Humans have always relied on ketones for energy when glucose sources were scarce (i.e. no fruits available during winter). It is a normal state of metabolism. In fact, most babies are born in a state of ketosis. However, with abundant sources of carbohydrate, people rarely access ketosis and it becomes a dormant metabolic pathway.Our ancestors likely had frequent periods of time when high carbohydrate food wasn’t immediately available. For this reason, our bodies are amazing at adapting to burning of ketones for fuel.
This is in part because patients need to be in deep ketosis to see an impact on epilepsy, likely deeper than the average dieter, but without a nutritionist guiding you it’s still hard to get down into ketosis. It’s not exactly clear why ketosis seems to improve epilepsy, but it seems to have something to do with the brain’s use of ketone bodies in place of glucose, which only happens when you’re nearly in starvation mode. (It's important to note here that "starvation mode" is not in reference to how hungry you feel.)
Moreover, in the above study of Sumithran et al. (2013), ketosis maintains post-prandial secretion of CCK as previously demonstrated by other researchers (Chearskul et al., 2008). Note that the orexigenic effect of BHB is blocked by transection of the common hepatic branch of the vagus nerve (Langhans et al., 1985). The hepatic branch contains fibers from the proximal small intestine, stomach and pancreas, and is sensitive to CCK (Horn and Friedman, 2004); ghrelin signals to brain are also transmitted via vagus nerve (Habara et al., 2014). Thus, the effects of ketosis on these two appetite-related hormones could be one of the many factors related to the effects of such nutritional regimen on food control.
I get many questions about intermittent fasting, the health benefits, the weight loss benefits, and the like. People normally use intermittent fasting for both the energy and mental clarity it can offer. But it’s not just good for that. It can offer breakthroughs of plateaus and even benefits in nutrient uptake in exercise. We go more in depth to intermittent fasting in Week 3 and 4, so keep your eyes peeled!
Ketosis is an option for many people with type 2 diabetes because they still produce insulin, which helps their body maintain a safe level of ketones in the blood. If you’re considering trying ketosis or the ketogenic diet with type 2 diabetes, be sure to consult your healthcare provider first to ensure it’s safe for you. This eating approach may interfere with some types of diabetes medication or be inappropriate for you if you have certain diabetes complications, such as kidney damage.
As for branched-chain amino acids, you'll find smart people who swear that they're keto-friendly, and others who don't. One of the BCAAs, valine, can be glucogenic, meaning that it can lead to glucose production and potentially contribute to leaving ketosis behind. But does that mean it will happen? Not necessarily, particularly if you're just an occasional supplement user.
Ketogenic diets have become popular in recent decades for their demonstrated positive effects on weight loss (Bueno et al., 2013), though the precise mechanism of action is not fully understood (Paoli, 2014). In fact there is contradictory data about KD in mice and rats. In fact, there are contradictory data about KD in mice and rats. For example whilst a huge amount of data confirm that KD in humans is effective in weight reduction, improving lipidemia and glucose tolerance (Bueno et al., 2013), it has been recently demonstrated that a long-term KD (22 weeks) caused dyslipidemia, a pro-inflammatory state, hepatic steatosis, glucose intolerance and a reduction in beta and alpha cell mass, all without weight loss in mice (Ellenbroek et al., 2014). Two considerations should be made: (1) the induction of ketosis and the response to ketosis in humans and mice are quite different and (2) mice and humans have different life spans, and results obtained in mice after several weeks on the diet can correspond to months on the diet in humans (Demetrius, 2005, 2006).
Protein: Keep in mind that keto is high-fat, and not high-protein, so you don’t need to eat very much meat. Too much protein turns into glucose in the body, making it harder to stay in ketosis. Stick to fatty cuts of grass-fed, pasture-raised, or wild meat, and wild-caught fish. Red meats, offal/organ meats, pork, eggs (preferably pastured), fish, shellfish, and whey protein concentrate.
Dr. Perlmutter is the leading integrative medicine neurologist in North America today. His ability to fully integrate conventional medicine diagnosis and treatment with the latest innovations in nutritional and environmental medicine is phenomenal. As a teacher and clinician, he has fundamentally changed how physicians and patients think about neurological degeneration and, happily, regeneration.
Scheme of orexigenic and anorexigenic effects of ketosis. The picture is highly schematic. For more details please see the text. AMPK, AMP-activated protein kinase; CCK, cholecystokinin; GABA, gamma-aminobutyric acid; BHB, β-hydroxybutyric acid; FFA, free fatty acids; ROS, reactive oxygen species; NPY, neuropeptide Y; AgRP, agouti gene-related protein.
When glucose levels are low, especially over time, most cells will switch to using ketone bodies for fuel. Ketones allow cells to be metabolically flexible, so to speak. Even the brain and nerve cells, which are heavily dependent on glucose can utilize ketone bodies for fuel. This ability of most normal cells to use ketones when glucose is unavailable indicates that their cellular mitochondria are healthy and functioning properly.
The BBB, largely formed by the brain capillary endothelial cells, provides a protective barrier between the systemic blood and the extracellular environment of the CNS. Passage of FAs from the blood to the brain may occur either by diffusion or by proteins that facilitate their transport. Studies indicate that FATP-1 and FATP-4 are the predominant FA transport proteins expressed in the BBB based on human and mouse expression studies (Mitchell et al., 2011).
Ketones are a special type of fat that can stimulate the pathways that enhance the growth of new neural networks in the brain. A ketogenic diet is one that is high in fats, and this diet has been a tool of researchers for years, used notably in a 2005 study on Parkinson’s patients finding an improvement in symptoms after just 28 days. The improvements were on par with those made possible via medication and brain surgery. Other research has shown the ketogenic diet to be remarkably effective in treating some forms of epilepsy, and even brain tumors.
For breakfast, we are going to change it up a bit. Here’s where we introduce ketoproof coffee. Now, don’t get me wrong – I know some of you won’t like it. If you’re not a fan of coffee, then try it with tea. If you’re not a fan of the taste (which is very rare), then try making a mixture of the ingredients by themselves and eating it like that. So, why ketoproof coffee?
Ketoacidosis is a dangerous condition for diabetics, and the main element is ACID not ketones. The blood pH becomes dangerously acidic because of an extremely high blood SUGAR level (the diabetic has no insulin, or doesn't respond to insulin .... so blood sugar rises ... ketones are produced by the body to provide the fuel necessary for life, since the cells can't use the sugar). It's the high blood sugar, and the acid condition that is so dangerous. Ketones just happen to be a part of the picture, and are a RESULT of the condition, not the CAUSE. Diabetics can safely follow a ketogenic diet to lose fat weight ... but they must be closely monitored by their health care provider, and blood sugars need to be kept low, and stable.
There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.