Ketogenic Nutrition – The fundamentals

An overview

• THE ARTICLE AIMS TO EXPLAIN THE MAIN NOTIONS, MECHANISMS AND TOOLS THAT ARE USED IN THE KETOGENIC DIET, AS WELL AS THE MAIN TYPES OF KETOGENIC NUTRITION
• WE WILL FIND OUT WHAT IS KETOGENIC DIET, KETOSIS, KETOGENESIS, KETONES
• WE WILL FIND OUT WHAT IS THE SCIENTIFIC MECHANISM BEHIND THIS DIET
• WE WILL SEE WHAT ARE THE MAIN MACRO AND MICRO-NUTRIENTS

1. What is ketogenic diet
   • The ketogenic diet aims to produce ketones (ketones) by the body and use them as their main source of energy[2]. For this process to take place, it is necessary to reach the state of ketosis (ketosis)
   • In short, the ketogenic (ketogenic) diet is a carbohydrate-restricted diet (on average no more than 25g/day) that is used for weight loss by activating the fat burning mechanism and using them as a fuel source instead of sugar (simple or complex carbohydrates). At the same time, it is a diet that includes a very large amount of fats of animal or vegetable origin, preferably in a form as unprocessed as possible, whether we are talking about saturated or unsaturated fats. The diet accepts dairy, but not refined, esterized or hydrogenated poly-unsaturated fats, also known as TransFats. It is a diet in which complex fatty acids are extracted by the body through ketogenesis from fat and are used as a cellular energy source. The body can use sugars (carbohydrates) or ketones (ketones) for energy. The 2 energy sources are interchangeable, but there are some differences.
   • There are several voices that say that this type of diet is unhealthy and that it involves risks. I would say that any type of diet, especially taken to extremes, can pose serious health risks, but it’s a good time to debunk much of the misconceptions about this nutritional model, which originates from the Paleo diet
   • The Ketogenic regimen has been used to treat cases of epilepsy (especially among children and has gained ground as a tool to regulate insulin levels for patients with type II diabetes (since this regimen decreases the need for insulin therapy)
2. What is not the ketogenic (ketogenic) diet?
   • The ketogenic diet is not just a low-carb diet (high fat and low carb diet), as diets of this type do not rely on reducing them so much that the body goes into ketosis. These diets fall somewhere in a gray area, where the body does not clearly make the transition from using one energy source to the other.
   • It is not a paleogenic diet (Paleo Nutrition[5]) Both diets encourage higher consumption of healthy fats and lower percentage of carbohydrates. Both diets encourage the consumption of unprocessed foods, discourage the consumption of grains and legumes. The main differences are that the paleo diet accepts carbohydrates from fruits and vegetables and does not accept dairy products. For more details, read the article on the comparison between ketogenic and paleogenic diets
   • It’s not the Atkins diet either, although it’s very similar, Dr. Atkins being one of the first to make us look at fat differently, but the targets of the two are different, and the latter aims to reintroduce carbohydrates along the way, to an acceptable level.
   • It is not a diet based on animal products (meat, eggs and dairy), although they are part of the ketogenic diet. There are, however, enough foods of plant origin rich in fat, which allow the adoption of the ketogenic diet by vegetarians or vegans. For details, here is the article about the keto diet for vegans.
   • It is not the state of ketoacidosis present in diabetics. Not to be confused. This is a pathological condition, in which the natural mechanisms of the body no longer function normally, and ketone bodies (ketones) produced to use other energy sources are in much greater quantities than they would reach through a ketogenic diet.
3. Definition of terms in ketogenic nutrition
   • To understand how this diet works, it is necessary to first define the terms encountered in the mechanism of action: keto, ketosis, ketogenic, ketones, ketone bodies. The term “keto” is an abbreviation of “ketogenic”. It defines your body’s ability to produce ketones using fat. When the level of ketones in the blood exceeds 0.5 mMol/L, the body reaches the state of ketosis. This state of ketosis can be achieved in two ways: through diet and supplements or through fasting. Through diet and supplements, although the body is in ketosis, as we have ketones from exogenous intake, both from fats from food and from supplements (such as HVMN Ketone, ketones in the form of salts or oils containing medium chain triglycerides – MCT oils, Brain Octane Oil). The body does not synthesize ketones on its own, as it does in fasting. Thus, a body in ketosis is not necessarily a ketogenic body. A ketogenic body, on the other hand, is in ketosis.
   • Although the terms ketones and ketone bodies are often mistakenly used to define the same thing, their meaning is slightly different. Ketones are organic compounds that have in their structure a carbonyl group (a double carbon-oxygen bond) linked to two HC groups. Not all ketones are also ketone bodies, nor vice versa. Ketone bodies are produced by the liver by metabolizing fats. When we talk about ketone bodies, we refer to acetone, acetoacetic acid (AcAc) or betahydroxybutyric acid (BHB) – the main ketone body in the blood, the latter not technically being a ketone. Both AcAc and BHB pass easily through the cell membrane, making it an excellent source of energy for both the body and brain.
4. The levels of ketosis status can be classified as follows, depending on the level of ketones in the blood:
   • No ketosis: values below 0.5 mmol/L BHB
   • Mild ketosis: 0.5 – 1 mmol/L BHB
   • Moderate ketosis: 1 – 1.5 mmol/L BHB
   • Strong ketosis (BioReset/Post): 1.5-3 mM BHB
   • Pathological ketosis: above 3 mmol/L BHB
5. The mechanism of action of ketogenesis
6. Macronutrients in the ketogenic diet
7. 5% carbohydrates, 20% protein, 75% lipids, or
8. 2-4 g of fat per 1 g of carbohitrates plus protein, or
9. maximum 20-30 g carbohydrates (some sources allow consumption of up to 50 g of carbohydrates)
10. Carbohydrates
11. The human body does not store sugar, only fat.
12. Proteins
13. Lipidele
14. caproic acid (C6)
15. acidul caprilic (C8)
16. acidul capric (C10)
17. lauric acid (C12)
18. Micronutrients in the ketogenic diet
19. Main types of ketogenic diets:
    • Moderate or medium ketogenic diet (MKD – Mild Ketosis Diet): Here we have few carbohydrates (5-15%), a lot of fat (65-75%) and protein (20%).
    • Standard Ketosis Diet (SKD): Here we have very few carbohydrates (5%), many fats (75%) and protein (20%).
    • Cyclic Ketogenic Diet (CKD): This diet almost completely restricts carbohydrates and sugars for 5-6 days, then takes a 2-day break during which few carbohydrates can be consumed.
    • Targeted ketogenic diet (TKD): No carbohydrates or sugars are eaten in this diet, except at very well chosen times to counterbalance certain intense energy needs (example: certain cures or workouts)
    • High-protein ketogenic diet (HPKD): A kind of Atkins or keto diet with a high percentage of protein 60%, fat 35% and carbohydrates 5%.

Referrer:

• The term ketogenic is used as commonly as ketogenic. In Romanian correctly use “ketone”, “ketogenic”, “ketosis”; The use of the form “ketones”, “ketogenic”, “ketosis” being accepted as neologisms. We can use the words with “k” in common expression.
• Fuel metabolism in starvation – Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA. [email protected]
• Ketosis or Ketosis; Definition
• Hallberg, S. J., McKenzie, A. L., Williams, P. T., Bhanpuri, N. H., Peters, A. L., Campbell, W. W., Volek, J. S. (2018). Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Diabetes Ther.
• Paleogenic diet or Paleolithic diet; how our ancestors fed for several million years; or what we think they’ve eaten for so long.
• Krebs, H.A. (1966). The regulation of the release of ketone bodies by the liver. Adv. Enzyme Regul. 4, 339-354.
• Volek, J.S., and Phinney, S.D. (2012). The Art and Science of Low Carbohydrate Performance.
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• Diabetes UK Website: Blood Sugar Level Ranges
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• Mente, A, Dehghan, M, Rangarajan, S, et al. Association of dietary nutrients,with blood lipids and blood pressure in 18 countries: a cross-sectional analysis from the PURE study, 2017. The Lancet. Diabetes & endocrinology 5, 774-787.
• The Difference Between Saturated and Unsaturated Fats
• Volek, J.S., Gomez, A.L., and Kraemer, W.J. (2000). Fasting lipoprotein and postprandial triacylglycerol responses to a low-carbohydrate diet supplemented with n-3 fatty acids. J. Am. Coll. Nutr. 19, 383-391.
• FDA Website: Final Determination Regarding Partially Hydrogenated Oils (Removing Trans Fat).
• Dehghan, M, Mente, A, Zhang, X, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study, 2017. Lancet.
• Rabast, U., Vornberger, K.H., and Ehl, M. (1981). Loss of weight, sodium and water in obese persons consuming a high- or low-carbohydrate diet. Ann. Nutr. Metab. 25, 341-349