The Ketogenic Diet - Lyle McDonald

This is a collection of notes from the book "The Ketogenic Diet", by author Lyle McDonald, published in 1998.

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1 Introduction

• Definition: a ketogenic diet is any diet that causes ketone bodies to be produced by the liver, shifting the body’s metabolism away from glucose and towards fat utilization. It restricts carbohydrates below a certain
  level (generally 100 grams per day), inducing a series of adaptations to take place.
• The body runs on a mix of carbohydrates, protein and fat. The removal of carbohydrates forces the body to use alternative fuel, such as free fatty acids (FFA). However, not all organs can use these, the brain and the nervous system can use ketone bodies instead.
• Ketone bodies are a by-product of the incomplete breakdown of FFA in the liver. When ketone bodies are produced at accelerated rates, they accumulate in the bloodstream, causing a metabolic state called ketosis to develop.
• A diet devoid of carbohydrates is unable to sustain high-intensity exercise performance although low-intensity exercise may be performed.
• Targeted Ketogenic Diet (TKD): allows carbohydrates to be consumed immediately around exercise, to sustain performance without affecting ketosis.
• Cyclical Ketogenic Diet (CKD): alternates periods of ketogenic dieting with periods of high-carbohydrate consumption. The period of high-carbohydrate eating refills muscle glycogen to sustain exercise
  performance.

 2 History

• Fasting (the complete abstinence of food) and ketogenic diets are metabolically very similar. The ketogenic diet attempts to mimic the metabolic effects of fasting while food is being consumed.
• In 1921, Dr. Wilder’s ketogenic diet controlled pediatric epilepsy in many cases where drugs and other treatments had failed. In 1994, the ketogenic diet as a treatment for epilepsy was essentially rediscovered. Check out the Charlie Foundation website.
  
• Ketogenic diets have been used for weight loss for at least a century, making occasional appearances into the dieting mainstream.
• The major problem with complete starvation is a large loss of body protein, primarily from muscle tissue. Although protein losses decrease rapidly as starvation continues, up to one half of the total weight lost during a complete fast is muscle and water, a ratio which is unacceptable.
• In the early 70’s, an alternative approach to starvation was developed, termed the Protein Sparing Modified Fast (PSMF).
• The largest increase in public awareness of the ketogenic diet as a fat loss diet was due to “Dr. Atkins Diet Revolution” in the early 1970’s. His diet was openly criticized by the American Medical Association and the
  ketogenic diet fell back into obscurity. Several deaths occurring in dieters following “The Last Chance Diet” - a 300 calorie-per-day liquid protein diet, which bears a superficial resemblance to the PSMF - caused more outcry against ketogenic diets.
  
• In the early 1990’s, Dr. Mauro DiPasquale, a renowned expert on drug use in sports, introduced “The Anabolic Diet” (AD). This diet alternated periods of 5-6 days of low carbohydrate, moderate protein, moderate/high fat eating with periods of 1-2 days of unlimited carbohydrate consumption.
• A few years later, bodybuilding expert Dan Duchaine released the book “Underground Bodyopus: Militant Weight Loss and Recomposition”.
• Most of the criticisms of ketogenic diets for fat loss revolve around the purported negative health effects (i.e. kidney damage) or misconceptions about ketogenic metabolism (i.e. ketones are made out of protein).