Franco Cavaleri Speaks to: Ketogenic Diets – How Ketosis Factors Into Atkins

As we’ve all seen, diets come and go and come again. Most fat-loss strategies deliver horrific consequences, but amazingly they’re kept alive by people desperately seeking magical solutions. Most diets result in weight loss because they lack calories but also deplete the body of glycogen, water, and muscle. You probably know many of these nutrient-deficient prescriptions for disaster: the grapefruit-and-water diet; the banana-and-water diet; the crème-and-protein-diet; the high-carbohydrate, low-to-no-fat diet; the liquids-only diet; the one-meal-per-day diet; the fruit-only diet; the lemon/ water fasting; the high-protein, high-fat diet; the no-carbohydrate diet.

One diet that really scares me, though, is the high-protein, high-fat, no-carbohydrate one popularized by the late Dr. Robert C. Atkins, which has been widely marketed and media-hyped. To my astonishment, this outlandish program has been universally accepted as safe. The Atkins Diet involves the consumption of as much protein from red-meat sources with as much animal fat as desired. I’m a proponent of abundant dietary fat, but not just any old fat. As we’ve seen, there are some fats we need to avoid and others we should consume abundantly.

The Atkins Diet is ketogenic. Few people know what they’re actually doing to their biochemistry by struggling through such a regimen. Within the liver two molecules of acetyl coenzyme A (acetyl CoA) are combined to yield ketone bodies—acetoacetic acid, beta-hydroxybutyric acid, and acetone, which are ultimately produced as a result of ketogenesis. Acetyl CoA can be obtained from dietary fats, dietary protein, or body tissues.

When dietary carbohydrates are depleted, the body quickly uses up its stored glycogen levels. Athletes or those in pursuit of quick weight loss learn to use ketone sticks (which measure ketone body levels in urine) to determine whether ketosis (the abnormal increase of ketone bodies in the body) has been induced by a low- to zero-carbohydrate diet.

Once the ketogenic state is reached, however, most of these athletes know to back away from the carbohydrate restriction and increase dietary carbohydrates to a level that prevents muscle catabolism and ketosis from persisting. It takes about 50 to 70 g (one potato, two apples, or two bananas) of carbohydrates daily to prevent ketosis for the average person. The popular ketogenic Atkins Diet involves the indiscriminate consumption of deep-fried and pan-fried globs of animal fat. This high-fat, high-protein, low- or no-carbohydrate program promotes the production of ketone bodies. Cells in muscles and other tissues have the ability to employ these substances as a source of energy.

When dietary carbohydrates are severely limited, ketone bodies can be produced in greater quantities than the body can use for energy. The Atkins Diet involves severe carbohydrate limitation. When dietary protein and fat are too high, ketone bodies can’t be oxidized in the body fast enough to remove the potential danger they pose. The body expels excessive ketone bodies in the urine and through the lungs. In fact, you can often smell acetone on the breath of an individual who’s been in ketosis for some time. Ketone bodies can also be detected on the breath of a diabetic when he or she fails to metabolize carbohydrates efficiently due to inefficient or insufficient insulin secretions.

The Atkins Diet promotes the abundant consumption of beef and dairy fats, which contain a great deal of arachidonic acid. Overconsumption of these arachidonic-acid-laden sources multiplies the risk of biochemical imbalances that are at the root of a multitude of epidemics, including obesity. That’s especially so when a diet such as the Atkins one is devoid of vegetables, whole grains, and legumes that would otherwise supply antioxidants, vitamins, and fuel for a starving body and friendly intestinal bacteria. The change in colon pH that this diet encourages is a perfect environment for pathogenic bacteria to disrupt friendly bacterial health, increasing the danger of colon cancer (24, 25). Not only does the lack of fiber in this diet contribute to the incidence of colon cancer, the high degree of dietary saturated fat does, as well. The indiscriminate fat consumption advocated by the Atkins Diet can also facilitate cardiovascular problems and interrupt insulin function. Furthermore, abundant red-meat consumption can cause colon cancer through factors independent of fat content (26).

With a nearzero intake of dietary carbohydrates, this diet creates a temporary depletion of hepatic glycogen. Glycogen is the liver’s main fuel for detoxification and metabolic activity. Exhaust this energy source and you’re in trouble.

The ketogenic state induced by the Atkins Diet and others like it alters the pH (acid/base balance) of the blood and body to induce more metabolic havoc (27, 28). The body functions in a pH range that’s quite narrow. Mild deviations result in profound metabolic impairment. Interestingly the ketogenic diet doesn’t change the pH of the brain. Carbohydrate-restricted diets like the one expounded by Dr. Atkins have been in use since the 1920s to help treat epileptic children with great success (29, 30, 31). The ketogenic diet somehow reduces seizure activity, but scientists still don’t know why. And ketogenic diets have been shown through some unknown mechanism to boost brain ATP, as well (32). However, a ketogenic diet must be carefully monitored in these therapeutic applications to help manage the potential acidosis of the body. As the body fights to maintain its functional acid-alkaline balance, nutrient stores, such as calcium and phosphorus from bone mass, might be taxed. Furthermore, cases of renal stone development, gastritis, ulcerative colitis, alteration of mentation, and hyperlipidemia have been reported with the administration of a ketogenic diet. Of course, with professional monitoring the risk of these side effects can be minimized (33). The dangers might be a good trade-off when considering the implications of an uncontrollable epileptic condition, especially when it’s severe. Still, for basic weight management a ketogenic diet isn’t advisable. The risks aren’t lower than those posed by excess body fat.

If an epileptic condition presents significant danger in your life, sure, the ketogenic diet is likely a reasonable choice, but I still believe that ketogenesis might not have anything to do, or at least all to do, with the beneficial effect of the typical ketogenic diet on an epileptic condition. Keep in mind that the biochemical process by which ketogenesis seems to eliminate or reduce seizure activity isn’t known. Many studies demonstrate that polyunsaturated fatty-acid supplementation with linoleic and alpha linolenic acid, as well as with the fish-oil-derived DHA and EPA, also promotes brain health and inhibits epileptic seizures (34, 35, 36, 37, 38). The typical ketogenic diet involves greater intakes of fats, primarily animal ones, that have high essential-fat content as well as healthy EPA and DHA levels. It also entails the consumption of a lot of vegetable oils that consist of a bounty of linoleic and alpha linolenic acids.

Could it be that the method of therapeutic activity for the anti-epileptic ketogenic diet is simply through its rich supply of the essential and other health-promoting polyunsaturated, omega-3 fats that in the absence of dietary carbohydrates and reduced insulin activity leaves more fats for the brain to take up? Likely so. It’s at least one major contributing factor. I’m confident that the high polyunsaturated-fat version of Ageless Performance will prove to be a significant therapy for epileptic seizures the way ketogenic diets have but without the side effects and with a broader array of health benefits. Studies may ensue in the near future.

In addition to increased cardiovascular risk from the abundant dietary saturated fat, the dearth of vegetation and whole grains in the ketogenic Atkins-type diet results in a lack of the vitamin co-factors required to metabolize homocysteine. The accumulation of homocysteine occurs due to inefficient methionine metabolism. Red meats are rich in methionine. Eat them lavishly with few or no vegetables and you’ll likely run into trouble. A shortage of vitamins B6 and B12, folic acid, and methyldonors (such as SAMe and trimethylglycine) can increase the incidence of homocysteine-related problems. Homocysteine buildup has been implicated in cardiovascular disease, cerebrovascular problems, inflammation, chronic fatigue, and cognitive and other brain disorders. The Atkins Diet can create a predisposition for these common risks with the silent killer, cardiovascular disease, creeping up to get you without previous warning.

Although Ageless Performance focuses on limiting dietary carbohydrates, the objective is far from elimination. As part of the program, low-glycemicindex carbohydrates are consumed abundantly to fuel the brain and body without imposing an extreme insulinogenic influence, and ketogenesis doesn’t enter the picture. In the stressed ketogenic state, weight reduction can be significant (as much as 10 to 15 pounds in a week or two); however, most of the weight lost in the first phase of the Atkins Diet is water, glycogen, and muscle, not fat (39).

Although the Atkins Diet weight loss is attributed to the depletion of the body’s carbohydrate (glycogen) stores, most people are fooled into thinking this is a healthy outcome. Earlier I explained the carbohydratedepletion tricks for making weight classes at bodybuilding shows. Low or zero carbohydrate diets cause glycogen to be lost in the body rapidly. This also causes water to leave the body very quickly.

The result is significant:

Immediate weight loss might exceed 10 pounds, though fat won’t necessarily be reduced. Wrestlers use the same techniques to make weight classes, and a 1993 review in the International Journal of Sports Medicine indicates that the weight losses in these cases aren’t necessarily fat, either; worse, the metabolic impairment these practices induce can make fat loss even harder to achieve in future attempts (40).

Conflict of Interest Statement. The author/researcher is the owner of a biomedical research group – Biologic Nutrigenomics Health Research Corp and Biologic Pharmamedical Research, that funds and executes research on the pharmacology of nutritional and nutraceutical agents that are studied in the context of disease pathology including characteristics that have been associated with inflammation and dementias. The author/researcher is also the owner of related Intellectual Properties. author copyright Franco Cavaleri PhDc
Franco Cavaleri, BSc, PhDc, is The Rhema Group’s Chief Science Officer. He is also the principal research scientist at Biologic Pharmamedical; is a former Mr. IFBB North America; and is completing a doctoral degree in Experimental Medicine in the Faculty of Medicine.

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