Retrospective #81: A New Dietary Paradigm

A new dietary paradigm is emerging for a Way of Eating that avoids, mitigates or ameliorates the devastating impact of Metabolic Syndrome and the Diseases of Civilization with which it is strongly associated. These outcomes affect about half the population that may be genetically predisposed and therefore susceptible. The new paradigm arises from what we are learning of the health and longevity benefits associated with Calorie Restriction (CR).

This blog does not, however, advocate Calorie Restriction per se. It is instead advocating a restricted-calorie Very Low Carbohydrate Ketogenic Diet, recently named [when this was originally written in early 2013] “Nutritional Ketosis.” This phrase was first used, I think, by Jeff Volek and Stephen Phinney in their very good book, “The Art and Science of Low Carbohydrate Living” and was later popularized by Jimmy Moore (“Livin’ La Vida Low-Carb”).

“Nutritional Ketosis” is defined as a low level of ketosis for a sustained period in which the body is “keto adapted” so that it burns fatty acids and ketone bodies instead of glucose as its primary energy source. A low millimolar concentration of ketone bodies can be measured in the blood. The two best aspects of being in mild ketosis are: 1) you have lots of energy and 2) you’re not hungry, so long as you have body fat to ‘burn’ for energy.

Dr. Richard Veech of the National Institutes of Health says, “Doctors are scared of ketosis. They’re always worried about diabetic ketoacidosis. But ketosis is a normal physiologic state. I would argue it is the normal state of man.”

The “Ketogenic Diet” has long been associated with multiple benefits.  A very high fat (90% fat) ketogenic diet was first used in the 1920s at Johns Hopkins University as an effective treatment for childhood epilepsy. It’s still used today for treatment of drug-resistant forms of childhood epilepsy. It is effective in about 50% of drug-resistant cases.

In “The Neuroprotective Properties of Calorie Restriction, The Ketogenic Diet and Ketone Bodies,” lead author Mark Mattson, MP, says, “The neuroprotective effects of the ketogenic diet, however, are not limited to epilepsy. The antiepileptic effects of the ketogenic diet have been associated with improvements in cognitive function. Similarly, oral intake of medium-chain triglycerides has improved cognitive function in patients with Alzheimer’s disease.” “Neuroprotective” is how the benefit is described in diseases like Parkinson’s, Alzheimer’s and Huntington’s.

 The authors assert in the paper cited that the “underlying mechanisms” of the ketogenic diet are “similar to those activated by calorie restriction.” But does this mean that you have to eat a diet that is so very high in fat as to be anticonvulsive? Happily, it does not. That’s where ketone bodies enter the picture. Ketone bodies are byproducts of catabolism, i.e., the breakdown of fat molecules (triglycerides). “During conditions of reduced glucose availability, energy is derived from the conversion of fats to ketone bodies,” they explain. You just have to cut out the carbs!

Quoting again from, “The Neuroprotective Properties of Calorie Restriction, The Ketogenic Diet and Ketone Bodies”: “Following a day of fasting or exposure to the ketogenic diet, ketone bodies reach low millimolar concentrations in the blood.”  “Fasting and the ketogenic diet increase the permeability of the blood-brain barrier to ketones.” They cross the blood-brain barrier. Ketone bodies are thus good – in fact, ketone bodies are the ideal brain food.

Mattson’s conclusion: “Calorie restriction and the ketogenic diet share two characteristics: reduced carbohydrate intake and a compensatory rise in ketone bodies.”“An expanding body of evidence indicates that ketone bodies are indeed neuroprotective, and that the underlying mechanisms are similar to those associated with calorie restriction – specifically at the mitochondrial level.”

Since 2000, Mark P. Mattson, PhD, has been chief of the Laboratory of Neurosciences at the National Institute of Ageing in Baltimore. He is also Professor in the Department of Neuroscience at Johns Hopkins University. Mattson is a leader in the area of neurodegenerative disorders, and has made major contributions to understanding the pathogenesis of Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis and stroke. He has published more than 900 peer-reviewed articles and is “the most highly cited neuroscientist in the world” (Wiki).