A Ketogenic diet is a very low carbohydrate diet that is higher in fat and moderate in protein.
The term “Keto” is short for ketogenic and is named after the energy molecules that the body produces when blood sugar (glucose) levels are low enough that the body needs to switch its fuel source from sugar to fat.
Our bodies are beautifully designed to be able to use not just one, but both of these fuel types. We are actually able to switch back and forth between these states, however it is important to note that we either are in a sugar burning mode or a fat burning mode, but not both at the same time. Think of it like a hybrid vehicle that can switch back and forth between using gasoline or electricity to run.
This ability to switch fuel sources has most definitely been a major player in our ability to survive over time. Our physiology is that of hunter-gatherers. In the past, before modern times, we would have times of plenty when food was readily available, followed by times of leanness, when food was scarce and we had to be able to function and survive in either state. During the times of plenty, we would feast and fatten up a bit in order to store energy for the inevitable lean times that would follow.
When food is plentiful, especially food rich in carbohydrates (i.e. fruits, grains, root vegetables), our bodies function in sugar burning mode where we primarily burn glucose (from eating carbohydrates) for fuel and convert any excess that we eat into body fat to be stored for later use.
When food is not plentiful, or when carbohydrates are scarce, our bodies switch from using carbohydrates/sugar as fuel to burning fat for fuel. While in this state, we can tap into our stored body fat to fuel us. Part of this ability to use fat as fuel involves the liver (and to a much lesser degree the kidneys) making energy molecules from fatty acids (obtained either from the fat we eat or from our stored body fat) called ketones. These ketones can serve as a fuel source throughout the body, but especially for the brain. This is very important as the brain, unlike many other body tissues, cannot run on fat itself, but it can run on ketones.
In the past, ketones were looked at as mere by-products of fat metabolism. In fact, they were discovered in the urine of patients with uncontrolled diabetes in the mid-19th century making them a hallmark sign of metabolic dysfunction since that time.
However, we now are learning that there is much more to ketones. They are not a byproduct, but are powerful energy and signaling molecules that can have impactful health and anti-inflammatory benefits. Research is growing in this field at an exponential rate and we are most-likely just seeing the tip of the iceberg with much more knowledge to gain on how these molecules work, and how and where they can benefit us.
One of the most robust and storied areas of research showing a clear benefit of a ketogenic diet is in its use to treat intractable epilepsy. This knowledge bank goes back 100 years! More current research has expanded into many other areas and showing promise in areas like Alzheimer’s dementia, migraine and other neurological conditions. We are seeing hugely significant benefits in the treatment of obesity, diabetes, fatty liver, and other metabolic diseases. Ketones and a ketogenic diet are also looking to provide very exciting benefits as an adjunct treatment in some types of cancers, as well as in the treatment of depression and other psychological and mental health conditions.
While this data is very exciting, we must be careful not to jump on the band-wagon that ketones are a cure-all for everything that ails mankind. It is important to not get ahead of ourselves and draw conclusions that are not yet known.
Based on current literature, I am a huge advocate for the use of a ketogenic diet to treat metabolic dysfunction and believe that the evidence is there to support this. It is a powerful tool available to us that is highly underutilized. However, I do believe that the end-goal (if possible) is to establish metabolic flexibility. What does this mean? This means that for one to be truly metabolically healthy, I think the goal is that our metabolism can become so efficient that we can switch back and forth between fuel sources with ease and utilize all nutrition to accomplish our goals the way it was meant to be utilized. This can take a lot of time for many people as we essentially have been sugar burners for most of our lives and our ability to burn fat for fuel has become dormant, like a rusty old car that needs a lot of maintenance to get back to working like a well-oiled machine.
Does this mean that everyone needs to be on a ketogenic diet? No, it does not. I do believe there are health benefits to at least cycling times of being in nutritional ketosis into one’s nutrition plan generally, however whether or not you need to stay in ketosis long term really depends on why you are using the diet in the first place. For example, if you are using it to treat epilepsy, or another neurological condition, then yes, you would want to maintain it long term. On the other hand, if you were *just* looking to improve your metabolic health, improve blood sugars or are looking for weight-loss then perhaps not.
For some, just moderate carbohydrate restriction and improving the quality of carbohydrates that you eat might be enough to prevent or achieve these goals, however for some, especially if there is a higher degree of insulin resistance, then a deeper dive into actual nutritional ketosis may be needed to realize success.
The general safety of a ketogenic diet and minimization or elimination of side effects requires proper formulation that considers your unique physical adaptations and nutrient requirements. In other words, NOT ALL KETOGENIC DIETS ARE THE SAME. Unfortunately, you cannot just go online and download just any diet labeled “Keto” and get started… well, at least you shouldn’t. Obviously, getting into a state of nutritional ketosis is an important goal on a ketogenic diet, but how a person gets there in terms of food choices and nutrient quality is equally important.
Have you tried a ketogenic diet? I would love to hear your experience in the comments!