What Is The Ketogenic Diet?

The Ketogenic Diet is one which promotes ketosis: a state where the body uses fat as the main energy source instead of carbs, essentially by converting fat (dietary or stored) into ketone bodies.

what is the ketogenic diet

22-Oct 2016, by Lee Sandwith

The state of ketosis can be achieved in several ways:

  1. Diet (nutritional ketosis)
  2. Fasting (fasting ketosis)
  3. The consumption of exogenous ketones
  4. Vigorous exercise.

From everything I’ve read and listened to, I think this explanation from Dr Peter Attia is one of the best:

There are some absolute, bona fide experts out there who are staunch advocates of The Ketogenic Diet and it is work by a number of highly respected scientists which has convinced me to persevere with it, despite having personally experienced some of the negative impacts, specifically on my cholesterol levels (more on this later).

Unsurprisingly, in this ambiguous world we find ourselves in, there are some equally strong opponents. I don’t intend to go into details in this article but if you’re interested a quick Google search will throw up a bunch of articles.

There’s also lots info out there on the history of the ketogenic diet so I won’t spend any time duplicating content here but if you’re interested the glorious Wikipedia is a good place to start.

The top benefits of ketosis?

Interestingly, the diet was first developed as treatment for epilepsy, however, this is is not an avenue I’d like to persue here as I’d like to stay focused on longevity.

There are lots of articles out there sharing details on the benefits of ketosis so I don’t intend on explaining each in detail. For further reading, there’s an extremely nice article from Authority Nutrition outlining the basics of the diet and one focusing on the top 10 benefits. There’s also another on Livestrong which may be worth a read.

For those of you who like things in bite sized chunks, here are what I believe to be the top longevity and lifestyle related benefits ketosis and the ketogenic diet:

  1. Better control over appetite and hunger
  2. Increased cognitive ability
  3. Weight loss
  4. Improved lipid profile: Triglycerides and HDL cholesterol
  5. Optimisation of blood sugar and insulin
  6. Potential treatment and cure for type 1&2 diabetes
  7. Potential cancer prevention and treatment

The key immediate benefits which have encouraged me to persevere are the first two. When I’m in ketosis I have much greater control over my appetite and I feel like my brain is super charged.

The effect the diet has had on me from a cognitive perspective is simply astounding. Obviously this is a sample size of one, but there is solid research out there to back up adding cognitive enhancement to the long list of potential benefits.

In addition, my interest in ketosis is maintained due to the potential long-term benefits, specifically the potential for it to fight cancer: I’ve seen first hand what cancer can do and I definitely don’t want it!!

Despite what we have been lead to believe, the chances are that cancer is not a purely genetic disease but something which develops through external factors with glucose playing a major role (potentially). Knowing that the ketogenic diet has the potential to prevent cancer has really caught my attention and hopefully it will catch yours too.

In summary, The Ketogenic Diet can offer some immediate benefits such as satiety management, enhanced brain function and glucose optimisation, and it can lay a strong foundation in terms of preventing nasty diseases such cancer.

How to achieve nutritional ketosis

Similar to my 40-20-20 approach outlined in my last article, nutritional ketosis is achieved by getting the balance between the three macronutrients right.

The perfect balance varies from individual to individual but broadly we’re talking about keeping carbs very low, consuming a moderate amount of protein and getting the remainder of your calories from fat.

The traditional ratio is 4:1, meaning 4 parts fat, 1 part coming from a combination of carbs and protein which normally results in 80-85% of calories coming from dietary fat.

Take a moment to let that sink in.

85% fat!

In addition, it is normally also necessary to target less than 50g of carbohydrates per day, and to limit the amount of protein as too much can cause something called gluconeogenesis which essentially converts protein into glucose and can keep you out of ketosis.

Achieving these ratios will pretty much guarantee that you enter ketosis within a few days and as your body starts to adapt over time – referred to as keto adaptation – you can easily reach moderate levels of ketosis within a day or two.

To add some complexity, the sources of each macro are also important. For example, the fibre content within the carbs you choose is very important for a number of reasons and the type of fat is a factor too.

I’ll come back to these points in a later article but to close off on this section listen to how an expert explains different approaches and some of the nuances, this time Dr. Dom A’Gostino on Rhonda Patrick’s podcast.

For me, getting carbs below 50g is the key trigger but this varies from person to person so there’s no hard and fast rules. Also, as Dr. Dom intimates in that excerpt, the good news is that nutritional ketosis can also be achieved by following a somewhat less strict diet than the 85% fat approach outlined above essentially by using what has been coined a modified Atkins diet (or modified ketogenic diet) where the carbs are slightly higher, fat lower.

What the ketogenic diet is not

I was sold the concept of the diet by a close friend who has been an advocate of a low carb approach for some time on the grounds that if your diet comprises mostly fat then your body metabolises calories in a different way, thus enabling you to consume more calories than normal and still lose weight.

Although this defied all logic, this was a very attractive concept.

Second, it was sold that a low carb diet can also help reduce cholesterol and have major benefits in relation to insulin sensitivity, the former of which really appealed to me as my lipid profile was something I was slightly concerned about.

Whilst both of these things may be true for a percentage of people, it’s certainly not true for all and in my humble opinion the diet should definitely be approached with caution.

I’m testament to this as after 3 months of following a strict ketogenic diet, I ended up gaining weight and my LDL Cholesterol levels sky rocketed to what is considered dangerous levels in the medical community. Given that heart disease runs in my family, this freaked me out beyond belief and took me on a completely new journey of discovery.

Fear not, it turned out quite well and I plan on sharing everything I have learned.

In summary, in my experience:

  1. The ketogenic diet will not allow you to defy the laws of thermodynamics (you may be able to consume slightly more calories but the calories in/out model still applies)
  2. There’s a good chance that you will experience elevated cholesterol – according to some experts this affects around 20% of people who try the diet and it should be something to be concerned about.

With all that being said, I still believe that the positives of the diet outweigh the negatives. I’m still experimenting but the benefits I have experienced have been pretty astounding and I haven’t given up on it yet.

So what now?

Over the coming weeks and months, my plan is to go into much more detail on The Ketogenic Diet, trying to break it down into simple language, providing some solid evidence, research and resources for anyone interested in giving it a try.

In the meantime, if you’re interested in reading further, I would recommend listening to these podcasts:

From an article perspective, I plan on getting into the following as a next priority:

  1. How to get into ketosis safely, the pit falls, risks, what not to do
  2. Ketosis and cholesterol
  3. How to measure ketosis
  4. Insulin sensitivity and blood glucose
  5. Sample meal plans
  6. Fibre and the gut microbiome

If you have a preference of which ones I should tackle first please let me know by dropping a comment. Also, if you want to give the diet a try I would strongly recommend that you take your time and do some research first but if you really want to jump right in, check out my keto recipes for a bit of inspiration.

Finally, this is the third article in a series about low carb diets so if you’re interested in the preamble check out this one and this one.

Image courtesy of meandmydiabetes

  • Excellent reading Lee. I’ve been on a Keto diet for around 8 days and nothing happening so far. Had my blood test again today as I also have high cholesterol , LDL etc and the results of the test today showed it has all increased. However my doctor said the results would’t show up so soon anyway and recommended I simply reduce the saturated fat if continuing on the Keto diet! On a positive side I was Diabetic 2 and for the last 5 days my blood sugar has come down to normal. I also believe it still comes down to portions and balance! Thanks again Lee.

    • Hi Toni. Thanks for the feedback! Writing articles like this is quite a time consuming endeavour so getting positive feedback is very encouraging, thank you. How is the keto diet working for you now, should be about 13 days right? Initially I found that it took about 5 days to get into ketosis and I always experience the satiety control benefits almost immediately. The cognitive enhancement thing doesn’t really kick in for me until I hit around 1.2 mmol/dl; are you monitoring your blood to test whether you’re actually in ketosis? Everything sounds great re your blood sugar, that’s a major positive, congratulations! On your cholesterol, it’s an interesting subject and something I’ve been studying vehemently of late. I’ve just finished an article in which I share my latest results and they have been so crazy that you may get some piece of mind on yours 🙂 you can check it out here

    • Hi Toni. Thanks for the feedback! Writing articles like this is quite a time consuming endeavour so getting positive feedback is very encouraging, thank you. How is the keto diet working for you now, should be about 13 days right? Initially I found that it took about 5 days to get into ketosis and I always experience the satiety control benefits almost immediately. The cognitive enhancement thing doesn’t really kick in for me until I hit around 1.2 mmol/dl; are you monitoring your blood to test whether you’re actually in ketosis? Everything sounds great re your blood sugar, that’s a major positive, congratulations! On your cholesterol, it’s an interesting subject and something I’ve been studying vehemently of late. I’ve just finished an article in which I share my latest results and they have been so crazy that you may get some piece of mind on yours ? you can check it out here – http://ingfit.wpengine.com/the-ketogenic-diet-and-cholesterol-part-1/

      • Hi Lee,

        Thanks for your reply. My cholesterol was also off the charts before Keto, so this is a little concerning. My last check a few days ago was: total Cholesterol: 265 – HDL 36 and LDL 182 It has increased from around 4 months ago although my doctor informed me the this new diet wouldn’t show in only 7 days from a blood test. She also recommended I reduce the saturated fat and increasing more e.g. olive oil etc

        I can only assume I am in Ketosis as I cannot get any Keto testing kits here. I reside in Thailand and have tried everywhere including Boots and emailed Bayer (they have an office here) but didn’t reply to any emails sent. I was also told that there’s a good chance that if I try to have a kit posted here it will be sent back due to import rules!

        Around 4 days after starting the Keto diet I was regularly visiting the toilet and felt really bad for a day including flu like symptoms so I assume it’s working. My weight has slightly dropped.

        Reducing my blood sugar in a short time was awesome! I do find it a little difficult walking past my local bakery but on the other hand it’s great to have a lamb chop etc unlike my previous boring diet 😉 Watching my wife drink my Guinness was the hardest but I will persevere! 😉

        Last year my cholesterol levels were also off the charts and believe it or not almost double yours! I had skin problems and was seriously overweight due to extreme LDL levels. I went on the typical diet, exercised and reduced my weight by 12 kilos in 3 months. I could not reduce my blood sugar though! In almost a year I have not increased in weight and decided to become even healthier by going Keto to reduce even more.

        Although Keto makes sense, sadly a lot of videos, websites etc are sponsored hence I think have sold out! There’s one video from a famous doctor that had him saying ‘this is a top secret you mustn’t share and only for you’ on a YouTube channel! After this I stoped watching and found your blog most real and I really believe now as you wrote the saturate fat should be reduced! I recently cut back on the saturated fat similar to you and until my next blood test (2 months) will not know! Now to find those Keto strips and I will keep following your posts. Excellent reading.

        • Hi Toni,

          I am in a similar position to you as I live in Dubai and things like keto strips are very difficult to find. I used Amazon Shop & Ship and got the urine strips (Ketostix) and the Abbot Blood Monitor; the strips for the latter are expensive but the gold standard.

          I know what you mean about the amount of confusion out there. That’s one of the reasons I started the website and what encourages me to keep going. I think it’s difficult to find true objectivity as most people are trying to monitise their projects. Me included if I’m completely honest but I it’s more important to keep everything honest in my opinion otherwise there is no credibility.

          Your cholesterol numbers sound fine to me. Suggest you find a hospital which can do an NMR as the important number is LDL-P, not the LDP-C you’re getting from the standard test.

          Where are you in Thailand btw?

          • Hi Lee,

            I live in Bangkok although I’m from the UK. I don’t know why but whenever I try to buy from Amazon they say they don’t ship to Thailand. I’ll look around and perhaps take a chance from ebay.

            Respect that you would like to monitise your project but keeping it real.

            I don’t believe a Keto diet is an ‘eat all things fat’! I believe we should still regulate our portions! This is what interested me in your 40/20/20 It makes sense!

            My diet plan is to remove all the carbs, sugar etc but eat proteins with healthy amounts of fat! I’m not frying everything in butter etc as some wrote. We’re all genetically different however for myself I was never overweight etc until around 7 years ago! I started eating in 5 star hotels gorging on buffets! I don’t think it will be too difficult to bring my weight back down.

          • Haha! The buffets will certainly do it 🙂

            Totally agree with you about keto being more complex than just eating loads of fat, especially when it comes to saturated fat which is what I suspect may be impacting my cholesterol. I’m still getting around 100g carbs per day and staying in ketosis and agree that portion control is important; people who argue that calories don’t matter are simply wrong, you can’t defy the laws of thermodynamics 🙂

            Check out Shop & Ship, I believe they have just started in Thailand. If you sign up, you can order anything from amazon.co.uk and you provide a UK address which routes to an Aramex address, they then forward the package to you in your country. You have to pay for the service but it’s quite reasonable and awesome for getting the obscure things that you can yet get locally.

            Love Bangkok, major Thailand fan ?

            Keep in touch. If you sign up to my email list I’ll let you know when the next article comes out which I think you’ll be very interested in.

            Best, Lee

          • Hi
            Apologies for the late reply. Thanks for the Aramex tip but I discovered I can get these products on eBay. For now I ordered some Baya Keto strips. I’m staying with my reduced carbs etc but increased my omega-3 intake. I will stay in touch and subscribe. many thanks for your time.

            Last 3-4 days having a crazy time in the gym! I’ve never had so much energy especially after a few hours!! This can’t be from glucose!!

          • Great stuff Toni, keep me posted on how things go 🙂

Want More?

Enters your email address to receive support, motivation, hints, tips and special offers.