Ketosis VII: Practical recommendations

Well, here we are at our final Ketosis post!  It has been a long ride for all of us, and I hope you have learned as much as I have while researching the topic.

We have seen a lot of benefits of ketosis from helping lower triglycerides to helping with certain neurological conditions.  Now while all of these things sound great, how do we appropriately approach ketosis?  While many of us may want to try and be in ketosis at all times after seeing these benefits, and that it is a normal, physiologic process, I do think there are some reasons to not be in ketosis all the time, but I will cover those in a separate, later post, since I think they relate better to a different topic I have been thinking about lately.

So we know we have three main ways to get into ketosis: fasting, low-grade exercise, and high fat diets.  I think an appropriate ketosis-style diet is one that will combine all three of these into a cyclic approach, that way we make sure to leave ketosis for a little bit every now and then.  Also, as you will remember from my cornerstones of health posts I believe a system of HOW you eat it is very important to overall health, and we will also incorporate this system into our ketogenic protocol.

Ketosis VI: Therapeutic Roles

We have covered most of the hardcore science that I wanted to review when looking at ketosis and ketogenesis.   We have covered most of the relevant biochemistry in terms of how are ketone bodies formed and how they are regulated.  That is all well and good, but I am sure many of you are just wondering how ketosis can benefit you, right?  Well, this article is meant to show you some of the benefits for ketosis. 

Ketogenic diets have been used as therapeutic diets for some conditions for over a century, and while it isn’t used as much anymore, it probably should be.  This article will mainly go over how it can help out those in a disease state; however, I think the mechanisms through which ketones act in the diseases show us some of the power of these energy molecules.  You many not have one of these diseases, but seeing how much they can help with certain conditions certainly makes you think twice about them.

Ketosis Part V: Medium-Chain Triglycerides

We have covered a lot of ground so far in looking over the literature on ketosis and ketogenesis.  We have seen what ketone bodies our body actually uses, and how they are regulated on many levels.

We already know that a high-fat diet is a great way to induce ketogenesis.  However a question many of you may be asking is “Do all fats have the same ketogenic potential?”  Well, the answer to that is no, some fats are better at inducing ketogenesis than others.  The most ketogenic fats we have are the medium-chain fats.

We consume many different kinds of fats, and all these fats vary in two different ways, chain length and saturation.  Saturation refers to the number of double bonds a fatty acid chain has, with no double bonds being a saturated fat, and one or more double bonds being an unsaturated fat.  The medium-chain fatty acids we will talk about here are all saturated fatty acids.  They are called medium-chain because they have between 6 and 12 carbons in their chain (1).  Here are a couple of diagrams of some of these medium-chain fats.

Caproic/Hexanoic Acid

Ketosis IV: Cellular Regulation

As we have seen already the control of ketosis is controlled through a variety of mechanisms in our bodies. And, most importantly, many of these mechanisms are intricately tied to our bodies’ own energy sensing pathways. We have seen ketosis regulation at a variety of levels throughout our bodies.  It can be controlled through conscious action, by eating a high-fat diet or fasting.  It can be controlled throughout our internal environment by hormones and other signaling molecules like insulin and glucagon.  And now we will go down a bit farther even, and look at how ketosis is controlled at the cellular level.  Again this one will be a technical article, so as always if you have questions post them to comments!

Ketosis Part III: Hormonal and Enzymatic Regulation

Alright, and we’re back!  So our story so far has covered what ketone bodies are and how they are formed, and some of the ways we can turn our bodies into ketone body creating machines.   This article will look further at some ways the creation of ketone bodies is regulated.  As I did with the last article I will put out the “lots of science” disclaimer on this article.  This one will be more technical than the last one was, it is just the nature of the beast when you are talking about some of these complex biochemical pathways.

I know that all the weird letters and numbers that represent proteins in our body don’t really mean much to most people, but remember they are really just designations for various receptors our body uses to recognize each specific chemical in our body.  It is important to remember that things in our body usually can’t just go in and out cells and tissues as they please.  Few things in our body just happen.  They are all controlled by various receptors and proteins that help to move them.  So, while I will be presenting the actual biochemistry here, I hope I can bring each section home at the end and give everyone a take home message that will be meaningful.

Ketosis Part II: Regulation

Now that we have a good idea of what ketone bodies are, and how they start to get formed and where I think it is time to loot at the regulation of the process.  I think what has been really interesting to me in researching this topic is that I expected to find some sort of “master switch” for ketosis.  What I mean by that is I figured that something would happen that would turn on ketosis, and as such you are either in ketosis or out of ketosis.  However, as we saw in the last article everyone produces small amounts of ketones at rest, and ketosis is physiologic process that just happens when the substrates are available and are not being used for other processes. 

There are two main types of regulators for ketogenesis, and while they may seem very different to some people, I think they are rather similar.  It all depends on what energy our body is using, and in what amounts.  Ketogenesis can be controlled either through physiologic processes or through enzymatic processes.  We will start with the physiologic ways that ketosis is controlled, and then go to the enzymatic/hormonal ways, since those are probably a bit more complicated.

When we talk about physiologic processes that induce ketosis we are talking about what is going on in our body to make it start naturally producing ketone bodies.  There are three main ways this happens, and a fourth little trick people use to jump start the process (any guesses now what that is?).  The three ways are: starvation/fasting, prolonged exercise, and a low carb/high fat diet.  Let’s take a look at each of these in turn.

Ketosis Part I

Everyone has heard of it, some of you may love it, some of you may hate it.  While most people know the general facts about ketosis, I have been hearing a lot about it lately, and it seems like every time you talk to someone different about it they have a different opinion on it.  Some people think it is the ideal state for our bodies to be in, while some think of it like the plague, and something to be avoided at all costs. Well, I am going to try and clear up some of the confusion on the matter.  This won’t be an easy, or small task, so bear with me as I try and go through all the facts to make sure I get everything right.   As a general game plan I think a good place to start will be what are ketone bodies, how are they made, how are they transported and what tissues can use them.  Then we can move into their metabolism, uses, and long term ketosis.  Other topics will come up along the way, but that is what the information I hope to synthesize here for you.  In order to transmit all of this information we will have to get fairly technical, and I will have some pretty complicated figures presented, but hopefully I can pull out the main points of them for everyone.  Well, let’s get started.