– Nutritional ketosis is an extremely effective tool. It can also be used to improve metabolic health and well-being in people with diseases caused by insulin resistance or inflammation. There are many myths and misunderstandings about ketogenic diets and nutritional ketosis, so I’d like to focus on the scientific evidence surrounding the safety and efficacy of this approach to nutrition. And I understand how difficult it is for people to commit to such an endeavor when everyone around them is saying, “Oh, this is dangerous, so you shouldn’t be doing it.” So you must be confident that if you undertake this, you will do so in a safe and efficient manner.
In study after study, not just ours but others’, a well-formulated ketogenic diet has a greater effect on weight loss and particularly loss of abdominal adipose tissue, and adipose tissue, or a fat mass within the abdomen, is the most dangerous fat that we carry in our bodies. For example, in a study I conducted with Dr. Jeff Volek and Dr. Cassandra Forsythe, one of his graduate students, we compared a high carbohydrate low-fat calorie-restricted diet to a ketogenic diet that people followed where their instruction was to eat to satiety, is, not count calories or restrict calories but eat enough to feel full.
What Dr. Stephen Phinney Discovered After 12 Weeks
And at the end of the 12-week period, the high-carbohydrate, low-fat group’s weight loss was around half that of the ketogenic diet group. Now, some detractors may argue that a lot of the weight you lose when following a ketogenic diet is water. But when we actually measured body fat carefully, we found that the water loss on the ketogenic diet accounted for only about 1/5 of the difference between five kilograms on the carbohydrate-rich low-fat diet and ten kilograms on the ketogenic diet. The remaining body fat accounted for the remaining 9/10 of the difference. More crucially, we measured body fat content using the dual x-ray absorptiometry technique, also known as DEXA.
When someone follows the ketogenic diet correctly, there is a noticeably higher reduction in abdominal fat. This means that it’s not just total body fat or fat stored beneath the skin that is mobilized more quickly; it’s also part of the fat that is most hazardous.
The second most frequent side effect is a drop in blood glucose in those with prediabetes or diabetes who have either modestly or noticeably high blood glucose levels. Now, that makes sense because if you consume less carbohydrates in your diet, there would be less glucose created by digestion and the level of sugar entering into the blood will be reduced, at least that’s what we typically find.
But in Dr. Forsythe’s research.
. These people have prediabetes, but their blood sugar levels are still a little high. The blood glucose levels of those following the ketogenic diet were significantly lower than those of those following the high-carb, low-fat diet, which remained stable. The fact that we also tested blood insulin levels is more intriguing. Additionally, insulin is a hormone that causes glucose to enter cells; therefore, if blood sugar levels dropped, you would assume that the body was producing more insulin to cause glucose to enter cells.
However, it was the opposite of what we observed. And that is that both blood glucose and insulin levels significantly decreased. The only explanation for this is that the ketogenic diet increases insulin sensitivity, meaning that the body responds to each molecule of insulin with a noticeably increased intensity.
The Results Were Consistent With Prediabetes(Metabolic Syndrome)
We have observed this consistent result in numerous research, and it is this result that has inspired us to believe that we can genuinely correct the underlying cause of Type 2 diabetes. A well-designed ketogenic diet also alters the blood lipid levels that are indicative of metabolic syndrome.
By the way, prediabetes is another name for metabolic syndrome.
A lower level of good cholesterol, a rise in triglycerides, and a higher percentage of tiny dense or bad LDL cholesterol are typically signs of metabolic syndrome. Triglycerides decreased in this cohort, as we saw when we examined that. Now, they decreased in both groups, but patients following the ketogenic diet experienced a more than two-fold decrease. Furthermore, despite the fact that they were eating more fat, their blood fat levels decreased.
Also known as prediabetes, metabolic syndrome is a condition.HDL increased by roughly 13%, which is more than any HDL response we can obtain from any medications we have on hand and can prescribe. So this is pretty much the only advantage of a properly designed ketogenic diet. The most harmful tiny dense LDL remained unchanged after that. They actually decreased little in the group consuming a high-carb, low-fat diet and significantly in the group following a ketogenic diet. Again, all of the lipid alterations are favorable to the ketogenic diet and are moving in the right way.
So once more, the worry about eating a high-fat diet, eating foods like eggs, meat, and dairy that contain cholesterol, is unfounded because when one follows this diet correctly, blood lipids and cholesterol levels change for the better. The majority of your daily calories will come from fat if you consume modest amounts of carbohydrates and moderate amounts of protein. And many of the saturated fats that humans consume often come from foods like cocoa butter, dairy products, and animal products.
So the question is: Is it harmful to consume a lot of saturated fat while on a ketogenic diet? People consider it dangerous because, according to research on blood levels of saturated fat, higher levels are associated with a higher risk of diabetes, heart attacks, and overall mortality.
Therefore, if you assume that eating saturated fats raises blood pressure, this could be harmful. However, no one had ever actually investigated what a ketogenic diet does to one’s blood levels of saturated fat, so we did. And we discovered that even though the ketogenic diet participants consumed three times as much saturated fat daily in their diets, their blood levels of saturated fat were lower than those of the group following the high-carb, low-saturated fat diet.
And once more, this is puzzling. We appear to have severed the connection between intake and blood levels.
And that goes against the universally acknowledged rule among dietitians that you are what you eat. You are actually what you conserve from the food that you consume. The ketogenic diet also educates your body to burn fat more efficiently, which is a wonderful feature. How successfully? We looked at highly skilled athletes in research where some of them followed a conventional high-carb loading diet regimen while the other half followed a carefully designed ketogenic diet.
Furthermore, these individuals had been on these diets for at least six months or more, indicating that they had reached full ketosis for those following a low-carb or ketogenic diet. And when we examined the resting rate of fat oxidation, we discovered that it was roughly twice as high on the low-carb ketogenic diet as it was on the high-carb diet.
So once more, theoretically highly trained athletes’ bodies are highly conditioned to burn fat for fuel during exercise, yet only a change in the diet increased the bodies’ capacity to do so. And as they continued.
. The patients on the ketogenic diet showed amazing abilities to use fat for fuel when we had them exercise at increasing intensities. When you’re keto-adapted, your body has the ability to get rid of saturated fat, so the amount you eat is not important; rather, it’s how much your body saves from what you eat. This is why the athletes like it because they can run on body fat stores much better than trying to eat and load up on carbohydrates. Saturated fats are not detrimental when taken if you are keto-adapted because the body does not preserve them while you are in this state.
We know that when we evaluate biomarkers of inflammation, some of which have been studied over the previous century, such as white blood cell count, and some of which have more recently been added to our methods of detecting inflammation, this is a very important area of current research.
That these levels predict the later onset of diseases such as heart disease, Type 2 diabetes, Alzheimer’s disease, and many types of cancer. So, in collaboration with Drs. Volek and Forsythe, measured every biomarker we could think of and identified 14 different biomarkers of inflammation.
And when we compared them for people on the high-carb diet versus people on the low-carb high-fat diet, none of the levels of inflammation decreased more in the high-carb low-fat diet. In contrast, 7 of the 14 were significantly reduced in people following a well-designed ketogenic diet.
That is, the ketogenic diet reduced inflammation significantly on average, indicating that it has a broad anti-inflammatory effect. Until recently, that was referred to as a phenomenon by scientists. We see it happening, but we have no idea why. And it turns out that there is a specific gene that regulates the flow of traffic around inflammation, similar to a traffic cop gene. And the ketone that is circulating directly targets this gene.
-hydroxybutyrate, or BHB, is a primary ketone in our blood. And this is where ketones communicate with your genes, and your genes, in turn, turn down the heat, if you will, through a regulated series of events to reduce inflammation in the body, which has the potential to have very positive effects not only on reducing insulin resistance but also on reducing other common chronic diseases. We now not only know that inflammation decreases, but we also know why it decreases and why it is so effective, even at low levels of ketones, which can be achieved simply by limiting carbohydrates to less than 5% of total calories and keeping protein moderate.
We’re collaborating with Indiana University Health on a study in which we recruited over 260 people with Type 2 diabetes and put them on a well-designed ketogenic diet.
This study will last two years, but I’d like to show you the preliminary data from the first ten weeks. All of these people were diagnosed with Type 2 diabetes. Some were poorly controlled, others were moderately well controlled, and still, others were extremely tightly controlled. So we classified the diabetes control biomarker hemoglobin A1c (HBA1c) into three categories: high, intermediate, and well-controlled.
And, after 10 weeks, there was a reduction in hemoglobin A1c levels in all three cases, with the greatest effect in those with the highest levels. People with the worst diabetes control had the greatest effect, but all three groups had an effect. As a result, more than half of these people went from having hemoglobin A1c levels in the diabetes range to non-diabetes levels. What’s particularly intriguing is that in conventional diabetes care, better glucose control is achieved by administering more medications. In this case, we removed the majority of the drugs from five of the seven diabetes medication classes.
Diabetes Drugs Side-Effects
And the two most dangerous, insulin and sulfonylurea, are the two classes of drugs that are most likely to cause hypoglycemia, which is probably the most threatening short-term side effect in diabetes management, so we either stopped or significantly reduced the majority of those medicines in these patients. So, once again, we have the paradox of less medication and better control. And the reason we can achieve better control with less medication is that -hydroxybutyrate in ketones, in general, speak to the genes and fundamentally change how the body functions, including changing how the body responds to insulin, allowing the body to benefit from far less insulin.
As a result of this, we told people to eat until they were full. It limited carbs, protein in moderation, and as much fat as they needed, and they could put butter on their meat, butter or dressing on their vegetables, and dip with vegetables, etc.
So they were eating until they were full, but 75% of these patients lost more than 5% of their body weight. And the average body weight loss was slightly more than 7%. That was only in the first ten weeks. At six months, the weight loss in this cohort increased from 7% to 12%. So this isn’t a quick loss followed by a quick gain, but it appears to be a sustained long-term effect.
Because, once again, people six months into our study are doing the same thing we told them to do at the start: limit carbohydrates, and protein in moderation, and eat fat to satiety, which allows the body to burn a lot of body fat stores because the body has become so efficient at burning fat for fuel. Other conditions that we’ve seen improve with the ketogenic diet include general muscle and joint aches and pains.
Promising Results From Our Study On The Keto Diet
Irritable bowel syndrome usually improves. Female polycystic ovary syndrome People who suffer from migraines report that the ketogenic diet reduces the frequency or intensity of their migraines, and some even report complete remission.
According to Dr. Forsythe’s research, metabolic syndrome or prediabetes has improved, as have liver fat levels, which is a side effect of poorly controlled diabetes. We also see improvements in fluid retention and blood pressure. This is a very effective tool. It can have very beneficial effects on a variety of chronic conditions; however, when a person is taking medications for these chronic conditions, those beneficial effects usually necessitate a sharp and rapid reduction in dosage.
And that can be dangerous unless you have the assistance of a physician who is familiar with this type of diet and how to manage medications. This cannot be done casually; you cannot begin a diet and then return to your doctor six weeks later and ask, “So, what do you think I should do with my diabetes medication?” Because when people follow the diet correctly, the majority of the changes occur within the first six days. Finding a doctor who understands this can be difficult at times, but we are seeing an increase in interest in physicians, so if you look carefully, you can probably find someone who can help you, if you need that kind of assistance when following this type of regimen.
Conclusion
So, to summarize, a well-planned diet is not only safe, but it can also be very effective in disease reversal.
These effects are extremely potent. However, this must begin with careful monitoring. Simply put, you must find a physician who can assist you in properly managing your medications, where the benefits far outweigh any potential risks associated with changes in medication use. SEE IF THE KETO DIET IS RIGHT FOR YOU!
Read More: Dr. Stephen Phinney on Nutritional Ketosis and Ketogenic Diets (Part 1)
