The ketogenic diet is popular these days.
The diet basically comes in two versions:
And for many people this milder version works great because they find that it blunts their appetite and eliminates cravings, making it easier to not overeat and lose weight.
But many people who are finding success with this way of eating are being told by well-meaning friends and doctors that this diet is DANGEROUS!!!! That it could kill them or destroy their kidneys, and they must stop it right away.
Is that true?
Your body has two fuels it can run on, like a hybrid car. It can burn sugar and it can burn fat. And depending on what you’re eating and what you’re doing (sitting on the couch vs sprinting) your body is burning various mixes of both sugar and fat.
Besides the carbohydrates you’re eating, you have enough stored sugar in your body to last around 24 hours.
Fat is a different story, and most of us have enough fat on our bodies to last quite a long time.
There’s a famous case from 1965 of a 27 year old man who weighed 456 pounds. He fasted, taking in NOTHING but water, a multi-vitamin and some potassium pills, for 382 days. He not only survived, but did well, and lost 275.5 pounds.
After around 24 hours of not consuming carbs (either from not eating, or from eating a very low carbohydrate diet) your store of carbs runs out and your body switches over to primarily using fat.
The issue is that, while most of your body can switch over to using fat for it’s energy needs and be happy, there are a few parts of your body that can’t. These are your red blood cells that carry oxygen through your blood, some parts of your internal organs, and parts of your brain. Our bodies need a little bit of sugar and can’t run entirely on fat.
Now your body is able to make a small amount of blood sugar from the protein of your body (your muscles) or any protein you eat, but it’s not enough to supply all your cells with sugar.
Fortunately there’s a little “hack” your body uses, and that’s to turn some of your fat into ketones. Ketones are a special fuel made by your liver that aren’t fat and aren’t carbs, but act a bit like carbs. They’re able to replace some of the sugar needs of your brain and organs, reducing the amount of sugar your body needs to produce. This keeps you from breaking down all your muscles to make sugar, which is still a myth you’ll hear in some body-building circles or from some undereducated trainers.
So after 3-4 days of fasting or eating a very low carbohydrate diet, the body is running on three fuels. Most of your body is using fat, some of your body is using ketones, and a few cells are using the little bit of sugar coming from what your body can make or what might be coming from your diet.
The trick to this safe state of ketosis is having a working pancreas. Even in the case of the 456 pound fasting man, who ate nothing at all for over a year, his working pancreas kept producing a trickle of insulin.
This tiny amount of insulin is necessary to keep the machinery working properly, and prevents the body from overproducing ketones.
You see ketones are mildly acidic. At normal levels your body compensates for this small amount of acidity produced by these ketones and they cause absolutely no problems.
However, in the case of a type 1 diabetic who’s pancreas has been destroyed by autoimmunity, they no longer produce any insulin, and unless they inject insulin there is no brake to stop the production of ketones.
And so the amount of ketones in the blood can rise to unnaturally high levels. This high level of ketones can begin to acidify the blood to levels that the body can’t adjust for. This is KETOACIDOSIS, and this acid blood can, as it continues to rise, begin to cause severe, and then life-threatening problems.
But it is not a ketogenic diet that causes this problem.
It is a lack of insulin.
As long as you have a functioning pancreas, and barring any extreme or freak circumstances, you will not be able to go into a state of ketoacidosis.
The most common things that will hurt your kidneys are high blood pressure and high blood sugars, and the ketogenic diet has been shown to reduce both high blood pressure and high blood sugar. So for most people a well-formulated ketogenic diet not only won’t hurt their kidneys, but will actually protect them.
Most doctors aren’t trained to understand ketosis, but are trained to be on the lookout for ketoacidosis. So when they hear the word ketones or ketosis, they automatically flash to this dangerous condition. In this case, they don’t know what they’re talking about. And the same goes for well-meaning friends or trainers.
A well-formulated ketogenic diet will not hurt you or your kidneys. You are not at risk of dying of ketoacidosis, and as long as you have a working pancreas, barring some extreme freak situation, there is no way you can even reach ketoacidosis, not even if you fasted for 382 days straight!
Having said all this, a ketogenic diet is not right for everyone. While there are many ways to do a ketogenic diet incorrectly, some people just do not do well on this diet. This can be because of gut problems like dysbiosis, or hormonal issues, or other dysfunctions. Or it may just be a bad for a person’s genetics, or lifestyle.
Still for many people who are suffering with overweight, pre-diabetes, insulin resistance, and high blood pressure a mild ketogenic diet can work extremely well. And for people suffering with epilepsy, Alzheimer’s disease and various dementias, and certain kinds of cancer, a more aggressive ketogenic diet can work miracles.
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