To pick up from the discussion last week on ketones…

The rapidly expanding knowledge of ketones.

We’ve known for many decades that ketones are another fuel for the heart and brain and that’s one of its key roles. There are many roles of ketones in the human body: brain healing, prolonged energy metabolism, psychiatric disorders, longevity, modulation of inflammation, and much more. Most people think that humans only run on glucose, and that is just not true. We are using energy from both fat and glucose simultaneously from the time we are born to the day we die. With diet manipulation, we can shift the proportions of glucose and fat that we use for energy, but at the end of the day, we always use both.

Recent studies have shown the epigenetic effects of the ketone, beta hydroxy-butyrate (BOHB) and this was really groundbreaking in opening up a whole new understanding of potential mechanisms surrounding a ketogenic diet.

Biochemistry geeks will revel in the fact that beta hydroxy-butyrate is a potent histone deacetylase inhibitor and that’s a critically important target for a lot of the cellular targets. A lot of drug companies would love to have a drug that is as potent as the ketogenic diet. Basically we have a diet that can induce a metabolic response, having a drug like effect. This has been demonstrated in a lot of different areas (figure adapted from the Art and Science of Low Carbohydrate Living).


Eat carbohydrates to your tolerance level

So when you eat carbohydrates at a level that is higher than your tolerance, and intolerance varies widely in the population, is when we develop metabolic syndrome. Discovering your level of carbohydrate tolerance is done at several levels through laboratory testing, exercise tests, medical history, family history, environment, and much more.

The evidence is very strong and solid to support over consumption of carbs in our country and that has to be defined on a personal level. But these are the standard signs and symptoms of metabolic syndrome that are used as a diagnosis (see blog post 1 and 2).

There are a lot of other biomarkers and additional features of metabolic syndrome that are being identified, but increased levels of plasma saturated fat is common in metabolic syndrome and its directly tied to dyslipidemia. But you have to do a fatty acid level profile to know this for sure. We can look at your levels of palmitic acid and arachidonic acid for example.

Comprehensive reviews of the literature clearly show that carbohydrate restriction is a preferred approach to managing metabolic syndrome. A recent meta-analysis in Plos one even went a step further and did an advanced statistical analyses called a Bayesian analysis. This showed that statistically a person had a 99% greater chance of losing weight if they are in a ketogenic diet than a low-fat diet. There is a tremendous amount of evidence supporting this and very little refuting that low carbohydrate diets consistently outperform low-fat diets on all features of metabolic syndrome.

Next time a bit on metabolic bio-markers on a ketogenic diet…