The Ketogenic Diet

With Dr. Eric Madrid

Eric Madrid

Family Physician

Dr. Madrid sees patients at our Hemet and Menifee locations. You can learn more about him by clicking the link below.

There are two sources of fuel for the human body.  The first and most common is sugar.  200 years ago, the average American consumed 7 pounds (3.2 kg) or sugar per year. Now in 2020, that number is close to 120 pounds (55 kg) per year.   This fact may likely explain the increase in obesity, high cholesterol, diabetes and possibly even cancer in our society (a cancer cell’s primary source of fuel is sugar).  

Prior to the advent of anti-seizure and diabetic medications, a low carbohydrate diet was the approach doctors used with patients to not only prevent seizures, but also to control diabetes (which was rare 100 years ago). Few people realize that simple carbohydrates such as rice, bread, pasta and tortillas break down into sugar once consumed and digested.  When the intake of simple carbohydrates and /or sugar is reduced to less than 50 grams per day for more than a few days, the body will need to start burning fat for energy.  This is how weight loss occurs and ketosis can begin.  

Traditionally, the keto diet is defined as a diet where 60-70% of the total calories are from fat (such as avocado, fish, nuts, cheese, MCT oil, etc.), 20-25% from protein (meat, fish, chicken, nuts, green leafy vegetables) and 5% from carbohydrates (strawberries, blueberries, etc.). Ketosis occurs when fat tissue is broken down into free fatty acids.  These fatty acids are then transported to the liver where the liver will convert them to ketones, molecules which act as an alternative fuel source. I frequently explain to patients that ketones are like “high octane fuel” for the body.  They are a “cleaner burning fuel” that both the brain and the rest the body can utilize when sugar intake is reduced.  Use of ketones for fuel, as opposed to sugar, also results in less oxidative damage to one’s body. 

Ketosis can mean a lot of things to a lot of people.  The ketosis diet which I recommend is rich in servings of green leafy vegetables. It also includes healthy fats, seafood, meat, chicken, eggs, cheese, nuts and seeds. Moderation is key!  What is typically avoided are sweets, sugars, bread, rice, tortillas, potatoes, beans and other processed foods. While I recognize a ketogenic diet may not be for everybody, it can be a great alternative for those who have not succeeded in controlling their weight or diabetes using other low-calorie diets. Many who are carbohydrate sensitive (or insulin resistant) and have trouble controlling their blood sugar levels, have also seen significant benefits when going on a low carbohydrate, high healthy fat diet.

I personally went on the keto diet back in the summer of 2017.  I was inspired by Dr. Jason Fung’s book, The Obesity Code. At that point, I had reached my peak weight of 247 pounds.  Although I am 6 feet 3 inches tall, clothes were not fitting right and sleep was not refreshing. In addition, my knees and back were hurting, despite never having a history of an injury. After 90 days, 100 % committed to a low-carb lifestyle, I found myself down 30 pounds (14 kg).  I was able to accomplish all this without rigorous exercise, but only maintaining my usual 30 minute walk, 3 to 5 days per week. The low-carb approach allowed me to lose the weight that I had been trying to get rid of for more than 10 years. As a result of my success, many patients inquired as to what I was doing, so I shared with them my strategy.

A year and a half later, I’ve had dozens of patients significantly improve their blood pressure, lose weight and sleep better. Several patients have reversed their sleep apnea. I have also had nine patients with type two diabetes—but requiring insulin—get off of their insulin. In addition, I’ve had another dozen or more type 2 diabetic patients who have been able to stop their diabetic medications altogether, or significantly reduce the number of medications they are taking.  (NOTE: It is important never stop a medication without first consulting with your physician).

Lastly, a big part of this food plan includes what is referred to as intermittent fasting. Intermittent fasting (IF) is the concept that one should fast, or not eat, during a fixed time window. Many start with a 12:12 program, which means fasting for 12 hours, then eating a keto diet during the next 12 hour window.  For example, eat between 7 AM and 7 PM, fast from 7 PM to 7 AM. No snacking after 7 PM!  Many also will fast in 16:8 intervals.  This involves fasting for 16 hours, then eating a keto diet during an 8-hour time window.   During the fasting window, water, coffee and unsweetened beverages are allowed.  Overall, fasting helps improve the one’s metabolism, assists with weight loss and gives the gut time to heal.

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