What’s the ketogenic diet all about?

Part of a series of articles on how to optimize the off-season. 

By T.J. Murphy

@burning_runner

For the two years or so I’ve been interested in the ketogenic diet. I wrote a story for Outside Magazine on a leading expert in the subject, Dr. Ken Ford at the IHMC. Ford is what originally perked up my interest. He’s the founder and director of the Institute and his background is eclectic as it is accomplished.  A leading thinker in artificial intelligence and robotics, his science expertise knows few borders. Here are the highlights high-speed:

Ph.D in computer science, Tulane; Emeritus Editor-in-Chief of AAAI/MIT Press; Fellow of the Association for the Advancement of Artificial Intelligence (AAAI), a charter Fellow of the National Academy of Inventors, a member of the Association for Computing Machinery, a member of the IEEE Computer Society, and a member of the National Association of Scholars.

Just getting started.  Awards include Doctor Honoris Causas from the University of Bordeaux in 2005 and the NASA Outstanding Leadership Medal in 1999. And he has served on the National Science Board, the Air Force Science Advisory Board and as chairman of the NASA Advisory Council.

He was legit. Believe or not he’s a down to Earth guy. John Welbourn, an interesting character himself (played on the offensive line about a decade in the NFL after studying poetry, rhetoric and the classics at UC Berkeley). Welbourn is (in my opinion) one of the top leaders in defining, exploring, understanding and teaching what athleticism is and how to excel at it. I listen to both Ford and Welbourn any chance I get. Unsurprising to me, they’re friends and have an ongoing discussion about how to achieve and sustain performance and solve the various problems that tend to come up.

At a recent talk given at the IHMC, Welbourn characterized Ford as “the most interesting man in the world.” It gets a laugh when he says it because I think those hearing it know its an audacious thing to say but there’s a good case to be made that it’s true.

One area of interest to Ford is (and has been for 15 years or so) the ketogenic diet. There are a number of reasons for this. One is testing out applications of the ketogenic diet as a neuro-protective technology. This isn’t new—a keto diet has been used as a medicinal application for epileptics since the 1920s. It prevents seizures in many (not all) children who have epilepsy.  An extreme version of the low-carb diet is used for this purpose, where the patient is carefully restricted to an intake of fat and carbs at a 3:1 or 4:1 ratio. For Ford and the IHMC, and  IHMC associate researcher Dom D’Agostino, high ketone levels are being studied as a tool for Navy divers (who use stealth rebreather technology, aka no bubbles, exposing them to situations where seizures are an imminent threat) for similar neuro-protective values.

As Ford will tell you, this is just one of the myriad benefits that nutritional ketosis may have for people. Preventing and treating cancer is surging with research interest, for example; applying nutritional ketosis toward preventing certain neurological disorders is an interest; and there’s growing evidence in the field of epigenetics supporting the idea that ketones are a signaling molecule that turns on genes we’d like to have on and shuts off genes we’d like to shut off.

The most popular use of the ketogenic diet has been fat loss. Low-carb diets, like Atkins and Banting, have been demonized in the media because saturated fats have been demonized since the 1950s. Saturated fats became the bad guy when physiologist and economist, Ancel Keys, posited that saturated fat intake gives you heart disease and killed you. Here’s an important thing to know about Keys: He was a fish physiologist. A man with a fish physiology PhD set the tone on our view of saturated fats. He was on the cover of Time (note the word fish got stripped from the cover), a diet and health issue, and although his case was poorly thought out and based on bogus analysis, his viewpoint on saturated fats became the foundation of health policy in the United States and with organizations like the American Heart Association.

Ancel Keys, fish physiologist, on the cover of Time.

What makes you fat and sick isn’t the macronutrient fat. It’s eating too many carbs. If you have a carbohydrate resistance problem (I do) and you eat 200 grams or more of carbohydrate per day, it translates into insulin resistance being pre-diabetic and possibly/probably being a type-2 diabetic. New organizations like the Noakes Foundation and Virta Health are directly confronting this problem and the simple answer is cutting back carbohydrate intake. This doesn’t have to be ketogenic carb restriction. A Zone protocol, which may, depending, work out for in an individual to be in the range of 100 to 150 grams of carbs per day, can be highly effective for fat loss and sorting out the insulin resistance problem.

But another area that’s growing with both interest and use is in endurance athletics. Being in ketosis means being in a metabolic state where burning fat is efficient. It’s also like hooking yourself up to a oil tanker-amount of fuel. If you don’t have to rely on the relatively limited amounts of glycogen you can store in your muscle and liver, and rather hook your energy needs to stored body fats (plentiful in even the leanest of athletes), you enjoy two primary benefits: One, avoid bonking altogether and don’t have to stress out about carb intake levels every hour and two, aren’t doing yourself harm with incessant aid-station raids for sports drinks, gels, cookies etc. Ultra runners have been pioneers in this, like Zach Bitter (American record holder for 100 miles on the track) who, as a ketone-adapted athlete participating in a study, recorded data supporting how efficient he was at using fat (burning up to 1.57 grams per minute) when runner at the lower range of intensities.

Bitter wrote about this on his blog:“My fat metabolism peaked at 1.57 grams/minute. At this point in the test, my VO2 uptake was at 49.4. By dividing this number by my eventual VO2 Max of 66.1, I can calculate at what intensity I burn the most fat: 74.4%. At that intensity, I was burning 98% fat 2% carbohydrate (1.57 fat grams/minute and .07 carb grams/minute). To put this into perspective, 65% of my VO2 Max had me running approximately a 7:15 per mile. Even when I increase my speed to around 7:00 per mile, I was still burning nearly all fat!”

The scientist leading the study, Dr. Jeff Volek at Ohio State, told me in a phone call that we are just beginning to get some ideas about what a keto-adapted athlete is capable of and not capable of. He’s hoping to see more and more research performed. But his priority is that this research is first directed toward providing solutions for the obesity crisis. He is now a part of a new large-scale effort in this regard, Team Virta, working with Sami Inkinen (Silicon Valley giant and, not to mention, a longtime endurance athlete, triathlete, and self-described data geek) and his long-time research colleague and co-author, Steven Phinney. (Phinney conducted early studies, early 1980s in fact, and also coined the term “nutritional ketosis.”).

In a 2016 study in Cell Metabolism, researchers suggested the following highlights of nutritional ketosis for endurance athletes:

Highlights:

Nutritional ketone bodies can promote the advantageous aspects to starvation ketosis

  1. Nutritional ketosis alters the hierarchy of substrate competition for respiration in exercise
  2. Ketosis increases metabolic flexibility during exercise, reducing glycolysis and increasing muscle fat oxidation
  3. Improved performance during cycling time trial suggests ketosis during exercise may be beneficial for some athletes

For me, my primary interest in the ketogenic diet is in regards to being part of a compound effort to mitigate the aging process as best as it can be mitigated. I’m in my mid-50s now. An endurance athlete since the 1980s (good lord) who has two young kids and wants to be able to think of himself as an athlete as long as absolutely possible.

This aligns with a key interest of Ford’s. He’s following the various strains of research investigating the value of the ketogenic diet and nutritional ketosis as a technology to fire up a sort of buffer to the catabolic aspects of aging. Most notoriously, the loss of lean muscle mass. It seems that resistance exercise and exercise in general will only get you so far. Actually, long-slow-distance training is probably going to speed along age-related muscle loss (aka sarcopenia) rather than prevent it. Resistance exercise is the remedy. The more lean muscle mass, the better.

But resistance exercise may only take you so far. There are certain properties of the ketogenic diet that suggest it may be a power tool in this equation.

And that’s my interest. So for the next 10 days, I’ll be writing daily about what it’s like to be in ketosis, what the diet is like, and what challenges come up and also consider solutions. It’s just 10 days. I’m writing more about just getting into it as opposed to what it offers or doesn’t offer in the long term.

So here on day one, after a week of following what’s known as a well-formulated ketogenic diet—50 grams of carb or below, plenty of fat and moderate protein intake (too much protein will kick you out of ketosis just like too many carbs)—I am typing these words. I took a blood ketone test with with a Precision Xtra ketone meter at 11am ET. I registered a level of ketones in the blood of 1.8 millimolars. About a week ago, after a month or so when my diet was all over the place (I lost control of it, in part some of the chaos of having a baby and a toddler part of the daily routine. Meaning that having a routine with two little ones is more about wishful thinking rather than actually having a routine) my blood ketone level was a scant .2mm. Which is not in ketosis. Ketosis (per my understanding) starts at .6mm. But the optimal ketone zone is more in the range of 2.0 to 3.0, according to Volek and Phinney.

A ketone meter reading my blood sample today.

I told a friend about my solid ketone reading. “How do you feel?” he asked. Pretty good. Very good. It’s strange how hunger and cravings change when your body’s ketone mechanism is kicked on. The common observations is that your thinking gets more clear and hunger ups-and-downs virtually disappear. The latter surely has a lot to do with the fact that when you’re free of the the demands a high-carb diet has on your insulin system (and the concurrent sugar highs and crashes).

So I’ll write about what this is like. I also recently recorded an discussion between Dr. Tim Noakes (author the Lore of Running and founder of the Noakes Foundation—again, similar to Team Virta in its mission to solve the type-2 diabetes epidemic—and six-time Hawaii Ironman champion, Dave Scott.  A year ago, at a Dave Scott triathlon camp in Kona, I found out that he has become a thoroughly knowledgable advocate of the ketogenic diet. Both Noakes and Scott have changed their view on carbs for sports performance and have embraced (both personally and in their recommendations) a low-carb ketogenic diet for athletes and just about everyone else.

Thanks for reading. Please be sure to come back tomorrow for Day 2’s reporting.

T.J. Murphy is the editor of LAVA Magazine. Follow T.J. on Twitter @burning_runner and sign up for his health/performance newsletter here

Listen here to a journal/podcast on the keto-adapting experience.