Keto Diet: Therapeutic affects and Performance benefits : In the past decade or so the keto diet has consistently trended with people all over the globe. This is probably due to its wide array of applications. For example, it is said that to aid with weight loss, treat various medical conditions, and even help your brain function more efficiently.
However, a question that appears to remain unanswered is, is the low carb, high fat, moderate protein diet, suitable for everyone?
This article looks at the pros and cons of the ketogenic diet, and evaluates who can benefit most from following it.
What is the keto diet?
Simply put, the keto is a very low carbohydrate, in fact typically less than 50 grams per day, moderate protein, high fat diet. The basic premise of the keto is to restrict carbohydrate intake and thereby exhaust the body’s reserves of glycogen. As a result the body will then be forced to use an alternative energy source to glucose, which is ordinarily the body’s primary source of energy.
Changing energy sources causes the body to shift its energy metabolism from glycolytic pathways to that of ketosis, meaning that fats from both body fat and dietary fat are subject to beta-oxidation in the liver and are broken down into smaller molecules known as ketone bodies.
These ketone bodies include acetone, acetoacetate, and beta-hydroxybutyrate, which are then used by the cells of the body as a substrate to generate adenosine triphosphate (ATP). Ultimately ATP is the energy currency of the body which can be synthesised through both glycolytic and ketogenic metabolic pathways.
Essentially, nutritionally induced ketosis, that is eating so few carbohydrates, mimics fasting without actually fasting or starving. Therefore, you could say that the keto diet is a form of metabolic programming.
Therapeutic effects of the keto diet
Because of the keto diet’s ability to change the body’s biochemistry and metabolism, it is noted to be beneficial to a number of health conditions. So far the ketogenic diet has been observed to benefit ADHD, obesity, epilepsy, diabetes, neurodegenerative diseases, cardiovascular disease, PCOS, and even some cancers.
Fundamentally, the keto diet reduces insulin and blood glucose, while increasing levels of the catabolic hormone glucagon. Leveraging this antagonistic relationship between these two hormones to force changes in energy pathways, appears to be a key factor in why nutritionally induced ketosis is able to treat so many different health conditions.
For example, in people who suffer from insulin resistance and diabetes, nutritionally induced ketosis has been shown to improve blood glucose and in some cases even reverse insulin resistance.
In fact this study further strengthens this proposition.
For anyone who suffers from any of the above conditions, the ketogenic diet may be a viable remedy.
Physical performance benefits of the ketogenic diet
Proponents of the ketogenic diet are quick to point out the energy higher capabilities of ketones relative to that of glucose. This is because ketone bodies, gram for gram, have been shown to generate significantly more ATP relative compared to glucose.
For example according to this study, 100 grams of acetoacetate generates 9 400 grams of ATP, 100 grams of beta-hydroxybutyrate yields 10 500 grams of ATP, while 100 grams of glucose generates generates just 8 700 grams of ATP.
Needless to say, ketone bodies, collectively, have a significantly higher capacity to generate energy than glucose. Consequently, the higher the body’s capability to generate ATP, the higher the capacity to do work becomes.
Nevertheless, different types of exercise can also have distinctly different energy requirements. Moreover, consideration of the efficacy of energy generation is not absolute, additionally, how quickly an energy substrate can generate ATP is also important.
Take a 100 metre sprint race, for example, this type of exercise demands fast and explosive energy. As it turns out, lipid metabolism and oxidation of fatty acids demands significantly more oxygen than glucose does. Thus ketosis, under certain conditions can be physiologically limiting. In fact, according to the experts at 6 x Mr Olympia Dorian Yates’s Temple gym blog;
“Exercising at an intense enough level, that causes panting, is a sign that your body lacks the necessary oxygen to oxidise fat. This is basic biochemistry. An unavailability of oxygen invariably reduces the beta oxidation of free fatty acids (FFE), and thus ketone synthesis becomes disrupted.”
Therefore, the rate-limiting factor of oxygen is absolutely crucial with respect to the intensity and type of exercise one participates in. For intense exercise that requires lots of oxygen, ketosis is sub-optimal.
These clear and distinct energy benefits of ketones appear to be better suited to endurance athletes such as ultra distance runners and iron men competitors, where events take place for duration of many hours.
What sports are best suited to the keto diet?
The short-term effects of the keto diet appear to be significantly more well-documented than the longer term effects and based on this evidence the keto diet is potentially advantageous for endurance athletes rather than sprinters, bodybuilders or power lifters etc.
The reasons for this are two-fold, as explained above, ketosis can be physiologically limiting on performance, but also, with regard to strength training and muscle building, a ketogenic diet is again physiologically limiting.
This is because muscle hypertrophy demands consuming a substantial amount of protein. To put this into perspective, the International Society of Sports Nutrition has a general guideline of 1.4–2.0 grams of protein per kilogram of body weight per day, for bodybuilders and resistance trained athletes.
According to this range, a 13 stone athlete would have a daily protein requirement ranging between 115 grams – 165 grams. Consuming this amount of protein on a ketogenic diet results in the disruption of the ketogenic pathway and ketosis would at best become intermittent.
Protein, notably the amino acids Phenylalanine, Isoleucine, Threonine, Tryptophan, and Tyrosine, are all glucogenic; meaning that the body can metabolise glucose from them. Subsequently, ketogenic style diets tend to contain lower amounts of protein thereby limiting any increase blood glucose.
Lower protein consumption is of course counter intuitive for strength athletes.
The keto diet has many well-documented benefits, and can be used efficiently to improve various health conditions discussed in this article. Nevertheless, the therapeutic effects of the keto diet come with several practical considerations.
A ketogenic diet is extremely restrictive in terms of the exclusion of many foods, and also comes with an initial adaptation period whereby the ketogenic pathway has to be activated and then sustained. This initial period can be difficult for many people to adhere to due to a lack of energy and increased hunger.
Additionally, ketosis, while advantageous in terms of capacity to generate ATP, is also physiologically limiting and is best suited for lower intensity/longer duration exercise and sports.
Finally, higher protein diets can yield small amounts of glucose which trigger insulin and disrupt ketosis. Both strength athletes and bodybuilders require higher amounts of protein and as a result, means that keto based diets are less well suited to these types of athletes.
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