Who Should Read this Book: If you’re trying to understand what all of the hype is around the Ketogenic Diet, this is a great place to start.
The book is coauthored by doctors and I’d say half of it is advice from various professionals as well as people who have been on the diet for a while. It breaks down the benefits of ketosis, how to plan your diet, common misconceptions, why certain people can’t get into ketosis, how to test your ketone bodies, and specific food plans. It has a motivational tone to it but there’s a decent amount of science and actionable advice.
But first, what are “ketone” bodies?
Glucose is the primary energy source for almost every cell in the body. This is because it can be broken down into energy much more quickly than any other fuel source, and it does this without the help of the mitochondria (the main energy producing component of the cell). Using glucose for fuel, however, comes with some negative effects. What we gain in quickness, we lose in efficiency. During the process of sugar burning more free radicals and reactive oxygen species (harmful compounds that can cause cell damage) are released and less energy is created than when we use ketones and fat for fuel. Ketones are a more efficient fuel source that inhibits the production of free radicals and reactive oxygen species. This leads to a host of benefits, especially for the brain cells that use ketones instead of sugar for fuel. For example, studies done on people with different types of cognitive issues from Parkinson’s disease to epilepsy confirm that using ketones as fuel can improve brain function tremendously.
Why are they good?
Ketone bodies provide an alternative fuel for the brain, heart, and most other organs when serum glucose and insulin levels are low—i.e., on a very low-carbohydrate diet. Ketone bodies are preferred over glucose by the heart and can be used as efficiently as glucose by most portions of the brain. There is a growing body of research supporting their beneficial effects on aging, inflammation, metabolism, cognition, and athletic performance.
A keto diet is high in fat, medium in protein, and low in carbs. The composition should be something like 80% fat, 15% protein and 5% carbs. That’s pretty tough to do, considering our modern diet is so high in carbs. I’ve experimented on and off with the keto diet, although I’m not super strict with it. The easiest way to get into ketosis is through fasting, and I do 5 day fasts on a quarterly basis. Otherwise, I have my last meal around 7pm and don’t eat breakfast (only coffee) and have my first meal from around noon (intermittent fasting), which puts me in a state of mild ketosis. This gives me enhanced focus to write and be productive in the morning — I write most of these kindle notes in the morning.
Memorable quotes from the book:
The myth that fat is bad
Most of us have been taught that a low-fat diet is the healthiest, most nutritious diet, especially for cardiovascular health. At the same time, we’ve been told that a high-fat diet is completely unhealthy because it raises cholesterol, which in turn “clogs your arteries” and leads to heart disease (an erroneous idea that we debunked in Cholesterol Clarity). In the 1950s and 60s, virtually every major health organization came out against high-fat diets even though there was no direct evidence that they were harmful to anyone’s health. They simply believed the hypothesis, promoted by Ancel Keys, that saturated fat raises cholesterol, which in turn increases your risk for heart disease. That concept was never actually tested by researchers.
For those who find it hard to get into ketosis
There are three reasons why people fail to reach a ketogenic state: too many carbohydrates, too much protein, or not enough fat. Most people who attempt to follow this approach understand the importance of limiting carbohydrates. In my experience, when they fail to do so it’s usually because of their strong cravings for sweet or starchy foods.
Getting into ketosis is harder for some than others. Dr. William Wilson explains that people with type 2 diabetes or severe insulin resistance will very likely have trouble getting their blood sugar levels low enough. He suggests two shortcuts for circumventing this issue to help you produce ketones: first, have your doctor write a prescription for a medication called metformin, and second, get an over-the-counter supplement called CinSulin, a concentrated form of cinnamon. There is also a supplement called Glycosolve, made with berberine and banana leaf, that helps to normalize blood sugar levels naturally.
How to get into ketosis
The most reliable way to get into a state of ketosis is to take carbohydrates down to 30 grams or less per day and protein down to around 0.5 grams per pound of body weight, and to consume fat throughout the day from a combination of medium-chain triglycerides (MCTs) and animal sources like butter, heavy whipping cream, and fatty meats. – John Kiefer
Testing your ketones
Avoid using urine ketone test strips as a measure of keto-adaptation. This is akin to looking for banana peels in your garbage to figure out how many apples are in your refrigerator and how many of those you are eating. Apart from only measuring ketones eliminated as a waste product, urinary ketone test strips measure only one kind of ketone, acetoacetate, and fail altogether to measure the most critical and predominantly utilized ketone in a healthy state of ketosis: beta-hydroxybutyrate. This is always better and more accurately measured with a blood ketone meter.
Studies suggest that keto-adaptation, in which the impact of glycogen depletion is no longer relevant as the body is capable of running on ketones, appears to take approximately three to four weeks in most people.