· Ketosis: A lot of people see ketosis as an on or off switch- you are either in ketosis and burning fat, or not in ketosis and not. This is not quite the case. Ketosis is when your body is producing ketones. Ketosis is considered the level in which your body is producing enough ketones so that your brain can function at an optimal level. This does not mean that if your body isn’t producing that level of ketones that you aren’t going to be benefiting.
· The number that defines ketosis is generally 0.5mmol/L- probably the area where most people feel good and perform best on a ketogenic diet.
· However some people work really well at a lower level of ketones- you can still have ketones in the blood and benefit from them if you are eating CHO and not in ‘nutritional ketosis’.
· What is the ketogenic diet? It is a diet that causes us to produce enough ketones so that we feel optimal- producing enough beta hydroxybutyrate for the brain that we do not require as much glucose. Ketogenic diet is high fat diet, low CHO and moderate protein. Produces ketones that all tissues can use for fuel. Protein is moderate as amino acids (when in excess) can be converted to sugar which limits ability to reach ketosis.
· Coconut oil can help us get into ketosis very effectively due to MCT.
· How do I lose weight on ketogenic diet? Because it encourages the release of fat from the body to be used as fuel in a very effective way. Less chance of muscle breakdown compared to starvation diets.
· Is a ketogenic diet safe? We learn at an undergraduate level that ketosis is dangerous- as it can be seen in an uncontrolled diabetic- in a hospital setting. Body becomes acidic and cannot function. There are major differences between diabetic ketoacidosis and normal functional ketosis. Diabetic ketoacidosis is around 20+ mmol/L beta hydroxbuturate- whereas normal ketosis is 0.5-3. At this level the body can very easily buffer this added acidity. So a ketogenic diet is completely safe unless you have very severe metabolic dysfunction.
· If you have issues with gall bladder and bile function- ketogenic diet can be an issue as the gall bladder functions to emulsify fat and improve its digestion. An interesting way to get around that is through the use of MCTs and short chain fatty acids as they do not need to be emulsified by gall bladder to get into body.
· Is the ketogenic diet suitable for everyone? With the lower carb, higher fat approach and ketogenic diet being the most progressive approach, it is probably a nutritional strategy that it suitable for most people, most of the time.
· Difference between paleo and ketogenic diet: Technically they are very similar in the way that they tend to focus on whole, natural and unprocessed food. However many people on the paleo diet can go wrong by eating way too much meat --> too much protein --> which is then converted to sugar--- > makes it difficult to become fat adapted.
· What is fat adaptation? Means your body is able to use fat for fuel more effectively and use fat for fuel at higher exercise intensity.
· Metabolic flexibility: the ability to be able to swing in and out of using different fuel sources. Ability to store nutrients in the right place.
· If you are highly fat adapted, you can be more lenient; you can have your treats and get back into ketosis very easily.
· Enhancing metabolic flexibility with exercise: research shows exercise is not actually that effective for fat loss- particularly in absence of a good diet. Therefore sort out your diet as a priority- so when you do exercise you will get more out of it. However in the long term exercise is critical- as we need to look at how to maintain metabolic health- resistance and HIIT can help improve our insulin sensitivity, bone density etc. which is critically important.
· Best exercise for enhancing metabolic flexibility: weigh training/ strength training most effective.
· Fasting before starting a ketogenic diet: if you are following a great ketogenic diet it is not necessary however there is some merit to it in some contexts psychologically.