Do you have an excessive waist circumference, high triglycerides, low HDL, fatty plaques in your arteries, hypertension etc.?
Topics Addressed:
- Current diet recommendations & unintended consequences
- Insulin resistance = carbohydrate intolerance
- Over-consumption of carbohydrate as a driver of chronic disease
- Nutritional Ketosis as a potent therapy to restore metabolic health
- Current diet recommendations & unintended consequences
The 2015 guidelines it demonized saturated fat and still promoting relatively high carbohydrate diets as a result we have an obesity and diabetes epidemic.
The diet heart hypothesis is if you over consume fat in particular saturated fat it raise your cholesterol and raise your heart disease.
The unintended consequences of this obsession with fat in this country and decreasing fat resulted in turn with an over consumption of carbohydrate. It’s this excessive amount of carbohydrate that people are eating that are leading to an alternative problem of metabolic syndrome or pre-diabetes which puts a lot of people on the fast path to developing type 2 diabetes which in turn increases risk for heart disease. The more carbs you eat the more you suppress your own body’s ability to access and utilize fat for fuel.
Following the guidelines has resulted in added sugars and a lot of processed starches and grains and cereals. That consumption is the primary cause of the obesity and diabetes epidemic, most non-commutable chronic disease and probably driving cancer too.
Dr. Volek is most interested in diabetes in part because of the statistics on diabetes and prediabetes published in JAMA in2016. It showed that one half of adults in the U.S. have pre-diabetes.
The general consensus among the healthcare industry and physicians is that diabetes is a chronic progressive disease that it can’t be reversed and that is not the case. It’s caused by over consumption of carbohydrate, it can be reversed by bringing carbohydrate down into an appropriate range, which for many diabetics means a ketogenic diet.
Metabolism: When we eat a typical meal that has carbohydrate in it, that meal may have easily a hundred grams of carbs in it. That is about ten times what we have in our blood. We only have one to two teaspoons of blood sugar and throughout our entire circulatory system. The body has ways to dispose of that glucose and if you’re processing that carb meal in a healthy way the majority of that glucose gets taken up into skeletal muscle through an insulin mediated process and it gets oxidized eventually. It may be temporarily stored as glycogen but we have a finite capacity to store glycogen.
- Insulin resistance = carbohydrate intolerance
What happens if your insulin resistance though?The primary characteristic many tests are based on is insulin mediated glucose uptake into cells. If you can’t get the glucose into muscle where does it go? The only other pathway that glucose can be metabolized is into fat. That happens in the liver, so if you are insulin resistant the majority of carbohydrates that you’re consuming actually takes an alternative path where a greater proportion of it gets converted to saturated fat. It gets packaged into a VLDL particle and released into the blood. What you see in type 2 diabetes or pre-diabetes, you see not just higher triglycerides in the blood but if you look at the composition of those VLDL particles they’re enriched in saturated fatty acids. A lot of that gets de-saturated to a 16:1 or palmitoleic acid. That is highly associated with risk for diabetes and other chronic problems.
- Over-consumption of carbohydrate as a driver of chronic disease
Most people are consuming carbohydrates above their tolerance. The result is metabolic syndrome. The signs are: excessive waist circumference, high triglycerides, low HDL, fatty plaques in the arteries, hypertension etc.
Please see the image of the insulin resistance continuum.
The insulin resistance is as a form of carbohydrate intolerance. It’s a continuum where people on the far end of the spectrum, that are carb tolerant, may be able to tolerate very low-fat high-carbohydrate diets and remain insulin sensitive and there’s other people at the other end of the continuum and a whole lot of people in between. It even changes over the lifespan, as we get older and enter into middle-age and beyond tolerate carbs less effectively so we’re more carb intolerant.
If you’re burning fat you don’t rely on insulin. Burning fatty acids and ketones are independent of insulin. It is a healthier fuel to be burning the vast majority of time. The more carbs you eat the more you inhibit fat burning and you become dependent carbs as your primary fuel source.
There is nothing comes close to a ketogenic diet in terms of enhancing the body’s ability to burn fat and ketones.
The body has developed this system to be able to maintain perfect inner organs fuel exchange in the context of low carbohydrate availability. The term I (Volek) like to use is keto-adaptation to describe this process of switching all the cellular machinery over to being able to accommodate fatty acid as the primary fuel and ketones.
There’s a lot of health benefits associated with keto-adaptation. Obesity, chronic diseases, neurological conditions and cancer are much easier to manage with the ketogenic diet. Type-2 diabetes can be reversed with the ketogenic diet.
What is the ketogenic diet?
See the slide of how it differs from other low carb diets.
It is low in carbohydrate. Carbohydrates are probably the primary macronutrient that drives ketosis but protein is also anti Ketogenic. A ketogenic diet is limited in carbs and protein. Fat doesn’t really factor in that much in terms of inducing ketosis so fat can be high it can be low it can be moderate depending on if weight loss or weight maintenances is desired. The Ketogenic diet is very tasty and very satiating.
What does the ketogenic diet look like in terms of macronutrients?
Please see the image of where calories come from.
Carbs are 5% up to 10% of your calories if you trying to loose weight. Make sure you are getting 10-15 grams of non-starchy vegetables, and one or two ounces and nuts will give another 5-10 grams and even some fruits such as berries, avocados or tomatoes. The limit of what induces ketosis is highly variable, diabetics need to be generally closer to 30 or 35 or 40 grams of carbs, whereas some athletes can have more. (One gram of carbs is 4 calories). It is best to measure ketones to know because there’s no magic number here that works for everyone.
Please see the image of Ketone levels.
The real key here is the numbers if you’re eating carbs above 50 grams of carbs for most people you’re likely not more than point to maybe point 1 millimolar in the blood. It might be a bit higher after an overnight fast.
Nutritional ketosis (very low-carb diet) ranges from1 up to 5 millimolar.
Working with your doctor, Type 1 diabetics may reduce the levels of insulin required.
When you’re in ketosis the brain can extract about two-thirds of its energy from ketones and is protected from low blood sugar.
Next week we will continue with point four Nutritional Ketosis as a potent therapy to restore metabolic health
This Post has been condensed from the original: Ketones: From Toxic to Therapeutic to Ergogenic with Jeff S. Volek, PhD, RD https://www.youtube.com/watch?v=oRoifq_lWZA
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