The interest from endurance athletes in the so-called ketogenic diet continues to grow. With experts like Dr. Tim Noakes, MD (ultra-runner and acclaimed author of The Lore of Running and Waterlogged) and six-time Ironman champion Dave Scott endorsing the protocol that is high-fat, low-carb and moderate protein, how does one get started or at least find out about how to get started?
Here are a few items that can both offer guidance and info.
A copy of the Art and Science of Low-Carb Performance, by Dr. Jeff Volek, PhD and Dr. Steven Phinney, MD, is a good place to start, so that you can get a feel for if it’s something you want to commit to or not. The book includes a concise scientific explanation of what the ketogenic diet is, how it works and how to do it, by two of the leading researchers in the field. For those who want a triathlon-centered introduction to the diet, the best place right now is likely a visit to the Dave Scott Experience, where an education and orientation to ketosis is central to the camp.
If you decide to go for it, you would be wise to be safe about getting on board with strict ketosis. Two experts in the field of hormone regulation, diet and metabolism are both clinical MDs: Dr. Peter Attia and Dr. Kirk Parsley. Both have said that while the ketogenic diet can work wonders for some, we are all wired differently and for some it can send biomarkers sideways (as Parsley once told me, “I’ve seen some shit shows.”)
So the smart, safe route is to get a look under the hood before and during the transition to a keto lifestyle. Checking with your doctor is probably the best place to start. Also, Inside Tracker and WellnessFX both have cutting edge blood test analysis services with an array of products and price tags. Certain packages come with medical consultations as well. The thing to do is to get a blood panel done at the beginning and then check again two months or down the line to see where you fit in—someone who does great by the ketogenic diet or someone who is a shit show.
Precision Xtra Ketone Meter. A critical mistake for endurance athletes embarking on a ketogenic diet is the failure to detect and chart whether or not ketosis is being achieved. There are number of blood glucose and ketone meters on the market, but currently the Abbott Precision Xtra seems to be the favorite. Of the two principle ketone bodies, betahydroxybuterate and acetoacetate, betahydroxybuterate is the one that you want to keep an eye on as it is more stable and will give you an accurate picture of your ketone levels. This is the ketone body that the Xtra measures. Urine strips, while cheaper and not requiring a drop of blood, measure acetoacetate, which will not give you an accurate portrait of you level of nutritional ketosis.
Now onto supplements, if you so desire. While you don’t need supplements to adopt a ketogenic diet, there are two key problems that supplements can help navigate. One is the infrastructure problem. The modern food processing system is obsessed high-fructose corn syrup and hidden sugar. If you get caught out in the world without a tupperware container of a ketogenic meal or snack, there’s virtually nothing in the 7-11 that isn’t going to be high in sugar. Having a meal replacement (like the new EAS product described below) or a bar (like a Quest Nutrition bar mentioned below) is a good backup.
Let’s start with EAS’s new ketogenic version of Myoplex. I should first mention that as I’ve learned over the past year, the prospects for supplements in regards to the ketogenic diet have been coming to a boil. Let me point out again you don’t need them to go ketogenic, they might simply help. Seeing EAS get into it suggests they’re intending to lead the field. I recently wrote a story for Outside Magazine on how nutritional ketosis has gone well beyond being a tool for burning body fat or as a metabolic weapon for endurance athletes and into the realms of preventing chronic diseases like cancer. On the athletic performance side, the story included data from American 100-mile ultra-run record holder, Zach Bitter, how had been keto-adapted for more than six months when he participated in one of Jeff Volek’s studies. As Bitter recorded on his blog, being adapted to ketones through diet allowed him to draw 98% of his fuel from fat stores at 75% VO2max and 76% of his energy from fat while at 84% VO2max. The value for an ultra-runner is pretty clear: in races as many as 24 hours or more, the more that stored body fat can be used as fuel, the more muscle and liver glycogen can be spared. Another effect of being keto adapted and being in a state of ketosis is that it is also protein sparing. In fact, a well-formulated ketogenic diet, as Jeff Volek puts it, is not heavy on protein. Rather, it is moderate to light on protein so as to keep insulin levels low (in other words, eat a massive dinner of meat and you’ll kick yourself out of ketosis).
Read up on Volek’s ketone-adaptation research here.
A new frontier is going to be ketone supplements and ketone esters that are likely to be coming on the market soon. Researchers at the National Institute of Health, Oxford and those associated with the IHMC (in particular Dom D’Agostino) have been working on ketone esters. D’Agostino’s primary focus has been in accordance with helping Navy SEAL divers prevent potentially fatal seizures when diving with stealth rebreather technologies.
Although not a ketone ester, the newly announced EAS ketogenic supplement is a meal-replacement produced by EAS, a version within their Myoplex line that has been produced using keto-friendly macronutrient ratios: 75% of the calories come from fat, 20% protein and 5% carbs.
Dave Scott, who has become an advocate for the ketogenic diet for long-term health benefits and endurance performance, helped design the new product.
As Scott explains in an interview posted on EAS, a key value of the low-carb/high-fat ketogenic diet is that it turns of the cravings for sugar:
“I’ve found that one of the benefits of a LCHF diet is that you turn off the ‘sugar switch,’ begin to efficiently metabolize healthy fats, and get off of the insulin rollercoaster. By eliminating these high and low fluctuations, the body learns to draw from its other steady state of fuel: ketone bodies. The body is continually exchanging sensory information between the stomach and the brain. Eating healthy fats affect your satiety center by stimulating the production of leptin, a hormone produced by adipose (“fat”) tissue that works in the brain to inhibit food intake and increase thermogenesis. Leptin sends a signal of “fullness”, creating the desire to stop eating.Once you become keto-adapted, you’ll be pleased to discover that you’ll have the urge to eat less throughout the day, likely thanks to the stable levels of hormones, reduced insulin sensitivity, and filling, satiating power of fat.”
For the full interview, click here.
Keto Force. Keto Sports has a small line of ketone supplements and is probably most known for Keto Force, the key ingredient being an endogenous form of betahydroxybuterate, a ketone body. The recommended usage for Keto Force is for the individual transitioning from a high-carb diet to a low-carb diet, a phase that has considerable individual variation to it. For some, it’s not a big deal. For others, the ‘carb flu’ can last for weeks until the metabolism adapts and begins to produce a higher level of ketones. It’s not cheap: $67.50 for a bottle that contains 16 servings, but it might be helpful in kick-starting the keto metabolism and preventing the so-called flu.
Coconut oil. Visit anyone who has been on a ketogenic for a while, and ask where they store the coconut oil. Coconut oil is rich in MCTs, or medium chain triglycerides, which help you boot into ketosis. You can cook with coconut oil, or put it in your coffee or in your smoothy. It helps increase ketone levels as well as healthily help you curb appetite and cravings for carbs.
Quest Nutrition. Quest nutrition products are formulated with the ketogenic/Atkins “net carbs” math that subtracts fiber content from the carb tally to come up with an effective number. Good source for low-carb treats, bars and things like low-carb french toast for those who don’t want to leave such things behind. (It’s guaranteed that regular French toast will knock you out of any state of ketosis).
TJ Murphy is the Editor-in-Chief of LAVA Magazine. Follow him on Twitter: @burning_runner.