Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning


Naturopathic Nuggets about the Ketogenic Diet

  • The Ketogenic Diet is a century old remedy for epilepsy, that is now proven neuroprotective, affecting other neurological disorders including Alzheimer’s & Parkinson’s Disease.
  • The Ketogenic Diet has been researched to improve many conditions including Acne, Autoimmune Diseases, Cancer, Diabetes, Heart Disease, Metabolic Syndrome, Polycystic Ovary Syndrome (PCOS), Traumatic Brain Injury & Concussions and Obesity
  • A ketogenic diet consists of 70% healthy fats, 25% quality protein and 5% carbs to trigger ketosis for optimal fat burning and weight loss.
  • To reach ketosis it is critical to avoid eating too many carbs or too much protein as either can become fuel for the body & brain. The key is to minimize carbs and increase fat to promote fat burning but prevent starvation which would cause muscle wasting.
  • Side effects of ketosis include constipation, diarrhea, heart palpitations, keto breath, keto flu, leg cramps, reduced stamina & fitness. They are often the result of dehydration and/or salt deficiency, and usually resolve within a few weeks.
  • Please consult your licensed Naturopathic Physician for assistance with the Ketogenic Diet if you suffer from diabetes, heart disease, gallbladder or pancreatic disease, or are taking prescription medications.

Keto Basics

 

 

 

Keto Foods

 

 

 

 

 

Keto Snacks

 

 

 

Ketogenic Diet: What is it?

A ketogenic diet is when carbs are dramatically reduced to 5% or less than 20 grams, protein is limited to 25%, and fat intake escalates to at least 70% to replace the carbs, helping you feel full. When carbs are restricted, the liver converts fat into ketones for energy & brain function. Instead of surviving on carbs (sugars) for brain fuel, your body uses ketones from your fat stores, transforming your body into an efficient fat-burning machine. This is called ketosis. In fact, many clinical studies have supported the countless benefits that a ketogenic diet has on health, weight loss and disease prevention.

The Ketogenic diet is different from the Atkins diet in that the ketogenic diet highlights less protein, no deli or processed meats (bacon & ham) and healthier fats. While both diets are low carb emphasizing the body’s fat-burning effect, the ketogenic diet has a lot of research to validate its effectiveness.

The ketogenic diet is now being studied for its neuroprotective effect through improved cellular metabolism on other neurological disorders aside from Epilepsy, including Alzheimer’s Disease (AD), Amyotrophic Lateral Sclerosis (ALS), AutismBrain Cancer, Headache, Neurotrauma (Traumatic Brain Injury), Pain, Parkinson’s Disease (PD) and Sleep Disorders (Gano, Patel, & Rho, 2014).

Ketogenic Diet: Why?

For many decades, the universally accepted diet in North America emphasized a high carbohydrate, low fat intake. However, recent studies verify this diet has backfired for the majority of North Americans.

Results from a long-term study by the Centres for Disease Control & Prevention indicate that in the last decade overweight North Americans have increased from ¼ to of the population! As such, society is fatter and less healthy in view of all the health-related concerns associated with weight gain and nutrient deficiencies.

In fact, obesity is a growing epidemic worldwide, and increases risk for heart disease, high cholesterol, high blood pressure, diabetes and metabolic syndrome. Ketogenic diets have proven to be highly effective in the fight against not only Obesity (Bueno et al., 2013), but also Diabetes, Polycystic Ovary Syndrome (PCOS), Acne, Neurological Diseases, & Cancer while improving risk factors for Lung & Heart Disease (Paoli, Rubini, Volek, & Grimaldi, 2013).

The Keto Diet Health Benefits

Keto Diet Health Benefits: Acne

Certain studies have proven that high carb diets may play a role in acne through stimulating insulin, increasing androgen bioavailability & influencing insulin-like growth factor-1 (IGF-1) activity. Ultimately, insulin mediated actions cause increased cell growth in sebaceous ducts, abnormal shedding of follicular skin, increased androgen-mediated sebum production, growth of acne bacteria and the consequent inflammation. Conversely, low carb diets improve skin quality (Smith, Mann, Braue, Mäkeläinen, & Varigos, 2007).

Clinical and physiological evidence has found that the ketogenic diet specifically may be effective in decreasing the severity and progression of acne (Paoli et al., 2012).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Alzheimer’s Disease

Recent research highlights the neuroprotective effects and even modify disease progression of the ketogenic diet on Alzheimer’s Disease and other neurodegenerative conditions (Gasior, Rogawski, & Hartman, 2006). In fact, Reger et al., 2004 administered medium chain fats and found improved memory in Alzheimer’s patients, and the degree of improvement matched the blood levels of ketones (β-hydroxybutyrate), which happens when the fat is converted to fuel.

Contrarily, high carb diets worsen cognitive performance & behaviour in Alzheimer’s patients (Young et al., 2005).

In fact, increasing essential fatty acids may be protective against Alzheimer’s Disease, while saturated or trans fats increase risk (Morris et al., 2003).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Appetite Regulation & Cravings

The ketogenic diet requires increased fat intake which helps you feel full. Meanwhile the ketones produced from fat conversion suppresses appetite and influences appetite control hormones. Ghrelin (hunger hormone) increases were suppressed & leptin was lower on the ketogenic diet (Sumithran et al., 2013). Basically, the ketogenic diet keeps you full and prevents rebound hunger causing weight regain.

A study actually found that obese adults on the low carb diet had dramatic reductions in carb & sugar cravings, and were less bothered by hunger compared to the low fat group (Martin et al., 2011).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Autoimmune Diseases

The mechanism of autoimmune diseases includes food allergies, which can cause gut & systemic inflammation, dysbiosis (altered gut bacteria) & leaky gut syndrome, all of which disrupt healthy immune function.

The ketogenic diet indirectly omits some food allergies through carbohydrate restriction, such as gluten, corn & rice grains, reducing inflammation. Ketosis also normalizes insulin function, which can fight inflammation as well. Additionally, the weight loss from a ketogenic diet can improve inflammation from fat cells.

A 2017 study in World Journal of Gastroenterology recognized the significant effect that a ketogenic diet had on an imbalanced gut microbiome. Microbial balance in epileptic infants was corrected with a ketogenic diet for one week, and 21% of infants became seizure-free, while others had a 50-90% reduction in seizure frequency (Xie et al., 2017)

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Belly Fat (Visceral Fat)

ketogenic diet not only causes weight loss but also fat loss, reducing inflammation which can perpetuate visceral obesity. A 2018 study published in the Journal of the International Society of Sports Nutrition, found that a ketogenic diet decreased fat mass and visceral adipose tissue without decreasing lean body mass (Vargas et al., 2018).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Cancer

Ketogenic diets have been researched to suppress tumour progression & systemic inflammation, while improving body & muscle weights in cancer cachexia, weight & muscle wasting (Nakamura, Tonouchi, Sasayama, & Ashida, 2018).

Cancer cells rely on glucose (sugar) for fuel. Ketogenic diets are used in cancer treatment to starve the cancer cells, as they cannot use ketones for fuel like healthy cells can. Moreover, reducing blood sugar reduces insulin & insulin-like growth factor, IGF-1, preventing cancer growth (Weber, Aminazdeh-Gohari, & Kofler, 2018).

Ketogenic diets have been found to increase survival time and slow tumour growth in pancreatic, prostate, stomach, brain & lung cancers (Khodadadi et al., 2017)

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Cholesterol Imbalances (Low “Good” HDL & High “Bad” LDL)

Ketogenic diets have been associated with significant reductions in total cholesterol, increases in HDL “good” cholesterol levels, decreases in triglycerides “fat” levels and reductions in LDL “bad” cholesterol levels (Kosinski & Jornayvaz, 2017).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Diabetes Type 2

The effect of a  ketogenic diet was investigated in type 2 diabetes patients versus a low glycemic diet. The ketogenic patients has greater improvements in their hemoglobin A1C (HbA1C), body weight and HDL “good” cholesterol compared to the low glycemic group. Stunningly, diabetic medications were reduced or eliminated in 95% of the ketogenic group. Clearly, ketogenic diets may be quite effective in improving and reversing type 2 diabetes (Westman, Yancy, Mavropoulos, Marquart, & McDuffie, 2008).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Epilepsy

Medically resistant epilepsy is very responsive to a ketogenic diet and has been used as a non-drug treatment since the 1920s. The proposed mechanisms include ketone production, low blood sugar,  changes in brain energy metabolism, neuron cells, neurotransmitter function to improve the disease & reduce the seizure frequency (Agarwal et al., 2017).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Heart Disease

The ketogenic diet has been researched to improve all markers that define metabolic syndrome, including heart disease. A study in Lipids journal compared the low fat to the low carb diet with similar calorie intake. The ketogenic diet (low carb) was found to lower blood sugar & insulin levels, improve insulin sensitivity, reduce visceral fat & overall weight, while improving cholesterol profiles (less triglycerides, post-meal fat, ApoB ratio & Cholesterol/HDL ratio, with increased good cholesterol, HDL). Even though the ketogenic diet had 3X more dietary saturated fat, blood fats were reduced as was fat storing or lipogenesis (Volek et al., 2009).

Ketogenic diets have been associated with significant reductions in total cholesterol, increases in HDL “good” cholesterol levels, decreases in triglycerides “fat” levels and reductions in LDL “bad” cholesterol levels (Kosinski & Jornayvaz, 2017).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: High Blood Pressure

Studies for blood pressure are scarce. One study did find improvements in blood pressure in obese patients on a ketogenic diet over 48 weeks compared to a low fat diet (Mayer et al., 2014).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Inflammation

Many studies support the anti-inflammatory benefits from ketogenic diets. It’s ability to reduce chronic inflammation enable the ketogenic diet to affect many conditions, including epilepsy, obesity, heart disease, autoimmunity, metabolic syndrome, and neurological diseases.(Pinto et al., 2018).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog
Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Insulin Resistance

The effect of a ketogenic diet was investigated in type 2 diabetes patients versus a low glycemic diet. The ketogenic patients has greater improvements in their hemoglobin A1C (HbA1C), body weight and HDL “good” cholesterol compared to the low glycemic group. Stunningly, diabetic medications were reduced or eliminated in 95% of the ketogenic group. Clearly, ketogenic diets may be quite effective in improving insulin resistance and reversing type 2 diabetes (Westman, Yancy, Mavropoulos, Marquart, & McDuffie, 2008).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Metabolic Syndrome

The ketogenic diet has been researched to improve all markers that define metabolic syndrome, including abdominal obesity, heart disease, high blood pressure, high blood sugar or insulin resistance and high blood fat. A study in Lipids journal compared the low fat to the low carb diet with similar calorie intake. The ketogenic diet (low carb) was found to lower blood sugar & insulin levels, improve insulin sensitivity, reduce visceral fat & overall weight, while improving cholesterol profiles (less triglycerides, post-meal fat, ApoB ratio & Cholesterol/HDL ratio, with increased good cholesterol, HDL). Even though the ketogenic diet had 3X more dietary saturated fat, blood fats were reduced as was fat storing or lipogenesis (Volek et al., 2009).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog
Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog
Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Muscle Gain

ketogenic diet not only causes weight loss but also fat loss, reducing inflammation which can perpetuate visceral obesity. A 2018 study published in the Journal of the International Society of Sports Nutrition, found that a ketogenic diet decreased fat mass and visceral adipose tissue without decreasing lean body mass (Vargas et al., 2018).

Although ketogenic diets have shown increases in muscles mass while decreased fat in the obese & overweight, this was newly examined in resistance trained athletes, comparing a ketogenic diet to a traditional western diet (55 % carbs, 25 % fat, 20 % protein) on changes in muscle and fat mass. In fact, lean mass gain, muscle mass gain & fat loss was greater in the ketogenic group compared to the traditional western diet (Rauch et al., 2014).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Parkinson’s Disease

Although uncontrolled, one clinical study found 28 days on the ketogenic diet caused a 43% reduction in Parkinson’s symptoms. Also, all patients found moderate to very good improvement in symptoms (Vanitallie et al., 2005)

Similar to Alzheimer’s, increasing essential fatty acids was found to lower risk of developing Parkinson’s Disease (de Lau et al., 2005).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder in fertile women suffering from obesity, high fasting insulin & insulin resistance. Since ketogenic diets improve these conditions, women with PCOS were put on a ketogenic diet. Significant improvements were seen in weight, percent free testosterone, LH/FSH ratio, and fasting insulin in women with obesity and PCOS on a ketogenic diet over 6 months (Mavropoulos, Yancy, Hepburn, & Westman, 2005).

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog
Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Traumatic Brain Injury & Concussions

An animal study found that the ketogenic diet after traumatic brain injury reduced lesion size by 58%. The ketogenic neuroprotection was found to be age-dependant, with younger brains having greater benefit (Prins, Fujima, & Hovda, 2005).

The ketogenic diet provides neuroprotection to both neurodegenerative diseases and traumatic brain injury & concussions through (Gasior, Rogawski, & Hartman, 2006):

  • interfering with glutamate-mediated toxicity, which damages neurons
  • ketones that provide the brain energy for healing and improve neuron resilience
  • enhancing GABA levels
  • enhancing antioxidant mechanisms to reduce oxidative damage
  • protection against neuron cell death as see in seizures & ischemia, which starves the tissues of oxygen from restricted blood flow
  • increasing calbindin, which buffers calcium in the cell, preventing cell death
  • carbohydrate restriction which reduces oxidative stress, stabilizes cellular calcium and improves mitochondrial function (cell’s energy power plant)

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog
Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Diet Health Benefits: Weight Loss

There is no doubt that ketogenic diets result in weight loss. See Keto & Weight Loss for research on the ketogenic diet & weight loss. Mechanisms to promote weight loss include appetite suppression, calorie reduction, increased fat burning, decreased fat storage, reduction in potential food allergies & resultant inflammation, increased protein intake, increased insulin sensitivity & metabolism, feeling satisfied and weight loss maintenance from hunger hormone inhibition.

Dr. Jiwani Keto Diet Health Benefits: Ketosis for Optimal Health & Fat Burning | Dr. Jiwani's Naturopathic Nuggets Blog

 

Ketogenic Diet: When to Ask for Supervision

It is recommended that your should see your doctor for a health assessment before starting any dietary changes. You may want to seek the expertise of a licensed naturopathic physician to help you execute this appropriately for your health concerns.

There are some individuals that should not attempt the ketogenic diet without medical supervision by a doctor or licensed naturopathic physician.

This includes patients who are or have:

  • Bariatric Surgery
  • Breastfeeding
  • Children
  • Diabetes
  • Eating Disorder
  • Fever
  • Gallbladder Disease or Removed
  • Kidney Stones
  • Mental Health Conditions
  • Pancreatic Disease
  • Pregnant
  • Prescription Medications
  • Sick with Infection
  • Underweight

 

 

Related   The Keto Diet for Weight Loss

 

Ketogenic Diet Myths

Dr. Jiwani Ketogenic Diet for Newbies: The Why, When & How of this Low Carb Fat Burning Regime 70-25-5* | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Myth #1:
A High Fat Diet Clogs Your Arteries
Causing a Heart Attack

Dr. Jiwani Ketogenic Diet for Newbies: The Why, When & How of this Low Carb Fat Burning Regime 70-25-5* | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Myth #2:
A High Fat Diet Makes
Your Cholesterol High

Dr. Jiwani Ketogenic Diet for Newbies: The Why, When & How of this Low Carb Fat Burning Regime 70-25-5* | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Myth #3:
Your Brain Needs Carbs

Dr. Jiwani Ketogenic Diet for Newbies: The Why, When & How of this Low Carb Fat Burning Regime 70-25-5* | Dr. Jiwani's Naturopathic Nuggets Blog

Keto Myth #4:
Low Carb Causes Vitamin Deficiencies

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Keto Myth #5:
Low Carb is Bad for Your Thyroid

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Keto Myth #6:
Low Carb is Bad for Your Kidneys

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Keto Myth #7:
Low Carb Makes You Depressed

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Keto Myth #8:
You Need Carbs to Exercise

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Keto Myth #9:
Low Carb is Bad for Your Gut Bacteria

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Keto Myth #10:
Low Carb is Bad for Your Bones

References

Agarwal N, Arkilo D, Farooq O, Gillogly C, Kavak KS, Weinstock A. Ketogenic diet: Predictors of seizure control. SAGE Open Medicine. 2017 

Brehm BJ, Seeley RJ, Daniels SR, D’alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. The Journal of Clinical Endocrinology & Metabolism. 2003 Apr 1;88(4):1617-23.

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Feinman RD, Fine EJ. Nonequilibrium thermodynamics and energy efficiency in weight loss diets. Theoretical Biology and Medical Modelling. 2007 Dec;4(1):27.

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Gasior M, Rogawski MA, Hartman AL. Neuroprotective and disease-modifying effects of the ketogenic diet. Behavioural Pharmacology. 2006 Sep;17(5-6):431.

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Paoli A. Ketogenic diet for obesity: friend or foe?. International Journal of Environmental Research and Public Health. 2014 Feb 19;11(2):2092-107.

Prins ML, Fujima LS, Hovda DA. Age‐dependent reduction of cortical contusion volume by ketones after traumatic brain injury. Journal of Neuroscience Research. 2005 Nov 1;82(3):413-20

Rauch JT, Silva JE, Lowery RP, McCleary SA, Shields KA, Ormes JA, Sharp MH, Weiner SI, Georges JI, Volek JS, D’agostino DP. The effects of ketogenic dieting on skeletal muscle and fat mass. Journal of the International Society of Sports Nutrition. 2014 Dec 1;11(S1):P40.

Reger MA, Henderson ST, Hale C, Cholerton B, Baker LD, Watson GS, Hyde K, Chapman D, Craft S. Effects of β-hydroxybutyrate on cognition in memory-impaired adults. Neurobiology of Aging. 2004 Mar 1;25(3):311-4.

Smith RN, Mann NJ, Braue A, Mäkeläinen H, Varigos GA. The effect of a high-protein, low glycemic–load diet versus a conventional, high glycemic–load diet on biochemical parameters associated with acne vulgaris: A randomized, investigator-masked, controlled trial. Journal of the American Academy of Dermatology. 2007 Aug 1;57(2):247-56.

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Vargas S, Romance R, Petro JL, Bonilla DA, Galancho I, Espinar S, Kreider RB, Benítez-Porres J. Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial. Journal of the International Society of Sports Nutrition. 2018 Dec;15(1):31.

Veldhorst MA, Westerterp-Plantenga MS, Westerterp KR. Gluconeogenesis and energy expenditure after a high-protein, carbohydrate-free diet–. The American Journal of Clinical Nutrition. 2009 Jul 29;90(3):519-26.

Volek JS, Phinney SD, Forsythe CE, Quann EE, Wood RJ, Puglisi MJ, Kraemer WJ, Bibus DM, Fernandez ML, Feinman RD. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids. 2009 Apr 1;44(4):297-309.

Weber DD, Aminazdeh-Gohari S, Kofler B. Ketogenic diet in cancer therapy. Aging (Albany NY). 2018 Feb;10(2):164.

Westerterp-Plantenga MS, Nieuwenhuizen A, Tome D, Soenen S, Westerterp KR. Dietary protein, weight loss, and weight maintenance. Annual Review of Nutrition. 2009 Aug 21;29:21-41.

Westman EC, Mavropoulos J, Yancy WS, Volek JS. A review of low-carbohydrate ketogenic diets. Current Atherosclerosis Reports. 2003 Nov 1;5(6):476-83.

Wheless JW. History of the ketogenic diet. Epilepsia. 2008 Nov;49:3-5.

Xie G, Zhou Q, Qiu CZ, Dai WK, Wang HP, Li YH, Liao JX, Lu XG, Lin SF, Ye JH, Ma ZY. Ketogenic diet poses a significant effect on imbalanced gut microbiota in infants with refractory epilepsy. World Journal of Gastroenterology. 2017 Sep 7;23(33):6164.

Young KW, Greenwood CE, Van Reekum R, Binns MA. A randomized, crossover trial of high-carbohydrate foods in nursing home residents with Alzheimer's disease: associations among intervention response, body mass index, and behavioral and cognitive function. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2005 Aug 1;60(8):1039-45.


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