Introduction to the Ketogenic Diet

The ketogenic diet is one that has gained much popularity over the past few years. It was originally created in the 1920’s as a treatment for childhood epilepsy. Before this time, the medical community understood the importance of fasting for epilepsy and other health conditions, but as fasting was often challenging for many to do, they discovered the ketogenic diet as a more accessible way to manage epilepsy. With the introduction of anticonvulsant medications, the ketogenic diet was largely abandoned. However, for the cases that were not successfully controlled by medication, the ketogenic diet was reintroduced (1, 2).

In the past decade, it has had a prominent space in the health world for epilepsy, weight loss, Parkinson’s, and beyond (3). 

 
Photo by Brooke Lark on Unsplash

Photo by Brooke Lark on Unsplash

 

Glucose vs. Ketones for Energy

Our bodies need energy to function. Oftentimes the body uses glucose for energy. Glucose comes from the digestion of carbohydrates (sugars and starches). When the stomach digests sugars and starches, they are broken down into glucose, which is a type of sugar. Glucose is then released into the bloodstream, where it is either used or stored. In order to use or store the glucose, our bodies need insulin. If our bodies do not have enough insulin, the glucose stays in the bloodstream, which keeps blood sugar levels high. Insulin is a hormone, which is made by beta cells in the pancreas. Beta cells continuously check blood sugar levels to determine if more or less insulin should be made. 

**With diabetes, the body either stops or slows the process of making insulin or is unable to use the insulin well, allowing for high blood sugar. You can also have non hyperglycemia, which is high blood sugar has not become diabetes yet**

The ketogenic diet is a diet that is composed of low carbohydrates, moderate protein, and high fat foods. Rather than using glucose for energy, this specific diet causes the body to instead use ketones from fat. Ketones are chemicals that the liver makes out of fat. After the liver turns fat into ketones, it sends them into the bloodstream to be used for fuel, which some experts argue is a better fuel for the body than glucose, especially for the brain.

Gluconeogenesis vs. Ketogenesis

Gluconeogenesis is when the liver turns non-sugar compounds into glucose for the body to use. The liver does this with amino acids, lactase, and glycerol. Gluconeogenesis means “the making of (genesis) new (neo) sugar (gluco).” When carbohydrate intake is cut back and the body’s sugar storage is low, the body will turn amino acids from both foods and its own muscles into fuel. 

Ketogenesis is when the body produces ketones  (acetone, acetoacetate, and beta-hydroxybutyrate) from fatty acids. This occurs when carbohydrate storage is low or when fatty acid concentration is increased (4). 

It would appear, at first glance, that we would want to be in a state of ketogenesis and that gluconeogenesis might interfere with our goals on the ketogenic diet. However, there are particular reasons why gluconeogenesis is helpful, especially as we transition from the body making energy from carbs to making energy from fats:

  1. It helps you avoid hypoglycemia- Hypoglycemia is when your blood sugar levels become low. Gluconeogenesis sustains glucose production when it’s needed, especially during the transition from a high carb to a low carb diet (5). 

  2. Some parts of the body NEED glucose- The brain, the lens and cornea of the eye, testes, and skeletal muscles require continuous glucose in order to function. Gluconeogenesis provides the glucose they need while also allowing ketosis to provide the primary source of energy through ketones (6, 7).

Conditions that the Ketogenic Diet may Help

As noted above, the ketogenic diet has helped improve people’s lives who are living with a number of debilitating health conditions. These can include:

  • Epilepsy

  • Alzheimers

  • Parkinson’s

  • Diabetes

  • Metabolic Syndrome 

  • Polycystic Ovary Syndrome (PCOS) 

  • Glucose Transporter Deficiency Syndrome

  • Multiple Sclerosis

  • Autism

  • Nonalcoholic Fatty Liver Disease

  • Migraine headaches

  • Traumatic Brain Injury

  • Brain cancer

  • Amyotrophic lateral sclerosis (ALS)

When approaching how to navigate one of these complex health conditions, it may be worthwhile to see how the ketogenic diet can improve these conditions and overall health of the person. But why would the ketogenic diet help these conditions? 

Research on the ketogenic diet has shown that it can lower inflammation in the body (8) and potentially be a tool to manage pain (9). It has been shown to inhibit activation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB), which is an inflammatory mediator involved in various inflammatory diseases (10). Additionally, it can improve mitochondrial function and production and can serve a neuroprotective purpose, though the mechanisms for this effect are still largely unknown (11).

Additionally neuronal death in the brain is an issue for neurological disorders, such as Alzheimers. Research shows that the ketogenic diet can protect against the death of neurons in the brain, and in research with mice who had ALS, ketogenic diets have improved motor neuron counts and prevented motor function loss (11).

 Weight Loss

The ketogenic diet has also proved to be a highly effective way to lose weight. When your body moves into ketosis, it uses the fat on your body to make ketones as fuel, which allows you to lose the pesky pounds you’ve been wanting to get rid of. Research has also posited that weight loss may be due to feeling less hungry on the ketogenic diet (12).  


In one particular study with 83 obese patients, they tried the ketogenic diet for 24 weeks. The weight and body mass of the patients decreased significantly. As an added benefit, their levels of HDL cholesterol (good cholesterol) went up, while LDL cholesterol (bad cholesterol) went down. The level of triglycerides, which are a fat lipid found in your blood, also decreased (13). 

Benefits

In summary, the ketogenic diet has a lot of potential benefits for health, including:

  • Neuroprotective function for various neurological conditions

  • Weight loss

  • Reducing appetite

  • Increasing HDL cholesterol

  • Reducing LDL cholesterol

  • Reducing blood sugar

  • Lowering inflammation

  • Reducing pain

  • Lowering triglycerides

We would love to speak with you to determine if the ketogenic diet, along with other life-sustaining and life-improving health interventions, is right for you.

Worked cited:

  1. https://www.news-medical.net/health/History-of-the-Ketogenic-Diet.aspx#:~:text=The%20ketogenic%20diet%20became%20popular,success%20as%20an%20epilepsy%20therapy.

  2. https://pubmed.ncbi.nlm.nih.gov/19049574/

  3. https://keto-mojo.com/article/history-of-the-keto-diet/

  4. https://www.ncbi.nlm.nih.gov/books/NBK493179/

  5. https://www.sciencedirect.com/science/article/abs/pii/0026049588900017

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874681/#:~:text=The%20brain%20is%20dependent%20on,carbohydrate%20diet%20(ketogenic%20diet).

  7. https://www.healthline.com/nutrition/low-carb-ketogenic-diet-brain#section4

  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981249/

  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124736/

  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981249/

  11. https://onlinelibrary.wiley.com/doi/full/10.1111/eci.12591#:~:text=Since%20ketogenic%20diets%20stimulate%20mitochondrial,as%20a%20possible%20treatment%20for

  12. https://pubmed.ncbi.nlm.nih.gov/25402637/

  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/