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Natural Awakenings Spokane WA/Coeur d'Alene ID

Century Old Dietary Plan Repurposed

by Deborah A. Martinez

The ketogenic diet has been in use now for 100 years. It was first proposed in 1921, before the development of anti-seizure medications, as a therapy for childhood epilepsy, according to Dr. Masood and colleagues in their review, Ketogenic Diet. After the introduction of pharmaceuticals, the ketogenic diet was used for the treatment of drug resistant pediatric seizure disorders. More recently, this high fat, low carbohydrate dietary plan has been repurposed as an option for weight loss.

The weight reduction benefit comes from creating a state of “nutritional ketosis” in the body. Nutritional ketosis occurs when a diet is consumed that is high in fat, moderate to low in protein, and low in carbohydrates. Fat breaks down in the setting of low carbohydrate availability. Ketone bodies are the by-products of fat breakdown. The cells of the body are forced to derive their nutrition and energy from ketone bodies when glucose from carbohydrates is not available. The ketogenic diet, therefore, retrains the cells of the body to use fat (ketone bodies) instead of carbohydrates (glucose) for their metabolic energy.

Typically, in a ketogenic diet, 70 to 80 percent of the calories come from “healthy fat,” 20 percent from protein, and 5 to 10 percent from carbohydrates. Protein is kept low because eating too much protein can prevent ketosis. The amino acids in protein are converted to glucose. The increase in blood glucose stops body fat breakdown and therefore ketone body production. The ketogenic diet does include enough protein to preserve lean body mass—including muscle—while allowing nutritional ketosis to occur. Generally, ketosis occurs after two to four days of initiating a ketogenic diet, however, this is is highly individualize.

Doctors Blair O’Neill and Paolo Raggi in their published debate, The Ketogenic diet: Pros and Cons, discuss research supporting both positions. Most critics cite: difficult sustainability, nutritional deficiencies, increased LDL (bad cholesterol) and lack of information regarding long-term outcomes. Proponents highlight significant weight reduction, return of blood tests toward normal (HDL [good cholesterol], glucose and A1C), decreased insulin resistance, and decreased hunger and cravings.

A well-formulated ketogenic dietary program addresses these concerns while providing the diet’s benefits. All of the below measures will contribute to the safety and benefits a ketogenic diet has to offer.

- The program should feature a well-defined food plan for easy incorporation into one’s lifestyle.

- A system for self-monitoring of the nutritional ketosis state should be part of the approach.

- Inclusion of high-quality supplements including vitamins and minerals, essential fatty acids, as well as calcium and magnesium should be required to avoid any potential nutrient deficiencies inherent in food sources. Nutritional supplements also safeguard against aggravation or precipitation of nutritionally related health problems.

- A support system to enhance implementation and commitment should be available.

- Collaboration with an individual’s primary healthcare provider should be encouraged for monitoring of relevant blood work if indicated.

Deborah A. Martinez, M.D. is a retired surgeon and owner of Credible Complementary Therapy located at 2020 E. 29th Ave., Spokane. During the month of January, Dr. Martinez is offering Natural Awakenings readers a free online health evaluation and 15-minute consultation. Email: [email protected] to receive a link to the survey. For more information, call 509-724-3946 or visit
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