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Ketogenic diets seem to be all the craze as of late, and are ostensibly therapeutic (as well as great for losing fat for a bodybuilding contest). Naturally, there seems to be myriad falsehoods about ketogenic dieting (and exogenous ketones) that have propagated society; I think it’s time we clear the air and separate the myths from the facts.
Dive in as this article tackles a long list of pertinent ketogenic diet myths (the truth isn’t always what it seems).
Furthermore, in the absence of carbohydrates, most fats can be consumed in larger quantities safely as they will be converted to ketone bodies, stored, and/or used for energy. Remember, fats are the body’s main source of long-term energy and are essential nutrients. If carbohydrate intake is low, such as on a ketogenic diet, than it's necessary to increase fat intake accordingly, and it won’t harm your long-term health to do so.
Note that elevated ketone body production (ketosis) is not a risk factor for heart attacks, nor is dietary fat intake. It’s important to keep in mind the types of fats you consume, as well as the amounts, are ultimately what matter most. Many dietary fats are actually healthy for the heart and promote more efficient blood flow.
Being sure you’re getting the right micronutrients is also crucial for healthy heart function (MPA HeartSolve™ and MPA CardioSolve™ are ideal for this).
However, there is plenty of data that links high-carbohydrate diets to insulin resistance (which eventually turns into full blown type 2 diabetes when left uncontrolled), and in turn manifests into obesity.[2] While simple sugars are typically the culprit behind insulin resistance, there’s still plenty of risk when consuming a large amount of supposed “whole grains.” It’s important to note that many companies these days produce foods that contain whole grains but also tons of other ingredients that spike insulin levels and wreak havoc on blood sugar.
Go pick up a supposed “heart healthy” box of cereal at the grocery store and you’ll likely notice the first ingredient is whole-grain oats followed immediately by sugar. Odds are there’s just as much sugar in the cereal as there is oats.
That being said, ketoacidosis is far beyond the normal ketosis induced by low-carb dieting, and is typically only caused in cases where individuals are type-1 diabetics, alcoholics, or starving. Therefore, only those who are type-1 diabetics and those who consume large amounts of alcohol on a regular basis should follow a ketogenic diet under the monitoring of a trained physician.
Moreover, in healthy individuals, the kidneys will work rapidly to excrete excess ketones via urine before they ever even begin to approach levels of ketoacidosis. In short, you would have to be taking exorbitant amounts of exogenous ketones to reach toxic levels of ketones in the body, and even then it wouldn’t likely be fatal.
Physiologically, electrolytes becoming depleted during a state of ketosis is due to lack of water retention and frequent urination. When ketosis has been entered for a long duration, it is likely to increase the frequency of urination, and in so doing your body may lose large amounts of electrolytes.
Therefore, it may be useful to drink an electrolyte solution and/or take supplemental calcium if you are urinating a lot while in a state of ketosis, but it’s dependent upon how you feel.
There also seems to be some concern that high protein intake will lead to renal issues, but this supposition isn’t very well thought out either as the body will work in a similar fashion to get rid of excess nitrogen through excretion. There is some data suggesting that people with preexisting renal impairment should be careful with their protein intake, but little that suggests high protein intake causes renal problems.[3]
Bear in mind that the difference between medicine and poison is in the dose; both the kidneys and liver are vital organs that are involved in filtration and metabolism of nutrients, so overloading them with exorbitant amounts of anything is not going to be good for long-term health.
As long as fat intake is coming from healthy sources, that aspect of a ketogenic diet shouldn’t harm your cardiovascular function (in fact, it will do the opposite). Ketone bodies, on the other hand, also appear to improve blood profiles and cardiovascular health by lowering LDL cholesterol and fasting serum insulin levels.[7]
Moreover, muscle protein breakdown/degradation typically occurs when the body is starved/deprived of amino acids, but not necessarily when carbohydrates are absent.
If you’re eating high-quality, complete protein sources several times a day, the body will have a sufficient stream of essential amino acids to support synthesis of muscle tissue and thus prevent muscle loss.
Also, iterated in other myths we’ve touched on, dietary fats serve as a great source of both long-term and short-term energy (since they can be converted to ketones or used directly by the body). It’s important to note that the primary reason the body breaks down muscle tissue is so the amino acids can be used for energetic purposes (via gluconeogenesis).
Therefore, having fats and ketones available in the body would take preference over the utilization of amino acids for energetic purposes. All this being considered, it is wise to increase protein intake slightly when on a ketogenic diet since carb intake is very low.
Recent data actually suggests that ketone bodies play a crucial role in reducing inflammation by inhibiting a specific class of proteins called inflammasomes.[9]Also consider that plenty of research has shown that many essential fatty acids, particularly omega-3s and omega-6s, are crucial for fighting inflammation when consumed in proper amounts.[10]
This is why eating foods like marine fish (tuna, mackerel, salmon) in modest amounts is actually quite good for the heart and fighting inflammation as they are rich in omega-3s.Moreover, various oils are great for optimizing cholesterol profiles and cardiovascular health.
For example, macadamia nut oil contains the highest concentration of monounsaturated fatty acids of any natural food oil.[11] Research suggests that diets rich in macadamia nut oil reduce LDL (“bad”) cholesterol and promote cardiovascular health by fighting inflammation.[12]
Be careful when you blanket statement things and assume that high-fat intake equals more inflammation.
Moreover, being physically inactive and/or overweight are major risk factors for developing high blood pressure. In this regard, ketogenic diets may be favorable for lowering blood pressure as most people will find it easier to stay in a healthy weight range on a ketogenic diet.
It’s imperative to keep in mind that high fat intake doesn’t necessarily mean you will develop high blood pressure. If anything, many essential fatty acids are actually good for your blood pressure as they promote cardiovascular health and fight inflammation (thereby reducing force on the artery walls).[13] In fact, research suggests that individuals who lack nominal amounts of omega-3s in their diet are more likely to have blood pressure issues.[14]
HDL cholesterol, on the other hand, is often referred to as “healthy” cholesterol as it actually promotes cardiovascular health and reduces risk of various health issues.[16] In many regards, ketogenic diets can actually promote healthier blood lipid profiles due to elevated ketone body production and ingestion of heart-healthy fats from various food oils.
For example, coconut oil contains a superb amount of medium-chain triglycerides (MCTs) which have been shown to reduce LDL cholesterol and promote cardiovascular health.[17] This is just one example of why you can’t just assume that (saturated) fats are bad for cholesterol, as many people believe.
But what’s the science behind starvation? And how long does it really take before the body enters “starvation mode”? In 2003, an editorial in the Journal of Adolescent Health gave an overview of the available literature regarding human starvation.[18] Generally, it appears as though humans can survive upwards of 30-40 days without food (energy), as long as they are properly hydrated. Severe symptoms of starvation begin around 35-40 days after food/energy intake has ceased, and as highlighted by the hunger strikers of the past, death typically occurs at around the 45 to 61 day mark.
Moreover, the onset of starvation symptoms, such as extreme hunger and lack of energy, don’t set in until 7 to 10 days with no food/energy intake. The key thing to take into consideration here, is that a ketogenic is in no way a form of malnutrition, nor is it even remotely close to a form of starving the body. If you’re consuming food, no matter what kind of food it is, you’re not starving. It’s that simple.
Dive in as this article tackles a long list of pertinent ketogenic diet myths (the truth isn’t always what it seems).
Myth: Eating too much fat will harm me in the long run
It’s not necessarily the amount of fat that you should be concerned about for long-term health and longevity (though that is still a factor), but rather the type of fat you’re consuming. Of special note, chronic consumption of large amounts of synthetically-produced trans-fatty acids appears to have significant consequences on cardiovascular function.[1] Trans-fatty acids have a “kink” in their carbon chain that causes them to have an unusual chemical structure, and they’re tough for the body to digest properly.Furthermore, in the absence of carbohydrates, most fats can be consumed in larger quantities safely as they will be converted to ketone bodies, stored, and/or used for energy. Remember, fats are the body’s main source of long-term energy and are essential nutrients. If carbohydrate intake is low, such as on a ketogenic diet, than it's necessary to increase fat intake accordingly, and it won’t harm your long-term health to do so.
Myth: Eating fat will give me a heart attack
Heart attacks, also called myocardial infarctions typically occur due to coronary artery disease, which is group of diseases caused by a buildup of excessive fatty deposits and mineral deposits in blood vessels. In turn, the heart has risk of ischemia (lack of oxygen to myocardial cells) due to poor blood flow.Note that elevated ketone body production (ketosis) is not a risk factor for heart attacks, nor is dietary fat intake. It’s important to keep in mind the types of fats you consume, as well as the amounts, are ultimately what matter most. Many dietary fats are actually healthy for the heart and promote more efficient blood flow.
Being sure you’re getting the right micronutrients is also crucial for healthy heart function (MPA HeartSolve™ and MPA CardioSolve™ are ideal for this).
Myth: Whole grains are good for me
There seems to be a lot of misinformation in popular culture as to whether whole grains are actually healthy or not. Historically speaking, humans of the past centuries consumed minimal amounts of processed grains (which can still be “whole”) and they were also the least obese and least type 2 diabetic generations. Unfortunately, all that tells us is there is a correlation between high-carbohydrate diets and obesity/type 2 diabetes, and not necessarily a causation.However, there is plenty of data that links high-carbohydrate diets to insulin resistance (which eventually turns into full blown type 2 diabetes when left uncontrolled), and in turn manifests into obesity.[2] While simple sugars are typically the culprit behind insulin resistance, there’s still plenty of risk when consuming a large amount of supposed “whole grains.” It’s important to note that many companies these days produce foods that contain whole grains but also tons of other ingredients that spike insulin levels and wreak havoc on blood sugar.
Go pick up a supposed “heart healthy” box of cereal at the grocery store and you’ll likely notice the first ingredient is whole-grain oats followed immediately by sugar. Odds are there’s just as much sugar in the cereal as there is oats.
Myth: Ketones are toxic
When ketones reach a level that is considered toxic, ketoacidosis takes place. Ketoacidosis is when blood levels of ketones are extremely elevated and the keto acids cause pH levels in the body to drop significantly. In exceptionally rare cases, this can result in death.That being said, ketoacidosis is far beyond the normal ketosis induced by low-carb dieting, and is typically only caused in cases where individuals are type-1 diabetics, alcoholics, or starving. Therefore, only those who are type-1 diabetics and those who consume large amounts of alcohol on a regular basis should follow a ketogenic diet under the monitoring of a trained physician.
Moreover, in healthy individuals, the kidneys will work rapidly to excrete excess ketones via urine before they ever even begin to approach levels of ketoacidosis. In short, you would have to be taking exorbitant amounts of exogenous ketones to reach toxic levels of ketones in the body, and even then it wouldn’t likely be fatal.
Myth: A ketogenic diet will lead to brittle bones
Brittle bones, or more properly, bones that are prone to fracture due to low tissue integrity, are typically caused by onset of osteoporosis and/or lack of calcium intake. Ketogenic diets may cause electrolyte imbalances in individuals if proper replenishment isn’t followed, which could lead to calcium depletion.Physiologically, electrolytes becoming depleted during a state of ketosis is due to lack of water retention and frequent urination. When ketosis has been entered for a long duration, it is likely to increase the frequency of urination, and in so doing your body may lose large amounts of electrolytes.
Therefore, it may be useful to drink an electrolyte solution and/or take supplemental calcium if you are urinating a lot while in a state of ketosis, but it’s dependent upon how you feel.
Myth: A ketogenic diet is bad for my kidneys
In the event someone has an excessive amount of ketones in the blood, the body (particularly the kidneys) will work as fast as possible to filter out ketones via urine rather than converting them to adipose tissue. Actually, most people aren’t even aware that ketogenesis and metabolism of ketones doesn’t even take place in the kidneys, but rather primarily the liver.There also seems to be some concern that high protein intake will lead to renal issues, but this supposition isn’t very well thought out either as the body will work in a similar fashion to get rid of excess nitrogen through excretion. There is some data suggesting that people with preexisting renal impairment should be careful with their protein intake, but little that suggests high protein intake causes renal problems.[3]
Bear in mind that the difference between medicine and poison is in the dose; both the kidneys and liver are vital organs that are involved in filtration and metabolism of nutrients, so overloading them with exorbitant amounts of anything is not going to be good for long-term health.
Myth: A ketogenic diet is bad for my heart
To say this is false would be an understatement. Time and time again research has shown the diets rich in certain food oils, such as macadamia nut oil, fish oil, coconut oil, chia seed oil, and many others actually improve cardiovascular health, lower LDL (“bad”) cholesterol, and fight inflammation.[4],[5],[6]As long as fat intake is coming from healthy sources, that aspect of a ketogenic diet shouldn’t harm your cardiovascular function (in fact, it will do the opposite). Ketone bodies, on the other hand, also appear to improve blood profiles and cardiovascular health by lowering LDL cholesterol and fasting serum insulin levels.[7]
Myth: I'll lose all my muscle on a ketogenic diet
Skeletal muscle loss, also referred to as muscular atrophy, is actually quite rare on a ketogenic diet as long as protein intake is adequate. Carbohydrates do have protein-sparing properties in that they are prioritized for energy over amino acids, but if protein and fat intake are nominal (as on a healthy ketogenic diet), then the body wouldn’t have much reason to catabolize muscle tissue for energetic purposes.Moreover, muscle protein breakdown/degradation typically occurs when the body is starved/deprived of amino acids, but not necessarily when carbohydrates are absent.
If you’re eating high-quality, complete protein sources several times a day, the body will have a sufficient stream of essential amino acids to support synthesis of muscle tissue and thus prevent muscle loss.
Also, iterated in other myths we’ve touched on, dietary fats serve as a great source of both long-term and short-term energy (since they can be converted to ketones or used directly by the body). It’s important to note that the primary reason the body breaks down muscle tissue is so the amino acids can be used for energetic purposes (via gluconeogenesis).
Therefore, having fats and ketones available in the body would take preference over the utilization of amino acids for energetic purposes. All this being considered, it is wise to increase protein intake slightly when on a ketogenic diet since carb intake is very low.
Myth: A ketogenic diet causes inflammation
Inflammatory markers in the body increase and decrease based on myriad factors. The irony of the idea that ketogenic diets induce inflammation is that research suggests the contrary--that is to say that higher-carbohydrate diets are proinflammatory in nature (particularly if they contain large amounts of simple sugars).[8] This appears to be because of the biochemical changes seen in cells when blood sugar levels are chronically elevated.Recent data actually suggests that ketone bodies play a crucial role in reducing inflammation by inhibiting a specific class of proteins called inflammasomes.[9]Also consider that plenty of research has shown that many essential fatty acids, particularly omega-3s and omega-6s, are crucial for fighting inflammation when consumed in proper amounts.[10]
This is why eating foods like marine fish (tuna, mackerel, salmon) in modest amounts is actually quite good for the heart and fighting inflammation as they are rich in omega-3s.Moreover, various oils are great for optimizing cholesterol profiles and cardiovascular health.
For example, macadamia nut oil contains the highest concentration of monounsaturated fatty acids of any natural food oil.[11] Research suggests that diets rich in macadamia nut oil reduce LDL (“bad”) cholesterol and promote cardiovascular health by fighting inflammation.[12]
Be careful when you blanket statement things and assume that high-fat intake equals more inflammation.
Myth: A ketogenic diet is bad for my blood pressure
Ketone bodies in and of themselves don’t elevate blood pressure (i.e. they’re not a risk factor). Blood pressure can rise for a multitude of reasons, whether it’s genetics, poor dietary/lifestyle choices, race, tobacco use, etc. Hypertension is more likely to arise from a significant intake of sodium and/or lack of potassium in the diet; when the body has large amounts of sodium in it, water is retained and blood pressure can increase.Moreover, being physically inactive and/or overweight are major risk factors for developing high blood pressure. In this regard, ketogenic diets may be favorable for lowering blood pressure as most people will find it easier to stay in a healthy weight range on a ketogenic diet.
It’s imperative to keep in mind that high fat intake doesn’t necessarily mean you will develop high blood pressure. If anything, many essential fatty acids are actually good for your blood pressure as they promote cardiovascular health and fight inflammation (thereby reducing force on the artery walls).[13] In fact, research suggests that individuals who lack nominal amounts of omega-3s in their diet are more likely to have blood pressure issues.[14]
Myth: A ketogenic diet is bad for my cholesterol
Cholesterol comes in three primary forms; very-low-density lipoproteins (VLDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). Both LDL and VLDL cholesterol are typically referred to as “bad” cholesterol as having high levels of these are associated with increased risk of cardiovascular disease and other health complications.[15]HDL cholesterol, on the other hand, is often referred to as “healthy” cholesterol as it actually promotes cardiovascular health and reduces risk of various health issues.[16] In many regards, ketogenic diets can actually promote healthier blood lipid profiles due to elevated ketone body production and ingestion of heart-healthy fats from various food oils.
For example, coconut oil contains a superb amount of medium-chain triglycerides (MCTs) which have been shown to reduce LDL cholesterol and promote cardiovascular health.[17] This is just one example of why you can’t just assume that (saturated) fats are bad for cholesterol, as many people believe.
Myth: A ketogenic diet will put me into "starvation mode"
Before we dive into the rationale behind this myth, it’s important to really grasp what “starvation mode” is on a physiological level. In scientific literature, starvation is defined as severe deficiency in caloric energy needed to maintain life. Prolonged starvation can cause irreversible organ damage or even death. In short, starvation is the most extreme form of malnutrition.But what’s the science behind starvation? And how long does it really take before the body enters “starvation mode”? In 2003, an editorial in the Journal of Adolescent Health gave an overview of the available literature regarding human starvation.[18] Generally, it appears as though humans can survive upwards of 30-40 days without food (energy), as long as they are properly hydrated. Severe symptoms of starvation begin around 35-40 days after food/energy intake has ceased, and as highlighted by the hunger strikers of the past, death typically occurs at around the 45 to 61 day mark.
Moreover, the onset of starvation symptoms, such as extreme hunger and lack of energy, don’t set in until 7 to 10 days with no food/energy intake. The key thing to take into consideration here, is that a ketogenic is in no way a form of malnutrition, nor is it even remotely close to a form of starving the body. If you’re consuming food, no matter what kind of food it is, you’re not starving. It’s that simple.
