Is the Ketogenic Diet really a revolutionary approach?
Review of "Fat for Fuel" a book by Joseph Mercola: Fat for Fuel: A Revolutionary Diet to Combat Cancer, Boost Brain Power, and Increase Your Energy
One of the most comprehensive guides to the ketogenic diet.
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Ketogenic Diet, Cancer Prevention Diet, Brain Cancer Diet
The ketogenic diet is very popular these days, and I am often asked for opinions on this radical approach. This diet goes back to Dr. Russell Morse Wilder, at the Mayo Clinic, who coined the term "ketogenic diet" in the 1920s to describe a diet that produced a high level of ketone bodies in the blood due to excess fat and carbohydrate deficiency. As Wikipedia rightly reports "it was a valid treatment for drug-unresponsive seizures in children".
However, what I really want to do in this post is to give more accurate and practical information from what you can learn on google and I will summarise some key points from this interesting book.
I will also report my personal experience by reporting my clients' general perceptions and experiences with this diet. In fact, most of them at the beginning thought that it was just a low-carb diet. Sometimes I hear people say "I did some keto but then I got bored" As if you could possibly do a little keto.
So I would like to shed some light on keto using Mercola's book as a guide because I believe it is a valuable tool to understand the pros and cons of this radical approach.
What Is the Scientific Assumption behind the Ketogenic Diet?
The scientific assumption behind the Ketogenic Diet (KD) is that the health of the mitochondria is preserved with this diet. Yes, you heard right this is not about weight loss.
Basically, the author introduces KD as a "mitochondrial metabolic therapy" or MMT for advanced healing.
But what does it mean? I will try to shed some light using my love of synthesis.
Mitochondria are our engine, they transform macronutrients into energy
The health of mitochondria naturally deteriorates during aging and some chronic diseases (e.g. Cancer, Alzheimer's disease, etc)
Mitochondria atrophy in the cancer cell
KD preserves the health of mitochondria by using ketone bodies as fuel for the engine
KD prompts your body to produce ketones by burning a huge amount of fat in your diet (up to 60-70% of your daily calorie intake)
KD makes the body switch to fat-burning (this is the weight loss part) and for this property, it is also called the "fasting-mimicking diet"
But in practice how does it work?
Here we go back to my client who said "I've been on some keto for a few weeks".
No, you can't: either you are in ketosis or you are not.
Let me explain better, you reach ketosis when you are using ketones as fuel and you can measure them either in the blood or in the urine (not always). To achieve this, decrease your net carbohydrates per day to 30-40g of (think that normally 100g of pasta contains 65-70g of net carbohydrates) and keep the net protein to a minimum by multiplying 1-1.5g of protein or lean mass. (20-30% of body weight). And the fat? You eat tons of it.
More precisely, the protein may vary based on your health and sports activities and intermittent fasting helps to switch to fat-burning.
Again to summarize:
Every meal, including snacks, needs to have a high fat/adequate protein/ low carb ratio
This means that you need to add at least a full tablespoon of EVO or MCT oil or butter or avocado to your meals
Omega-3 high-fat foods such as macadamia or mackerel are preferred over full-fat cheeses if you want to lose weight
You can only eat that amount of fat if you cut down on your carbohydrate and protein intake, otherwise, you won't switch to fat burning.
Pros and Cons
Here is my list of Pros
You are never hungry and you have a lot of energy
You don't have sugar cravings
If you like animal proteins and you're not a pasta person could be your diet
Definitely, you must be a fan of fatty food
It works well with intermitting fasting
Your brain is very sharp especially if you are normally sensitive to grains and give you brain fog
Here is my list of Cons
Constipation, bad breath
You hardly eat fruits and legumes
It might give you insomnia because you feel energetic all the time
if you are underweight or easily lightheaded is not your diet
It's a very restrictive and radical approach
Alcohol consumption is reduced to a minimum
Not the best diet for long-lasting weight loss
The Final Score
If you want to learn more about the science behind such a popular and misunderstood approach, this is a great book. My rigorous quest to understand the scientific basis of KD has been fulfilled. I, therefore, give 5 out of 5 stars.
As for the part dedicated to chronic diseases such as cancer, I remain doubtful,
KD has many peer-reviewed publications for Brain Cancer
KD is contraindicated if you are taking cortisone
KD is contraindicated in liver disease or metastasis
It is a very difficult regimen to enforce in the case of Alzheimer's disease or dementia
I don't find this regimen such a revolutionary approach when it comes to chronic diseases or weight loss.