Should You Try a Ketogenic Diet and Intermittent Fasting?

Just about half the patients we see in our office classify themselves as overweight and wish they weren’t. Not many are in the obese range, likely because when you come to a place called WholeHealth Chicago you’ve got a running start in being interested in health, well-being, and longevity.

Still, weight is an issue for most of us at some point in our lives.

In an earlier Health Tip, I wrote that carbs are the real villain in managing weight. All carbs–both simple (sugar, refined white flour) and complex (whole grains, legumes)–are high-glycemic foods that quickly raise your blood sugar.

Reducing carbs means focusing on healthful fats, berries, meat, poultry, fish, shellfish, eggs, and veggies that grow above ground (including greens, cauliflower, cabbage, peppers, tomatoes, and cukes), and avoiding sugar and sugar-containing foods like beans, potatoes, rice, bread, pasta, carrots, corn, peas, French fries, and salty snack foods.

By doing so, you will have officially started a ketogenic diet.

How does the body process carbs?

Carbs quickly raise your blood sugar. High blood sugar triggers your pancreas to pump out insulin in an effort to bring your sugar back to normal. In the process, the insulin also drives any fat circulating in your bloodstream into your fat cells, where it’s stored and accumulates into a potbelly, love handles, and extra chins.

The insulin also pushes fat into your liver, moving you toward a condition called fatty liver disease.

Ultimately, all this insulin production exhausts your pancreas. With insufficient insulin you develop metabolic syndrome, pre-diabetes, and, finally, Type 2 (adult onset) diabetes.

A ketogenic diet reverses all this

Eating a keto diet isn’t at all difficult once you get past the idea of not eating high-glycemic carbs. Since you’re eating more fats (healthful ones) to stay satiated, along with many other good foods, it’s actually quite delicious.

Going keto simply means you’re burning your stored fat into molecules called ketones. Having more ketones in your blood than usual is called ketosis. Ketones themselves are a perfectly good energy source, although if asked, your individual cells would probably prefer glucose (from carbs) because glucose works fast to boost energy.

You can get a sugar high easily enough from white rice, crackers, donuts, or even oatmeal. You’ll never get a cob-salad-with-bleu-cheese-dressing high or a grilled- salmon-with-cream-sauce high. But you will feel completely full and satisfied. A ketogenic diet is surprisingly satiating once you get the hang of it.

By going keto your cells don’t have access to glucose for energy so they burn your stored fat instead. As a result, you lose weight.

People do confuse ketosis with the entirely different ketoacidosis, a dangerous situation of very high blood sugar and high levels of ketones that can occur in people with uncontrolled diabetes. When ambulance drivers pick up an unconscious person, they’ll quickly check for ketoacidosis.

Obviously, not the same as ketosis.

Intermittent fasting

Combine a keto diet with long periods during which you’re not eating anything–called intermittent fasting—and you’ll burn even more fat.

Although there are several ways to go about intermittent fasting, my personal preference is to do as much of the fast while I’m asleep. Here’s my intermittent fasting schedule: I finish my last meal of the day at 8 pm and don’t eat again until noon the next day, for a total of 16 hours without eating.

This means skipping breakfast, except for black coffee and plenty of water and zero-calorie beverages like VitaminWater Zero or Bai (Bai actually has 10 calories–close enough to zero for me).

Keto + intermittent fasting = big benefits

Here are some of the health benefits of going keto with intermittent fasting:

• Weight loss is the most obvious and with weight loss you reduce the chances a slew of health risks, including diabetes, heart disease, arthritis, cancer, and something called all-cause mortality. This is exactly what it sounds like. You live longer.
• Reverses metabolic syndrome. Metabolic syndrome is a combination of high blood pressure, belly fat, high LDL/low HDL cholesterol, and high blood sugar, a ticking bomb for heart disease and diabetes.
• Reduces chronic inflammation, which drives down symptoms of autoimmune disease and lowers your risk of developing Alzheimer’s.

Getting started on keto (and common questions)

Here’s an excellent review of the keto diet for beginners. Stock your refrigerator and pantry with responsibly raised meats and poultry, wild-caught fish, cheese, eggs, nuts, healthy oils, avocados, and organic dairy.

You’ll also eat a lot of organic, above-ground veggies, but you’ll be bathing them in delicious fats and creamy sauces. The vegetables will replace the fiber you’ll be missing by eliminating grains, beans, and legumes.

Can I go off keto?

On that glorious morning when you’re reasonably happy with your weight you can certainly start reintroducing some of the foods you’ve missed. Keep in mind, though, that it’s excruciatingly easy to gain back what you’ve lost, so it’s best to take it slowly. One of my patients who reached her ideal weight enjoys a weekly slice of toasted sourdough with her eggs.

Should I continue my intermittent fasting?

Actually, yes. Contrary to what we were told as children, we don’t need breakfast or that morning cereal, scone, or oatmeal. Many intermittent fasters find they’re satisfied eating two keto meals a day. (Some eat just one meal and fast for more hours.)

Can I get help with all this?

Absolutely. Our nutritionists, Olivia Wagner and Becca Zachwieja, are very familiar with keto/intermittent fasting and can guide you through meal planning, grocery selections you may not have considered, and how to cope with the challenge of spying a bowl of potato chips at that backyard picnic.

Be well,
David Edelberg, MD