You hear a lot about how the ketogenic diet can treat seizures along with mood disorders and inflammatory illnesses. My question is ketosis the optimal state for the body to be in? Should we all be on a low carb high fat diet? From what I've researched it seems the answer is yes. What do you all think?

As far as I'm concerned, the short answer is yes -- or at least we should be living the vast majority of our days throughout the year in a fat adapted state. I'm pretty much sold on the paleo concept that 'harvest season' was historically our time if plenty and the time of carbs. It was the time of year where we put on a little fat to help insure that we would make it through winter. In modern times, the time of plenty is 24/7, 365 days a year. And carbs do just what they always do - help us put on weight. For many of us, the only way not to put on weight while eating a carb centric diet is to resist the urge to eat. I couldn't do that very well and it got worse over time. Eating carbs messes with my metabolism and has me feeding blood sugar spikes and crashes instead of true hunger. Eating in a fat adapted state -- where my body is just as happy to use ketones as fuel as it is glucose -- keeps my blood sugar stable and lets me experience true hunger and satiety. Low carb is how I need to eat. Others may tolerate more carbs than I do. Others may be limited to fewer carbs to stay fat adapted. But I think the western diet is too carb centric across the board and we are paying the price with our health. That's my 2 cents.

I'm with Ken, my short answer would also be yes.

I remember 9-10 months ago when I got started on all this. One of the key things that convinced me that LCHF was worth a shot was because of the science I had uncovered in those early days when I was still uncertain. Sure, it was competing with the mainstream view, but when viewed in isolation, it seemed like a completely feasible - even natural - approach. And of course, since the mainstream approach of "eat less/move more" had never worked for me anyway, what did I have to lose by giving it a shot?

Easily the best decision I've made in my entire life.

A couple of books I can suggest you might want to consider picking up if you want to understand more about how ketosis works:

* Why We Get Fat (And What To Do About It), by Gary Taubes. This book covers a bit of history in the first half by tracking how today's mainstream views came to be that way, and then debunks it all completely in the second half. There's enough science there without going into massive detail; for that you might want his previous book, Good Calories Bad Calories, which is essentially the same read but bigger/more detailed.

* The Art & Science of Low Carbohydrate Living, by Jeff Volek & Stephen Phinney. This book is pure low carb logic. It doesn't go too much into passionate arguments, it just presents the numbers, and they are allowed to speak perfectly adequately for themselves. Not the biggest book, but definitely of very good quality. Of all the half dozen or so books I've read on the subject so far, this is probably my favourite.

Another yes, or at least at a level where dipping into and out of ketosis is easily achieved, as most on an ancestral diet would have done with the seasons. More carbs in summer, periods of enforced fasting in winter, etc. Gary Taubes made a good case that LC would reduce risk of many diseases of civilization in his book Good Calories, Bad Calories and I have yet to read evidence to the contrary.

I see it more as a legitimate alternate metabolic state for people whose bodies aren't so good at at glucosis. So maybe the most optimal approach for whatever population that describes.

No. I'm developing a belief that the optimal state for a body is state in which it can use either fuel source efficiently.


No.

Yes, for me. No more diabetes, high blood pressure and cholesterol under control makes my answer easy.

Until I discover a reason otherwise, I plan on being ketogenic and fat-adapted the rest of my life.

For me, yes. I've been in ketosis for the better part of 2 years, and like others, I no longer have and am no longer on medication for HBP, no longer have the moderate sleep apnea I was diagnosed with over 2 years ago, and I am no longer eating the foods that would trigger hypoglycemia. My triglycerides are very low and my HDL is at the high end of the scale.

Does this mean that I could have done this with a low carb approach without going into ketosis? Yes, but I feel better when my primary fuel is fat, and I can tell. Mental clarity, energy, and a positive outlook are the unscientific byproducts for me.

I concur with all the comments in this thread but something I find a bit frustrating is the lack of clarity about what level of ketosis is 'best' or 'optimal' or 'desirable' – especially in the longer term.

For weight loss, not everyone needs to reduce carbs to the same low level. Some people do need a very low level (such as the 20g CHO per day Atkins induction) to kick start weight loss but others (myself included) don’t need to go this low.

But if a person's CHO intake is low enough to achieve a desired weight loss but higher than recommended for ketosis (for example, higher than 50g per day) does this mean that the person is not in an ‘optimum state’?

One could take the approach that it is best to ‘err on the low side’ and go very low carb but personally I don’t like this for the following reasons:

1) As CHO intake is reduced one’s food choices become more constrained and I personally find that below about 60g CHO per day my daily menus start to become a bit boring.
2) The lower one’s CHO intake the harder it is to obtain adequate vitamins and minerals. (Yes, one can take vitamin & mineral supplements but personally I am reluctant to do so – it is simply not natural).

So I am left with the question, if ketosis is the optimal state to be in how low a level of CHO intake is necessary to achieve this optimal state?
Or putting the question another way;
Given that less than 50g CHO per day is commonly regarded as necessary to achieve ketosis, does this mean that a higher CHO level of say 60, or 80 or 100g/d is suboptimal for health?

In the case of mineral supplements, I'm not entirely sure that they're unnatural. An obvious example of a mineral that we seek out for its own sake is salt. And if you put out mineral licks for deer, they will certainly take advantage of them, and there it's just us taking advantage of a natural tendency of the deer, they're perfectly capable of finding direct mineral sources from the wild.


Years ago I saw online an article with a photo of a woman native to an iodine-poor region where people still ate a traditional diet. The woman was burning some plants she had gathered to prevent/treat goiter. The explanation given in the caption was that these plants, otherwise inedible, contained enough iodine to be protective. Not quite related--but it was also very common for Native American tribes to treat corn with ashes--and it served the same purpose of freeing up the niacin in the corn and protecting from pellegra that lime grindstones did--and just like with the lime grindstones, would have provided some mineral supplementation of the diet as well.

I think exercise comes into the question of what an optimal diet is, ketogenic or not. While it's true that increasing calories burned through exercise might not result in fat loss due to increase in appetite, burning more calories per day, while eating the same diet, increasing quantity while keeping quality clamped, means a higher total intake of vitamins and minerals.

I like canned salmon for the thoroughly broken down bones, and I like ribs that have been cooked to the point where the bones are largely mooshy and can be eated for the same reason. Soft ends of chicken bones. I liked these before I gave much thought to the added nutrition they might add to the meal. Between these and liver and other organ meats, and the considerable nutritional content of very low carb veggies, which I'm hard set to hit much more than thirty grams of total carbohydrate a day, if they're my major carbohydrate source--I'm reasonably complacent in principle, although in practice I can't claim that my ketogenic diet is always what I'd call ideal.

I've been wondering for a long time about micro-nutrients, whether a very low carb diet supplies adequate nutrients. I haven't been able to find anything that comes close to being an answer. Dr Wahls addresses this but advocates a diet with a higher carb content than many people here eat in order to increase the micronutrient content of the diet. Maybe there's no such thing as optimal just good enough and that differs for each of us. I keep hoping I'll stop looking for the holy grail of eating plans and just settle for what is clearly better than most and also very good for me but maybe not that elusive optimal.

Jean

I think this too. Also that we can dip into and out of it easily. So that both fuel systems are metabolically healthy.

I will guess that for the 65% + percent of Americans who are overweight, it would take fewer carbs to stay metabolically healthy for both fuel systems. I would not say everyone needs to be under 20g of carbs (as an example of one way of being LCHF).

Excellent point. I'll keep that in mind.

I think I read somewhere that it is not good to be dipping in and out of ketosis ( i.e. on a daily basis) but I don't recall any sound reasons being given and I can't remember the source. I think the comment was made in the context of a discussion about 50g per day CHO being the maximum below which ketosis is stable. The implication was that dipping in and out of ketosis would occur if the CHO intake is between 50 to 100 g/day while ketosis would stop above 100 g/day CHO.

I have also come across this statement for which I can quote a source:
…studies have shown that both classes of substrates [ie. glucose and ketones] can be utilised simultaneously. An additional observation has been that, whenever ketone bodies are utilised by the brain, there is a net output of pyruvate and lactate from the brain to the blood. Output of these two intermediary metabolites does not occur when only glucose is utilised by the brain. Source: "Metabolic Compartmentation and Neurotransmission", Jill E. Cremer and Dennis F. Heath, page 546

However, the book does not explain whether simultaneous use of glucose and ketones is good, bad or indifferent.

So I am still wondering about all of this and am searching for some clarity.

While it doesn't answer your question regarding the best way to use combined fuel sources effectively, there is anecdotal evidence of fat-adapted ultra marathon athletes consuming some glucose sources just before and during these events. While the fat-adapted endurance runner does not have to consume the fuel that a glucose fueled runner does during the event to delay hitting the wall (running out of glycogen), some are using the combination by adding small amounts of glucose to enhance performance. This bears further investigation, as the question becomes how the metabolism handles both fuel sources to produce an optimal performance. Does fat always remain as the primary, and how does the transition work between fat and glucose?

Great discussion and points by all in this thread. We are all curious about how to optimize and create the most effective WOE.