The Healthy Executive

Ketogenic Diet Rationale And Preparation

Ketogenic endocrine process

A ketogenic diet is a short-term power diet (4-6 weeks) to burn bodyfat while preserving lean muscle. In this post I go over the science of ketogenesis, the necessary preparation, and the weekly nutrition cycle.

Ketogenic Nutrition Rationale

  • Principal Idea: Switch energy source from burning glucose (sugar from carbs) to burning ketones (fat).
  • Practical Implementation : Modify diet to switch caloric energy from carbohydrates foods to fats. In effect this is an ultra-low carb high-fat diet.
  • Expected Outcome: Reduce bodyfat by 4–8 lbs or 1–3% while preserving lean muscle mass and strength.
  • Heads Up: Many people hear the word “ketogenic” and mistakenly confuse it with diabetic keto-acidosis (DKA). They are completely different things, other than sharing a root Latin word.

I’m trying to cover just the Keto essentials here and not re-invent any wheels. As a result, I will point to useful reference information instead of just re-summarizing. If something is missing or doesn’t make sense, please let me know at jeff@thehealthyexec.com.

My Ketogenic Science Sources

On daily basis, I read relevant scientific research and published studies, and work to understand study limitations and biases. From this process I determine authoritative sources in a specific field aka “totems”. I define a totem as “the highest current performance level in an field, used as a standard or benchmark to be equaled or exceeded”.

I then typically read all the published works by a totem on their area of expertise. I absorbed information about the ketogenic diet, ketone supplementation (ketone esters, ketone salts, MCTs) and various topics related to nutrition, metabolic drugs, combination metabolic therapies, and strategies for performance enhancement and resilience.

For Keto, my science totems are:

  • Dr. Jeff S. Volek (Registered Dietitian) and Dr. Stephen D. Phinney (medical doctor).
    • These guys have performed many studies and have treated thousands of patients with a low-carb diet.
  • Dominic D’Agostino
    • His goal is to bring as much useful an free information as possible from his clinical research (and others). Emphasis on peer reviewed publications on ketones in journals like International Journal of Cancer, Science and Nature Medicine
  • The Ketogenic diet has also been extensively used for decades and has been well researched to successfully treat epilepsy in children.

My Ketogenic Community Sources

A respectable amount of personal health innovation is occurring in networked communities (crowd-sourcing) such as Reddit, Quantified Self, and Hyper Wellbeing.

In personal health community I find there are some folks who are very good at synthesizing (researching, applying, measuring, and explaining). For Keto, my go to sources are:

  • Lyle MacDonald is a physiologist and author who has spent over a decade obsessively finding ways to apply cutting-edge scientific research to sports nutrition, fat loss and muscle growth. Lyle is colorful and polarizing, but he knows his stuff.
  • Dr. Peter Attia is a surgeon and M.D. with a passion for Keto and sports performance. He does leading edge research using himself as a test subject.
  • Dr. John Keifer who wrote Carb Nite.
    • Although he is a physicist, he systematically worked through 1,500 studies to optimize his method and then tested it on hundreds of clients. I’ve reviewed these personally and find them solid.
  • reddit logoBy far, the best online community is Reddit, lots of practical advice and experience:
    • /r/keto
    • /r/ketogains – Keto & exercise
    • /r/ketoscience – scientific studies and papers about keto
    • /r/vegetarianketo – It’s possible!
    • /r/ketorecipes – Lots of recipes, food porn
    • /r/progresspics – Show your progress

Why Cyclic Ketogenesis?

A cyclic ketogenic diet (or carb-cycling) is a low-carbohydrate diet with intermittent periods of high or moderate carbohydrate consumption. This is a form of the standard  Ketogenic diet (SKD) used as a way to maximize fat loss while maintaining the ability to perform high-intensity exercise. (The targeted ketogenic diet or TKD, is based on timing incremental carbs around intense workouts, and is ideal for obsessive compulsive professional bodybuilders who have no life outside of competing).

Weight-loss plateaus occur when hormones try an protect the body from “starvation” from even a mild calorie deficit (see the first figure). I won’t go into endocrine pathways here, but regular carb refeeds “reset” hormones (insulin) out of “starvation” mode (grehlin) and up-regulate fat-loss hormones (leptin) and down-regulate protein catabolism (cortisol) for another 4–6 days (see the second figure).
wpid-IMG_0919.PNGCyclic ketogenesis hormones

Preparing For Ketogenic Nutrition

Success requires preparation.

Here are the steps I went through to start a Ketogenic diet:

  1. Understand what you are getting yourself into. The keto macro-nutrient ratios are: 60–75% of calories from fat, 15–30% calories from protein and 5–10% calories from net carbs (30g max).
    • You can (and should) personalize your goals, calories and macros using this keto calculator or this one.
    • You can quickly read some good Keto summaries that cover the key points here or here.
    • For more depth and detail I used Carb Nite as a reference because it was one of the best synthesis of research studies I’ve found.
    • Net carbs = total carbs – fiber carbs. Fiber carbs are not really nutrients and have no effect on your insulin levels.
  2. Food Prep
    1. Begin by cleaning out carbs from your cabinets and refrigerator. I realize this works differently if you have kids or a spouse who are not going Keto.
      • Tip: Enlist the support of your partner or kids to keep you accountable. I deputize my kids as the “carb police” and believe me, they love holding me to my word :)
    2. Shop and stock with Keto foods. This preparation is the “heart” of Keto success and does entail a one-time learning curve. But I found it pretty easy with some practice reading labels. Meats, eggs, cheeses, and leafy greens are the core. And I learned how to “pair” high-fat with high-protein foods for meals (such as eggs or shrimp cooked in coconut oil).
      • For what it’s worth my Keto shopping list includes: Eggs, Bacon, Chicken, Turkey, Salmon, Shrimp, Cottage Cheese, Hard Cheeses, Nuts and Seeds, Coconut Oil, and Psyllium Fiber.
      • Tip: Have “portable Keto” options when learning the diet or when you travel. In my backpack I always carry individual-sized protein shakes, nuts, jerky, and cheese sticks.
      • Tip: Leverage the wisdom of crowds. I routinely google “keto recipe ingredient” or “keto store name” or “keto restaurant name”. Within seconds I get great answers from others who have figured best Keto options for a particular situation (often on Reddit).
      • You can my exact Keto meals in my nutrition log.
      • Good lists of Keto foods here or color-coded here.
      • Tip: I have a hard time with nuts and portion control. As a result, I buy raw nuts and avoid salted or toasted nuts – those are like crack cocaine to me :)
  3. Monitor Prep: I’m sure you would agree that “what gets measured gets done”. I have found the following apps highly useful in preparing and implementing a keto diet.
    • imageKetodiet App is a great Keto app with recipes, a meal planner, grocery list generator, tracking reports, and helpful tips and support. I especially like that calculates net carbs precisely, which is important with a low macro target like 30g/day. (Note: currently the full feature set is iPad only, but the developers are working hard to port the full feature set to iPhone and Andriod).
    • I am using MyFitnessPal (MFP) in parallel with the Ketodiet app to compare the two, with the long term intent of using just one. MFP allows you to set your daily carb macro target on a percentage basis (free) or by the gram (paid). It does not calculate net carbs (i.e. subtract fiber carbs) and the MFP database doesn’t seem quite as precise as Ketodiet for <1g carb foods.

My Weekly Ketogenic Plan

  1. Adaptation: For the first six days keep carbohydrates to 30 grams or less per day— equivalent to two slices of white bread; only fiber does not count as a carbohydrate in this total.
    • I find /r/keto invaluable for food and recipe tips, I use Ketodiet App to meal plan, and I use MFP to make good restaurant menu choices.
    • Low Carb “Flu”: When following a low carbohydrate diet, for the first few days, there is an adaptation period during which most people report feeling run-down or tired. Some people report feeling irritable, out of sorts, and unable to make decisions. For most people these feelings disappear after the adaptation period, however, and are replaced with feelings of calm and balance, and more consistent energy.
  2. Carb Refeed: Day seven starts off like the previous six days but starting at around dinner time (sometime between 4 and 6 pm) you must eat a sizable amount of carbs: spaghetti, apricots, pie, potato-chips, bread, bananas, bagels, donuts, ice-cream, cookies, cheesecake and almost anything else you’ve been craving. You should eat carbs for the rest of the evening—this includes all the way until bedtime and maybe even a midnight snack.
  3. Day After Refeed: Go back to 30 grams or less of carbohydrates per day—the same as your first six days.
  4. Exercise: The best time to do any heavy lifting is the day after a carb refeed, as muscles are restocked with glycogen and will perform strongly. Cortisol is low for 2–3 days after a carb refeed, so this is also a good time to get any heavy cardio work done. The heavy cardio work will also deplete glycogen and help promote ketogenesis (fat-burning) sooner.
  5. Scheduling: I do schedule carb refeed on Friday night followed by heavy weights on Saturday and intensive cardio activities on Sunday and Monday. The remainder of my week consists of walking and light weights to prevent cortisol spiking problems (which might contribute to protein catabolism and strength loss).
    • Tip: Keto is a short-term power diet for fat loss. I suggest you use it in 4–6 week bursts. I am 3 weeks into my first cycle and plan to blog out my experience. I am not sure about adaptation effects as yet. Some users report better results on their second and following cycles as their experience grows and body more fully adapts. Other users report diminishing returns when doing continuous Keto for months on end.

Why? And What’s Next?

As an online health coach, I was not completely happy with my body composition results at the end of  my 12 week Dogfood Challenge.

So I am trying a cyclic ketogenic diet for a few weeks to see if I can nudge my bodyfat from 11.5% to 9% without losing my strength gains.

Stay tuned for the upcoming post where I will detail my actual results.

Update: Here is my data and ketogenic nutrition results after 4 weeks of self-experimentation.image

 


Also published on Medium.

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