With the increasing popularity of the ketogenic diet, fasting and medium chain triglyceride (MCT) supplements there has been a lot of talk surrounding the health benefits of being in ketosis. For starters ketosis is a metabolic state whereby the liver produces ketones and the body switches from glucose to ketone’s and fat’s as its primary fuel source (1). Ketosis is achieved during periods of low glucose consumption such as during ketogenic or low carb diets. However, states of ketosis can also be achieved during prolonged fasts. Exogenous ketone supplements have also been formulated to immediately increase ketone availability and medium chain triglycerides have also been shown to increase ketone production (2,3). So, what’s so special about being in ketosis? Ketosis has been associated with improved weight loss and cognitive function (4,5). Additionally, being in a state of ketosis has been shown to improve symptoms related to cardiovascular disease, type 2 diabetes, Alzheimer’s disease, Parkinson’s disease and even certain types of cancers (6)!
As mentioned previously during periods of low carbohydrate availability or fasting the body produces ketone bodies. There are three major types of ketone bodies; acetoacetate, beta-hydroxybutyrate and acetone (7). Once the body is adapted it begins to start using ketone’s as an energy source compared to glucose. Almost all bodily tissues including the brain can run off of ketones. This metabolic state shift creates numerous changes throughout the body resulting in some of the aforementioned health benefits.
Although there has been a lot of controversy lately on the effects of the ketogenic diet and weight loss when compared to a more traditional western diet. There is a fair amount of evidence which suggest that weight loss and appetite suppression are common when following the ketogenic diet (8). It has been demonstrated that being in ketosis increases fat oxidation which may result in greater weight loss over time. Additionally, people in ketosis commonly report feelings of appetite suppression, which may reduce calorie intake and result in greater weight loss overtime (9). It is important to mention that if you are looking to maximize weight loss then total calorie consumption is critical. Even when in a state of ketosis, it is essential to remain in a caloric deficit to maximize weight loss (10).
Being in a state of ketosis has also been shown to improve various metabolic parameters associated with type two diabetes and cardiovascular diseases. Reducing carbohydrate intake has been shown to reduce insulin spikes and improve insulin sensitivity thereby drastically improving symptoms associated with diabetes. In fact, many studies report after being in ketosis for an extended period of time some patients can actually stop all pharmacological treatments (11). Additionally, being in a state of ketosis has been demonstrated to improve cholesterol parameters and reduce blood pressure levels (12)!
Moreover, being in a state of ketosis may offer various neurological benefits as well. One of the most documented uses of the ketogenic diet is for treating symptoms of epilepsy. It has been long known that begin in ketosis offers a neural protective effect which has improved the lives of millions previously non-responsive to epileptic treatments (13). However, there has also been a resurgence of research investigating the effects of ketosis on other neurological diseases.
A common issue with aging as well as mild cognitive impairment and neurodegenerative diseases like Parkinson’s and Alzheimer’s is the brains inability to utilize glucose for fuel. This creates and energy deficit and results in a host of problems including reduced cognitive ability and impairment in activities of daily living. Ketones, uniquely possess the ability to pass the blood brain barrier and provide the brain with a secondary fuel source which may fix the energy deficit (14). As a result, being in a state of ketosis has been demonstrated to significantly improve cognitive performance in patients with Alzheimer’s, Parkinson’s and mild cognitive impairment (15,16).
Lastly, a new line of research has begun investigating the effects of being in ketosis on certain types of cancers. Cancer is defined as uncontrollable cell growth. The theory is that cancer cells utilize glucose as their main fuel source and entering a state of ketosis may starve out the cancer cell and prevent it from replicating, as cancer cells cannot utilize ketones. Obviously, there is a lot more to consider here however, some of the initial research is promising (17,18).
It is remarkable how entering into a state of ketosis could have such a wide variety of health benefits from improved weight loss, improved metabolic parameters, improvements in neurological disorders and maybe even treat certain cancers! While there are different ways one can enter into ketosis (I.e ketogenic diet, fasting) if you’re looking to attain one of these benefits you should adapt the ketogenic diet to fit the needs best suited for that goal. For example, if you’re looking to maximize weight loss ensure you’re in a calorie deficit. If you’re looking for improvements in neurological conditions then constantly being in a state of ketosis is likely ideal, so you may want to be stricter with your intake keeping your fat high and protein moderate. However, if you’re just looking for general health benefits and are participating in resistance training you may want to consider slightly higher protein intakes. Lastly, make sure you utilize all of the resources available to you from informational blog post, supplements designed to aid people on the ketogenic diet and natural ketogenic sources like medium chain triglycerides!
- Veech, R. L. (2004). The therapeutic implications of ketone bodies: the effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism. Prostaglandins, leukotrienes and essential fatty acids, 70(3), 309-319.
- Kesl, S. L., Poff, A. M., Ward, N. P., Fiorelli, T. N., Ari, C., Van Putten, A. J., ... & D’Agostino, D. P. (2016). Effects of exogenous ketone supplementation on blood ketone, glucose, triglyceride, and lipoprotein levels in Sprague–Dawley rats. Nutrition & metabolism, 13(1), 9.
- Vandenberghe, C., St-Pierre, V., Pierotti, T., Fortier, M., Brodeur-Dubreuil, C., Cunnane, S.C. (2016). Acute plasma ketone response to coconut oil alone or in combination with different medium chain triglycerides. ISSFAL Congress, Banf Canada, Poster Presentation
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- Rho, J. M., & Stafstrom, C. E. (2012). The ketogenic diet as a treatment paradigm for diverse neurological disorders. Frontiers in pharmacology, 3, 59.
- Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European journal of clinical nutrition, 67(8), 789.
- Balasse, E. O. (1979). Kinetics of ketone body metabolism in fasting humans. Metabolism-Clinical and Experimental, 28(1), 41-50.
- Bueno, N. B., de Melo, I. S. V., de Oliveira, S. L., & da Rocha Ataide, T. (2013). Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. British Journal of Nutrition, 110(7), 1178-1187.
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- Sharman, M. J., Kraemer, W. J., Love, D. M., Avery, N. G., Gómez, A. L., Scheett, T. P., & Volek, J. S. (2002). A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. The Journal of nutrition, 132(7), 1879-1885.
- Henderson, C. B., Filloux, F. M., Alder, S. C., Lyon, J. L., & Caplin, D. A. (2006). Efficacy of the ketogenic diet as a treatment option for epilepsy: meta-analysis. Journal of child neurology, 21(3), 193-198.
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- Van der Auwera, I., Wera, S., Van Leuven, F., & Henderson, S. T. (2005). A ketogenic diet reduces amyloid beta 40 and 42 in a mouse model of Alzheimer's disease. Nutrition & metabolism, 2(1), 28.
- Zhou, W., Mukherjee, P., Kiebish, M. A., Markis, W. T., Mantis, J. G., & Seyfried, T. N. (2007). The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer. Nutrition & metabolism, 4(1), 5.
- Poff, A. M., Ari, C., Seyfried, T. N., & D’Agostino, D. P. (2013). The ketogenic diet and hyperbaric oxygen therapy prolong survival in mice with systemic metastatic cancer. PloS one, 8(6), e65522.