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{{DISPLAYTITLE:An Introduction to the Ketogenic Diet}}The ketogenic diet restricts bot carbohydrate intake, and to a lesser extent protein intake, to the point where the body converts that fat into ketones. These ketones are an alternative fuel source for most cells in the body, supplementing or replacing glucose as a critical fuel source. The [[Ketogenic Diet as a Treatment| ketogenic diet has the potential to help with a number of health conditions]], but also has [[Health Risks of the Ketogenic Diet| some significant potential health risks]].=Who Should Consider the Ketogenic Diet?=The table below reflects my personal thoughts on who would be good candidates for the Ketogenic Diet.{{Skeleton}| class="wikitable"! Situation! Recommendation! Alternatives! Rationale|-| Epilepsy| A – aggressively pursue with your neurologist/find a specialist who uses the Ketogenic Diet| [[MCT Diet]], [[Modified Atkins Diet]] or [[Low Glycemic Index Treatment]]| There is overwhelming evidence that the Ketogenic Diet can help a significant portion of epilepsy suffers, and the condition is serious enough to outweigh the health risks.|-| Cancer| A – aggressively pursue with your oncologist/find a specialist who uses the Ketogenic Diet| The Ketogenic Diet may need to be combined with calorie restriction and combined with other treatments| While the research is still only at an emerging state, the condition is so serious that is vastly outweighs the health risks.|-| Alzheimer's disease | B – pursue with your neurologist/try alternatives first| [[MCT Diet]] or [[MCT]] supplementation | While the research is still only at an emerging state, the condition has few alternative treatments so the benefits probably outweigh the health risks. Trying MCT supplementation or the MCT Diet is probably appropriate before trying the full Ketogenic Diet.|-| Parkinson's disease| B – pursue with your neurologist/try alternatives first| [[MCT Diet]] or [[MCT]] supplementation | There is very little research, but the condition has few alternative treatments so the benefits probably outweigh the health risks. Trying MCT supplementation or the MCT Diet is probably appropriate before trying the full Ketogenic Diet.|-| Schizophrenia| B – pursue with your specialist/try alternatives first| Gluten Free Diet| While we only have a few case studies, the potential benefit of this horrible condition probably justifies the health risks. Trying the gluten free diet first is probably appropriate. |-| Amyotropic Lateral Sclerosis| C – talk to your neurologist| High fat, non-ketogenic diet| The evidence is too limited to make clear recommendations, but there could be some benefit.|-| Depression and bipolar disorder| C – talk to your specialist| | The evidence is limited, but there could be some benefit.|-| Severe obesity| C – talk to your nutritionist| | The Ketogenic Diet can clearly help with weight loss, the benefits and risks must be carefully weighed.|-| Type 1 diabetes| D – consider | | |-| Autism| D – consider | | |}
=What is the Ketogenic Diet?=
The word "ketogenic" literally means that it creates [[Ketones]]. Our bodies produce ketones from fat when carbohydrates become scarce. To trigger ketosis (the production of ketones) we normally have to restrict carbohydrate intake to a very low level. The exact amount of carbohydrate varies by individual, but often it has to be restricted to less than 20g/day. (Normally the amount [[Fiber]] is ignored in the diet, and [[Net Carbohydrates]] are used.) Because the body will convert protein to glucose, it is also necessary to tightly control the intake of protein. Too much protein will prevent ketosis, but to a little will cause malnutrition. Some authors recommend the RDA for protein, while others suggest 0.6 to 1.0 grams per pound of lean body mass. When carbohydrate availability is restricted, the body does not immediately swap over to using fat and ketones, but rather there is a period of adaptation often referred to as [[Ketoadaptation]]. This made last a few weeks, and some people report feeling sluggish during this time. The ketogenic diet entails some potentially serious health risks, so medical supervision is required, along with regular tests and diet supplements. The ketogenic diet is one of the more stringent [[Low Carbohydrate Diets]], and should not be taken lightly.
There are various answers to this, both 'yes' and 'no'. While many cells can burn Ketones instead of Glucose, cells with few or no mitochondria must have glucose. However, protein can be converted to glucose, so while carbohydrate is necessary, it does not have to be consumed in the diet. If no protein is consumed, then the body will cannibalize muscle tissue to provide the required glucose. The only type of carbohydrate intake that could be considered critical for health would be [[Fiber]], which is converted by the digestive bacteria into Short Chain Fatty Acids which are the primary fuel source for some cells such as the lining of the colon.
=Advantages of the Ketogenic Diet=
* [['''Ketogenic Diet as a Treatment]]'''. The greatest advantage of the ketogenic diet is probably [[Ketogenic Diet as a Treatment| its use for the treatment or management of disease]].
** '''Strong evidence: Epilepsy'''. There is a preponderance of evidence that the ketogenic diet is an effective treatment for epilepsy. I believe that anybody with epilepsy or is a caregiver for someone with epilepsy should discuss this with their doctor.
** '''Limited evidence, but serious disease'''. Cancer, Alzheimer's disease, Parkinson's disease, Amyotropic Lateral Sclerosis (ALS), Schizophrenia, Depression, Bipolar disorder (therefore possibly [[Overtraining Syndrome]]), Type 1 diabetes. While the evidence is somewhat limited, there is a growing body of supporting literature, and these diseases have such a catastrophic impact on life that the ketogenic diet is almost certainly worth investigating. I would encourage anyone with one of these conditions to discuss the ketogenic diet with their doctor.
** Anecdotal suggestion that over-ketosis might cause growth inhibition in children.
** The [[Ketogenic Mechanism of Action]] is probably the ketones levels, so increased protein intake (or [[Net Carbohydrates| Net Carbohydrate]] intake) can impair muscle growth.
* '''Altitude'''. There is evidence that the ketogenic diet provides protection against hypoxia, and in this may convey a survival advantage at extreme altitude<ref name="Myles-1976"/>. In addition, it is possible that the ketogenic diet may improve the ability to function at high altitude. My personal experience is that during my [[Altitude Training]], I am able to remain unimpaired while breathing much lower percentages of oxygen.** See "Survival of fasted rats exposed to altitude".
=Disadvantages of the Ketogenic Diet=
* '''Health Risks'''. There are some serious [[Health Risks of the Ketogenic Diet]]. These can largely be mitigated with care, but anyone considering the Ketogenic Diet should be aware of both the risks and the mitigations.
|[[File:anslowcarbperf.JPG|none|thumb|200px|[http://www.amazon.com/The-Art-Science-Carbohydrate-Performance/dp/0983490716 The Art and Science of Low Carbohydrate Performance] is obviously focused on the ketogenic diet for athletes. While it suffers from the same bias as the "The Art and Science of Low Carbohydrate Living", it is highly recommended for any athlete who is considering the ketogenic diet.]]
|}
=See Also={{KetoSeeAlsoKetoList}}
=References=
<references>
<ref name="Myles-1976">WS. Myles, Survial of fasted rats exposed to altitude., Can J Physiol Pharmacol, volume 54, issue 6, pages 883-6, Dec 1976, PMID [http://www.ncbi.nlm.nih.gov/pubmed/1021222 1021222]</ref>
</references>
