Ketogenic Diets

[VGRAY77]

While researching ketosis and low carbohydrate diets I came across the fact that they have been and still are being used to treat epilepsy. The following links may be of interest to some.

http://www.mynchen.demon.co.uk/Ketogenic_diet/General/An_introduction_to_the_ketogenic_diet.htm

http://www.charliefoundation.org/noframes/diet/dietfaq.php

http://home.iprimus.com.au/kuekids/keto/page2.html

http://www.php.com/sigsupplements/ketogenic/ketotips.htm

http://www.diet-i.com/ketogenic-diet.htm

http://www.stanford.edu/group/ketodiet/

http://www.neuro.jhmi.edu/Epilepsy/keto.html

[VGRAY77]

The classic 4 to 1 Ketogenic diet contains four times as much fat as carbohydrate plus protein by weight. Since fat has 9 calories per gram compared to 4 calories per gram for carbohydrate and protein the Ketogenic diet will have a 9 to 1 calorie ratio.

Typical Ketogenic diets are operated in the range from 2:1 to 5:1. Below 2:1 it is difficult to achieve ketosis.

A 4 to 1 Ketogenic diet with 1800 calories would work out to:

4 grams of fat to 1 gram of carbohydrate plus protein
36 calories fat to 4 calories of carbohydrate plus protein

180 grams fat = = = = = = = = = = = = 1620 calories
45 grams carbohydrate plus protein = = 180 calories
180/45 = 4:1 Ketogenic ratio 1800 calories


A 3 to 1 Ketogenic diet with 1800 calories would work out to:

3 grams of fat to 1 gram of carbohydrate plus protein
27 calories fat to 4 calories of carbohydrate plus protein

174.19 grams fat x9 = = = = = = = = = = = 1567.76 calories
58.06 grams carbohydrate plus protein x4 = 232.24 calories
174.19/58.06 = 3:1 Ketogenic ratio 1800 calories


A 2 to 1 Ketogenic diet with 1800 calories would work out to.

2 grams of fat to 1 gram of carbohydrate plus protein
18 calories fat to 4 calories of carbohydrate plus protein

163.64 grams fat x9 = = = = = = = = = = = 1472.72 calories
81.82 grams carbohydrate plus protein x4 = 327.28calories
163.64/81.82 = 2:1 Ketogenic ratio 1800 calories

For those doing Atkins induction that are having difficulty staying in ketosis, I wonder if they may be getting too many grams of protein.

[doreen T]

... For those doing Atkins induction that are having difficulty staying in ketosis, I wonder if they may be getting too many grams of protein.
There's a slim possibility that may be true, if the protein intake GREATLY exceeds the person's metabolic requirements. A sedentary woman of average height requires minimum 50 - 60g protein per day to provide the necessary amino acids for building and repair of tissues and organs in the body, the production of enzymes and hormones etc. True, the body recycles proteins from dead cells which are being replaced, but a certain "fresh supply" must come from the diet every day, especially sources of the 8 essential amino acids which can't be manufactured in our bodies. It's also true that the liver can convert excess protein to glucose through the process of gluconeogenesis, but this happens verrrrrrry slowly, not enough to trigger a big insulin spike. If insulin levels are otherwise kept low due to controlled blood sugar, then the pancreas is producing glucagon which controls gluconeogenesis based on the blood sugar level. In other words, if blood sugar is adequate, then not a lot of protein will be converted to glucose. More likely the de-aminated proteins will be converted to free fatty acids .. and then ketones :)

In obese adults looking to achieve BDK (benign dietary ketosis), the chief source of ketones is coming from the lipolysis of BODY FAT, with dietary fat acting like "kindling". In ketogenic diets for children with epilepsy, dietary fat must be the chief source of the ketones which is why the fat intake is so high. A 3-yr old doesn't have a lot of body fat to provide the necessary ketones :)

The "Dr's Quick Weight Loss Diet" from the 1960's, otherwise known as the "Stillman Diet" is high protein, low fat. Carbohydrate is very low to nil on this diet and the only fat is that which occurs naturally in lean skinless meat, lowfat cottage cheese and whole eggs. No oils or other added fat is allowed .. .. yet it's very much a ketogenic diet, with ketones coming from the lipolysis of body fat.

It's also worth noting that the ketogenic diets for epilepsy also rely on the child being kept mildly dehydrated in order to allow ketones to accumulate to a fairly high level in the blood to properly suppress seizure activity. This is the exact opposite what is desired in a lipolytic BDK diet ... we are encouraged to stay well-hydrated and drink lots of fluids to keep the ketones flushed out. The reason is because when ketones accumulate in the blood ... this signals the pancreas to stop producing glucagon, which is the fat-releasing hormone (as opposed to insulin which is the fat-storing hormone). This is protective for a small child so they don't use up a lot of precious body fat to make ketones, but it's counter to the efforts of an obese adult who WANTS to lose body fat.


hth,

Doreen

[doreen T]

Forgot to add ...

In the case of someone who is extremely metabolically resistant .. it may be a case that they continue to produce too much insulin in response to the consumption of carbs and proteins. Insulin is the fat-storing hormone and inhibits the release of stored body fat .. THis is why Dr. Atkins prescribes the Fat Fast which is low enough in carbs/protein (combined total of 25g or 100 calories) to ensure insulin levels will be minimized,.... and only 90 - 100g fat. This keeps the overall calories low enough to FORCE the body to turn to its fat stores for fuel.

But of course the protein level is too low for adequate metabolic processes to be followed for more than a few days, just long enough to get lipolysis under way, then right back to Induction level. In DANDR (1999 edition) he recommended no more than a week, and this was for patients being followed in his clinic.

[ edit: Here's a link to current information about the Fat Fast, from atkins.com ... http://atkins.com/Archive/2001/12/21-237659.html ]


Doreen