Monday, 29 April 2013

Ketogenic diets - when they're not ketogenic.

High in the Arctic, Eskimo!
It's generally assumed that eating less than 50g/day of carbohydrate results in ketosis. Assume makes an ass out of "u" and "me". From Lyle McDonald's book The Ketogenic Diet:-

The Ketogenic Ratio (KR) = K/AK, where K = Ketogenic stuff and AK = Anti-ketogenic stuff.

K/AK =  (0.9*Fat + 0.46*Protein)/(1.0*Carbohydrate + 0.1*Fat + 0.58*Protein) where Fat, Protein & Carbohydrate are in grams.

For the treatment of epilepsy (very strongly ketogenic), K/AK must be greater than 1.5. For people who want to get into benign dietary ketosis, K/AK can be lower.

Eskimos eat a diet containing virtually zero dietary carbohydrate (~50g/day as muscle & liver glycogen). However, they are not in ketosis. See STUDIES ON THE METABOLISM OF ESKIMOS.

Eskimos eat so much protein that the Anti-ketogenic effect of Protein offsets the Ketogenic effect of Fat + Protein. Table IV is interesting, as it shows how much energy is lost as ketones on the third day of successive fasts in non-Eskimos (Subject #1 fasted once only). Note:- Beta-hydroxybutyric acid  produces 5kcals/g.

Subject #1:- 10.5kcals. ?kcals, ?kcals.
Subject #2:- 100.5kcals, 7.0kcals, 2.75kcals.
Subject #3:-  9.75kcals, 0.0kcals, 0.0kcals.

The answer is "not a lot" (except for Subject #2 on the first fast).

Continued on Ketogenic diets - when they're not ketogenic, Part 2.


Unknown said...

I was actually going to comment on this matter some time back, because I do agree that the Eskimos cannot be used as a positive example to extol the virtues of ketosis. They're not really in ketosis.

Nigel Kinbrum said...

Mind-reading skills - I haz them! ;-)

Unknown said...


Although I'm also left wondering just how much we know of the full picture. It's an old study and who knows, perhaps they do undergo a lot of intermittent ketosis to take the edge off all that gluconeogenesis. A metabolic adaptation with a peculiarly up-scaled gluconeogenic component that's constantly at play would be rather stressful by way of cortisol.

Nigel Kinbrum said...

Living in that cold environment could make all the difference. Maybe Eskimos have a lot of BAT, which allows them to eat whatever they want with the metabolic flexibility to vary their RER from 0.6 (I thought that 0.7 was the lowest it could go!) up to >1.

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