Ketosis – advantaged or misunderstood state? However, so many great questions and comments emerged from the discussion that I realize it’s worth spending much more time on this important and misunderstood topic. In terms of setting expectations, I suspect this series will require at least four parts, after which I hope to get back to finishing up The Straight Dope on Cholesterol series. So, back to the topic at hand. I do suspect part of the issue is that folks don’t understand the actual question. I’ve used the term “metabolic advantage” because that’s so often what folks write, but I’m not sure it has a uniform meaning, which may be part of the debate. I think what folks mean when they argue about this topic is fat partitioning, but that’s my guess. To clarify the macro question, I’ve broken the question down into more well- defined chunks. Does ketosis increase energy expenditure? I am pretty sure when the average person argues for or against ketosis having a “metabolic advantage” what they are really arguing is whether or not, calorie- for- calorie, a person in ketosis has a higher resting energy expenditure. In other words, does a person in ketosis expend more energy than a person not in ketosis because of the caloric composition of what they consume/ingest? ![]() ![]() Let me save you a lot of time and concern by offering you the answer: The question has not been addressed sufficiently in a properly controlled trial and, at best, we can look to lesser controlled trials and clinical observations to a make a best guess. Believe me, I’ve read every one of the studies on both sides of the argument, especially on the . This particular study sought to compare a non- ketogenic low carb (NLC) diet to a ketogenic low carb (KLC) diet (yes, saying . Table 3 in this paper tells you all you need to know. Despite the study participants having food provided, the KLC group was not actually in ketosis as evidenced by their B- OHB levels. At 2- weeks (of a 6- week study) they were flirting with ketosis (B- OHB levels were 0. M), but by the end of the study they were at 0. M. While the difference between the two groups along this metric was statistically significant, it was clinically insignificant. That said, both groups did experience an increase in REE: about 8. The Recommended Daily Allowances (RDA) for different nutrients were developed on Western diets, and therefore, high-carb diets. Given that a ketogenic metabolism uses. Keto Diet Week 3 Experience - My third week of keto. Side effects, menu plan, weight loss, and more. Keto diet journey and keto diet weight loss story. Blood Glucose Testing Intermittent Fasting Beats Traditional Diets and Even Chronic Calorie Restriction for Weight Loss and Other Health Benefits. ![]() ![]() ![]() ![]() ![]() NLC group and about. KCL group (this is calculated using the data in Table 3 and Table 2). These changes represented a significant increase from baseline but not from each other. In other words, this study only showed the reducing carbohydrate intake increased TEE but did not settle the . Subjects being evaluated in such studies will typically be housed in a metabolic ward (don’t confuse a metabolic ward with a metabolic chamber; the ward is simply a fancy hospital unit; the chamber is where the measurements are made) under strict supervision and every few days will spend an entire 2. Not surprisingly, virtually no studies use metabolic chambers and instead rely on short- term measurement of REE as a proxy. Note to readers: This post was written in December of 2011. PLEASE do not ask me why I eatA broader question, which overlays this one, is whether any change in macronutrients impacts TEE. Increased FGF2. 1 promotes lipolysis in adipose tissue and the release of fatty acids into the circulation. Fatty acids are then taken up by the liver and converted into ketone bodies. FGF2. 1 expression in liver and adipose tissue is increased not only by fasting but also by a high fat diet as well as in genetic obesity which, according to these studies, may indicate that increased FGF2. Hence, ketosis may increase TEE either by increasing REE (thermogenic) or AEE (the ketogenic mice move more). Is the ketogenic diet, by maximally reducing insulin levels, maximally increasing lipolysis (which dissipates energy via thermogenic and/or activity ? Bottom line: There is sufficient clinical evidence to suggest that carbohydrate restriction may increase TEE in subjects, though there is great variability across studies (likely due the morass of poorly designed and executed studies which dilute the pool of studies coupled with the technical difficulties in measuring such changes) and within subjects (look at the energy expenditure charts in this post). In other words, is there something “special” about ketosis that increases TEE beyond the dose effect of carbohydrate removal? Many frameworks exist to define physical performance which center around speed, strength, agility, and endurance. Likely. Does ketosis enhance anaerobic power? No. Does ketosis enhance muscular strength? Unlikely. Does ketosis enhance muscular endurance? Like the previous question about energy expenditure, addressing this question requires defining it correctly. In fact, to do so cleanly requires a model where the relationship between these variables is clearly defined. The heart is studied because the work action is (relatively) simple to measure: cardiac output, which is the product of stroke volume (how much blood the heart pumps out per beat) and heart rate (how many times the heart beats per minute). Before we jump into the data, you’ll need to recall two important pieces of physiology to “get” this concept: the acute (vs. Hydraulic work is a bit more nuanced; it measures the mechanical work being done by the fluid.)Adding insulin to a fixed glucose (GI) load increases both cardiac output and hydraulic work, but it’s only significant in the case of hydraulic work. Oxygen consumption was significantly reduced in all arms relative to glucose alone, so we expect the cardiac efficiency to be much higher in all states. Delta G, or Gibbs free energy, is the “free” (though a better term is probably “available” or “potential”) energy of a system. Delta G = Delta H – Temperature * Delta S, where H is enthalpy and S is entropy. The more negative Delta G is, the more available (or potential or “free”) energy exists in the system (e. Delta G of - 1. 00. To help with the point I really want to make I refer to you this video which does a good job explaining Gibbs free energy in the context of a biologic system. Take a moment to watch this video, if you’re not already intimately familiar with this concept. In other words, these interventions offer more potential energy (with less oxygen consumption, don’t forget, which is the really amazing part). Recall that ketones make their way onto the metabolic playing field without going through PDH. Back to the original question. Richard Veech (NIH) and Dr. Kieran Clarke (Oxford). Because the results of their work have not yet been published, I can’t comment much or share the data I have, which they shared with me. According to Kevin, it is not generally appreciated how making ketones from fatty acids affects overall energy efficiency. Nevertheless, this can be examined by comparing the enthalpy of combustion of 4. B- OHB, which is about - 2,1. Thus, there is about 2. This suggests that being in nutritional ketosis may require more overall system energy, while still increasing work potential. Well, frankly, I’m tired of reading so much nonsense on this topic. Everybody with a Word. Press account (and countless people without) feels entitled to spew their opinions about ketosis without even the slightest clue of what they are talking about. Next time, I’ll try to back it out of the weeds and get to more clinically interesting stuff. The Ketogenic Diet : Bodyrecomposition. The Ketogenic Diet. A Complete Guide for the Dieter and Practitioner. First Edition. Softback. Number of Pages: 3. Show me my purchase options. About the Book. Very low- carbohydrate (aka ketogenic) diets such as The Atkins Diet, Protein Power and The South Beach Diet have come and gone repeatedly over the years and there is currently great research and real- world interest in their effects. Unfortunately, altogether too much misinformation exists regarding them. Folks who are pro- low- carbohydrate diets tend to present them as the quick and easy solution to everything including obesity. Easy weight loss without hunger or calorie counting is promised but never seems to pan out as well as we might hope. At the other extreme are the anti- low- carbohydrate folks who tend to present low- carbohydrate diets as nothing short of a nutritional disaster being perpetrated by a bunch of con men. The truth, of course lies somewhere in the middle. While low- carbohydrate diets aren’t for everyone and have their pros and cons, the research is clear: they have major benefits under certain circumstances and can be as healthy (and sometimes healthier) than . It is meant to be a reference manual for low- carbohydrate diets; it is unlike any other book on low- carbohydrate diets that you have ever read or seen. Covering every topic in extreme detail, The Ketogenic Diet addresses everything from the basic physiology of how the body adapts to a low- carbohydrate intake, the details of human fuel utilization, the impact of low- carbohydrate diets on body composition and many, many more. Of course, none of the above is useful without practical application guidelines. Details on how to optimize low- carbohydrate diets for different goals (such as fat loss, bodybuilding and endurance performance) are discussed along with three distinct types of low- carbohydrate diets. In addition, the book includes a complete discussion of resistance, aerobic and anaerobic exercise physiology along with specific training programs for different goals and different levels of trainee. At 3. 25 pages and containing over 6. Please note: this book does not include information on the ketogenic diet for adolescent epilepsy (the topic is discussed briefly). I highly suggest The Ketogenic Diet: A Treatment for Epilepsy, 3rd Edition (Paperback) by Freeman, Freeman and Kelly (link will take you to Amazon. Table of contents. Section I: Introduction. Introduction to the ketogenic diet. History of the ketogenic diet. Section II: The physiology of ketosis. Basic ketone body physiology. Adaptations to ketosis. Changes in body composition. Other effects of the ketogenic diet. Section III: The diets. Setting calorie levels. The standard ketogenic diet (SKD)1. Carbs and the ketogenic diet. The targeted ketogenic diet (TKD)1. The cyclical ketogenic diet (CKD)Section IV: Other topics for the ketogenic diet. Breaking fat loss plateaus. Ending a ketogenic diet. Tools for the ketogenic diet. Final considerations. Section V: Exercise physiology. Muscular physiology and energy production. The effect of exercise on ketosis. Exercise and fat loss. Section VI: Exercise guidelines. General exercise guidelines. Weight training. Section VII: Exercise programs. Intermediate programs. The advanced CKD workout. Fat loss for pre- competition bodybuilders. Section VIII: Supplements. Index. Show me my purchase options. Excerpt. The following is from Chapter 1. The Targeted Ketogenic Diet (TKD)Having examined glycogen levels and glycogen depletion in the last chapter, the details of the first . The targeted ketogenic diet (TKD) is nothing more than the standard ketogenic diet (SKD) with carbohydrates consumed at specific times around exercise. This means that the general guidelines for constructing a SKD in chapter 9 should be used with the exception that more carbohydrates are consumed on days when exercise is performed. If fat loss is the goal, the number of calories consumed as carbohydrates should be subtracted from total calories, meaning that less dietary fat is consumed on those days. The TKD is based more on anecdotal experience than research. Invariably, individuals on a SKD are unable to maintain a high training intensity for reasons discussed in chapters 1. However, for a variety of reasons,some dieters choose not to do the full 1- 2 day carb- up of the CKD (discussed in the next chapter). The TKD is a compromise approach between the SKD and the CKD. The TKD will allow individuals on a ketogenic diet to perform high intensity activity (or aerobic exercise for long periods of time) without having to interrupt ketosis for long periods of time. Weight training is not generally limited by the availability of blood glucose. Studies giving carbs prior to resistance training have not found an increase in performance (1). However, almost without exception, individuals on a SKD who consume pre- workout carbs report improved strength and endurance and an ability to maintain a higher intensity of training during their workout. Anyone following a ketogenic diet who wishes to perform high intensity training can benefit from the TKD approach. Show me my purchase options. Reader Feedback“I have been looking for a diet book like this for years. Since I’ve been involved in weight lifting I have tried to read as much as possible about various diet methods. When low- carb diets became popular I was skeptical, but wanted to learn more. I read through the material I could find online and just finished “The Greenwich Diet”. In all cases I found myself totally unsatisfied with everything I read. Every book pitched it’s particular take on the low carb diet as a miracle cure and didn’t provide much information about what was really happening to your body. I decided to give The Ketogenic Diet a try and was stunned — it is the most complete diet book I have come across. I finally understand how many types of diets work (not just low carb diets). Mc. Donald begins with a history of ketogenic diets and then goes into a detailed explanation of how various nutrients (both macro and micro) affect your body. After this explanation he presents three versions of the ketogenic diet, with two of the diets aimed at athletic individuals who are looking to maintain their exercise performance while on one of these programs. Each diet is accompanied by detail information about how to implement the diet. As I have said, the material in this book is incredibly detailed and completed, but what really makes this book worth 5 stars is that the information is presented in a non- biased way. According to the introduction, Mc. Donald wrote this book to clear confusion about ketogenic diets, not to champion them. Much of the material is accompanied by research references and Mc. Donald clearly states where research is lacking or where he is offering his own opinion. Overall, “The Ketogenic Diet” will make an excellent addition to any dieter’s collection of reading. Also, if you are considering a ketogenic diet this will gives you an unbiased view of how they really work.”Douglas – Seattle, WA“People that opted for a low- carb lifestyle are actually making a life- or- death decision on their own lives. It does not help that there are a lot of misinformation around it, specially suggesting that you will have all sort of health complications because of it. This is a very complete book on the subject. It explains the physiology around a ketogenic diet. It’s well researched and full of references. It leans toward athletes but anyone could learn a lot from it. This book does not tell you how to follow a Ketogenic diet. For that purpose I would recommend “Protein Power”. I’ve read literally tens of books on low- carb diets. This one is the only one that really explains what happens in your body. I highly recommend this book for anyone that want to know more on how a low- carb diet works.”Mauro – Sao Paulo, Brazil“The Ketogenic Diet is the ultimate resource on low- carbohydrate and ketogenic diets. You will learn the physiology of ketosis, basic and effective nutrition and training concepts, and how to set up various ketogenic diets depending on your goals whether you are involved in sports, looking to lose fat without losing muscle, or even to achieve peak conditioning for bodybuilding/fitness competitions or photo shoots. Rather than glorifying the ketogenic diet, Lyle Mc. Donald gives you the scientific foundation and practical guidelines allowing you to determine when and why to use this diet. By virtue of its 3. Borge (aka Blade) – Norway – Myo. Revolution“The amount of misinformation circulating about ketogenic diets is dumbfounding. This book is the most thorough investigation of all medical research regarding ketogenic diets that has ever been assembled. The references are impressive, to say the least. Although quite technical, I had no problems understanding any of it. Lyle presents a clear, no- nonsense/no- hype explanation of what a body goes through in ketosis. A must- read for anyone on a ketogenic diet or considering one. Everyone should bring an extra copy to their physician to stave off the “misinformed speech” problem.”Denise – California. Purchase Options. The Ketogenic Diet: A Complete Guide can be purchased in one of three formats. The first is as a PDF e- book download for $3. You will receive a link for immediate download from my shopping cart and the book can be read with any free PDF reader (i. Preview Adobe Reader, Foxit) or printed. The second is as a hardcopy book for $4. Shipping/Handling. Your order will be sent to my print on demand company, printed and shipped to you. Orders typically arrive in 3- 6 days within the United States but can take up to 4 weeks internationally. For only $1. 0 more than the hardcopy book itself ($5. Shipping/Handling), you’ll get the e- book for immediate download as well as receiving a hardcopy book from Vervante. You can add your chosen version to your shopping cart with the buttons below. E- book: 3. 7. 0. Hardcopy: 4. 2. 0. S/HBundle: $5. 2.
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