Low Carb vs. Ketogenic Diet

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This is a longer post, but one that I feel is necessary to help clarify the blurred lines between following a low-carb diet and a true ketogenic diet.  Here is my breakdown, in case you want to scroll down to a particular section:

  • What's the Hype Behind Low-Carb Diets?
  • The Function of Carbohydrates in Your Body
  • Low-Carb vs. Keto
  • My Approach to Low-Carb

What's the Hype Behind Low-Carb Diets?

For those of you who have your eye on the nutrition world (and even for those of you who don’t), you may have noticed the recent hype surrounding a low-carb or Ketogenic diets.  You probably even know someone who is following (or trying to follow) the prescribed protocol. 

I read about ketosis 25 years ago in Dr. Atkin’s Diet Revolution but my impression of ketosis wasn’t exactly positive.  I’m fairly certain this was due to the overwhelming negative publicity about people splurging on bacon and burgers and the like instead of focusing on the healthier fare.

However, while ketosis was described in this book, many who followed its protocol likely did not experience true ketosis due to the high amounts of protein they likely consumed.  Dr. Atkins was on to some truths prescribing a lower intake of carbs, but he missed the mark by not expounding more on the importance of quality over quantity.

There is also a very distinct difference between eating a low-carb diet (LCD) and following a true ketogenic, or keto diet.  The number one thing to understand about ketosis is that your body burns ketone bodies consistently instead of glucose.  The extent to which one restricts carbs determines the extent that their body uses ketones (more on this in a bit).

This may sound simple enough, but transitioning your body from a glucose- or sugar-burning machine to a fat- or ketone-burning machine is quite nuanced.

So, let me take a minute to explain how carbohydrates, or glucose, function in your body to supply energy so that you'll better understand the benefit of going low carb or keto.

The Function of Carbohydrates (Glucose) in Your Body

When you eat carbohydrates (whether from grains, sugar, dairy, vegetables or fruit), your body breaks down this macronutrient into glucose (and some other monosaccharides). 

When glucose enters your bloodstream, a signal is sent to your pancreas to release insulin, a master hormone which carries away glucose to various cells in your body.  Insulin is called the master hormone because it plays a LARGE role in many functions in the body.

Insulin shuttles glucose to your brain, your muscles and, when those locations are full, your fat cells.  Yep, you heard me right!  If you eat too many carbohydrates (i.e. too much glucose) and your body doesn’t need the extra for energy, it is stored as FAT! 

With the constant onslaught of carbohydrates that most Americans eat, you can imagine how much glucose (and therefore, insulin) is constantly in circulation throughout your body.  IT'S A LOT!

Most Americans consume way more carbohydrates (200+ grams/day) than their bodies really need.  In fact, many renown doctors have stated that our bodies may really only need about 50 grams of carbohydrates a day to function well. 

I'm not suggesting that 50 grams/day should be your daily norm, but I am suggesting that your body may not depend on the HIGH amounts of carbohydrates we've been encouraged to eat for so long!

Now, what does your body do with all that extra energy you've taken in if it is not stored or used for energy???  You guessed it, it stores it as fat!

Additionally, if glucose is consistently in your bloodstream, so is insulin.  When this happens, the limited number of insulin receptors on your cells become full (and often overworked), and can potentially cause blood sugar and insulin levels to rise to dangerous levels. 

This leads to a myriad of damaging events, including glycation, inflammation, high levels of oxidation (free radicals), insulin and leptin insensitivity, hyperglycemia, diabetes, neurological conditions and more. 

What I’m saying here is that eating loads of carbohydrates (even though our Nutritional Guidelines state otherwise) is NOT beneficial!  In fact, it can be down-right dangerous, especially if you already have blood sugar issues! 

And just to be clear, let me quote one of the foremost experts on brain health, a leading board-certified neurologist and a Fellow of the American College of Nutrition (and much, much more), David Perlmutter, M.D., who has studied and written about the detrimental effects of high carbohydrates and its effects on the brain:

“The data confirming the relationship between high carbohydrate consumption and diabetes is clear and profound, and it’s compelling to note that in 1994, when the American Diabetes Association recommended that Americans should consume 60 to 70 percent of their calories from carbohydrates, rates of diabetes exploded…. This is significant since… becoming diabetic doubles your risk of Alzheimer’s disease.  Even being “pre-diabetic,” …is associated with a decline in brain function and shrinkage of the brain’s memory center; it is also an independent risk factor for full-blown Alzheimer’s disease.” Grain Brain, 2013.

Dr. Perlmutter’s book, Grain Brain, goes into much more detail in this regard, and states how high carbohydrate intake can also increase risks of cardiovascular disease, autoimmune disorders, brain dysfunction, cancer, and more. 

I also highly recommend Dr. Mercola’s book, Fat for Fuel, which takes a slightly different approach, extolling the beneficial effects of eating low-carb (what he designates as MMT – Mitrochondrial Metabolic Therapy) and how most disease (especially cancer) can be traced back to mitochondrial dysfunction – a direct result of high insulin levels and a high carbohydrate diet.

Both of these books focus on the therapeutic benefits of eating low carb, including nutritional ketosis, which is really quite a different approach than those who are just "going keto" to lose a few pounds.  If not done correctly, ketosis could be problematic and dangerous.

Low-Carb vs. Keto

In general, I recommend eating a lower-carb diet that focuses on real, unprocessed, nutrient-dense foods, and which leaves out (or heavily reduces) added sugars, refined & processed flours (including gluten-free), grains, and other foods that incidentally spike your glucose and insulin levels.

I've noticed dramatic differences in my energy, body weight, and overall well-being since adopting this dietary pattern - one that I generally label as Ancestral or Paleo.  You can read more about my Ancestral approach HERE.

But let’s be honest, the majority of people who are considering a LCD or keto diet are doing so to lose weight.  While this is definitely a side benefit, it’s not really the whole picture, nor should it be your only goal. 

Your goal should be optimal health!

If reaching optimal health includes losing some extra weight, then lowering your carbs and focusing on nutrient-dense, unprocessed foods (and no added sugars) is a great place to start!

Jumping into ketosis without first "warming up" your body, as I like to say, with a lower carb diet might shock your system and work against you.  I've also noticed that many people think they're following a keto diet when they're actually following a LCD.

Here's how I delineate the difference between a LCD and Keto:  

  • Eating a LCD generally falls in the range of 75-150 grams of carbohydrates a day.  It focuses on eating a variety of vegetables, including starchy veggies, healthy fats, berries & smaller amounts of other fruits, and moderate proteins.  It also avoids any added sugars & artificial sweeteners, refined grains, flours, & oils, as well as most processed foods.  
  • Ketosis generally falls UNDER 50 grams of carbs a day.  It focuses heavily on fats (~70% a day), minimal carbs (~15%), and minimal to moderate protein (~15%).  Oftentimes, there is a limited amount of veggies you can eat to stay in ketosis, which is why you need to be careful to monitor micronutrient intake.  It is generally recommended to stay in ketosis short term (1-2 weeks), unless otherwise advised or monitored by your doctor.

Now, there is a lot to read between the lines here, including what type of carbs you are eating (or not eating), the quality of foods you focus on AND whether or not you're starving your body from much-needed micronutrients (i.e. vitamins & minerals), which can happen when people go too low carb.  So let's keep going.

Ketosis

Ketosis is when your intake of carbs is so low that your body has to access other energy sources (namely your fat stores) to supply energy.  If your body is used to getting regular doses of glucose from food (as most people do), it may go into shock when its regular source of energy is suddenly cut off.  

This signals your brain to enter starvation mode, which then raises the level of cortisol in your body (among other things) and subdues other hormones and essential chemicals.  

For some, this may result in what is known as the "keto flu".  A few days of feeling like crap while your body tries to adjust to using fat for fuel.  This occurs in the liver where fat is broken down into fatty acids and then into ketone bodies.  These ketones are then distributed throughout your body, especially your brain, heart & muscles, for energy purposes.

Eventually, if your glucose levels remain low, your body accesses and metabolizes your fat stores for energy in the form of ketones and your weight begins to drop.

Even if you come out of ketosis, which our body does easily, and you continue to eat low carb (generally below 100 grams of carbs/day), your body may become better adapted at utilizing fat for fuel and not just glucose.  This is really where we want to be.

Now, as I discuss in my post The Keto Controversy, there are actually quite a few adverse reactions to ketosis, which you should be made aware of before you even consider trying this diet.  Yes, you may lose weight, but if you stay in ketosis too long or you do not make strong efforts to include nutrient-rich foods in your meals, your body may react negatively.

PLEASE MAKE SURE YOU SEEK NUTRITIONAL OR MEDICAL COUNSEL BEFORE GOING KETO!

My Approach

Most of my clients are coming from a high carbohydrate, low fat (HCLF) or even a high carbohydrate, high fat (HCHF) dietary background.  They live in a place of dependence on regular feedings of carbohydrates to avoid the daily blood sugar plunge - what some people like to call being "hangry".

There is a definite truth to this physiological state, one in which people can become short-tempered, moody, sad, disoriented, or what have you.  This happens as their body screams out for more energy from external food sources, yet fails to realize the ample stores of energy found in their fat cells.

Reducing someone's daily carb intake (and by default, their calorie intake) will allow their body to rely on both glucose AND fat for energy.  It also helps to reduce the constant glucose, and therefore, insulin surges that happen after consuming carbohydrates.

A Paleo or Ancestral approach to nutrition is where I like to start with my clients.  This eating pattern focuses on wholesome, unprocessed, real foods with little to no additives or refined ingredients.  It is naturally low in carbohydrates, higher in healthy fats and moderate in protein.

I like to call it Simply Eating - because it is!

This approach focuses on lots of colorful vegetables (preferably organic to avoid glyphosphates & other inflammatory chemicals) and fruits in moderation; quality meats, poultry, eggs & fish; a healthy dose of good fats from grass-fed or organic butter/ghee, extra virgin coconut oil, avocado oil & avocados, olive oil & olives, bacon fat from "clean" bacon sources; and nuts, seeds & nut butters (except peanuts).

It avoids sugars and artificial sweeteners of all kinds (including "natural" sugars), though depending on the person, a little bit of honey or quality maple syrup isn't going to kill anyone.  It avoids food additives and added chemicals that cannot be pronounced, and it definitely eliminates all processed vegetable oils!  Say goodbye to your Crisco and Wesson Oil, please!

For a few weeks, I like to have my clients avoid grains (including gluten-free ones), legumes & dairy while they allow their body to heal and adjust.  Then we slowly add these back in to see if there are any negative reactions or weight gain.  

I generally do not have a problem with high-quality dairy products (organic, grass-fed, & whole fat cream, milk, yogurt, kefir, & some cheeses) as long as there is not a negative reaction once they are reintroduced.  I drink a cup of coffee with whole milk cream every morning!

Now, this doesn't mean you can NEVER eat these foods again, because that would be ridiculous!  BUT you do learn to enjoy them here and there instead of the making them the usual fare.  

And to be perfectly honest, you'll find your taste preferences change measurably to the point where what used to taste good doesn't satisfy you in the same way.  I can hardly eat milk chocolate anymore and much prefer dark chocolate (80% or darker) over anything!

My clients have found this way of eating to be highly satisfying and satiating!  They do not even desire the foods they used to eat, except for maybe an occasional treat.  I have watched sugar addicts become sugar detesters - and this is a HUGE win for anyone's health!

Ketosis has a place in the health & medical sphere, no doubt.  But there are some negative consequences that should be considered & discussed with a knowledgeable practitioner and/or nutritionist.  I think it's reckless to put it out there for the masses without providing ALL the information!  You can read more about the Keto Controversy HERE.

If you want more information on or need some personal coaching incorporating a low-carbohydrate or Ancestral-type "diet", don't hesitate to reach out.  I love to guide people through this process of discovering their optimum health!

Until next time....

Cheers! Landon