Beyond Fasting: The Ketogenic Rabbit Hole

Beyond Fasting: The Ketogenic Rabbit Hole

I'm about to take you down a deep rabbit hole, on a path that will challenge what you believe about nutrition and health. This is a journey of experimentation, and I encourage you to keep a very open mind, and in fact, I hope you decide to experiment with these themes yourself. I'm not a nutritionist or doctor, but I am very passionate about finding ways to optimize my body and health (especially as I age), which is why I've been doing intermittent fasting for the past five months -- and that experience has been life changing. I've gone from XL to medium sized shirts, from a 38 to 32 waist, and most importantly, from 34.7% body fat to 24.5% (and my goal is to get under 20%). Intermittent Fasting has put me in control of my body for the first time in my life.

And just when I felt that I was really starting to figure it all out, this rabbit hole opened up. And it's called ketosis.

In addition to intermittent fasting, I'm experimenting with ketosis through the end of 2015, which is triggered by eating a ketogenic diet comprised of 75% fat, 20% protein and 5% carbs. Yes, that's right -- in order to lose fat and become healthier, I'm going to eat mostly fat. The mind blowing counter-intuitiveness of that statement is why I'm writing this blog.

But before we can talk about this ketogenic approach to nutrition and health, we have to understand how the body uses two energy sources -- glucose and ketones -- and why, with your diet, you are probably only ever tapping into glucose (and how that may be making you unhealthier, especially as you age).

See an enlarged version of this picture here. The illustrations come from a video for a ketone supplement called Keto-OS -- see my comment below.

Glucose is the "lighter fluid" energy source that your body uses to create energy for its cells, whereas ketones are the "charcoal" -- harder to ignite, but can power your body for longer when used because ketones burn fat and are a more efficient metabolic energy source. Why does the human body have the ability to burn two entirely different types of energy? The theory is that as humans evolved, we went through periods of feast or famine and had to be able to make use of energy when available, as well be able to as stash away longer-term energy, which was stored on our bodies as fat, and then convert it to energy (via the creation of ketones by the liver) when the glucose was depleted.

But in our modern society, sugar and carbs are all around us, all the time. We never starve for 2 days between meals. This means our bodies dutifully store away excess glucose as fat, but we never tap into those reserves to actually use them -- we don't need to; our bodies can be powered 100% of the time with glucose thanks to plentiful access to calories all around us.

What this meant for me was that six months ago, I was on the verge of having Metabolic Syndrome, and I didn't even know it. Metabolic Syndrome (a proxy for insulin resistance) put me at an elevated risk for getting many types of Cancer, Alzheimers, Obesity, Diabetes, Stroke, and Coronary Heart Disease. One is defined as having it if one has three of the following five indicators:

  • Expanding waistline (above 40"; mine was 38")
  • High Triglycerides (above 150 mg/dL; mine were at 141)
  • Low HDL (below 40 mg/dL; mine was at 38)
  • High blood pressure (systolic BP > 130 or diastolic BP >85 mm Hg)
  • High blood glucose (above 100 mg/dL; mine was at 98)

Astonishingly, the prevalence of Metabolic Syndrome is estimated to be 34% of the US adult population, and if you've got it, you have a 2x increase in risk for heart attack. Dr. Peter Attia has an excellent hour-long talk about the ketogenic diet and Metabolic Syndrome, which I highly recommend to anyone who's flirting with these numbers, as I was. Here's a screenshot from his talk showing his numbers (and I've overlaid mine):

I'm going to get my blood re-tested next month to see how (or if!) intermittent fasting has helped bring my markers down from these at-risk numbers, but I know that at the very least my waist has gone from a 38 to a 32, which is encouraging.

The big take-away: When you eat sugar and carbs, your body burns what it can and converts the rest into fat as storage. But when you don't eat sugar or carbs your body switches to a fat burning mode called ketosis, and it becomes "keto-adapted" which means it gets good at burning fat directly, and your body doesn't care if the fat it's burning is fat you're ingesting, or fat it has stored away. This is why, counter-intuitively, when you almost completely remove carbs from your diet and replace those calories with fat, your body becomes more adept at burning fat instead of storing it. The ideal caloric intake ratio is 75% fat, 20% protein and 5% carbs.

The big caveat here is that you can't have a diet that's high in fat and high in carbs, because whenever you ingest carbs, your body switches to burning them and you fall out of ketosis, which also means you start storing the fat. So if you're inclined to cheat on diets, and you just can't resist eating those carbs, then this approach will backfire on you. And I happen to be one of those people. I just hate having the cognitive overhead of having to think about whether I should be eating something or not (that's why fasting has been so good for me -- either I'm eating that day, or I'm not. Very binary). So why would someone like me who absolutely hates "diets" try the ketogenic diet for a month? It's because, just like with fasting, recent medical research is starting to show that staying in ketosis is very good for one's body, including:

  • Being in ketosis makes your body more efficient, which makes you less hungry. (Many people also experience a clarity of mind when their bodies switch to ketosis, myself included)
  • Ketosis helps get rid of abdominal fat, which is an especially harmful type of fat
  • Being in ketosis tends to lower triglycerides dramatically
  • Being in ketosis is known to raise HDL
  • Being in ketosis dramatically lowers blood sugar and insulin levels (In one study in type 2 diabetics, 95.2% had managed to reduce or eliminate their glucose-lowering medication within 6 months)
  • Blood pressure tends to go down in ketosis
  • Removing carbs from one's diet leads to lower inflammation
  • And most importantly for me: Low-carb diets are the most effective treatment known against Metabolic Syndrome

Eating on a ketogenic diet is interesting -- you can have in abundance the kinds of foods you usually restrict, so long as you don't let yourself go near sugar or carbs. Here are some examples:

A very ketogenic dinner: Pork belly (perfect ratio of fat to protein) and lots of veggies. The glass of wine contributes about 4 grams of carbs (my daily limit is 50 grams).

Dumplings made from cabbage instead of flour... and delicious!

Salami, with some special gluten free, grain free, very low carb "keto crackers" that my wife Sue baked.

For a snack, I have nuts or sardines, an incredibly healthy way to get protein and other nutrients.

If you'd like to go down this rabbit hole with me, I'd love your company. I don't know if I'll keep eating ketogenic past the end of 2015, but I am enjoying the experiment so far. If you want to dive in head first, I highly recommend the following resources:

Tim Ferriss interviews Dr. Dom D'Agostino:

This three hour-long podcast is incredibly medically dense but also incredibly good. If you're skeptical about what I've written above, I highly recommend you give it a listen. This is the single best resource I've found to date about this topic.

Dr. Stephen Phinney - 'Optimising Weight and Health with an LCHF Diet' - Part 1

This is a three-part series of videos (I've only linked to the first video), each about an hour long, and they're spectacular.

Dr Peter Attia on How he changed to burning fat instead of burning sugar

This is the video I linked to earlier in the post.