Keto Answers Chapter 1. Understanding Keto

Author: Anthony Gustin Publisher: Four Pillar Health. Publish Date: 2019-8-30 Review Date: 2022-4-18 Status:📚

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HOW DOES KETOSIS WORK?

Short Answer: Ketosis occurs when carbohydrate intake is restricted enough to cause low blood sugar and insulin levels, which stimulates the burning of stored fat and the production of ketones in the liver.

Thus far we have really driven the point home that ketosis is what makes a keto diet unique. Understanding how ketosis works can be a great way to understand the changes that are going on in your body. However, to understand how ketosis works, we have to first discuss how carbohydrate metabolism works. When you consume carbohydrates, those carbohydrates are broken down to glucose and released into the bloodstream. Glucose is a type of sugar, and in this case is what we know as blood sugar.

This increase of blood sugar, from the breakdown of carbohydrates, causes the pancreas to secrete a hormone known as insulin, which binds to cells in the body to open the door for glucose to enter the cell and go through a process known as glycolysis. Glycolysis further breaks glucose down into a substrate that can be used by the cell to produce energy or scientifically speaking, ATP (adenosine triphosphate).

Since carbohydrates can be broken down very quickly, whenever they are present (which for a lot of people is all the time), they are the primary fuel source for the body.

However, if we restrict our carb intake enough, as we would on a keto diet, we see a decrease in blood sugar, which means that the need for insulin decreases, so insulin levels also lower. When we have low levels of glucose and insulin, our pancreas secretes another hormone known as glucagon. Glucagon has many functions, one of which is to interact with our adipose tissue or fat cells to release stored fat into our bloodstream where it can be used by cells for energy. But that’s not quite enough.

Interestingly, while most of our body can run on fat for fuel, the brain cannot. This is why we possess this unique metabolic mechanism of ketosis. The liver can break down fat and use it to make little energy molecules known as ketones or ketone bodies. However, the liver does not possess the necessary enzymes to use ketones for fuel, so these little energy soldiers are shuttled out of the liver and into the blood, where they are able to travel to cells and tissues and be taken in and used for energy.

Research has found that many cells in the body will skip using ketones for fuel and use fat instead, allowing the ketones zooming through the bloodstream to be taken in and used by the brain.3 Remember, the brain can’t effectively use fat, which is why this adaptation of the body is crucial.

Most people think that eating fat is required to stimulate ketone production, but that isn’t necessarily the case. Here’s a brief science lesson. Note that there is a difference between the fat that we eat and the fat in our body. Ketones are made when stored fatty acids are mobilized and delivered to the liver. Ketones are not made from the fat you eat with the exception of MCTs,

The fat that we eat gets absorbed in our digestive tract and packaged into little carriers known as chylomicrons. Chylomicrons travel through our bloodstream and are roped in by muscle and adipose tissue where they can then dump off the fatty acids they are carrying into cells to be used for energy or stored for later use. However, chylomicrons only go to the liver to be disposed of after they have dumped their fatty acids, meaning they are not able to deliver significant amounts of dietary fat to the liver for ketone production. That means that the fat we eat will preferentially be used for energy by our tissues and not for ketone production. Do not fall victim to the misconception that eating more fat will get your ketones higher or that it is necessary to be in a state of ketosis.

HOW IS KETO GOING TO IMPROVE MY MOOD?

There is actually growing evidence for the use of the ketogenic diet for mental health disorders, including depression and anxiety, which we will touch on in greater detail later in the book. For now, it is important to know that the combination of improving your energy levels, reducing hunger, improving gut health, minimizing nutrient deficiencies, and improving body image are all ways that a ketogenic diet can improve your mood. Of course, it is important to note that the quality of your keto diet is important here. As we will get into in the coming chapters, consuming low-quality foods will prevent you from seeing many of the benefits we just discussed.

HOW DOES KETO IMPROVE BRAIN HEALTH AND FUNCTION?

Short Answer: Ketones provide more energy to the brain than glucose and do so while producing less oxidative stress, thus causing less inflammation.

The brain has a massive energy demand, around 20-23 percent of the body’s total energy demand.21 This is important because the brain has to utilize the energy that is available to it, and for most people not on a keto diet, this is primarily glucose. However, when available, ketones are the preferred fuel source for the brain. In fact, research has shown that the brain’s uptake of ketones is proportional to their availability in the blood.22 What is interesting to note about ketones versus glucose metabolism is the push-pull method that has been so brilliantly explained by one of our favorite keto researchers, Dr. Stephen Cunnane. Dr. Cunnane explains that glucose is pulled into the brain based on the demands of the brain. However, ketones are pushed into the brain based on their availability in the blood. Since ketones provide more energy compared to glucose, this means that ketones possess the ability to provide more energy to the brain to assist in brain function.

It’s not just about what ketones are doing, it’s also about what they aren’t doing. Metabolizing glucose can be oxidative (requires oxygen), meaning it can cause oxidative stress. Over time, that stress can contribute to chronic systemic inflammation, which can damage our cells’ mitochondria, the organelles responsible for creating energy. The inflamed brain with damaged mitochondria is an unhealthy, impaired brain. Ketones are a much “cleaner” source of energy, meaning that when they are burned, they do not promote inflammation. Additionally, since ketones can provide more energy compared to glucose, they are better suited for the brain due to its high energy demands. Ketones are also signaling molecules, and one thing they are able to signal for is greater antioxidant production—important for anti-aging in general, especially as it relates to the brain.

The health benefits of metabolizing ketones in place of glucose also plays a huge role in brain disease prevention and management, especially since research has found that the brain loses its ability to metabolize glucose as we age.23 Chronically fueling the brain with glucose is one way to accelerate this. Like all cells in our body, the cells of the brain can become resistant to insulin, causing the brain to struggle to access fuel, thus forcing an energy crisis. A starving brain is also not a healthy brain. In fact, research has shown that insulin resistance is a common driver of neurodegenerative diseases.24 Alzheimer’s has recently been described as Type III diabetes because it is becoming evident that as we age, our brain’s ability to metabolize glucose decreases. This can result in a slew of deficiencies that impair cognitive health. This and other indicators suggest that maybe our brain should not be only metabolizing glucose for fuel, especially for extended periods of time—which for many could be their whole life!

Neurodegeneration and other declines in brain health do not have to occur as we age, at least not to the degree that we are currently seeing. Switching to the metabolic state of ketosis can aid in preventing or slowing this. In fact, research in neurodegenerative individuals has demonstrated that keto can improve aspects of brain function such as memory.25 This is because the insulin resistant brain can still metabolize ketones despite its inability to effectively utilize glucose. This not only solves the energy crisis but also helps reduce neuroinflammation and improve insulin sensitivity, all markers for improving brain health and function.26

Maciej Gasior, Michael A. Rogawski, and Adam L. Hartman, “Neuroprotective and Disease-Modifying. Mechanisms,” The Lancet Neurology 3, no. 3 (2004): 169-178.
Robert Krikorian, Marcelle D. Shidler, Krista Dangelo, Sarah C. Couch, Stephen C. Benoit, and Deborah J. Clegg, “Dietary Ketosis Enhances Memory in Mild Cognitive Impairment,” Neurobiology of Aging 33, no. Effects of the Ketogenic Diet,” Behavioural Pharmacology 17, no. 5-6. (2006): 431.

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Loss,” European Journal of Clinical Nutrition 67, no. 7 (2013): 759.

21 M. Bélanger, J. Allaman, and P.J. Magistretti, “Brain Energy Metabolism: Focus on Astrocyte-Neuron

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Metabolic Cooperation,” Cell Metabolism 14(6) (2011): 724-738.

22 Alexandre Courchesne-Loyer, Etienne Croteau, Christian-Alexandre Castellano, Valerie St-Pierre, Marie Hennebelle, and Stephen C. Cunnane, “Inverse Relationship between Brain Glucose and Ketone Metabolism in Adults during Short-Term Moderate Dietary Ketosis: A Dual Tracer Quantitative Positron

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Emission Tomography Study,” Journal of Cerebral Blood Flow & Metabolism 37, no. 7 (2017): 2485-2493.

23 Mayer B. Davidson, “The Effect of Aging on Carbohydrate Metabolism: A Review of The English Literature And a Practical Approach to the Diagnosis of Diabetes Mellitus in the Elderly,” Metabolism

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no. 6 (1979): 688-705.

24 Suzanne Craft and G. Stennis Watson, “Insulin and Neurodegenerative Disease: Shared and Specific

I HEARD THAT OUR BRAIN NEEDS CARBS FOR PROPER FUNCTION?

Short Answer: Your body can make all the glucose it needs for brain function without you eating a single carbohydrate.

Certain portions of the brain do require some glucose, but this glucose does not have to come from your diet, it can come from a process known as gluconeogenesis, or the production of glucose from non-glucose sources. The rest of your brain can utilize ketones for fuel, and in fact, the brain likely prefers ketones. Remember, ketones are taken up via the brain in proportion to their availability in the blood. The liver can produce between 100 and 150 grams of ketones per day, which is more than enough to meet the energy demands of the brain. This means that the brain can derive all of the energy it needs from ketones and gluconeogenesis, removing the need for carbohydrate consumption. Combine this with the fact that burning ketones is a lot healthier for the brain, you should trust us in saying “your brain likes the ketones.”

🔮 The Cosmos

Keto Answers Chapter 1. Understanding Keto

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