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The Ketogenic Diet
The ketogenic diet is a high-fat, low-carb diet that has been trending of late. It promises to help folks lose weight, balance stubborn blood sugars, rip your abs, and help reset the body’s ability to use fats as a primary fuel supply. But is it safe?
With more than 1/3 of Americans being pre-diabetic and obese (1), shifting the body to burn fat instead of sugar and carbs for energy is an urgent need, but is the ketogenic diet the best way to do so? Let’s find out!
The ketogenic diet is different than a paleo diet. The paleo diet restricts refined and processed foods, grains, legumes and dairy, which naturally makes it a lower carb, higher protein and higher fat diet. Paleo doesn’t restrict starchy vegetables, like potatoes and tubers, while a ketogenic diet strictly restricts carbohydrates.
A classic ketogenic diet is composed of 80-90% fat, with carbohydrates and proteins constituting the remainder of the intake. The diet provides sufficient protein for growth, but insufficient amounts of carbohydrates for the body’s metabolic needs. Energy is largely derived from the utilization of body fat, and by fat delivered in the diet. These fats are converted to the ketone bodies β-hydroxybutyrate, acetoacetate, and acetone, which provide an alternative energy source to glucose or sugar. (5)
Fatty acids, in the form of ketones, are the main source of cellular energy production. Ketones can easily cross the blood-brain barrier, and can act as a powerful fuel supply for the brain and central nervous system. (5)
Shifting the body to burn fats or ketones can support the body in many ways. The ketogenic diet was first used in the 1920s for epilepsy and is still used for that purpose today. (3) It has shown to be effective for certain cancers, as it starves the cancer cells of sugar. (4) Burning ketones from a high-fat, low-carb diet has shown to be neuroprotective for the brain, boost brain mitochondria cells, reduce inflammation, boost memory, and deliver more energy and antioxidants while protecting against Alzheimer’s and Parkinson’s. (5)
Ketogenic Diet Risks
Numerous studies have found a ketogenic diet to be successful in managing weight gain and obesity. (2) Other studies contradict the use of a ketogenic, high-fat diet for weight loss.
One study compared a low-carb, ketogenic diet with a low-carb, non-ketogenic diet. The weight loss was the same for both, but cited side effects from the low-carb ketogenic diet. (3)
Other studies have found that long-term use of a ketogenic diet can cause arterial stiffness. (6) Other side effects include dehydration, gastrointestinal disturbances, such as nausea, vomiting, diarrhea, constipation, gastritis and fat intolerance. (7) Long-term use may increase the risk of osteopenia, renal stones, cardiomyopathy, secondary hypocarnitinemia, and iron-deficiency anemia. (7)
While the ketogenic diet is generally regarded as safe, in isolated cases, the long-term complications can be life-threatening. (8,9,10,11)
The Ayurvedic Perspective
Whenever I come across conflicting scientific studies, I generally like to look to ancient wisdom to help break the tie. As a hunter-gatherer, it would be impossible to eat a ketogenic diet. Remember, it was devised as a medicinal diet for epilepsy, and not as a way-of-life diet. Think about it… How could traditional people eat a diet consisting of 80-90% fat? We only recently developed techniques to press oil out of seeds and nuts. An extreme diet such as keto would be nearly impossible for our ancestors!
The only culture that came close to eating a ketogenic diet were the Inuit people of the Arctic, who had a naturally occurring, very high-fat, low-carb diet of mostly seal blubber and fish meat. Amazingly, they acquired a gene to block them from going into ketogenesis from their super high-fat diet. (12) The question begging to be asked here is, why would the only culture who naturally ate a ketogenic diet acquire a gene to prevent ketogenesis if the ketogenic diet was in fact a health-promoting diet?
The fact is that a ketogenic diet is a starvation diet. Yes, we have evolved to thrive in times of starvation and become ketogenic for short periods of time—like every spring, when food stores would commonly run out and it would be too early for a harvest. However, this kind of ketogenesis was not from eating a diet of 70-80% fat. It was from fasting!
There are natural dietary shifts that take place each season: A high-protein, high-fat diet in the winter, a high-carbohydrate diet in the summer from lots of veggies, fruits and grains, and a very low-fat diet in the spring.
Traditionally, late winter into late spring represented a time of famine, when foods were scarce as a result of a long winter with no vegetation. More hunting was done, roots were dug up, but by all accounts, food, in general, was hard to come by. Surviving the winter and early spring was a feat in itself, followed by solstice celebrations to welcome back the sun and vegetation in late spring.
This is why fasting—a popular variation of a ketogenic diet—became a part of traditional cultures. Native Americans went on fasting vision quests, and fasting religious practices, like Lent and Ramadan, are still a part of cultures today. These rituals are from times past when the early spring was a period of scarcity. Traditional life was a balance of feast and famine, with the feast being at the end of summer, and the famine being at the end of winter and early spring. Intermittent fasting was commonplace in ancient times, not only in the spring, but a day or two without food could come at any time, year-round.
Each spring, the body was forced to burn its own fat—the goal of a ketogenic diet—as a source of fuel, as there was minimal fat available in the diet. It was a natural time of calorie restriction that forced the body to reset its ability to use fat as a primary source of fuel. This form of ketosis and fat-burning was not caused by a low-carb, super high-fat, ketogenic diet, but it was, in fact, a very ketogenic time.
The beauty here is that nature only delivers such scarcity and ketogenesis for just a couple of months of the year. This is intriguing, as most of the side effects and complications of a ketogenic diet were from long-term, not short-term use. (6-11)
Dr. John’s Take
According to Ayurveda and to what we experience in nature, a ketogenic diet (as currently recommended with 70-80% fat in the diet) is extreme. It may have only been practiced by Inuits in Arctic regions—and even they acquired a gene to block ketogenesis! That said, seasonal ketogenesis, as I described above, does happen naturally every spring, as we experience food scarcity and often famine at that time.
The modern ketogenic diet, as outlined today, was created as a medicinal diet, and I believe it is still as such. It is in my opinion that with any medicinal diet, it is best to get on the diet, get better, and then get off the diet.
The ketogenic diet can be a great way to reset fat-burning for 2-week or maybe 3-week stints. Once fat-burning has been re-established, I suggest going back to a seasonal diet. To maintain fat-burning as a significant source of fuel and keep our mood, detox ability, energy, and sleep stability, we must constantly be reminded of our cultural tendency to eat too much food. We should generally strive to lower the amount of food we eat, as well as our frequency of eating.
The spring should be a time to eat less of everything. In particular, fewer carbohydrates, as they are mostly not harvested until fall. We can all do this quite naturally by following my free seasonal eating guide, where we deliver seasonal grocery lists, superfood lists, and seasonal recipes to your inbox each month.
Stay tuned this spring, as I will guide you through a natural, fat-burning ketogenic reset.