Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet (17 page)

Keep carbs low
Eat more fat
Test ketones often
Overdoing protein is bad

DOCTOR’S NOTE FROM DR. ERIC WESTMAN: In nutrition, the term essential nutrient means a nutrient that cannot be made by the body and therefore must be consumed for the body to function properly. Essential nutrients for humans include water, vitamins, minerals, protein, and fat. Carbohydrate is not an essential nutrient!

The first time I heard anything about the possible negative consequences of consuming too much protein was at the Nutritional and Metabolic Aspects of Carbohydrate Restriction conference in Brooklyn, New York, in January 2006. There I learned about a fascinating concept that forever changed the way I look at protein, because it holds the key to why some low-carb diets work well and others do not. Understanding this revolutionary concept will put you light years ahead of most doctors, dietitians, and all the other health gurus out there.

So what is it?
Gluconeogenesis
(pronounced GLUE-CO-NEE-OH-GEN-EH-SIS). Glucosaywhatsaywhat?! Get used to hearing and saying this word, because it is a fundamental principle that can determine whether or not you are successful on the ketogenic diet.

Gluconeogenesis provides all the glucose you need to restore thyroid function and heal the thyroid when you are in ketosis. Several of my keto clients have now thrown away their thyroid medications.

– Stephanie Person

Gluconeogenesis (sometimes abbreviated as
GNG
) is the body’s way of creating glucose by breaking down proteins, and it occurs mainly in the liver. You may have heard that the body needs carbohydrates to function—and it does—but gluconeogenesis allows your body to make its own carbs from the protein you consume, so that you don’t have to get carbs from dietary carbohydrates. Pretty nifty, huh? The body is incredibly efficient at making exactly what it needs from the raw materials we feed it. In this case, if glucose levels in the blood are low because there is little to no carbohydrate in the diet, then protein becomes the body’s source of glucose.

The liver normalizes and maintains blood glucose levels in the body by creating glucose through gluconeogenesis. During those times when the body is not taking in any food (for instance, while you are sleeping), the liver goes to work on gluconeogenesis, using amino acids (the building blocks of protein), lactic acid, and glycerol (a molecule that comes from fat) to create the sugar the body needs. Hormones such as cortisol and insulin control this process to maintain steady levels of glucose. After about one day of fasting, the glycogen (stored glucose) in the liver is reduced enough that gluconeogenesis begins in earnest and the liver begins creating glucose for the body. Isn’t this an incredible process?

Individuals having underlying issues with, say, abnormally depressed cortisol or possibly even adrenal autoimmunity leading to depressed cortisol may experience abnormal cravings for carbohydrates and unexpected low blood sugar symptoms in the face of impaired gluconeogenesis.

– Nora Gedgaudas

So what is the significance of gluconeogenesis in ketosis? If you are consuming a low-carb, high-fat diet and you’re eating the right amount of carbohydrate for your personal tolerance level, but you’re still struggling to see adequate ketone production, it’s quite possible that you’re eating too much protein. Consuming high amounts of protein and low amounts of carbs can force gluconeogenesis to begin, increasing your blood sugar and insulin levels and ultimately discouraging the production of ketones. To remedy this, it’s necessary to reduce protein intake.

Here’s an important thought to keep in mind when attempting to determine your protein threshold: if you are especially sensitive to carbohydrates (like me), then you will also be more sensitive to protein. It makes sense if you think about it: if increased quantities of carbohydrates raise your blood sugar levels, then gluconeogenesis from consuming excess protein, which results in more blood glucose, will have a similar effect.

I generally recommend that my patients eat any kind of meat, poultry, or seafood, but I make it clear that this is a high-fat diet, not a high-protein diet. Unless there is some unusual metabolic dysfunction, the main blocker of ketone production is insulin. Since insulin levels are determined by dietary carb intake and even protein, these components of the diet have to be managed so that ketosis is maximized.

– Dr. Jay Wortman

What can you do to determine your protein threshold? Ketogenic diet experts have varying opinions about what the ideal protein intake is. Many have guessed that 1 to 1.5 grams per kilogram of body weight is the right amount, but this could bring on gluconeogenesis in many people. Dr. Ron Rosedale, an expert in nutritional and metabolic medicine, advises that those who want to be in ketosis consume 1 gram of protein per kilogram of ideal body weight (based on your body mass index; a good calculator is available online at www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm) and then subtract 10 percent. Meanwhile, on my
Ask the Low-Carb Experts
podcast, renowned protein expert Dr. Donald Layman suggested limiting protein intake to no more than 30 grams per meal and no more than 140 grams per day. To figure out what amount of protein works best for you, though, there is no perfect formula. Just as with carbohydrates, it comes down to a process of trial and error.

I’m a pretty tall guy at six foot three, and I started out at around 120 grams of protein daily to see how I would do. When I wasn’t seeing the ketone production and other health effects I was looking for, each week I dropped my daily protein intake by 10 grams, until I discovered that ketones started to increase to beneficial levels at about 80 grams of protein a day. Now that may not seem like very much protein—there are 6 grams of protein in just one egg, for example—but it is what I needed to do in order to produce ketones in my body. Moderating my protein intake turned out to be a critical factor in my success on a ketogenic diet.

Ketosis simply takes the concept of high-fat dieting to a more extreme level, and rather than implementing the 20 percent carbohydrate, 65 percent fat, 15 percent protein approach, a ketogenic diet actually brings carbohydrate calories down to 5 to 10 percent, protein calories to 10 to 15 percent, and fat calories up to 75 to 80 percent.

– Ben Greenfield

Coming up in the next chapter, we’re going to talk about what you need to be eating
more
of if you want to be ketogenic. Since you’re cutting carbs and moderating your protein consumption, you’re going to be eating a lot more fat. This will no doubt be one of the most difficult things to wrap your head around because in America today, we have been conditioned to be scared half to death of eating fat, especially saturated fat. But you’ll soon find out why this fear is totally unfounded and how eating more fat from natural, real foods can send your ketones skyrocketing.

The most reliable way to get into a state of ketosis is to take carbohydrates down to 30 grams or less per day and protein down to around 0.5 grams per pound of body weight, and to consume fat throughout the day from a combination of medium-chain triglycerides (MCTs) and animal sources like butter, heavy whipping cream, and fatty meats.

– John Kiefer

Key Keto Clarity Concepts

• A ketogenic diet is not high-protein but rather high-fat.
  
• Carbohydrate restriction is a must, but protein moderation is critical as well.
  
• Protein is an essential nutrient, but its consumption needs to be moderated.
  
• If you are sensitive to carbohydrates, protein needs to be reduced.
  
• Gluconeogenesis can be problematic for ketosis if too much protein is consumed.
  
• You don’t have to eat carbs; your body will make its own carbs.
  
• Eating too much protein can prevent adequate ketone production.
  
• Making ketones takes much less protein than you might think.