Diet & Nutrition

The reality that rings true for the fitness and supplement industry is that there will always be a trend. Whether it be the diet that promises to be the end-all for fitness goals or the supplement that promises to redefine a category, we are always searching for the latest and greatest. The most recent emergence as you are probably aware of by now is the ketogenic diet and actually combines both a diet trend and a whole category of supplements geared toward helping you live the ‘keto’ lifestyle.

For those that weren’t already aware, the ketogenic diet really isn’t new at all. It was originally devised when endocrinologist Rollin Woodyatt observed that three ketone bodies were produced by the liver as a result of starvation or a high fat/low carb diet. The observation then made it’s way into dietary practice and was introduced in the 1920’s as an alternative to non-mainstream fasting and therapy for epilepsy. It saw noteable success, howoever it started to be abandoned with the introduction of anticonvulsant therapies (1). It saw a minor resurgence in 1994 for the same type of treatment, but it wasn’t until the emergence of low carb dieting around 2007 that we saw the ketogenic diet and variations make a large comeback along with the widespread ‘carbophobia’ trend before once again, seeming to receed a bit. Now, that brings us to present day and the ketogenic diet is once again in the spotlight with many touting to live the ‘keto lifestyle’ and the supplements to go along with it.

MCT POWDERTraditionally, MCT oil was used after research in the 1970’s demonstrated that there were more ketones produced by MCT per unit of energy due to them being transported quickly to the liver via the hepatic portal vein, as opposed to the lymphatic system (2). These additional ketone bodies allow slightly more protein and carbohydrates to be included as MCTs are metabolized into ketones even in the presence of dietary carbohydrates.

These days, much like the MCT oil, BHB (β-hydroxybutyrate) salts have emerged onto the scene to play a part in the keto movement. These BHB salts are simply compounds consisting of sodium (Na+), potassium (K+), and the ketone body β-hydroxybutyrate. In products containing such BHB salts, the individual components are being held together by ionic bonds and when ingested, they are absorbed into the blood where it dissociates into free Na+, K+, and BHB, thus directly and immediately putting ketones into your blood.

What is the State of True Ketosis?

Now, with these things in mind, one misconception and marketing ploy is that those unfamiliar with the ketogenic diet may be lead to think that simply ingesting ketogenic products like BHB salts will put them in a ketogenic state, however that isn’t the case. True ketosis is a metabolic state in which dietary carbohydrates are in such low amounts that there is a reliance on almost exclusively ketone and fatty acid metabolism.

While it may sound relatively simple, a little background will help you understand the physiology behind it a little more. For brain function, it requires around 400 calories per day, running almost exclusively on glucose, meaning you need a minimum of 100g of glucose (carbohydrates) per day just to fuel it. The human body is an amazing machine that constantly adapts to the stresses placed up on it and carb restricted diets, which cut off the glucose supply to the brain, are one such stress. To counteract, the body combats by borrowing and/or converting sugars from other areas or sources within the body. As a safeguard in this event, it is supplied by the liver which stores glucose and can pump it into the blood to fuel the brain.

The liver can store around 100 grams of glucose, allowing you to run for about a day before the stores are depleted. If you run it this low, the next logical place you would think glucose could come from would of course be our skeletal muscle that can store 400-500 grams of glycogen. This is great in numbers, but it’s the equivalent of standing outside of a bank vault because there is the lack of the enzyme that can break down the glycogen and make it readily available to your brain.

Rest assured, your body has a solution for everything and in the absence of any more available glucose from carbohydrates, it once again relies on the liver to deliver. In this situation, the liver begins to produce the aforementioned ketone bodies to be released into the blood for use by your brain and other tissues for energy.

If you are unaware, this is critical because when one is ‘burning fat’, whether it is in the form of a calorie deficit or ketogenic state, what is really happening is a fatty acid molecule is undergoing a chemical change. Essentially, when you “burn fat,” you’re really taking a fatty acid molecule and converting it to something called acetyl CoA.

In the ketogenic state, the amount of fat that your liver is using for energy is so high, there is an excessive amount of this acetyl CoA that it starts converting it into the ketone bodies. As a result and due to the need for a new energy source, the body happily begins dumping these ketone bodies into the blood stream for energy. Once this process is underway, and the body is doing this continually, the body has officially reached a state of true ketosis.

No Magic Switch…

Superman Front Most MuscularNow that you know what ketosis is, here is a little insight for the process. It takes some time (up to 2 weeks for some) for the body to transition into a ketogenic state so you won’t even come close to achieving a true state of ketosis by cutting out carbs for a day or two. Anyone that has done a true keto diet understandably will get annoyed when someone says they are going to ‘try keto’ for a week as by they will most likely barely be getting into true ketosis by the time they end the experiment.

The same can be said for the supplements on the market such as the BHB salts or even MCT oil that has come back in to prominence. There’s no supplement that can make you go into a state of ketosis as this must be done through dietary manipulation, however it is easy for it to get misconstrued when people hear of products that discuss ketones and the like. Further supporting this misconception is that a common way of testing for the state of ketosis is the use of urine testing strips. While these strips do serve a helpful purpose, it must be remembered that simply having ketones present in urine doesn’t indicate the state of ketosis. By ingesting BHB salts or MCT oil, you are providing exogenous ketones that will of course show up in urine and cause a reading of false ketosis.

Furthermore, for those utilizing the ketogenic diet for fat burning, if you are ingesting exogenous ketones or using MCT oil, it can actually hinder your fat burning as your body can use these ketones or MCTs as a readily available fuel source rather than the ones being released from your body to burn.

So What Value Do Exogenous Ketones Have?

Quest MCT OilWhen it comes to MCT oil and BHB salts, they both do indeed serve a helpful purpose, but it must be kept in context. MCT oil is a great source of energy and as stated before, produces more ketone bodies compared to other long chain fatty acids. They are easily used for energy, very similar to carbohydrates (via the ketone pathway) and have secondary benefits on metabolism (3) and blood sugar regulation (4).

As for the new BHB salts, they have been emerging as both a standalone product as well as being featured in products such as pre-workouts. They provide an instant and immediate source of ketones in the blood stream, translating to providing energy via the form of ketones. They are most promising from a performance standpoint, offering the potential for stimulating the metabolic shift away from glucose (5) and improving mental cognition (6) all while providing an immediate fuel source from ketones.

For both the MCT oil and BHB salts, they can help reduce the impact of carbohydrate intake on ketosis to some degree, but to what degree is still being examined. Among other items that are still being researched is that there may be the potential for BHB salts to increase exercise capacity via reducing oxygen consumption, and that will be some potentially exciting research in itself.

References

1. The ketogenic diet: one decade later. Freeman, JM and EH, Kossof. 3, March 2007, Pediatrics, Vol. 119, pp. 535-543.

2. Medium-chain triglycerides as a therapy for intractable childhood epilepsy. Huttenlocher, PR and Wilbourn, AJ. 11, November 1971, Neurology, Vol. 21, pp. 1097-1103.

3. Postprandial thermogenesis in lean and obese subjects after meals supplemented with medium-chain and long-chain triglycerides. Scalfi, L and Coltori, A. 5, May 1991, Vol. 53, pp. 1130-1133.

4. Medium Chain Triglyceride Oil Consumption as Part of a Weight Loss Diet Does Not Lead to an Adverse Metabolic Profile When Compared to Olive Oil. St-Onge, Marie-Pierre and Bosarge, Aubrey. 5, October 2008, J Am Coll Nutr, Vol. 27, pp. 547-552.

5. Ketones Suppress Brain Glucose Consumption. LaManna, Joseph and Salem, Nicolas. 2009, Adv Exp Med Biol, pp. 301-306. 645.

6. Effects of beta-hydroxybutyrate on cognition in memory-impaired adults. Reger, MA. 3, March 2004, Neurobiol Aging, Vol. 25, pp. 311-314.

Ketogenic Dieting

By now, if you are remotely connected to the fitness world, you are probably aware of the recent emergence of keto. It can truly be a game changing diet method if implemented right, but most underestimate just how challenging a true keto diet is and how counterproductive it can be if done incorrectly. Despite its surge in popularity, keto is still one of the most misunderstood diet methods, and now with many variations, styles and diets all using the word keto, it is getting a bit out of hand.

There are numerous benefits for using ketogenic dieting, especially for those interested in burning body fat while maintaining lean mass. It’s been researched for decades and there is still new science emerging all the time, so the aim of this article is to define and hopefully set the record straight on the subject.

Keto Is Neat-O: Defining the Beast

In a nutshell, true ketosis is a metabolic state that occurs when dietary carbohydrates are in such low quantities that your body must rely almost exclusively on fatty acid oxidation and ketone metabolism. While this sounds simple, there is way more going into this as you probably imagined, so let’s delve into that.

Essentially for basic function, the human body requires a substantial amount of energy and in particular, a currency called ATP. For example, if the average human body requires 1800 calories per day, not including any activity or physical movements, then the amount of calories required for normal functioning alone is 1800 calories. This can be more or less, but for examples sake we made this a general number.

Brain FuelThe control center of the whole body is of course your brain and it requires about 400 calories per day, running almost exclusively on glucose, meaning you need a minimum of 100g of glucose (carbohydrates per day just to fuel it. Obviously your body is an amazing machine that constantly adapts to the stresses placed up on it. Carb restricted diets, which cut off the glucose supply to the brain, are one such stress that the body combats by borrowing and/or converting sugars from other areas or sources within the body. As a safeguard in this event, it is supplied by the liver which stores glucose and can pump it into the blood to fuel the brain.

Rest assured, your body has a solution for everything and in the absence of any more available glucose from carbohydrates, it once again relies on the liver to deliver. In this situation, the liver begins to produce ketone bodies to be released into the blood for use by your brain and other tissues that don’t utilize fat for energy.

If you are unaware, this is critical because when one is ‘burning fat’, whether it is in the form of a calorie deficit or ketogenic state, what is really happening is a fatty acid molecule is undergoing a chemical change. Essentially, when you “burn fat,” you’re really taking a fatty acid molecule and converting it to something called acetyl CoA.

In the ketogenic state, the amount of fat that your liver is using for energy is so high, there is an excessive amount of this acetyl CoA that it starts converting it into the ketone bodies. As a result and due to the need for a new energy source, the body happily begins dumping these ketone bodies into the blood stream for energy. Once this process is underway, and the body is doing this continually, the body has officially reached a state of true ketosis.

Keto Terms: Don’t Get It Twisted

Tired ManNow that you know what ketosis is, here is a little insight for the process. It takes some time for the body to transition into a ketogenic state…you won’t even come close to achieving a true state of ketosis by cutting out carbs for a day or two. The body gradually adapts over a course of 2 weeks or so (shorter, generally the leaner the person is) and in that time period, people often feel tired, foggy and sluggish while the body is adapting to utilizing a new energy source.

To put this into perspective about how profound of a fuel source change this is on the body, on average, with other factors aside, a person can utilize about 30 grams of fat per hour, however in studies that have six weeks of ketosis adaptation, individuals can burn up to 90g of fat per hour.

After an adaptation period of two weeks, however, we have noticed that the levels of ketones do rise. More importantly, after adaptation focus, drive and mental clarity begin to improve. The crossover point you enter after 2-6 weeks of dieting is known as “keto-adaptation.”

Keto is a perfect example of the entire result depending on the diet, as the state of ketosis is influenced in an overwhelming majority by the dietary intake. Structure wise, a diet comprising of 75% fats, 20% protein and 5% carbohydrates is the best method for getting into and maintaining ketosis, which works out to:

150g fat, 90g protein and 22g carbs for our 1800 calorie example.

Understandably some, especially those involved in physique based goals will see the protein levels as being too low and will fear losing strength and/or muscle mass, but we can assure you that’s not the case, and leads us to the next subject…

Don’t Blow Your State of Keto

With a diet that is as complex as this, it’s not surprising that there is quite a bit that can make it not work correctly or as optimally as one would like. The items that need to be addressed in regards to this are:No Carbs

  1. Confusing a low carb diet with a ketogenic diet
  2. Consuming too much protein on the ketogenic diet
  3. Too many carbs/false insulin spikes
  4. Not allowing long enough for reaching ketosis

First and foremost, when you’re just on a low carb diet and not in state of ketosis, your body still utilizes both fat and carbs to fuel your daily energy needs. Your body won’t accumulate blood ketones nor burn them as they don’t require ketones for energy in this state. As stated earlier, a ketogenic diet means your body has reached the point where it’s actually producing ketones in sufficient amounts that there are elevated levels of ketones in your blood and they’re being utilized for fuel because there is a complete lack of carbs for glucose.

Proving this is a study1 in which a group of individuals consumed the same amount of protein and calories while in a deficit, divided up into three groups. The groups were allotted 104, 60 and 30g of carbs respectively. It was found that the highest carb group (still low carb) lost 25% of the weight from lean muscle while the 30 grams of carbs group lost almost no muscle, the reason being that the ketones have a protective effect for amino acids such as leucine and aid in sparing muscle.

In regards to protein, rarely would we consider having too high of a protein intake a bad thing, but when it comes to the case of ketosis, this is indeed counterproductive. It is important to reprogram your mindset to understand that a ketogenic diet is high fat, and slightly lower protein intake than you are probably used to. If you are ingesting protein above certain quantities and especially in the absence of carbohydrates, protein can actually undergo gluconeogenesis (converting protein into carbs) and kick you out of ketosis! A safe number is to stay in the 20% of your calories from protein range, or .8 grams of protein per lb of bodyweight.
Low Glycemic Index SaladUltimately, it is important on a ketogenic to keep the small amount of carbohydrates that you DO eat as low glycemic as possible, and they will come in the form of trace carbs. Green, leafy vegetables are the best bet as the carbs are minimal and contain fiber, which is critical for maintaining normal digestion as well as providing micronutrients. While this may seem simple enough, also watch out for sabotaging your state of ketosis. Avoiding sugars is pretty obvious, but it’s also important to avoid things that cause an insulin response such as sugar alcohols and BCAA (specifically leucine causes an insulin response). If you need to supplement, consider keto friendly options that are low in carbohydrates. Options for post workout like ProtiZyme are great for recovery and if you need to get more calories in, MuscLean is a perfect choice, being keto friendly with high protein and fats with little to no carbs.

Finally, one of the biggest keys is patience. It can take time for the body to reach a state of ketosis and studies show most people don’t stick with the diet long enough for a full ketogenic state to kick in as for the first few days of the diet transition, workout performance suffers. It can take from anywhere from 4-15 days for someone to reach ketosis and in general, if you are re-entering ketosis from a refeed (carb up day) and/or are leaner, you’ll get into ketosis faster.

On the Re-Up – Carb Refeed or No?

The ketogenic style diet is a pretty daunting idea as it may be appealing to want to use it to finally be shredded, but not having those delicious carbs every once in a while is a pretty big commitment. With this in mind, there are a few popular variants of the diet including the cyclic ketogenic diet which is where individuals, after reaching ketosis, maintain a strict keto diet for 6 days before ‘carbing up’ on the 7th day.

Well, with the popularity of such a method, there have been studies recently completed examining and comparing regular sustained ketogenic state diets vs. the cyclic version involving carbohydrate days. Both groups in the study2 followed diets with a 500 calorie deficit, with the cyclic ketogenic group having carbohydrates on a refeed day. It was found that the group that the strict keto group lost nearly exclusively body fat, but the cyclic keto group lost lean mass as well. The reason for that is that while maintaining the ketogenic state, the ketones protected the muscle; meanwhile the cyclic group had to go through the process of regaining a ketogenic state following the carb up.

If you’re looking to transition out of a ketogenic style diet back to one that includes carbohydrates, it is pretty straight forward and similar to reverse dieting as seen in other diets. Specifically for ketogenic reverse diets, gradually add in carbs at specific meals, ideally pre and post workout and gradually increase from there.

Concluding Keto

Weight LossTo summarize, the diet is done by utilizing a diet ratio of 75% fats, 20% protein 5% carbohydrates, starting your calories at the basal metabolic rate or up to a 500 calorie deficit to facilitate fat loss. Avoid keto pitfalls such as eating too much protein, causing insulin spikes (BCAA, sugars, sugar alcohols) and most of all, allow yourself time to adapt to the full ketogenic state.

There are definite benefits to doing a ketogenic style diet including fat loss while maintaining lean muscle and improving insulin sensitivity. While it is a very rewarding style of diet, it can also be mentally challenging and daunting task, especially at first. If you stick with it though, the rewards are well worth it and add yet another valuable tool to your arsenal in your quest for a great, healthy physique.

References:

1. Young, C. M., Scanlan, S. S., Im, H. S., & Lutwak, L. (1971). Effect on body composition and other parameters in obese young men of carbohydrate level of reduction diet. The American Journal of Clinical Nutrition, 24(3), 290-296.

2. Sharp, M.S., Lowery, R.P., Shields, K.A., Hollmer, C.A., Lane, J.R., Partl, J.M., … & Wilson, J.M. (2015). The 8 Week Effects of Very Low Carbohydrate Dieting vs Very Low Carbohydrate Dieting with Refeed on Body Composition. NSCA National Conference, Orlando, FL