The History of the Keto Diet

The Ketogenic diet (Keto) stands for the process of ketogenesis (the production of ketone bodies in the body, as in low sugar/low carbohydrate diets). Ketone bodies are three water-soluble molecules that are produced by the liver from fatty acids during periods of low food intake (fasting), carbohydrate restrictive diets, starvation, or prolonged intense exercise. These ketone bodies are readily picked up by the extra-hepatic tissues, and converted into acetyl-CoA which then enters the citric acid cycle and is oxidized in the mitochondria for energy. In the brain, ketone bodies are also used to make acetyl-CoA into long-chain fatty acids.

In layman’s terms, the body’s favourite food for energy is carbohydrates. For a person to enter ketogenesis, they must restrict their intake of sugar and carbohydrates to (in my case) around 20 grams per day, while at the same time loading-up on animal fat and proteins. About one week into this diet (depending on your level of exercise) a person will go thru the “keto flu.” The symptoms of the “keto flu” are body aches, head ache, and nausea. This will last anywhere from three to seven days (again, depending on your level of exercise). What is happening to produce these flu-like symptoms is that the body is in the process of using up all its store of carbohydrates in the muscles. Afterwards, it turns to a person’s body fat and begins consuming it for energy. At this point, the symptoms will abate and you will have entered ketogenesis. It is very important to stay adequately hydrated in a keto diet. The main reason for this is that the body stores poisons in fatty tissues and when the body is burning fat for energy these toxins will be released into the kidneys and could, possibly, lead to kidney failure. An easy way to check for proper hydration is to  monitor the colour of your urine… Mostly colourless, with only a tinge of yellow is the sign of adequate hydration. There is more to this diet than I have listed here. A good resource for how to successfully enter ketogenesis is to refer to the BeerBiceps YouTube channel: Mistakes & Advice – Weight Loss & Bodybuilding Ketogenic Diet.

One thing I noticed while in ketogenesis is my clarity of mind. A fog, I did not even know existed, lifted and I was absolutely clear of mind. I cannot adequately communicate the feelings of peace and contentment I felt… Only to say that the chattering monkeys of doubt and negative self talk just went away. And my mind was more clear thinking than I had ever experienced before. This euphoria occurs because, as it turns out, ketone bodies are a superior food to fuel the body. It is probably for this reason that early medical practitioners experimented with this type of fasting as a way to alleviate the symptoms of epilepsy.

The first modern scientific study into fasting as a cure for epilepsy was conducted in France, in 1911. Before that time, potassium bromide was used as a treatment, but this method of treatment had the side effect of slowing the patients’ mental capacities. In the study, twenty epilepsy patients followed a low-calorie, vegetarian food plan that was combined with fasting. Two patients showed significant improvements, but most could not adhere to the dietary restrictions. While on the diet, all experienced improvements in mental abilities compared to the effects of taking potassium bromide.

In the 1920s and 30s the ketogenic diet became popular as a therapy for epilepsy. But, the diet was largely abandoned in favor of newer pharmacology for anticonvulsant therapies. Although the majority of epilepsy cases could be effectively controlled using these medications, they still failed to achieve epileptic control in 20% to 30% of epileptics. For these individuals, and particularly for children with epilepsy, the diet was re-introduced in order to manage the condition.

The role of fasting in the treatment of disease has been known for many thousands of years. An early treatise in the Hippocratic Corpus, on the so called “Sacred Disease,” described how alterations in diet played a role in epilepsy management. The same author also describes in “Epidemics” from the collection, how a man was cured of epilepsy when he abstained completely from consuming food or drink.

An American named Bernarr Macfadden, popularized the idea of fasting as a means of restoring health. Hugh Conklin, a student of his and osteopath, introduced fasting as a treatment for controlling epilepsy. Conklin believed that epileptic seizures were caused by a toxin secreted in the intestine and suggested that fasting for 18 to 25 days could cause the toxin to dissipate. His epileptic patients were put on a “water diet,” which he reported cured 90% of children with the condition and 50% of adults. Analysis of the study that was performed later showed that, in fact, 20% of Coklin’s patients became seizure-free, while 50% demonstrated some improvement. The fasting therapy was soon adopted as part of mainstream therapy for epilepsy and in 1916, Dr McMurray reported to the New York Medical Journal that he had successfully treated epileptic patients by prescribing a fast, followed by a diet free of starch and sugar since 1912.

In 1921 the endocrinologist Rollin Woodyatt noted that three water-soluble compounds, acetone, β-hydroxybutyrate and acetoacetate (together called ketone bodies) were produced by the liver as a result of starvation or if they followed a diet rich in fat and low in carbohydrates. Russel Wilder from the Mayo Clinic called this the “ketogenic diet” and used it as a treatment for epilepsy, also in 1921.

Further research in the 1960s showed that more ketones are produced by medium-chain triglycerides (MCTs) per unit of energy because they are transported quickly to the liver via the hepatic portal vein, as opposed to the lymphatic system. In 1971, Peter Huttenlocher devised a ketogenic diet where 60% of the calories came from MCT oil, which allowed more protein and carbohydrates to be included compared with the original ketogenic diet, meaning parents could prepare more enjoyable meals for their children with epilepsy. Many hospitals also adopted the MCT diet in place of the original ketogenic diet, although some used a combination of the two.

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