glucose sparing,” a name that has been proposed by many to reduce the confusion with pathological insulin resistance. Dr. Ted Naiman describes it as muscles that are in “glucose refusal mode.” Prior to converting to the ketogenic diet, your muscles were the major sites to soak up and use glucose in the blood for energy. They now prefer fat as fuel on a long-term keto diet. So, the muscles are resisting the action of insulin to bring sugar into cells for energy. Hence, the slightly elevated, yet very stable, glucose circulating in the blood. The high insulin is usually only in the morning during a fasting blood glucose test.

    2. A Meta analysis says a ketogenic diet is difficult to follow long term as with any dietary changes but didn’t mention anything about safety or causing insulin resistance.

    3. In a recent systematic review and meta-analysis of randomized controlled trials comparing the long-term effects (greater than 1 year) of dietary interventions on weight loss showed no sound evidence for recommending low-fat diets. In fact, low-carbohydrate diets led to significantly greater weight loss compared to low-fat interventions. It was observed that a carbohydrate-restricted diet is better than a low-fat diet for retaining an individual’s BMR. In other words, the quality of calories consumed may affect the number of calories burned. BMR dropped by more than 400 kcal/day on a low-fat diet when compared to a very low-carb diet.

    4. The fear around ketogenic diets comes from the earliest researched KD studies which had much stricter macros pertaining to protein and fat. For example these were 8% for carbohydrates, 90% for fat, and approximately 7% for protein.  This is actually unsafe for most humans long term, especially children. Ancestral ratios are higher protein and 80% fat maximum. I typically recommend 50-75% fat and 15%- 45% protein with 20-30g or less of carbs.

    5. In another article, the research on ketogenic diets is misrepresented and promotes fear surrounding it. It states the negative effects from a ketogenic diet causing optic neuropathy by citing a study stating the actual cause was due to thiamine deficiency and not KD.

    6. This more recent study shows healthy low carb diets lowers all causes of mortality. Compared to an older meta-analysis "Conclusion: Low-carbohydrate diets were associated with a significantly higher risk of all-cause mortality and they were not significantly associated with a risk of CVD mortality and incidence. However, this analysis is based on limited observational studies and large-scale trials on the complex interactions between low-carbohydrate diets and long-term outcomes are needed.”

What are the effects of therapeutic levels of ketosis vs moderate levels? What is the difference happening inside your body? What are the therapeutic & moderate number levels? 

  • Mild ketosis from an overnight fast not even eating ketogenic is BHB .1-.4 mM/L and supplies 2-6% of body’s energy needs 

    1. Moderate ketosis 1-2 mM/L (carb restriction or extended fast 1-2 days)

    2. Therapeutic ketosis above a 2-10mM/L (carb restriction or 1 or more week of fasting) 30-40% of body’s energy

When would you recommend the keto mojo (blood draw) vs. a breath-meter for measurement? 

Breath meters are not as accurate- they are measuring excess ketones. What we want to know is what is circulating in the body and being used. I always recommend blood meters.

What exactly is happening in your body when you’re in dietary vs moderate ketosis and why is it so beneficial? Something about mitochondria, please explain! And how does that translate into the real life bodily reality of a person? 

Dietary ketosis vs. metabolic ketosis (MCT oils on high carb diets will give you dietary ketosis but not metabolic ketosis) metabolic ketosis is using body fat as fuels not fats from diet.

We use dietary ketosis to help stimulate metabolic ketosis because this is your body’s natural check and balance system for energy production inside your cell. What is happening in the cell during glucose burning is that there are ROS (reactive oxygen species) oxidative byproducts that are released. The body wants to use ketones to allow the cell to clean up the “garbage byproducts” from glucose burning. Ketones are cleaner energy sources and are required for an extended period of time with certain chronic diseases to allow the body to regenerate and reset by reducing inflammation.

What situations call for a ketogenic diet? What symptoms can you look for to know whether or not keto is the best option for you? Aka: who should be on a keto diet and who should not? 

  • Neurological diseases: Alzheimers, Parkinsons, epilepsy, ALS, Huntington’s, traumatic brain injury, stroke

    1. Autoimmunity

    2. CFS/Fibromyalgia

    3. Low Heart Function: Blood lipids, blood pressure, blood sugar, and insulin levels, inflammation, and body fat all respond well to ketogenic diets. “hydraulic efficiency of the heart is increased by 25 percent in comparison to glucose

    4. Immune suppression- in cases of cancer the body needs Ketones so that glucose and glutamine do not feed the cancer cells and ketones activate a suppressed immune system

    5. Hormone sensitivity

    6. Chronic Virus infections- ketogenic state is a natural antiviral state

    7. Ketones rapidly act on the mitochondria in the Brain and Nervous system and Immune system cells

    8. Disease states that do well with a ketogenic diet.

Long-Term Considerations:

How long is too long to be on a ketogenic diet? Can you be on it for the rest of your life if you want? Do some people need to be?

Ketogenic is safe long term. Inuits are in mild ketosis as well as other indigenous tribes that don’t eat high fat but are also in ketosis.

People who need to be in ketosis include: insulin resistance, mitochondria dysfunction, cancer, active autoimmune diseases, menopausal women.

How do you know when it’s time to come off a ketogenic protocol? 

After maintaining remission for 3-6 months

Hormonal Regulation in Ketosis

Hormonal Effects:

Going on a ketogenic diet resets your blood sugar regulation which is the root imbalance of all hormonal symptoms. Blood sugar dysregulation leads to estrogen dominance. Ketones also improve cellular communication so hormones communicate better to the cell receptor sites. Also, a ketogenic diet naturally removes most high estrogenic foods and so this resolves estrogen dominance for most people very quickly.

  • You say it can help hormonally induced cancer. How?

    • By reducing pro-estrogen-dominant foods in the diet. 

    1. Why does ketosis make your hormones so regulated?
      Best periods of my life since I got my copper (non hormonal) IUD 7 years ago. Is it really regulated blood sugar or something specifically related to being in ketosis?

Medical Applications of Keto Diet

Addressing Specific Health Conditions: Does ketosis benefit parasite & candida/yeast problems beyond starvation? 

Yes, with the immune and nervous system. A ketogenic diet resets the systems and then your immune system can handle the “infection” on its own.

Is keto- chemopreventive? Aka if cancer runs in someone’s family or they are worried about getting cancer, would going on a keto diet preemptively prevent that? 

Definitely! Because ketones help remove the dead cells that can be carcinogenic and because you can practice more fasting while in ketosis you are allowing your body to do autophagy which is its natural process of deep cleaning.

Exploring Glyconutrients in Ketogenic Diets

 Glyconutrients are essential, but lacking in the modern diet. what are they & where are they?

8 essential sugars: mannose, glucose, galactose, xylose, fucose, n-acetylglucosamine, n-acetylgalactosamine, n- acetyl neuraminic acid. These form the basis of glycoforms which cover the surface of all cells. Glyconutrients provide the essential saccharides (sugars). However, not always sweet and have a profound effect on the immune system. Foods: aloe, shrimp shells, bone marrow, onions, carrots, etc.

Does fermenting ferment out glyconutrients? 

Yes, some.

What role do glyconutrients have in a ketogenic protocol? How many carbs do you have to ‘spend’ on them per day?

Depends on the condition but the more you can do the better while maintaining high ketone levels.

Do you need all 8 glyconutrients in a day? Or how often do you need them?

You can use them individually or all together. Most people are deficient in all so they can be used synergistically.

With the excess of misleading information on ketogenic diets, these questions often come up within my practice. In short, the ketogenic diet is a powerful way to improve health, benefiting conditions like neurological problems and hormonal imbalances. By focusing on burning fat for fuel instead of carbs, it can boost energy and control blood sugar. However, it's important to approach it carefully, especially with guidance from healthcare professionals, to ensure safety and effectiveness. 

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Easy Keto Recipe for Starch-Free Clam Chowder