Understanding the ketogenic diet’s benefits in athletics, lifestyle, and medical/therapeutic.

What do Lebron James, Katie Couric, and an 18-year-old girl with seizure-like events have in common? 

The ketogenic diet. 

Fats: steak, eggs, cheese, and many more delicious foods are a part of the diet. 

Each of them has used it for a different advantage: Lebron for an athletic application, Katie for maintaining a healthy lifestyle, and the 18-year-old girl with seizure-like events for a medical/therapeutical reasons. All of this has been achieved by comprising a majority of their nutrition with fats.

The fact that the ketogenic diet has these different applications is interesting. 

But, before I get into the different applications of the diet, it is important to understand what the diet actually is made up of and does. The ketogenic or keto diet is a diet in which most of your nutrition is comprised of fat. The other aspect of this diet is a low intake of carbohydrates or sugars (glucose). Because of the low intake of carbs, your body goes into a state of ketosis. Ketosis is a metabolic state characterized by the production of ketone bodies from acetyl-COA. In other words, your body stops using glucose as its main source of metabolic energy and starts using fats.

Lebron James 11/21/14

Let’s start with Lebron.

Lebron James is an NBA athlete. And as a professional paid athlete Lebron’s job is physically taxing especially during games. Now let’s say Lebron ate some carbs before a game. He will feel energized because the carbs that he ate are comprised of glucose. The glucose is used by the mitochondria–the powerhouse of the cell–within his cells to create adenosine triphosphate or if you want to be cool about it, ATP. 

ATP is important because it is basically the energy of life for all living aerobic animals, including us humans.

So Lebron feels energized by the carbs. However, his sugar-induced energy is short-lived because glucose burns very quickly; this means he runs out of carbs. His brain and muscles need the glucose to function properly, so without it, his athletic performance is hindered; not unless he went on a keto diet and ate something fatty before the game. 

But an experiment by Krzysztof Durkalec-Michalski found that Crossfit athletes who went on a ketogenic diet for four weeks and did an incremental cycling test (incremental cycling test measures oxygen consumption and carbon dioxide production by increasing the intensity of the cycling over time), started utilizing fat as an energy source when the maximal oxygen uptake–VO2 max–was up to eighty percent. This shows that fat consumption during exercise is used when a submaximal–heavy work that does not require maximal effort–effort is being exerted. 

Before you say, “Wait the experiment was done on Crossfit athletes how does that apply to King James?”

Both the incremental cycling test and the basketball game are endurance-heavy. 

For this reason, if Lebron had gone on a ketogenic diet before this hypothetical game, he could have done one of two things. The first is as said before, he could have eaten the fat-enriched food and his body would have consumed the fat to burn it for metabolic energy. Lebron will have longer energy on fats compared to carbs. The other way in which Lebron could have used the diet to his advantage is going on the keto diet while eating carbs before the game. The reason for this is because of mitochondrial biogenesis.

Mitochondrial biogenesis is a process by which cells increase mitochondrial mass. This can be induced by ketosis. With mitochondrial biogenesis, there is an increased glucose uptake by muscles. In regards to Lebron, this means better performance during a game compared to just eating carbs without having been on the keto diet. 

Katie Couric

This brings me to the next person Katie Couric. 

Katie Couric–and I’m going to go out on a limb here–is not an athlete. Now yes she does workout but she ain’t running back and forth on the basketball court breaking ankles or making three-pointers. Any healthy, average person should do some form of regular exercise, and that’s that. 

Back to Katie though, she has used the keto diet for maintaining a healthy lifestyle. Similarly, an experiment done by Robert DS Pitcheathly & Carlo Viscomi found a ketogenic diet within normal, healthy subjects had no bad effect on muscles. Also in a two and a half year follow up with patients, healthy patients had lost fast and weight. 

The ketogenic diet also has been reported by Vincent Miller and others to help with chronic diseases such as diabetes, obesity, and other diseases resulting from mitochondrial disability. 

Mitochondria

This leads me to the last person within the discussion of the versatility of the keto diet, the 18-year-old girl with seizure-like events.

This was a retrospective case study done by M.A.A.P. Willemsen and others. They looked at the 18-year-old girl’s lab results thinking that her blood glucose levels were low resulting in the seizure-like events. However, upon looking for low glucose levels within the spine, they found that the girl had a  GLUT1 deficiency syndrome: weakened glucose movement to the brain. 

The keto diet comes in because the ketones that are produced provided the brain as a replacement for energy, rather than glucose. The ketones are reconverted back into the acetyl-COA which then goes into the Kreb Cycle. The Kreb Cycle is the last step of cellular respiration. The use of the ketogenic diet isn’t new to the medical field: since the 1920s the keto diet has been used to treat patients with epilepsy. 

With all the applications of the keto diet, it is should be known that this diet does mean following a very strict plan of low to no carbs. Lack of vitamins and minerals calls for the need for supplementation. Also, the diet should not be followed for a long period of time because of the aforementioned lack of vitamins and minerals. 

And while the textbook definition of the keto diet is high fat and low carbs, in “Nutritional Ketosis and Mitohormesis: Potential Implications for Mitochondrial Function and Human Health” Vincent J. Miller and others state:

“A [keto diet] less restrictive in carbohydrate[s] and protein[s] … [is] more satisfying, sustainable, and feasible for the general population.” 

At the end of the day be smart about whatever diet you decide to go on. Know that there are pros and cons to each diet; there is no perfect diet. What leads to a healthy life is making the right decision overall that will better your life and your happiness.

By: I Tonuzi

References

Durkalec-Michalski, Krzysztof, et al. “Effect of a Four-Week Ketogenic Diet on Exercise Metabolism in CrossFit-Trained Athletes.” Journal of the International Society of Sports Nutrition, vol. 16, no. 1, 2019, doi:10.1186/s12970-019-0284-9. https://jissn.biomedcentral.com/articles/10.1186/s12970-019-0284-9

Miller, Vincent J., et al. “Nutritional Ketosis and Mitohormesis: Potential Implications for Mitochondrial Function and Human Health.” Journal of Nutrition and Metabolism, vol. 2018, 2018, pp. 1–27., doi:10.1155/2018/5157645. https://www.hindawi.com/journals/jnme/2018/5157645/

Pitceathly, Robert Ds, and Carlo Viscomi. “Effects of ketosis in mitochondrial myopathy: potential benefits of a mitotoxic diet.” EMBO molecular medicine vol. 8,11 1231-1233. 2 Nov. 2016, doi:10.15252/emmm.201606933 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5090656/

Willemsen, M.A.A.P., Soorani‐Lunsing, R.J., Pouwels, E. and Klepper, J. (2003), “Neuroglycopenia in normoglycaemic patients, and the potential benefit of ketosis.” Diabetic Medicine, 20: 481-482. doi:10.1046/j.1464-5491.2003.00952.x https://onlinelibrary.wiley.com/doi/full/10.1046/j.1464-5491.2003.00952.x

Image Credits 

Image 1: Malan, David, Unknown Title, https://www.aarp.org/health/brain-health/info-2015/brain-diet.html

Image 2: Allison, Keith, “Lebron James”, https://en.wikipedia.org/wiki/The_Block_(basketball)

Image 3: Stutz, Douglas H., “NBC Today Show host Katie Couric broadcasts live from Prince Sultan Air Base, Saudi Arabia, as part of the show’s coverage of Operation Southern Watch”, https://commons.wikimedia.org/wiki/File:Katie_Couric.jpg

Image 4: Jaiswal, Jyoti K. , M.S.C., Ph.D., Unkown Title, https://innovationdistrict.childrensnational.org/mitochondria-key-repairing-cell-damage-dmd/