Critical Thinking in Ketogenic Application
NUTRITION
BT Watts
DC, CSCS, CFMP
There is a definitive weight-loss movement slowly creeping its way across the country, gradually making a comeback in the consciousness of consumers, and ever so slightly creating a large patient base for the natural healthcare provider— the ketogenic lifestyle.
The ketogenic diet/lifestyle is bringing some sense to the weight-loss industry in a section of health care usually reserved for the monotony of calorie counting and tail-busting exercise routines. The strategies of butter in coffee, high levels of dietaiy fats, no-carb diet, and fasting are quite the rage. The ketogenic movement is throwing calorie counting by the wayside—in form and fashion—in a way that has not been seen in the weight-loss industry in 50 years. Yes, the ketogenic movement has gained enough traction that there are now innumerable books, podcasts, and supplements dedicated to the advancement of the movement.
Ketogenic-based dietaiy recommendations were first discussed in the medical field by Johns Hopkins researchers all the way back in the 1920s. Their “no-carb” dietaiy approach was a revelation for those suffering from a variety of neurologic pathologies. Traditionally, a ketogenic diet consists of getting nearly 75% of energy intake from dietaiy fats, 20% from protein, and around 5% from carbohydrates—very strict indeed! While the template is extreme, most “keto” diets today are variations of the original in which the percentages are modified for flexibility. The modification, mainly for carbohydrate intake, allows for better patient follow-through and, thus, long-term progress.
As a natural healthcare provider, obviously the long-term progress is the point of interest. It’s my opinion that any good doctor or healthcare provider knows the value of lifestyle modifications, especially when it comes to food. As the ketogenic lifestyle gains more steam and further grows in popularity, you’ll witness both the benefits and side effects of a fat-laden diet that prioritizes ketones rather than glucose as a source of fuel.
Much of the consumer-driven positivity surrounding the ketogenic-lifestyle is centered on the aesthetics of losing weight. After all, who doesn’t want to look and feel better? Proponents of the keto-lifestyle also note increased energy levels, better clarity of thought, and better sleep.
While the benefits are sure to get most of the media attention, there is also an aspect that you’ll see in clinical practice where tlie body fat percentage of some patients just doesn’t budge. They have the body mass to lose, but the scale just won’t cooperate,
“As the ketogenic lifestyle gains more steam and further grows in popularity, you’ll witness both the benefits and side effects of a fat-laden diet that prioritizes ketones rather than glucose as a source of fuel."
These individuals implement the keto-lifestyle the right way, yet their body is unwilling or unable to shed the excess fat. This response, or lack thereof, is often perplexing for the clinician and demoralizing for the patient.
With a little critical thinking, this challenge can be overcome with many patients. Body fat acts not only as a storage facility for excess energy, but also as a buffering or insulating agent against fat-soluble chemicals. That is to say, the fat is
a protective mechanism against toxicity, especially in those suffering with type 2 diabetes or fatty liver changes. In these instances, a ketogenic diet often will not work from a weight loss perspective. In this situation, the body seems to be making a decision that it is better to be overweight than toxic. Patients in this situation often feel like a “medical mystery,” and their frustration is a result of putting “the cart before the horse,” so to speak.
When fat cells are harboring fatsoluble material that your liver should be clearing out (but isn’t) through phase one and two detoxification mechanisms, they are not going to give up their volume easily. In this scenario, if adipose cells were to decrease their fat content but not the fat-soluble chemicals they are also harboring, you’d be in a toxic mess relatively swiftly.
It’s these patients who walk into your clinic and lament about not being able to lose weight. It’s these patients who have “tried” every diet known to man. Sure, they may lose weight as they starve themselves, but only to see the signs and symptoms of toxicity; brain fog, physical pain, and headaches are a mainstay. Symptoms of toxicity are rarely enjoyable and often leave the patient with confusion as they “thought they were supposed to feel better at a lighter weight.”
Inevitably, the weight makes a comeback as the body tries to return to chemical homeostasis, except the fashion and fury of the weight gain is even worse than before. Thus, the yo-yo effect of the serial dieter.
It’s these patients whom you ultimately have the ability to help through critical thinking. If we are willing to do the hard work of thinking and thorough inspection, we can then recognize the pattern, customize an approach that deals with the cause, and ultimately provide unparalleled value to our patient population. Fads come in and out of popularity over time, and some of them may actually prove to be of value to the patient, but nothing can replace the expertise and value of a superior clinician.
These patients, and there are a lot of them out there, require a gentle metabolic clearing program to support their body’s natural ability to detoxify and decrease the allostatic load.
Metabolic clearing means supporting natural chemical clearance through the proper support of phases one, two, and three of our detoxification pathways. In other words, it facilitates the elimination of toxins from the fat matrix.
A well-designed metabolic clearing program not only provides all of the necessary nutrients and cofactors, but it also creates an easy-to-follow road map for the patient to follow. The road map provides simple and clear instructions—an “easy to follow” process that removes the roadblocks to their weight loss and health goals.
If you are a healthcare provider who assists with weight loss, don’t get sucked into the “eat less and exercise more mentality.” Many of your patients do not need to work harder. Instead, they often need you to provide them with a thoughtful approach, scientific reasoning as to why they are straggling, and sometimes, above all, hope! Providing this type of value is a win-win.
References
EurJ Clin Nutr. 2013 Aug; 67(8): 789-96. doi: 10.1038/ejcn.2013.116. Epub 2013 Jun 26. Beyond weight loss: a review of the therapeutic uses of very-low carbohydrate (ketogenic) diets. PaoliAl, Rubini A, VolekJS, Grimaldi KA.
Dr. Watts is a highly respected and experienced leader in the space of health and wellness and in particular Functional Medicine & Clinical Nutrition. He has extensive experience in clinical practice having re-
viewed and analyzed more than 15,000 lab panels. Dr. Watts has been instrumental in helping thousands of chronically ill patients return to health. He is also a very accomplished trainer of other clinicians and has been instrumental in helping thousands of chronically ill patients return to health. Dr. Watts is also a very accomplished trainer of other clinicians in the area of laboratory analysis and patient care. For more information on this and other products visit www.biogenetix. com or call us at 720-287-2155.
