KETOSIS IN A NUTSHELL:
Your Most Evolutionary Friend
Published By Justin Dutra On: June 29, 2017
Ketosis in a nutshell:
In essence, a ketogenic diet mimics starvation kind of like intermittent fasting, allowing the body to go into a metabolic state called ketosis which in essence is a character of neurohacking if taken exogenously. Normally, modern human bodies are sugar-driven machines: ingested simple or complex carbohydrates are broken down into glucose, which is mainly transported and used as energy or stored as glycogen in liver and muscle tissue. When deprived of dietary carbohydrates (usually below 50g/day), the liver becomes the sole provider of glucose to feed your hungry organs – especially the brain, 20% of total energy expenditure. The brain cannot directly use fat for energy. Once liver glycogen is depleted, without a backup energy source, humanity would’ve long disappeared in the eons of evolution. The backup is ketone bodies that the liver derives primarily from fatty acids in your diet or body fat. These ketones which are called hydroxybutyrate (BHB), acetoacetate and acetone – are released into the bloodstream, taken up by the brain and other organs, shuttled into the “energy factory” mitochondria and used up as fuel. Excess BHB and acetoacetate are excreted from urine, while acetone, due to its volatile nature, is breathed out (hence the characteristically sweet “keto breath”). Meanwhile, blood glucose remains physiologically normal due to glucose derived from certain amino acids and the breakdown of fatty acids(1).
What are some other benefits of Ketosis(2):
Blood sugar balance and enhanced insulin sensitivity
Increase satiety, and decreased food cravings
Improved energy levels, oxygen capacity, motor performance & athletic performance
Enhanced blood flow through vasodilation
Neuroprotective benefits in seizure disorders; ADHD; Alzheimer’s disease, memory and cognitive function; Parkinson’s Disease and Multiple Sclerosis
Autism and improved behavior and social impacts
Mood stabilization in bipolar disorder (type II)
Stroke prevention; cardiovascular disease; metabolic syndrome management; improved cholesterol levels
But ketosis has a dark side so consider the following…
Dark Side To Ketosis #1: Triglycerides
Let’s say you decide you’re going to get into ketosis by eating boatloads of grass-fed butter, peanut butter, almond butter, animal meats, and oils, and you aren’t very selective in the quality of those fats. That’s a definite shortcut to throwing your triglycerides through the roof. And not only are high levels of circulating triglycerides a good way to get fat fast, but studies have consistently linked high triglyceride levels with heart disease, heart attacks and stroke. Fructose is one quick way to elevate triglycerides, but this really doesn’t seem to be an issue with high-fat, low-carbers. However, vegetable oils and butter and animal fats and nuts and seeds can also significantly raise triglycerides. One big issue here is that if these oils and fats have been exposed to high amounts of temperature and processing, triglycerides are getting dumped into your body chock full of free radicals. So if your high-fat diet includes a high amount of roasted seeds or roasted nuts, nut butters, heated oils such as heated coconut oil or heated extra virgin olive oil, barbecued meats or meats cooked at very high temperatures, then your triglyceride count is going to go up. You should have triglycerides that are less than 150mg/dL, and a triglyceride to HDL ratio that is no more than 4:1, and in most of the healthiest people I’ve worked with, triglycerides are under 100 and the triglyceride to HDL ratio is less than 2:1. If your ratio is whacked, your ketotic diet isn’t doing you any favors.
Dark Side To Ketosis #2: Inflammation
If you have high levels of cholesterol, which you probably do if you’re eating a high-fat, low-carb diet, then you need to be worried if your HS-CRP levels (a primary marker of inflammation) are above 1.0 mg/dL – even if you’re a hard charging athlete.
Try to get under 0.5 for CRP levels because a high amount of inflammation in your body is going to make the cholesterol circulating in your bloodstream more likely to become oxidized, generating a high amount of heart and connective tissue-damaging free radicals. As a matter of fact, it’s more dangerous to have high levels of cholesterol and high levels of CRP than low levels of cholesterol and high levels of CRP – even if your high levels of cholesterol are “healthy”, big fluffy LDL particles, and not small, dense VLDL particles. In other words, no matter how many healthy fats you’re eating, these fats may actually come back to bite you if you’re creating high inflammation from too much exercise, not enough sleep, exposure to toxins and pollutants, or a high-stress lifestyle.
Dark Side To Ketosis #3: Cholesterol Damage
Free-ranging glucose molecules in your bloodstream can adhere to cholesterol particles and cause those particles to remain in the bloodstream for long periods of time, since your liver can’t properly process cholesterol when it has a glucose molecule attached to it. The longer cholesterol circulates in your bloodstream, the higher the likelihood that it will dig its way into an endothelial wall and potentially contribute to atherosclerosis or plaque formation. This is why it’s so dangerous to eat a high-fat diet, but to also have your nightly dark chocolate bar, overdo it on the red wine, or have weekly “cheat days” with pizza, pasta, or sugar-laden ice cream. So if you’re going to eat a high fat diet, then you need to ensure your fasted blood glucose levels are staying at around 70-90mg/dL, and your hemoglobin A1C is staying below 5.5. If not, your high fat diet could actually be significantly hurting you.
Dark Side To Ketosis #4: Thyroid Issues
Carbohydrates are necessary for the conversion of inactive thyroid hormone to active thyroid hormone, and if you’re on an extremely strict low carbohydrate diet, then you may actually be limiting this conversion. Your TSH is what tells your thyroid gland to “release more hormone,” so your TSH rises when your thyroid gland is underactive, or conversion of inactive to active thyroid hormone is inadequate. A high TSH means that the pituitary gland is releasing its hormone to try to get the thyroid to respond and produce more thyroid hormone. Because of inadequate carbohydrates, TSH will often elevate in a high-fat, low-carber – indicating potential for long-term thyroid and metabolic damage. If I see a TSH above 2.0 or a trend towards higher values in someone who is testing repeatedly, I get worried – and prefer to see TSH at 0.5-2.0. Of course, this doesn’t mean that you begin to shove carbohydrates indiscriminately down the hatch. However, it means that your high-fat, low-carb diet should include thyroid supporting foods rich in iodine and selenium, such as sea vegetables and brazil nuts, and should also include carbohydrates timed properly, such as before, during or after workouts, when the carbohydrate is more likely to be utilized for energy and less likely to spike blood glucose levels. It also means that if you’re a very active athlete or exercise enthusiast and you’re following “trickle-down” advice from the sedentary or less active ketosis experts to eat less than 40g of carbs per day, you’re making a big mistake when it comes to your hormonal balance, and you need to up your carbohydrate intake to 100-200g of carbs per day. You’d be surprised at how easy it is (if you’re a very active person) to stay in ketosis on this level of carbohydrate intake. Go ahead. Do Ketonix breath testing to prove me wrong. You can eat boatloads of carbohydrates at night and be back in ketosis within just two to three hours. When you combine that with the cutting-edge tricks you’re about to learn, you’ll find that you can toss hormonal issues out the window, get into ketosis, have your cake, and eat it too.
Dark Side To Ketosis #5: Social “Limitations”
Let’s face it: if you’re eating 70-90% fats, it can be very, very difficult to hang out with your friends at an Italian restaurant. Or to walk past a bakery. Or to find yourself surviving and having fun at a holiday party with fresh baked cookies, wine, chocolates, and cocktails as temptation is everywhere.
Brain on Ketones: Energetics, Oxidation and Inflammation(3):
So the brain is happily deriving energy from ketones – sure, but why would this be protective against such a variety of brain diseases?
One answer may be energy. Despite their superficial differences, many neurological diseases share one major problem – deficient energy production. During metabolic stress, ketones serve as an alternative energy source to maintain normal brain cell metabolism. In fact, BHB (a major ketone) may be an even more efficient fuel than glucose, providing more energy per unit oxygen used. A ketogenic diet also increases the number of mitochondria, so called “energy factories” in brain cells. A recent study found enhanced expression of genes encoding for mitochondrial enzymes and energy metabolism in the hippocampus, a part of the brain important for learning and memory. Hippocampal cells often degenerate in age-related brain diseases, leading to cognitive dysfunction and memory loss. With increased energy reserve, neurons may be able to ward off disease stressors that would usually exhaust and kill the cell.
A ketogenic diet may also DIRECTLY inhibit a major source of neuronal stress, by -well- acting like a blueberry which has pro-polyphenol compounds. Reactive oxygen species are unfortunate byproducts of cellular metabolism. Unlike the gas Oxygen, these “oxidants” have a single electron that makes them highly reactive, bombarding into proteins and membranes and wrecking their structure. Increased oxidants are a hallmark of aging, stroke and neurodegeneration.
Ketones directly inhibit the production of these violent molecules, and enhance their breakdown through increasing the activity of glutathione peroxidase, a part of our innate anti-oxidant system. The low intake of carbohydrates also directly reduces glucose oxidation (something called “glycolysis”). Using a glucose-like non-metabolized analogue, one study found that neurons activate stress proteins to lower oxidant levels and stabilize mitochondria.
Due to its high fat nature, keto increases poly-unsaturated fatty acids (PUFAs, such as DHA and EPA, both sold over-the-counter as “brain healthy” supplements), which in turn reduces oxidant production and inflammation. Inflammatory stress is another “root of all evil”, which PUFAs target by inhibiting the expression of genes encoding for pro-inflammatory factors.
Neurons on Ketones (4):
Excited neurons transmit signals, process information and form the basis of a functioning brain. OVER-excited neurons tend to die. The brain teeters on a balance between excitation and inhibition through two main neurotransmitters, the excitatory glutamate and the inhibitory GABA. Tilt the scale towards glutamate, which occurs in stroke, seizures and neurodegeneration, and you get excitotoxicity. In other words, hyper-activity is toxic.
A recent study in hippocampal neurons showed that ketones directly inhibited the neuron’s ability to “load up” on glutamate – that is, the transmitter can’t be packaged into vesicles and released – and thus decreased excitatory transmission. On the other end of the excitation-inhibition balance, ketones increase GABA in the synapses (where neurotransmitters are released) of rats and in the brains of some (but not all) epileptic humans subjects. This increase in inhibition may confer both anti-seizure effects and neuroprotection, though data is still scant. Then there are some fringe hypotheses. The acidity of ketones may decrease the pH of certain brain microdomains, which might be the mechanism of keto’s positive effect on Type II Bipolar disorder (lots of mays and mights, I know). As keto affects the whole body, global changes due to calorie restriction and regulation of the satiety hormone Leptin are bound to alter brain function, and play a circumstantial role.