Almost everyone knows someone who has used a low carb diet. They have used it themselves had a friend use it or are getting ready to use it. Are these diets magic? Are they safe? Can I really eat all of the cheese and meat I want? Will I die if I go into ketosis?
These are just a few common questions I hear in regards to questions that concern low carb diets. In this series of articles I will present readers with scientific facts and my practical observations for implications concerning low carb diets. Some low carb supporters will not like what I will have to say. Some low carb haters will not like what I have to say. The objective of these articles are to educate readers on the practical implications of low carb dieting. Some will be offended and some will say how can that be. Either way sit back and enjoy as I attempt to shed light on the highly talked about topic – low carb diets (ketogenic diets)
I have provided a brief overview of some the topics that will be discussed in this series of articles.
What type of changes occur while using low carb diets
Do low carb diets make me mean
Do low carb diets spare muscle
Can I gain weight on a low carb diet
How much weight can I expect to lose
Can this diet help my medical condition
Different types of low carb diets
Why you need to cycle higher days of carbs
Who needs low carb diets
Are they safe for children
Are they beneficial for athletes
The topics mentioned above are just a few that will be addressed in Low Carb Dieting.
Before we move any further let me introduce the word ketogenic. Must of you reading this article are probably familiar with the world as it implies low carb or restriction of carb intake. Simply put for our purposes the words ketogenic and low carb are synonymous. A couple of other comments I would like to make before we move on. This comment is for Low Carb supporters that swear of all vegetables and fruits. Get on medline.com and do some research. Go to the library and look through some journals. A complete diet for long term use needs to incorporate greens and some fruits to be healthy. A short term diet devoid of fruits and vegetables might not be that bad, but rejecting greens and any fruits for life is a bad idea.
This comment is for the low carb haters. One of the number one reasons most of America is fat is because of chronically high insulin levels. Which is primarily contributed to excessive carb intake. Don't get me wrong I am not blaming high carbohydrate intake on all of our obesity problems. I should probably say excessive and the wrong types of carbohydrate at the wrong times are the problem. At the same time the answer is not to eat all of the saturated fat we can find: which can contribute to insulin insensitivity, elevated TG's, increased lipogenesis and digestive problems.
What is a ketogenic diet? A diet that causes ketone bodies to be produced by the liver, and shifts the body's metabolism away from glucose in favor of fat burning. A ketogenic diet restricts carbohydrates below a certain level (generally 100 per day). The ultimate determinant of whether a diet is ketogenic or not is the presence or absence of carbohydrate. Protein and fat intake vary. Contrary to poplar belief eating fat is not what causes ketosis. In the past starvation diets were used often to induce ketosis. I will repeat myself again and say lack of carbohydrate or presence of ultimately determines if the diet is ketogenic.
In most eating plans the body runs on a mixture of protein, fats and carbohydrates. When carbohydrates are severely restricted and glycogen storage (glucose in muscle and liver) is depleted the body begins to utilize other means to provide energy. FFA (free fatty acids) can be used to provide energy, but the brain and nervous system are unable to use FFA's. Although the brain can use ketone bodies for energy.
Ketone bodies are by products of incomplete FFA breakdown in the liver. Once they begin to accumulate fast and reach a certain level they are released, accumulated in the bloodstream and cause a state called ketosis. As this occurs there is a decrease in glucose production and utilization. There is also less reliance on protein to meet energy requirements by the body. Ketogenic diets are often referred to as protein sparing as they help to spare LBM whiled dropping body fat.
In regards to ketogenic diets there are two primary hormones- insulin, glucagon that need to be considered. Insulin can be described as a storage hormone as it's job is to take nutrients out of the bloodstream and carry them to target tissues. Insulin carries glucose from the blood to the liver and muscles, and it carries FFA from the blood into adipose tissue (stored fat triglyceride). On the other hand glucagon breaks down glycogen stores (especially in the liver) and releases them into the blood.
When carbs are restricted or removed insulin levels drop while glucagon levels rise. This causes enhanced FFA release from fat cells, and increased FFA burning in the liver. This accelerated burning of FFA in the liver is what leads to ketosis. There are a number of other hormones involved with this process as well.
In general we refer to three different types of ketogenic diets.
1) STANDARD KETOGENIC DIET- A diet containing l00 or less grams of carbohydrates is referred to as STANDARD KETOGENIC DIET
2) TARGETED KETOGENIC DIET- consuming carbohydrates around exercise, to sustain performance without affecting ketosis.
3) CYCLICAL KETOGENIC DIET- alternates periods of ketogenic dieting with periods of high carbohydrate intake
The Beginning of Ketogenic diets
Originally ketogenic diets were used to treat obesity and epilepsy. In general ketogenic diets are similar to starvation diets in the responses that occur in the body. More specifically these two states can be referred to as starvation ketosis and dietary ketosis. These similarities have led to the development of modern day ketogenic diets.
Ketogenic dieting has been used for years in the treatment of childhood epilepsy. In the early 1900's times of total fasting was used to treat seizures. This caused numerous health problems and could not be sustained indefinitely.
Due to the impracticalities and health problems occurring with starvation ketogenic diets researchers began to look for a way to mimic starvation ketosis while consuming food. They determined that a diet consisting of high fat, low carb and minimal protein could sustain growth and maintain ketosis for a long period of time. This led to the birth of the original ketogenic diet in 1921 by Dr. Ronaldo Wilder. Dr Wilder's diet controlled pediatric epilepsy in many cases where drugs and other treatments failed.
New epilepsy drugs were invented during the 30's, 40's and 50's and ketogenic diets fell to the wayside. These new drugs lead to almost disappearance of ketogenic diets during this time. A few modified ketogenic diets were tried during this time such as the MCT (medium chain triglycerides) diets, but they were not welly accepted.
In 1994 the ketogenic diet as a treatment for epilepsy was re-discovered. This came about in the story of Charlie a 2yr old with seizures that could not be controlled with mediacions or other treatment including brain surgery. Charlie's father had found reference to the diet through his research and ended up at John Hopkins medical center.
Charlie's seizures were completely controlled as long as he was on the diet. The huge success of the diet prompted Charlie's father to start the Charlie foundation. The foundation has produced several videos, and published the book The Epilepsy Diet Treatment: An Introduction to the Ketogenic diet. The foundation has sponsored conferences to train physicians and dietians to implement the diet. The exact mechanisms of how the ketogenic diet works to control epilepsy are still unknown, the diet continues to gain acceptance as an alternative to drug therapy.
Ketogenic diets have been used for at least a century for weight loss. Complete starvation was studied often including the research of Hill, who fasted a subject for 60 days to examine the effects. The effects of starvation were very successful in regards to treatment of the morbidly obese as rapid weight loss occurred. Other characteristics attributed to ketosis, such as appetite suppression and sense of well being, made fasting even more attractive for weight loss. Extremely obese patients have been fasted for up to one year and given nothing but vitamins and minerals.
The major problem with complete starvation diets is the loss of body protein, primarily from muscle tissue. Protein losses decrease as starvation contines, but up to one half of the total weight loss can be contributed to muscle and water loss.
In the early 1970's Protein Sparing Modified Fasts were introduced. These diets
allowed the benefits of ketosis to continue while preventing losses of bodily proteins.
They are still used today under medical supervision
In the early 70's Dr. Atkins introduced Dr. Atkins Diet Revolution With millions of
copies Sold the diet generated a great deal of interest. Dr. Atkins suggested a diet limited
in carbohydrate but unlimited in protein and fat. He promoted the diet as it would allow
rapid weight loss, no hunger and unlimited amounts of protein and fat. He offered just
enough research to allow the diet recognition. Although most of the evidence
supporting the diet was questionable.
During the 1980's Michael Zumpano and Dan Duchaine introduced two of the earliest
CKD's THE REBOUND DIET for muscle gain and then the modified version called
THE ULTIMATE DIET for fat loss. Neither diet became very popular. This was likely
due to the difficulty of the diet and the taboo of eating high fat.
In the early 90's Dipasquale introduced the ANABOLIC DIET. This diet promoted 5
days of high- fat-high protein-low carb consumption whle eating high carbs and virtually
anything you wanted for two days. The diet was proposed to induce a metabolic shift
within the five days of eating low carbs (30 or less). The metabolic shift occurred as your
body switched from being a sugar buring machine to a fat-burning machine.
A few years later Dan Duchaine released the book UNDERGROUND BODYOPUS: MILITIANT WEIGHT LOSS AND RECOMPOSITION. The book included his CKD diet which he called BODYOPUS. The diet was more specified than the Anabolic Diet and gave exercise recommendations as well as the basics concerning exercise physiology. Most bodybuilders found the diet very hard to follow. The carb load phase required eating every 2 hrs and certain foods were prescribed. I personally loved the book, but felt the difficulty of the diet made it less popular. In this author's opinion Ducahine's book is a must read for anyone interested in Nutrition.
Ketogenic Diets have been used for years to treat specific conditions such as obesity and childhodd epilepsy. The effects of these diets have proven beneficial in a number of these well documented cases, but for some reason when we mention any type of low carb diet (ketogenic diet) people begin to tell us about how their doctor or friend told them it would kill them or how that diet was shown to damage the liver or kidneys. Keep in mind epileptic children have been in ketosis for up to three years and shown no negative effects; quiet the opposite. The weight loss in morbidly obese patients has been tremendous and the health benefits numerous. Maybe before coming to the conclusion that all types of ketogenic diets are bad other factors need to be considered as activity levels, type of ketogenic diet, length of ketogenic diet, past eating experience, purpose of ketogeninc diet, individual body type and response to various eating plans, current physical condition, and quality of food while following ketogenic diet. As you can see there are numerous factors that come into play when saying a diet is good or bad. I think people should take the time look at the research and speak with various authorities in regards to low carb diets before drawing conclusions from the they says.
Relevant research in regards to ketogenic dieting
Efficacy and safety of the ketogenic diet for intractable childhood epilepsy: Korea multicentric experience
Chul Kang H, Joo Kim Y, Wook Kim D, Dong Kim H,
Dept of pediatrics, Epilepsy center, Inje Univ Coll of Med, Sanggye Paik Hospital, Seoul Korea
The purpose of the study was to evaluate the safety of the ketogenic diet, and to evaluate the prognosis of the patients after successful discontinuation of the diet in infants, children and adolescents with refractory epilepsy. The study looked at patients who had been treated with KD during 1995 through 2003 at Korean multicenters. The outcomes of the 199 patients enrolled in the study at 6 and 12 months were as follows: 68% and 46% of patients remained on the diet, 58% and 41% showed a reduction in seizures, including 33% and 25% who became seizure free. The complications were mild during the study, but 5 patients died during the KD. No significant variables were related to the efficacy, but those with symptomatic and partial epilepsies showed more frequent relapse after completion of the diet. The researchers concluded the KD is a safe and effective alternative therapy for intractable epilepsy in Korea, although the customary diet contains substantially less fat than traditional Western diets, but life-threatening complications should be monitored closely during follow up.
McDoanld, L (1998) The Ketogenic Diet. Lyle McDonald.
Copyright 2005 Jamie Hale