Ketosis is not a party trick

For some time I have been concerned about the widespread use of the ketogenic diet as a sort of ‘party trick’. If you look online for ketogenic foods you will come across all sorts of crazy food combinations that seem to offer the ability to stuff your face with chocolate flavoured fat, or mountains of bacon and eggs, with no metabolic consequences. Even before I start thinking about the biochemistry, something fundamental in me knows that can’t be right.

The ketogenic diet is a valuable therapeutic tool that is a quick and easily-followed path to the reversal of pathological (unhealthy) insulin resistance, which is the most likely reason people can’t begin to lose weight on a ‘normal’ weight-loss diet. Insulin resistance is your body’s natural and inevitable response to life on a low-fat diet with side servings of intensive exercise, chronic stress, low magnesium and poor sleep. It is now so common in the population that I tend to make an assumption that all my clients are suffering from it from it to some degree. Does that mean I put all my clients on a ketogenic diet? No, I don’t.

The ketogenic diet is the ideal starting point for clients dealing with diabetes or obesity, it’s suitable for some cancer clients too. At least in the early stages ketosis seems to offer the chance to eat as much as you like of all the naughty foods you’ve been avoiding for most of your life while shedding weight faster than ever. If you’ve struggled with your weight all your life, it really does feel like a party trick! Eating in a way that ensures ketosis is the primary energy-making pathway restores the body’s ability to shift between carb and fat burning in a very short time frame, thus improving metabolic adaptability, a key marker of health. Ketones are also being shown to be a remarkably ‘clean burn’ fuel, preferred by many body tissues, and generating lower levels of damaging free radicals than glucose, the fuel created from sugars and starches, and widely preferred by ‘the establishment’.

The fact is, you can overeat on a ketogenic diet and it feels like you can get away with it. That’s one reason people are enjoying it so much. It’s seductive, but long term followers have noticed that after months or years relying on ketones for fuel, and hardly ever switching into carb burning, another type of insulin resistance emerges. This is where your muscles and other tissues have become so used to using ketones from fats that they can no longer easily use glucose from sugars and starches. Thus, if ever you do eat something sweet or starchy, your blood sugar remains elevated for a long time. Many commentators have suggested that this form of insulin resistance, termed ‘physiological’ insulin resistance, is nothing to worry about.

I can’t agree. The idea that you have swapped from insulin resistance based on glucose consumption to insulin resistance created by fat consumption doesn’t sound healthy at all. It’s just one extreme to another: another form of metabolic dysfunction. It’s vital that we maintain an ability to process all natural fuel substrates if we are to claim to be healthy. As I have often written, being keto-adapted is more important for most people than being permanently in ketosis. (Exceptions may apply for specific diseases.)

One of the problems with the ketogenic diet is that it has never been widely used in the population so there is a lack of in-depth understanding of its effects. We know it’s ‘safe’ because it has been used to treat children with epilepsy for decades with no serious concerns. In fact it seems to be the perfect diet for anyone with any sort of neurological problems, including brain tumours. We also know it’s a perfect intervention diet for people with obesity and diabetes. But we don’t really know enough about its long term effects to be able to say it’s better or worse than some other options, for example the widely researched and wisely recommended Mediterranean diet, or the poorly researched and foolishly recommended EatWell Guide.

Last week, I read an article on the Optimising Nutrition blog which provided a vital piece of the jigsaw. They shared research showing that high blood ketone levels not only inhibit lipolysis (fat mobilisation), thereby reducing weight loss, but also raise insulin levels. That is precisely what we have been trying to avoid by reducing sugars and starches!

If this sounds confusing, it’s not meant to be. It’s entirely logical. Bottom line: overeating anything – sugar or fat – will overwhelm your body’s energy-sensing systems and lead to biochemical dysfunction. And while, in this particular case, it may not lead to visible fat storage, it may well lead to even more dangerous fatty liver or other metabolic disorders. We all know that if we stop and think for a moment.

And, just to be clear, it’s not the ketogenic diet that’s dangerous it’s the crazy recipe blogs telling you that you can eat fatty snacks all day long and still stay slim. These sites are seducing you into thinking that you have finally found a way to eat that subverts the laws of nature – that you can have your cake and eat it. This may be true for endurance athletes or Arctic trawlermen, but for the average semi-sedentary individual it can’t be done. While you may be able to overeat and stay slim, you definitely can’t overeat and stay healthy.

So, a carefully designed ketogenic diet which includes a range of healthy carbs and fats, i.e. ‘real food’, can work well to keep you metabolically balanced: a diet packed with unnecessary/unused calories in the form of fat bombs and bulletproof coffee will not.

When I wrote my diet book, The Dissident Diet, (available on Amazon Kindle) five years ago, I didn’t understand all the intricate biochemistry of ketosis, but I had enough clinical experience to understand that balance is important. It’s a diet that supports ketogenic fat loss, but also recommends having a carby day once a week to keep your metabolic switch working. It is a healthy way to use ketosis for weight loss; ideal for diabetics too. It was an Amazon bestseller in 2014, has been followed by hundreds of people and gathered some rave reviews. I recently updated the content with everything I’ve learned over the past five years, and I’m still happy to recommend it.

It doesn’t contain any recipes for fat bombs.

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