Talking With Docs - Is The Ketogenic Diet Good For You?

Keto diet ketogenic diet. You know, I don't love talking about diets. I don't think diets are the way to go personally, and I think generally you and I agree that a diet is not a good idea. You need to be thoughtful about the way you eat, the timing of what you eat, and the food you eat, but restricting yourself to something very specific is not the best idea. However, I'm going to talk about my grizzly bear diet. All right, okay. You've heard of carnivore and paleo. I've got the grizzly bear diet. Okay, stick around to the end. Okay, you stick around to the end and I'll tell you about it. I'll be here.

So, the ketogenic diet. Why did it even become a thing? It started back in 1921, and it goes way back, over 100 years ago, with a guy named Russell Wilder who was treating intractable seizures, or seizures that could not be controlled in any other manner. We didn't have access to the medications we have nowadays, so what they did was put these people on ultra-low carbohydrate or no-carbohydrate diets, a ketogenic diet. This seemed to help, particularly kids with intractable seizures, control their seizure disorder, which was amazing. For those of you who poo-poo big pharma, they came up with seizure medication so we don't have to starve individuals who suffer with seizure disorders anymore to treat them, because now we can give them seizure medication. Yes, so there you go.

So how did that transition into a diet that is very popular, with a lot of books, a lot of experts on the internet, and a lot of foods labeled "keto this, keto that"? I think as we moved through the decades of medicine, it was also being used to treat diabetes. The starvation approach in type 1 diabetes was thought to help as well, to get people into ketosis. That's confusing, because one of the complications of type 1 diabetes is diabetic ketoacidosis, which is a ketogenic state with a low pH in your blood and can be fatal. So this is complicated.

The basic tenet of all of this is that our body's primary source of energy is typically glucose. Glucose in its purest form is sugar, but it can be formed from more complex carbohydrates or from stores in our liver and muscle called glycogen. Once these are depleted, our body can use fatty acids, which are converted to ketones. This is actually preferentially used by our brains, because our brains have an obligatory amount of energy requirement, and ketones can meet it. What happens is that when insulin levels go way down, either because of starvation or because of a diet deficient in carbohydrates, this reduces insulin, increases something called glucagon, cortisol, and a lot of other stimulatory catecholamines, and this drives the body to start using fatty acids. That is a slightly less efficient way, but it is a way to access our fat stores that creates ketones. That's the process, isn't it? It's a lot, and I think in terms of using up glycogen storage, that takes a few days typically before you run out of your glycogen stores. The idea is that we're trying to induce that state with a high intake of fat, a keto diet, as opposed to taking in carbohydrates.

What does a keto diet look like, other than unappealing to me? A keto diet is a little restrictive, like a lot of the diets we've talked about. It's 60 to 70% fat, which is a shift away from the last 50 years, probably in a good way, 30% protein, and 10% carbohydrate. Some keto diets are even no-carbohydrate. We're talking in the range of 20 to 50 grams, and to put it in perspective, one medium-sized potato has about 20 to 30 grams of carbohydrates. So we're talking about a really small amount of carbs for your entire day. Typically, and I noticed you didn't see any ultra-processed foods in that diet.

Ultimately, people who do embark on the keto diet do lose weight pretty fast and pretty successfully in the short term. Yes. Why do you think that is? Well, it's more that they're eliminating other stuff. You're not eating all the junk food, the scientific term for all those other foods. You've cut all that out. So you get rid of sugar, you get rid of refined carbohydrates, and you typically get rid of ultra-processed food. However, you could still have ultra-processed things like a turkey pepperoni stick, which is processed but has no carbohydrate. The other thing about these diets is that when they are super restrictive, people typically don't overeat, because you get bored of them. That's actually a good way to reduce overconsumption of food: have a diet that's really boring. One of the main goals of this recently is weight loss. People are trying to lose weight, and we have an obesity epidemic. If you're asking what you can do to lose some weight, just tell me. Yes, that's why people do it. In addition, eating higher protein and higher fat means you feel full quicker and aren't hungry all the time. If you go the carb route, you're going to be hungry again. And this all relates back to hormones, like ghrelin and leptin, and actually a hunger hormone as well as its impact on insulin. A lot of it comes back to insulin, and we're going to do some videos about this later on. All right.

So that's what the keto diet looks like, and that's the history of where it came from. Now let's talk about whether it is sustainable, whether it leads to sustained weight loss, and whether it is good for you. Let's start at the beginning: is there evidence that there are any conditions or situations where this is a good idea? There's always evidence, and always evidence on either side of things. There's evidence I've seen and reviewed. I've also reviewed some debates between cardiologists about heart disease, and there is evidence to support rapid weight loss. There are clinical trials that do show you will lose weight quickly. What about in the long term? The problem, like with any diet, is that it's hard to adhere to. That's one of the reasons I don't like diets and prefer a lifestyle change and an eating habit. People don't adhere to it for very long. Some of you do, I'm sure, but leave a comment if you had an experience with keto, good or bad. You'll fall right off the keto bandwagon. Agreed.

What about evidence for things like your lipid profile? Unfortunately, it typically has a negative effect on your lipid profile. I've read some evidence and seen it, but I've also seen evidence that says it has a good effect. This is the trouble with all nutritional research: it's so hard to control exactly what people are eating, to properly document the calories they get from different sources, and to measure outcomes. That is the plight of all nutritional research. On a very personal note, I was able to reduce my bad cholesterol and triglycerides by 20% by changing my diet to very plant-based, eliminating meats and fats as much as I could, for about a year. Then I went on medication and flipped back to a balanced diet. But to your point, if you reduce refined carbohydrates and sugars, you're probably going to drop your triglycerides, which a lot of people don't get. Reducing alcohol does the same thing. Even though it's not specifically a keto thing, those changes would become part of a keto diet and would have that same potential benefit. Yes, but you'd think eating a bunch of bacon wouldn't be good for you. That's traditionally what we've been thinking for the last few decades. Bacon isn't good for you because of the processed nature of it, but I was talking about the fat content. Sure. I think it brings up a really good point: some of the potential consequences of a diet like this, whether keto or carnivore or something similar, may be longer-term issues you won't see in the short term. You could change your bloodwork, you might lose some weight, and you might feel better initially because of the elimination process, but the long-term consequences are hard to measure.

So, the bonus is you're going to lose weight fast. The negative is you might not be able to stick to it, and there are unknowns about what you're doing to your lipid profile. One group that has certainly benefited from this style of eating is the diabetic population, people who live with type 2 diabetes. Yes, people who live with diabetes, thank you. Just to say, people live with the disease now rather than before. They don't have it, they're living with it. That's the new way we say it now, and I like it. The reason it helps is that it controls your sugars better. Exactly. It also works through the weight loss associated with it, which will help your diabetes, and potentially could cure it. You think so? If you lose enough weight, you can definitely reverse type 2 diabetes.

Okay, any other conditions you think it can be beneficial for? There are a lot of people positing that it may be beneficial for things like Alzheimer's and mood disorders. Again, the research is not totally conclusive, but it's interesting and ongoing. I did read that. One thing to note is that this doesn't have to be completely animal-based. You could be a vegetarian, a vegan, or a plant-based eater and still have a keto diet. It just depends on where you get your calories from: more avocados, nuts, and seeds, and fewer complex carbohydrates. Good luck with that.

So that's a summary of what keto is. It's worth considering if you're struggling with weight or with diabetes, but talk to your doctor before making any drastic changes. If you like this video, please like and subscribe.

Grizzly bear diet. Okay, here it is. I was in Vancouver at a grizzly bear sanctuary and I saw the plaque that said their diet is 80% vegetables and berries, things that grow in the ground, and 20% fish and meat, well, the odd camper, I guess. Look at the grizzly bear, a big, powerful thing that lives a long time, mostly on plants, just like me. People like grizzly bears because of the hair, I meant the fierceness, but yeah, the hair, I guess. The grizzly bear diet, think about it. Now, if you like this video, please like and subscribe to our channel, and remember, you are in charge of your own health and you're in charge of what you eat. See you next time.