The ketogenic diet: why the switch is more important than the fuel

It’s three years this month since I wrote The Dissident Diet, based on my own experience of losing three stone, and a pilot study carried out with 16 people who needed to do the same. At the time it was ground-breaking, and more than a little brave, for a professional nutritionist to recommend a ketogenic diet when so many people in nutrition and medicine felt it was dangerous.

Since then, the ketogenic diet has become a buzz word; it’s considered both safe and effective for a whole range of the conditions that beset us in the 21st century. Its use in epilepsy is long established, but now we know that it can work wonders in obesity and diabetes, and we suspect it may be important for cancer and Alzheimer’s. Powerful indeed.

In a clinical setting I have used the diet to good effect with most of my clients. While it’s not suitable as a long term solution for everyone, I believe that nearly everyone (including those who consider themselves to be über-fit) can benefit from 6 to 12 weeks of ketosis to regulate their insulin responsiveness. It works a bit like a computer reboot.

And that’s the key.

I was in the Soho Theatre bar last Saturday night with my daughter, Polly, drinking tea and waiting to see the brilliant Pajama Men. We got chatting to a guy who shared our table and, when he discovered I was a nutritional therapist, he had just one question: “Should I be eating carbs?”

Where to begin?

For starters, diet is genuinely a completely individual thing. Some peopole cope well with carbs and others struggle. It depends on your genes, your metabolism, your stress levels, your environment, your exercise regime, and – in particular – your insulin response.

Just from looking at him I knew he could benefit from eating fewer carby foods for a while, but without more information I couldn’t be more precise.

What I could tell him, however, is that he was asking the wrong question.

The question he should have been asking is, “How can I get my body to switch quickly and seamlessly between carbs and fats when making energy”.

That, my friend, is the sixty-four million dollar question!

For most of us*, the benefits of the ketogenic diet are not brought about by an absence of carbohydrate but by oiling the switch that takes us from glycolysis (carb burning) to lipolysis (fat burning or, more accurately, ketone burning). It’s a switch that tends to become rusted in place because of our high carb, high stress lives.

Ironically, it turns out that oiling the switch is an apt metaphor because oils are the solution. Eating in a way that allows you to switch in and out of lipolysis between meals in order to use eaten or stored fat is a key factor for good health and longevity. The precise food balance to achieve that is different for different people but it’s not hard to work it out.

A common misconception around the ketogenic diet is that we are simply dealing with too much blood sugar but, in fact, we are most likely dealing with a parallel problem: too much insulin. Some of us, it seems, make much more insulin than othes in response to the same food – and that’s why our bodies don’t respond to conventional diet invervetions and medicine advice the way we’re supposed to.

People like us (i.e. those who have a persistent weight problem, diabetes, or cancer – in practice well over half the population) have insulin circulating in our blood stream long after the carbs we’ve eaten have been burned for energy, and the excess insulin stops us from accessing the fats we have eaten and stored – leading to fatigue, hunger and cravings. Crucially it stops us switching into lipolysis (fat burning) and using the body’s stored energy to tide us over periods of hunger.

Overcoming excess insulin secretion  – not just reducing carbs – is the key to reversing the disease states we’re facing. For that to happen we have to spend some time identifying and avoiding the foods that lead to excess insulin secretion (normally carbs but sometimes some protein foods too) and introducing more foods that don’t stimulate insulin (normally fats and well-chosen proteins). There’s a lot of personal trial and error and some complex biochemistry involved, which is why it’s a good idea to get professional help so that you don’t end up with a dietary imbalance. The ketogenic diet is no more one-size-fits-all than any other diet.

Certainly, in the early days, most people need a drastic reduction of carbs to reboot their insulin response, but in the longer term you will get to know your own body and discover the level of carbs that suits you. From clinical experience I can tell you that people can maintain healthy ketosis on very different carb/fat ratios.

So, you see, carbs aren’t the problem: insulin is.

If, like thousands of other people, you are hoping to lose weight next year, and especially if this is your resolution year after year because you haven’t found your answer, hyperinsulinaemia is probably the underlying  problem. Yes, weight loss is multifactorial – a product of all the things on your plate and in your environment – and yes, carbs are probably part of the problem – but until you restore insulin secretion to factory settings you have as much chance of losing weight as Jeremy Corbyn did in stopping the airstrikes.

To find out whether hyper-secretion of insulin could be your problem there are a couple of tests you could do. They are easy enough to do – but complicated to explain in a blog post. Contact me below to find out more.

And if you are hoping to keep the weight off over the Christmas season, or make inroads to a more pressing weight problem in 2016, please hop over to the Amazon Kindle store to buy my book.

*The exception to this is the application of the ketogenic diet for cancer where maintaining high circulating ketones may be a vital strategy for starving cancer cells.

3 thoughts on “The ketogenic diet: why the switch is more important than the fuel

  1. trekkiemaiden says:

    Love your insights – as usual spot on. It’s amazing how much of a journey this process is. It seems you and me both are at a watershed point. 12-13 years of LCHF and I’m now intermittent fasting – one meal a day (dinner) Monday-Friday and 2 (breakfast and dinner ) at the weekends. But crucially I am eating a bit more carby at those meals, even battered haddock (with salad) on Fridays. And at last am losing weight again, after 2 years sticking. So although nowhere near a high carb intake, I am eating a little more than I normally have done, I’m including a few more starchy veggies like sweet pots, turnip and parsnips for example. And am not at all hungry or preoccupied with food. So I’m guessing that although I didn’t lose weight those years, I must’ve been resetting any insulin resistance I may have had!!

    Have a great Christmas Dawn, take care, be warm, indulged and loved xxxx

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