Which of the 5 TYPES of Keto are for YOU?

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Special Thanks to my team and Nicholas Norwitz – Oxford PhD Researcher and Harvard Med Student – for working diligently on research as well!

Standard Keto Diet (75% fat, 20% protein, 5% carb): the 2-year Virta Health study shows the efficacy and success of it:

Study – Frontiers in Endocrinology

Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial

The ketogenic diet had a 74% two-year adherence rate.
Over the two years, the ketogenic group demonstrated a 54.7% diabetes reversal rate, compared to 10.5% in the usual care group. (Usual care is defined as standard of care treatment overseen by professional endocrinologists and dietitians.)
Over the two years, the ketogenic group demonstrated a decrease in HbA1c from 7.5 to 6.6, whereas the usual care group exhibited an increase from 7.7 to 8.2.

https://www.frontiersin.org/articles/10.3389/fendo.2019.00348/full

Therapeutic Keto Diet (90% fat, 10% protein, less than 1% carb)

Therapeutic, or classic, keto has a ratio of 90% fat, 10% protein, less than 1% carb:

Higher ketone levels – referred to as “therapeutic ketosis” (greater than 3.0 mM and glucose mM: ketone mM ratio of ~1), as opposed to nutritional ketosis (0.5-3.0 mM range) – are often required to achieve optimal symptomatic outcomes for people with epilepsy. This suggests that there are some benefits for the brain that occur only at higher ketone levels, at least in this population.

Ketone body oxidation correlates with ketone body levels in the systemic circulation & ketone body oxidation competes with glucose oxidation in the brain. Since we know that ketones are a cleaner fuel, this suggests higher ketone levels contribute to the cleaner production of energy (less ROS and inflammation) in the brain.

Courchesne-Loyer A. et al. Journal of Cerebral Blood Flow and Metabolism 2017: In this study, cerebral metabolic rate of ketone body (acetoacetate) oxidation (CMRa) and glucose oxidation (CMRglc) were measured by PET scan in the brains of 10 healthy participants fed a ketogenic diet for four days. The data show that “CMRa increased 6-fold, whereas CMRglc decreased by 20% (p = 0.014) on the KD [and that] plasma ketones were positively correlated with CMRa.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5531346/

Cyclical Keto

Gives 1-2 days of high carb in order to refill muscle and liver glycogen stores

Glycogen Usage During Exercise

The liver and muscles react to the hormonal changes by converting the stored glycogen into glucose and releasing this substance into the bloodstream for immediate use – adrenaline stimulates glycogen breakdown via beta-adrenergic receptors and phosphorylation (activation) of glycogen phosphorylase

There’s been one mouse study (Cell Metabolism) which found that a cyclical keto diet can improve longevity: https://www.ncbi.nlm.nih.gov/pubmed/28877458

Targeted Ketogenic (carbs surrounding your workout)

Targeted keto can be considered to be between standard keto and cyclical keto – cyclical has 1-2 days of high carb consumption, whereas targeted keto means you consume carbs before, during, or after a workout

Potential Concern:

If you eat carbs when muscle glycogen isn’t depleted, then you likely won’t be completely burning through your glycogen stores and eating carbs before will potentially (albeit temporarily) kick you out of keto, but you will have increased insulin sensitivity, putting you back into ketosis quickly

Higher Protein Ketogenic Diet (as you advance 50% fat, 40-45% protein, 5% carb)

Gluconeogenesis

This process is so tightly controlled, you will be fine (from the Protein to Fat Ratio topic)

Protein and Kidneys Concern

A systematic review of renal health in healthy subjects, published in Advances in Nutrition, consuming protein at levels above the US RDA (0.8g/kg/d) determined that “increased protein intake had little or no effect on blood markers of kidney function,” and that, “at least in the short term, higher protein intake within the range of recommended intakes for protein is consistent with normal kidney function in healthy individuals.”

https://academic.oup.com/advances/article/9/4/404/5055949

Carnivore – Focusing on Meat only, truly 0 carb

Note on Fiber

Study – World Journal of Gastroenterology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435786/

Nicholas Norwitz – Oxford PhD Researcher and Harvard Med Student:
https://www.dpag.ox.ac.uk/team/nicholas-norwitz

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