Ketogenic Diet: Being In Nutritional Ketosis Accelerates The Rate Of Burning Body Fat.

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In almost every human study of overweight patients lasting 3 months or longer comparing a ketogenic diet to a low fat diet, the weight loss with the low carb diet is somewhat or significantly greater (Sachner-Bernstein 2015). Most of the weight lost on a well-formulated ketogenic diet lasting a few weeks or longer comes from body fat.

The Relationship Between Nutritional Ketosis and Weight Loss

  1. Does being in nutritional ketosis necessarily cause weight loss?

Yes in a person who is relatively insulin sensitive, so that when that individual gets to their new stable (‘maintenance’) weight, they could eat a wider range of total daily carbs and still remain weight stable. (The carbs should not include sugar, wheat products or processed food.)

  1. Can a human remain in nutritional ketosis and not lose weight?

We first need to understand the science of ketosis. Ketones particularly ((beta-hydroxybutyrate [BOHB]) are the preferred fuel for the brain and to some degree the heart. Ketones allow these key organs to function as well or even better when dietary carbs are severely restricted as compared to when dietary carbohydrates are high.

Switching from carbs to ketones does not happen overnight – it takes weeks of consistently restricting carbs for this process of keto-adaptation to fully occur. But once this process is complete, the body can burn fat at over twice the rate compared to when carbs were a major component of the diet (Phinney 1983, Volek 2016).

Once keto-adapted, people consistently report that the intensity of their hunger and cravings is diminished; (Boden 2005, Mckenzie 2017) and that the daily swings in energy and mood they experienced on a high carb intake are reduced, if not banished. These problems tend to be replaced with a consistent sense of energy and mental alertness as long as a well-formulated ketogenic lifestyle is followed (Volek & Phinney 2012).

Ketones turn on your body’s defences.

Besides being the preferred fuel for the brain and heart, we have recently recognized that BOHB also functions like a hormone that signals multiple changes in gene expression (aka ‘epi-genetic effects’). Among other effects, BOHB turns on the body’s innate defenses against oxidative stress and inflammation (Schimazu 2013, Youm 2014), and it also acts to reduce insulin resistance at its source (Newman 2014).

Ketones (beta-hydroxybutyrate [BOHB] and acetoacetate [AcAc]) are produced by the liver when both serum insulin and liver glycogen levels are low (McGarry 1973). BOHB protects us from oxidative stress, inflammation, diabetes, and probably Alzheimer’s disease and aging as well (Roberts, 2017). All we need do to accrue these benefits is restrict carbs to allow the keto-adaptation process to occur.

Can a human remain in nutritional ketosis and not lose weight? Yes, when someone with some extra body fat begins a ketogenic lifestyle, perhaps it is the increased ability to burn these stores, coupled with the reduction in appetite and cravings that facilitates initial weight loss.

In this scenario, keto-adaptation facilitates weight loss, but only as long as the reduced hunger and cravings allow one to comfortably eat fewer calories per day than one burns.

Over time, most people who sustain a ketogenic lifestyle stop losing weight and find a new stable weight (Hallberg 2018). This is achieved when their natural instincts of hunger and satiety lead to an increase in dietary fat intake to balance out one’s daily expenditure. But as long as dietary protein is kept moderate and carbs low, this dietary fat is used in place of body fat to produce ketones, so clearly nutritional ketosis can be maintained without any further weight loss (Phinney 1983).

People ask if they can speed up the process without cutting back on carbs.

Here’s a problem that many people experience. They have been told that increasing blood ketones will speed their weight loss. However, rather than cutting back on carbs and avoiding extra protein to boost ketone levels, they are led to believe that they can get the same effects by adding extra MCT oil, coconut oil, or exogenous BOHB to push up blood ketone levels. But, this does not enhance their body’s ability to burn fat. It just gives them a type of fat that has to be burned (some of it as ketones) in place of body fat. No wonder they are usually disappointed when their weight loss stalls well above the goal they want to reach.

What This Means for Weight Loss and Weight Maintenance on a Ketogenic Diet

In summary, being in nutritional ketosis will accelerate the rate at which the body burns fat. If the extra fat that is burned is compensated by an increase in dietary fat, then no body fat loss will occur (but there still will be other benefits). However, most people carrying excess fat tissue who achieve nutritional ketosis by eating natural low-carbohydrate foods initially feel more satiated, allowing them to eat less fat than they burn, which results in net fat loss. But eventually, even when one is in sustained nutritional ketosis, our natural instincts prompt us to increase fat intake to meet our daily energy needs resulting in a stable weight and body composition.

Bottom line: For those wishing to lose weight additional rather than remain weight stable, one’s goal should be to reduce dietary fat intake down to the margin of satiety (just enough, but not too much) and avoid or limit non-satiating energy sources such as alcohol.

This Post had been condensed from the Virta post https://blog.virtahealth.com/weight-loss-ketogenic-diet/ By Stephen Phinney, MD, PhD and Jeff Volek, PhD, RD. Please copy and paste this link to read the original post.

Disclaimer: The content of this email or Post is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations is at the choice and risk of the reader.

I invite you to Follow my Blog, Facebook or be added to my email distribution list. My focus is to maximize my physical performance and mental clarity, body composition, and most importantly overall health with a wholesome diet and exercise

I will bring you compelling articles on Ketogenic and GAPS diets, the Super Slow High-Intensity Exercise Program and supplements.

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Yours truly,

Lydia Polstra

Ketone Supplements: The Pros and Cons

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Ketone supplements rapidly and transiently increase blood concentrations of beta-hydroxybutyrate (BOHB). There is a flurry of new studies being reported, some positive, some neutral and some negative.

The different forms (salts vs. esters), what they are co-ingested with (carbohydrates vs no carbs, minerals), the background diet (ketogenic vs. high-carb), and dosing, timing, and adaptation periods are just a few of the important factors that may determine the metabolic responses to ketone supplements.

In preparation for this Post it is helpful to first understand: Keto-Adaptation. Here is the link.  https://2healthyhabits.wordpress.com/2019/05/31/keto-adaptation-some-clues-to-its-complexity/

Ketones refer to the primary circulating fatty acid metabolites beta-hydroxybutyrate (βOHB) and acetoacetate (AcAc). More on ketone basics herehttps://2healthyhabits.wordpress.com/2019/03/15/drs-stephen-phinney-and-jeff-volek-on-the-basic-science-of-ketosis-and-keto-adaptation/

Shedding light on new methods of achieving ketosis:

  • Exogenous ketones (ketone supplements) and well-formulated ketogenic diets should not be assumed to have equivalent effects simply because they achieve similar BOHB blood levels.
  • For the past few million years, the only way for humans to make use of ketones for fuel was to restrict carbohydrates low enough and long enough to induce the liver to make them. An emerging alternative is to consume ketones as a dietary supplement.

Sources and Formulations of Exogenous Ketones

  • The source of most exogenous ketone supplements is chemical synthesis, which focuses on BOHB.
  • An important difference between endogenous (produced by your liver) and exogenous BOHB is that most synthetic BOHB used in dietary supplements is a mixture of the two ‘D’ and ‘L’ isomers, whereas endogenously produced BOHB consists of just the D-isomer. Metabolically, the two isomers are very different, and current published information indicates that most of the energy and signaling benefits of BOHB derive from the D-form. This is potentially problematic because the L-isomers are not metabolized via the same chemical pathways as the D-forms and it remains unclear whether humans can convert the L-form to the D-form.
  • Thus, while the L-isomers do not appear to be toxic, they are not likely to impart the same benefits as the D-forms.

Ketone Salts and Esters are two general formulations for dietary BOHB supplements – salts derived from the keto-acid or an ester formed between the keto-acid and an alcohol.

Ketone Salts: Salts typically utilize sodium, potassium, calcium, or magnesium. Given that recommended daily intakes of these various minerals range from a few hundred milligrams up to 5 grams, whereas the daily ketone intake goal to mimic nutritional ketosis blood levels would need to be on the order of 50 grams, achieving this goal with ketone salts would severely challenge human dietary mineral tolerance.

Most of the currently marketed ketone salt formulations are made with a mix of the D- and L-isomers of BOHB, so the actual delivered dose of the more desirable D-isomer is considerably less. The other concern with the salt formulations is that, as the salts of weak acids, they have an alkalinizing metabolic effect that might have a modest but cumulative effect on blood pH and renal function.

Ketone Esters are more appropriate for delivering higher doses of BOHB, but with repeated dosing can push the limits of taste and GI tolerance (loose bowels). This product has been shown to significantly reduce appetite after a single dose but its effect on body weight in humans over a longer period of time has not been studied, nor has its effect on blood glucose control been reported in humans with type 2 diabetes.

Comparison of ketone supplements (chemical ketosis) to nutritional ketosis

 The stimulus for the increase in ketones in response to a well-formulated ketogenic diet is the restriction of dietary carbohydrate, which triggers many favorable adaptations. Although both induce a form of ketosis, the lack of carbohydrate restriction in the context of using ketone supplements induces a different metabolic profile.

The blood levels of BOHB that can be achieved with the salts or ester formulations are in the 1-3 mM range, similar to what can be achieved with a well-formulated ketogenic diet in insulin sensitive humans. In more insulin resistant humans, the ester formulation may deliver higher blood levels than a sustainable diet.

In terms of epigenetic signaling, at levels of BOHB as low as 1 mM have potent effects. Furthermore, the association between very mild ketonemia (concentration of ketone bodies in the blood) and reduced coronary mortality with SGLT2 inhibitor use in patients with type 2 diabetes suggests that there might be clinical benefits with chronic BOHB levels as low as 0.3 mM.

That said, there also remains the question of the relative benefits of AcAc versus BOHB. AcAc generated in the liver acts as a NAD+ electron donor for the peripheral (aka non-liver), whereas pure BOHB taken orally potentially deprives the periphery of NAD+.

Another factor to consider is that in nutritional ketosis the liver makes a steady supply of ketones and continuously releases them into the circulation. In contrast, most ketone supplement protocols involve bolus intakes that don’t mimic the endogenous release pattern. The extent to which this impacts metabolic and signaling responses across different tissues remains unclear.

Some of the benefits of nutritional ketosis can be attributed to circulating levels of BOHB, and some of these benefits can accrue at blood levels at or even below 0.5 mM.

Practical Considerations in Prevention and Management of Chronic Disease

  • Until there is more definitive information, it will be difficult to specify the dosing and duration of supplemental ketones. However for fuel use, and very likely for exercise performance as well, sustained blood levels of BOHB in the range of 0.5 mM to 1.0 mM are likely to be required. This is achieved physiologically by an estimated ketone production of 50-100 grams per day in a keto-adapted human.
  • With the current ketone salt formulations, even 50 grams per day is likely above taste and physiologic mineral tolerances. So for these products, their potential benefits are likely limited to adding to existing blood ketone levels for someone already following a low carbohydrate diet.
  • For the ketone esters, on the other hand, repeated doses of 20-30 grams in any one day may be possible. Thus these products may be able to maintain a modest level of ketonemia without dietary carbohydrate restriction. Thus some of the cardiac and brain fueling benefits may follow, not to mention the epigenetic effects limiting oxidative stress and inflammation. But given the recent observation that administered ketone esters markedly reduce circulating free fatty acids – their sustained use in people with underlying insulin resistance may compromise their long-term benefits by promoting weight gain unless combined with carbohydrate restriction.
  • A drawback to the long-term use of ketone supplements is their poor palatability for the esters and their cost of about $1 per gram of delivered ketones for daily dosages from 25 to 100 grams.

Sports Performance:  There are enticing anecdotes of supplemental ketones being used to boost human physical performance in competitive events, notably among elite cyclists. Given that BOHB can deliver more energy per unit of oxygen consumed than either glucose or fatty acids, this makes sense. But what we do not know is if there is any required period of adaptation to the use of exogenous ketones, and thus how to employ them in training. It is clear that exogenous ketones decrease adipose tissue lipolysis and availability of fatty acids, the exact opposite to what happens on a well-formulated ketogenic diet. This distinction between exogenous ketones and ketogenic diets on adipose tissue physiology and human energy balance underscores an important reason why these two ketone-boosting strategies should not be conflated.

This Post has been condensed from the Virta Post, Ketone Supplements: The Pros and Cons – Shedding light on new methods of achieving ketosis by Stephen Phinney, MD, PhD and Jeff Volek, PhD, RD on March 12, 2018 https://blog.virtahealth.com/ketone-supplements/

More scientific information and Citations of the supporting studies are included in the Virta post.

Personally, I took ketone supplements for years. I finally lost the unwanted weight off and kept a healthy body fat percentage with the Ketogenic diet.

I invite you to Follow my Blog, Facebook or be added to my email distribution list. My focus is to maximize my physical performance and mental clarity, body composition, and most importantly overall health with a wholesome diet and exercise.

I will bring you compelling articles on Ketogenic and GAPS diets, the Super Slow High-Intensity Exercise Program and supplements.

To follow my Blog, please click the Follow button to receive an email when the next posting is available. Hint: You may have to click the Accept and Close button before follow is available.

I thrive on feedback. Please let me know you are interested in the content by clicking Like, Commenting or sending me a message or email about the Post.

If you wish to contact me by Email, please email lpolstra@bell.net using this form.

May you Live Long Healthy.

Yours truly,

Lydia Polstra

Email: lpolstra@bell.net

Facebook: https://www.facebook.com/2healthyhabits/

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Disclaimer: The content of this email or Post is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations is at the choice and risk of the reader.