Ketogenic is the new buzz word on the nutrition scene, and rightly so. It has several very strong association with weight loss, mental health and improved cancer prognosis to name a few. It is at the heart of my metabolic nutritional therapy. However it is not a cure-all, as every disease has to be approached from a holistic point of view. In addition, there are ways to screw this diet up in such ways that it can be counter-productive and make your symptoms worse.
Effects of mental & emotional stress.
When I first discovered the diet years ago and applied it to myself, I was one of those who didn’t get many benefits out of it. In fact, my gut health got worse and I started gaining belly fat. At that time, within one year I changed job twice, got fired once by an abusive boss, bought my first house, got a baby, was driving 3h/day through London traffic, was on the CrossFit bandwagon twice or more a week, I wasn’t having my veggies and only got through it with much-needed coffee. Needless to say, my stress and cortisol were through the roof.
Cortisol is a hormone with many positive and less positive effect, and a complex pathway of interaction with the body. One thing for sure is that during our evolutionary history we never got to experience long continuous bouts of high stress. In a situation of continued stress, cortisol can be the substance that will break down muscle tissues for the liver to make glucose. This pathway is commonly known as gluconeogenesis.
As the keto diet can be very stressful on the body of those who already have insulin resistance, transitioning too rapidly from high carb to keto could have potentially counter-productive results in some people, especially if their lifestyle is already very hectic. In such case, a moderate-carbohydrate paleo template could give better results.
General health considerations.
Are you insulin resistant? Do you have diabetes? Are you taking medications to lower your blood sugar? If that’s your case, please get professional advice. Your body will control your blood sugar within a narrow range, and taking medications while being on the ketogenic diet can push you so low you could faint… or worse.
How’s your gallbladder? For many people who’ve been long term on the low-fat diet, it is common to experience difficulties transitioning, because their digestive machinery is just not in place yet. For some, the bile in the gallbladder has not been used for a long while and started to get viscous, or even started to crystallise into outright gallstones. Others have already had their gallbladder removed. In either of those cases, they may need gallbladder and digestive support, and professional help. (study)
Are you pregnant? Here again, the ketogenic diet is contraindicated. There isn’t a lot of studies on the subject but the few there are gave negative preliminary results (study). The hypothesis is that the diet tricks the body into thinking that it is going through a period of famine and might increase the chances of miscarriage. However, there are reports of people who were able to conceive for the first time only after going keto (possibly due to a deficiency in amino-acids).
How’s your gut health? Because you can have the best diet in the world, but if you are not absorbing it, you’re really only just flushing money down the toilets… if you have intestinal or digestive health issues, that would need to be addressed first.
Another very important consideration that is left completely out by some people is the quality of the dietary fats you are ingesting. Much of the industrial vegetable oils & seed oils available from the grocery department are really not supportive of your health, especially if you suffer from cancer. Those oils are oxidised and otherwise damaged in the production & storage process, and sometimes downright hydrogenated (source). On the keto diet, dietary fat is a major component of your nutrition and therefore you cannot afford to use something that will create more harm than good. Dairies also can have a negative effect primarily because so many people are sensitive to them.
In addition, it is easy to “forget” to add veggies. I know it, I did it myself… and yes there are populations that are said to survive on pretty much no veggies and yet to be very healthy, but unless you come from the same ethnic pool, have the same gut microbes and use the exact same food as those population, it may be illusory to expect the same results.
Finally, a number of studies have shown that an imbalanced poor-quality meat diet can be pro-inflammatory. Those studies come with a number of unanswered question (such as animal feed, antibiotic use during their rearing, promiscuity & access to pastures, quality of the water, pesticide use in the feeds, etc) and one very large blind spot: amino-acid composition of the protein part of the keto diet. See this very nice blog post from Chris Kresser on why the evidence against red meat for cancer prevention is at best tenuous.
For the longest time, our ancestors have known to make broth out of bones and skins, and it turns out that this will make foods rich in collagen. There is also a palaeontology theory out-there that early humans were initially feeding on the left-over of the lion kills, which could potentially mean a lot of connective tissue and therefore a collagen-rich diet (source). Collagen is of very high importance for all your connective and epithelial tissues (study), and although the amino-acids that compose it are non-essentials (meaning the body can make some), it is understood that humans cannot make nearly enough of it to sustain their need. Glycine, one of the amino acids that compose collagen is also critical for the production of glutathione in the body and therefore the detoxification pathways. So a properly prepared keto diet must include some nose-to-tail eating (or almost so…).