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The Various Benefits of the Ketogenic Diet

A ketogenic diet is a dietary approach that focuses on minimal carbohydrates, moderate amounts of protein and high healthy fat consumption — the three keys to achieving nutritional ketosis. In fact, it's what I recommend for most people who would like to optimize their health.

There are many reasons why you should try a ketogenic diet. It can be very beneficial for people suffering from chronic conditions, or for people who would simply like to be healthier than their current state. You'll be excited to know that a ketogenic diet can help with the following:

•Weight loss

If you're trying to lose weight, then a ketogenic diet is one of the best ways to do it, because it helps access your body fat so that it can be shed. Obese people in particular can benefit from this method.

In one study, obese test subjects were given a low-carb ketogenic diet and a low-fat diet. After 24 weeks, researchers noted that the low-carb group lost more weight (9.4 kilograms) compared to the low-fat group (4.8 kilograms).1

Even my own body was able to feel the benefits of following a ketogenic diet. I was able to drop my weight from 180 to 164 pounds, despite eating 2,500 to 3,000 calories per day. Since then, I have increased my consumption to 3,500 to 4,000 calories just to maintain my ideal weight.

•Anti-inflammatory

The human body can use sugar and fat as fuel sources. However, the latter is preferred because it is a cleaner, healthier fuel, as it releases far fewer reactive oxygen species (ROS) and secondary free radicals.

By eliminating sugar from your daily food consumption, you're decreasing your risk of developing chronic inflammation throughout your body.

•Lowering risk of cancer

One exciting discovery about the ketogenic diet is how it can help prevent cancer. Dominic D'Agostino, Ph.D., an assistant professor at the University of South Florida, recently made headway on how the ketogenic diet can help impact this dreaded disease.

D'Agostino explains that all of your cells (including cancer cells) use glucose as fuel. However, cancer cells do not have metabolic flexibility and cannot adapt to using ketones as energy, which your regular cells can. Once your body enters a state of nutritional ketosis, the cancer cells starve to death.

•Increasing muscle mass

Jeff Volek, Ph.D, is a registered dietitian specializing on how a high-fat, low-carb diet can affect health and athletic performance. In one of his books, he states that ketones have a similar structure to branched-chain amino acids that can be useful for building muscle mass.

Ketones spare these amino acids, leaving higher levels of them around, which can help promote muscle mass.

•Reducing Appetite

Constant hunger can cause you to consume more calories than you can burn, which can eventually lead to weight gain. A ketogenic diet can help you avoid this problem because reducing carbohydrate consumption can reduce hunger symptoms.

In one study, participants who were given a low-carbohydrate diet had reduced appetites, helping them lose weight easier.2

•Lowering Insulin Levels

When you consume carbs, they are broken down into sugars in your body. In turn, this causes your blood sugar levels to rise and leads to a spike in your insulin.

Over time, you may develop insulin resistance, which can progress to type 2 diabetes. By altering your diet to a ketogenic approach, you can reduce your risk of developing type 2 diabetes.

In a study published in Nutrition & Metabolism, researchers noted that diabetics who ate low-carbohydrate ketogenic diets were able to significantly reduce their dependency on diabetes medication, and may even reverse it eventually.3

Different Types of Ketogenic Diets You Can Try

There are several variations of the ketogenic diet based on specific needs:4

•Standard Ketogenic Diet (SKD)

SKD is the type I typically recommend for most people, because it is very effective. It focuses on high consumption of healthy fats (70 percent of your diet), moderate protein (25 percent) and very little carbohydrates (5 percent).5

Keep in mind that there's no set limit to the fat, because energy requirements vary from person to person, depending on their daily physical activities.

However, majority of your calories still need to come from fats, and you still need to limit your consumption of carbohydrates and protein for it to become a standard ketogenic diet.6

•Targeted Ketogenic Diet (TKD)

TKD is generally geared towards fitness enthusiasts. In this approach, you eat the entirety of your allocated carbs for the day in one meal, 30 to 60 minutes before exercise. The idea here is to use the energy provided by the carbs effectively before it disrupts ketosis.7

If you're following this approach, I recommend that you eat carbs that are easily digestible with a high glycemic index to avoid upsetting your stomach. Then, when you're done exercising, increase your intake of protein to help with muscle recovery, then continue consuming your fats afterwards.8

•Cyclic Ketogenic Diet (CKD)

Whereas TKD is focused on fitness enthusiasts, CKD is focused more on athletes and bodybuilders. In CKD, you cycle between a normal ketogenic diet, followed by a set number of days of high carb consumption, also known as "carb-loading."9

The idea here is to take advantage of the carbohydrates to replenish the glycogen lost from your muscles during athletic activity or working out.10

If you're a high-level athlete or bodybuilder, CKD may be a viable method for you. It usually consists of five days of SKD, followed by two days of carb-loading. During the ketogenic cycle, carb consumption is around 50 grams, but when you get to the carb-loading cycle, the amount jumps to 450 to 600 grams. Again, this method isn't recommended for most people who do not have a high rate of physical activity.11

•High-Protein Ketogenic Diet

This method is a variant of the SKD. In a high-protein diet, you increase the ratio of protein consumption to 10 percent and reduce your healthy fat consumption by 10 percent. In a study involving obese men that tried this method, researchers noted that it helped reduce their hunger and lowered their food intake significantly, resulting in weight loss.12 If you're overweight or obese, this may help you at first, then you can transition to SKD after you normalize your weight.

•Restricted Ketogenic Diet

As mentioned earlier, a ketogenic diet can be an effective weapon against cancer. To do this, you need to be on a restricted ketogenic diet. By restricting your carbohydrate and calorie intake, your body loses glycogen and starts producing ketones that your healthy cells can use as energy. Because cancer cells cannot use these ketones, they starve to death.13

A 2010 study helps back up this claim. A 65-year old woman who was suffering from glioblastoma multiforme (GBM), an aggressive type of brain cancer, was put into a restricted ketogenic diet that started with water fasting and then proceeded to consume 600 calories a day only. After two months, her weight decreased and the ketones in her body elevated.

Furthermore, there was no discernable brain tumor tissue detected using magnetic resonance (MRI) or fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging scans.14

Put Away These Foods Before Going on a Ketogenic Diet

Before coming up with an actual ketogenic diet food list, it's important to take a look at what you're eating first and take out anything that's unhealthy. This means that you have to remove sugars, starches, packaged and processed foods from your diet, because a ketogenic diet focuses on eating real, whole food.

Furthermore, avoid drinking milk because it contains the carbohydrate galactose — drinking just one glass can basically eat up your entire carb allotment for the day. In addition, avoiding milk helps lactose-intolerant people to implement the ketogenic diet. Many other products should be avoided, such as hydrogenated vegetable oils (canola, sunflower, etc.), peanut butter, soy products and sodas. They may be low on carbohydrates, but they are unhealthy and can wreak havoc on your health.

The Ideal Foods to Eat for a Ketogenic Diet

So now that you've taken out all the unhealthy food sources, what's the next step? When it comes to the core of an actual ketogenic diet, remember that you need to consume only a moderate amount of protein, or about one-half gram per pound of lean body mass, each day. In addition, carbohydrates must be minimized and high-quality fats increased to serve as your new fuel source.

To ease yourself into a ketogenic diet meal plan, I usually recommend adding C8 medium-chain triglyceride (MCT) oil into your food. It's typically more expensive than other types of MCT oil, but I prefer it more because it converts into ketones more effectively. You can start with 1 teaspoon per day, then gradually increase your consumption to 2 to 3 tablespoons per day.

If your stomach does not agree with MCT oil, you can try MCT powder, which is easier on your stomach. The table below provides a good overview of other foods rich in high-quality healthy fats:

Coconut oil	Animal-based omega-3 fats from healthy sources such as wild-caught Alaskan salmon, sardines, anchovies and krill	Olives and olive oil (make sure they are third-party certified because most olive oils are diluted with vegetable oils)
Raw, grass fed butter	Raw nuts, such as macadamia, almonds and pecans	Various seeds such as pumpkin, sesame, cumin and hemp
Avocados	Grass fed meats	Lard and/or tallow
Ghee (clarified butter)	Raw cacao butter	Organic pastured eggs

When building your ketogenic diet meal plan, it's important to stick to green leafy vegetables because they are rich in fiber, antioxidants and various nutrients. Your best choices include broccoli, spinach, parsley, Brussels sprouts and zucchini.

While fruits are generally healthy for you, majority of them should be are avoided in a ketogenic diet because of their high amounts of sugar. However, certain berries are safe to eat in moderate quantities, such as blackberry, blueberry and cranberry, because they are rich in antioxidants that can support your health.

As for beverages, there are several you can choose from. The most important is water, but you may also drink organic black coffee (without any sweeteners or milk), which is rich in antioxidants. Coconut milk can be consumed as well, as well as herbal teas because they are rich in various antioxidants and nutrients. If you want a more extensive list, Paleo Flourish Magazine has recommendations that encompass various food groups.15

Ketogenic Recipes You Can Try

It may look like there are plenty of foods not allowed when following a ketogenic diet, but there are actually many recipes that you can cook that adhere this method. Here are three ketogenic recipes that I personally use in my daily routine:

Dr. Mercola's Chocolate Fat Bomb Recipe

Ingredients:

• 1 Tbsp. of black sesame seeds
• 1 Tbsp. of flax seeds
• 1 Tbsp. of black cumin seeds
• 1 Tbsp. of pumpkin seeds
• 1 Tbsp. of organic psyllium
• 1 Tbsp. of chia seeds
• 1 scoop of Dr. Mercola's Organic Greens
• 1 tsp. of calcium from ground-pastured eggshells
• 1/2 ounce of cocoa butter
• 1 whole avocado
• 1 to 2 Tbsp. of medium-chain triglyceride (MCT) oil
• 1 drop of Stevia
• Filtered water

Procedure:

1. Let the black sesame, flax, pumpkin and black cumin seeds soak overnight (roughly 14 hours) in a mixing bowl.
2. Mix the remaining ingredients.
3. Pour water to desired consistency — it can range from a liquid to pudding texture.
4. Using an immersion blender, blend for two to five minutes for desired consistency.

Dr. Mercola's Keto Salad Recipe

Ingredients:

• 2 ounces of ground organic lamb
• 1/3 red onion
• 1 whole avocado
• 2 to 4 ounces of sunflower seed sprouts
• 1 to 2 Tbsp. of Dr. Mercola's coconut oil
• 6 pieces of anchovies (packed in salt, not oil)
• A handful of oregano to your desired flavor (cut finely)
• 2 to 4 ounces of fennel bulb and/or leaves
• 2 sprigs of rosemary (chopped finely)
• 100 grams of red pepper
• A handful of Malabar spinach
• 1 habanero pepper (chopped)
• 1 Tbsp. of salmon fish roe
• 2 to 3 ounces of grass-fed pastured butter
• 3 ounces of fermented vegetables
• 4 to 7 shakes of Dr. Mercola's Himalayan salt
• 10 to 20 of shakes ground pepper (depending on your preference)

Procedure:

1. Gently heat the coconut oil in a frying pan.
2. Add onions and ground organic lamb at very low heat for 20 to 25 minutes.
3. In a separate bowl, cut and mix the remaining ingredients.
4. After 25 minutes, add the onions to the salad and then mix it well.
5. Rinse salt off the anchovies and soak them for five minutes.
6. Split each anchovy into three pieces and add to the salad.
7. Add the organic lamb to the salad.

Dr. Mercola's Macadamia Nut Fudge Recipe

Ingredients:

• 300 grams of cocoa butter
• 200 grams of Dr. Mercola's coconut oil
• 200 grams of raw, organic-pastured butter
• 300 grams of macadamia nuts
• 8 full droppers of stevia (you can use Luo Han as a substitute)
• 1 teaspoon Dr. Mercola's organic vanilla extract

Procedure:

1. Mix the butters and oils under low heat for three to five minutes.
2. Once the mixture cools, add the stevia and the vanilla extract.
3. Pour the fudge into 8-ounce wide ball jars.
4. Spread the nuts evenly across all jars.
5. Refrigerate until the fudge reaches the desired consistency

This recipe makes eight servings.

The Side Effects of a Ketogenic Diet

Starting a ketogenic diet can help optimize your health tremendously in many ways. But like any major dietary changes, it can have several undesirable (but not alarming) side effects, such as:

Bad Breath: Once you start on a ketogenic diet, you may notice that your breath will have an undesirable odor due to the increased acetone levels in your body. Acetone is a ketone produced during ketosis, which is expelled in your urine and partly your breath. On a positive note, detecting acetone in your breath is a good indicator that your ketogenic diet is working.16 You can brush your teeth and/or rinse your mouth with coconut oil to help remove the bad breath.	Short-Term Fatigue: You may begin to feel fatigue at the start of a ketogenic diet. It's actually one of the main reasons why many people choose not to continue with this approach long before they can enjoy the benefits.17 The reason why you get tired at the start is your body is adapting from using carbohydrates for energy to healthy fats. The transition doesn't happen overnight, and it may take you anywhere between seven to 30 days before your body achieves full ketosis.18
Frequent Urination: During the first few days of implementing a ketogenic diet, you may notice that you're using the bathroom more often. That's because your body is dumping the glycogen in your liver and muscles as urine. Furthermore, as the insulin level in your blood begins to drop, excess sodium is expelled in the form of urine as well.19	Digestive Problems: A huge shift into any dieting method can increase your risk of digestive problems, and the ketogenic diet is no exception. Constipation is commonly reported among those who are starting out on a ketogenic diet, but it may disappear in a few weeks once your body gets used to the healthier food you're eating.20
Sugar Cravings: You may develop intense sugar cravings as your body switches from sugar to fat for fuel. However, I encourage you not to give in to temptation. You can practice various relaxation method such as the Emotional Freedom Techniques or yoga to take your mind away from sugary foods.21	Hair Loss: You may notice that more strands of hair getting stuck on your brush during the first few days of your ketogenic diet. Don't worry because this is not a big cause of concern, since hair loss can result from any major dietary changes in general. It will stop once your body achieves ketosis.22

Going into nutritional ketosis by following a ketogenic diet is one of the most radical but highly beneficial lifestyle changes you can make to improve your health. As with most dietary changes, always remember to listen to your body. If you feel any side effects other than the ones listed above, then necessary adjustments may be needed to your food intake.

Frequently Asked Questions About the Ketogenic Diet

Q: How do I go into nutritional ketosis?

A: To enter into a state of nutritional ketosis, take a look at what you're currently eating and remove any unhealthy items such as sugary drinks and processed foods. The next step is to consume whole, organic foods that are high in healthy fats, has moderate protein and only minimal carbohydrates.

Q: How long does it take to get into ketosis?

A: Each person reacts differently to a ketogenic diet. You may experience a few side effects in the first seven to 30 days, such as constipation, fatigue and urination. But once your body normalizes, you will start feeling the benefits.

Q: How many carbs can I consume to be in a state of ketosis?

A: It's generally recommended that only 5 percent of your daily diet is allocated to carbohydrates because if you consume more than that, your body gets thrown off ketosis. However, this is only for SKD, or the standard ketogenic diet. If you're an athlete or a bodybuilder, you can consume more carbs without affecting ketosis by following a targeted ketogenic diet (TKD) or a cyclic ketogenic diet (CKD).

Q: How long does it take before ketosis shows results?

A: The results of ketosis can be felt as early as the first week when your body begins to dump water and carbohydrates, but the weight loss will only be minor.23 As time goes on, your body will begin to consistently shed excess fat, provided you stick to your ketogenic program.24

Finding Your Ideal Carb Level

According to Volek, a level of non-fiber carbs that allows you to enter into nutritional ketosis (a metabolic state associated with an increased production of ketones in your liver; it's the biological reflection of being able to burn fat) is on average about 50 grams per day or less of digestible or absorbable carbohydrates. However, we all vary how we respond to the same food, so this is not an exact recommendation.

Some people can be in a full fat-burning state with full ketosis at a level of non-fiber carbs that's higher than 50 grams; maybe 70 or 80 grams. Others, especially if you're insulin resistant or have type 2 diabetes, may require less than 40 grams or even 30 grams per day.

Again, it bears repeating that when we say carbohydrates, we're referring to non-fiber carbs only. If you look at the nutrition facts on a processed food package, it will list total carbs, and that's not what we're talking about. Don't get confused about this or you'll get really nervous. You do need carbs, but you need most all of them from vegetables.

By volume, vegetables are not very calorie-dense. You could have an 85 percent fat diet, and the volume of the fat would be one-tenth the volume of the vegetables you're eating.

To find your personal carb limit, it's important to actually measure your ketones, which can be done either through urine, breath, or blood. This will give you an objective measure of whether or not you're truly in ketosis, rather than just counting the grams of carbohydrates you consume.

"That even varies within a person over time," Volek says. "You may be able to tolerate more carbs when you're in your 20s, but suddenly now you're in middle age and the same level of carbs is resulting in a few extra inches on your waist, your blood sugars are creeping up, you now have prediabetes, or worse.

The appropriate level of carb for an individual is bit of a moving target, but it is a very important element to personalizing a diet, which I think is fundamental to this idea of personalized nutrition. It's finding the appropriate level of carb for you at any given point in your lifespan that allows you to maintain health."

Research has shown that ketosis is a very safe and a therapeutic metabolic state to be in, especially if you're diabetic or suffering from carb intolerance. But there are people who are naturally very insulin sensitive and carb tolerant that don't need to be in ketosis to thrive. So there's certainly room for flexibility, depending on your individual situation.

Ketogenic Diet Can Benefit Many Chronic Health Problems

Beyond insulin resistance and type 2 diabetes, there are a number of applications for a well-formulated ketogenic diet, including epileptic seizures, especially in kids who are unresponsive to drugs, and neurological conditions such as Alzheimer's and Parkinson's. Cancer is another area where ketogenic diets show great promise.

"I think that is the next frontier of ketogenic diets," Volek says. "There are multiple reasons why many cancers would benefit from a ketogenic diet, not just the decreased glucose availability influx (which many tumors depend on) but also the lower insulin response and less inflammation, as many tumors thrive in a pro-inflammatory environment.

There are multiple potential mechanisms by which a ketogenic diet would benefit, including epigenetic effects. We now know that the principal ketone body, beta hydroxybutyrate, is more than a metabolite. It's more than just an alternative fuel for the brain.

It acts like a hormone or a potent signaling molecule that affects gene expression, including upregulating genes that are protective against oxidative stress and enhance the antioxidant status.

Our knowledge and perspective on ketosis is expanding almost daily. It's all pointing toward positive health effects, which is quite interesting considering that for the last three or four decades, we've been demonizing ketones because we only associate it with ketoacidosis."

Other benefits include the resistance to sugar and other food cravings, as you're never that hungry once you've made the shift. Mental clarity is another great boon. According to Volek, the U.S. military is showing great interest in ketones for this reason — along with the fact that it boosts physical stamina and endurance.

Being an efficient fat burner may also predispose you to a longer life. Dr. Ron Rosedale told me many years ago that the single most important variable for controlling the aging process is the ratio of fat versus carbohydrate you burn. The more fat you burn, the slower you're going to age in general. More recent research supports this notion.

How Ketogenic Diet May Promote Longevity and Increased Muscle Mass

Recent research has found about a dozen genes associated with longevity. The primary function of one of these genes is to cripple the degradation of branched-chain amino acids, such as leucine, which can be useful for building muscle mass. Interestingly, in one of his books, Volek mentions that ketones share a close structural similarity to these branched-chain amino acids, and seem to be preferentially metabolized.

In other words, ketones spare those branched-chain amino acids, leaving higher levels of them around, which promotes longevity and increased muscle mass.

"We learned a lot about ketogenesis from the classic work done by people in the '60s studying starvation ketosis. One of the reasons why we can survive so long without food is we enter into ketosis, and ketosis spares protein breakdown. One of a more consistent effect we see in people on a ketogenic diet is that leucine levels go up in the blood, because they're not being oxidized to the same level.

Ketones are sparing oxidation and breakdown of important structural proteins, and therefore their levels or concentrations in the blood increase and allow them to do other important signaling-type functions.

I do see a very positive interaction here with nutritional ketosis and protein metabolism in general in sparing of the branched-chain amino acids in particular, which are unique in that they are a preferential fuel, unlike other amino acids, which don't really serve as a fuel substrate," Volek explains.

The Importance of Eating Moderate Protein

There's also a "sweet spot" regarding protein. You don't want more protein than your body actually needs. As noted by Volek, this is an important point because there's a common misconception that low non-fiber carb diets are high-protein diets. In reality, a ketogenic diet must actually be moderate in protein because excessive protein is anti-ketogenic.

On the other hand, you don't want to consume too little protein, as this may push you into a negative nitrogen balance. As a general rule, I recommend eating one-half gram of protein per pound of lean body mass per day, which for most sedentary folks is 40 to 70 grams, but this may be higher for athletes and larger individuals.

The best approach is to measure ketosis to know you are not over-consuming protein.  For details on how to calculate this, please see my previous article, "The Very Real Risks of Consuming Too Much Protein."

"It's also important to maximize the quality of the protein," Volek says. "I am a general proponent of high-quality protein sources [such as] whey protein. Most animal sources of protein maintain these essential amino acids [discussed above].

I do think, with the potentially unique characteristics of leucine and branched-chain amino acids, we may discover that it's beneficial to include extra leucine even within a context of a ketogenic diet ... Especially if you're an athlete wanting to enhance lean body mass, there could be some benefit to specific use of leucine in particular after exercise or even before exercise ...

I generally think including all three [is best]. Leucine is a potent stimulator of mTOR and protein synthesis in skeletal muscles. It's one thing to turn on the machinery, but you still have to have the building blocks in order to build proteins. I do think it's important that you have full complement of the essential amino acids to make sure that you have all the material there to take advantage of the signaling effect of leucine."

Low-Carb Benefits for Athletes

The dogma in sports nutrition for the last four decades has been that in order to perform at a higher level and recover adequately, athletes need to consume high amounts of (non-vegetable) carbs before, during, and after exercise. However, in more recent years, the understanding of how low-carb diets can augment performance in certain athletes is starting to catch on.

It has certainly gained a great deal of traction in the ultra-endurance world, where athletes are exercising continuously for several hours.

"To be quite frank, they're challenged from a fueling perspective," Volek says, "because if they're eating carbs, they're inhibiting their ability to burn fat optimally. They're putting themselves in a situation where they're increasingly dependent on providing more carbs.

You can only store a limited amount of carbs in your body as glycogen, about 2,000 kilocalories, and if you're exercising for more than a couple of hours, you're burning through the majority of that stored carbohydrate.

That's when an athlete hits the wall. We know that's associated with obvious decrements in performance. How do you avoid that? You can carb-load. That's been the traditional recommendation; to try to pack even more carbs into your muscles ... but that will only delay exercise fatigue by a half hour or so. That doesn't really solve the problem.

It actually exacerbates the problem in some ways. The alternative is to train your body to burn more fat. If you're burning fat and sparing carbohydrates, you don't hit the wall. That's one of the most commonly perceived benefits of a low-carb diet for athletes."

Athletes who adopt this strategy can become exceptionally good at burning fat. Even if they're not eating calories during exercise, lean athletes have at least 20,000 to 30,000 kilocalories on their body in the form of adipose tissue that they can access during exercise. That's more than enough to finish even a 100-mile race. So from a fueling perspective, it makes sense that you'd want to burn more fat as opposed to carbohydrate.

Ultra-endurance athletes who have switched to low-carb, high-fat diets are now winning races and, in some cases, setting new course records. They're also experiencing other benefits, such as speedier recovery rates, improved metabolic health, and a leaner body composition.

More Information

Mounting evidence suggests low- non-fiber carb, high-fat diets may be the key that many people have been looking for, as it solves more than one problem. Not only does it help you shed excess body fat, it does so while simultaneously improving metabolism, boosting overall energy levels, and promoting optimal health and maximizing longevity in a number of different ways.

It can also help ward off neurological dysfunction, boost mental clarity, and improve athletic performance.

For those who struggle with insulin resistance or diabetes, it's certainly one of the most efficient ways to reverse the condition. Even those suffering with more serious conditions, such as cancer, may reap significant benefits.

To learn more, I highly recommend picking up one or both of Volek's books — "The Art and Science of Low Carbohydrate Living," and "The Art and Science of Low Carbohydrate Performance" — the latter of which is geared toward athletes in particular.