Clinical improvement was observed in Alzheimer's patients fed a ketogenic diet, and this was marked by improved mitochondrial function. (14a) In fact, a European Journal of Clinical Nutrition study pointed to emerging data that suggested the therapeutic use of ketogenic diets for multiple neurological disorders beyond epilepsy and Alzheimer's, including headaches, neurotrauma, Parkinson's disease, sleep disorders, brain cancer, autism and multiple sclerosis. (14b)
Aside from carb flu, be warned that staying in long-term, continuous ketosis may have drawbacks that may actually undermine your health and longevity. To stay on the safe side, I recommend undergoing a cyclic ketogenic diet. The "metabolic magic" that ketosis brings to the mitochondria actually occurs during the refeeding phase, not during the starvation phase.
This short-term hack originated in clinical settings to help obese patients shed excess fat quickly. It was described in Dr. Atkins' New Diet Revolution for the same purpose. The diet consists of 1000 calories or less of almost entirely fat, with a little protein. This can be useful for people who have been on a ketogenic diet for at least three weeks, or who have had a weight plateau that has lasted at least three weeks. Since it's so high in fat, you have to be keto-adapted for it to be effective, not just in ketosis.
In a state of ketosis, your body breaks fat down in the liver and converts it into ketones to be used for energy. Fat doesn't generate an insulin response, so insulin levels remain stable. This makes it much harder to store excess fat, and easier to tap into body fat stores for energy. Not only will this allow you to maintain your weight, but it will greatly encourage weight loss.
There are variations of the ketogenic diet that are implemented for a variety of reasons. One of the top reasons these variations are used are for athletes who are not getting the necessary energy required for their intense workouts. There are also those who enjoy the benefits of ketosis, but they just do not feel the same without a carb refeed day every now and then.
Chickpeas are naturally high in carbs ” a single cup contains 45 grams of carbohydrates.31 However, you can modify the recipe to make it more nutritious. Try this recipe from Pete Evans, which replaces the chickpeas with beetroot.32 Beware, though, that beets have the highest sugar content of all vegetables, so consume them in very controlled amounts.
A related clinical diet for drug-resistant epilepsy is called the medium-chain triglyceride ketogenic diet, in which MCT oil is extensively used because it's more ketogenic than long-chain triglycerides. (13a) Another dietary therapy for epilepsy called Low Glycemic Index Treatment (LGIT) was developed in 2002 as an alternative to the ketogenic diet. LGIT monitors the total amount of carbohydrates consumed daily, and focuses on carbohydrates that have a low glycemic index.) (13b)
I'm honestly a little skeptical about it the idea of keto permanently. My brief glance at the literature seems to imply that it can have side effects of kidney stones, skeletal fractures, and slow the growth rate of children, but that was a study on kids with epilepsy (which it treated very effectively), so who knows how that applies to adults. And the other studies I found dealt with overweight and obese subjects, so it may be hard to find something on the long term effects on otherwise healthy adults.
Although a standard ketogenic diet is even more restrictive in terms of carb intake, a œmoderate keto diet (just as some folks have followed a modified Atkins diet) is another option that will very likely still be able to provide substantial weight loss results and other improvements in symptoms. Including slightly more carbs can be very useful for maintenance, allow for more flexibility, provide a higher fiber intake, and overall may feel more sustainable long term socially and psychologically.
I am also working to share personal success stories on my blog. If you are planning to start this keto diet, please take before pictures, progress pictures, keep a food diary, and keep track of your weight and measurements. Then when you are ready (maybe at your halfway point, or once you reach your goal weight, you can send me your results for me to share with others).
Also make sure that you know what foods have mostly carbs, fat, and protein, so you can make the right choices. For instance, it's not just bread, pasta, chips, cookies, candy, and ice cream that contain carbs. Beans may contain protein, but they're also very high in carbohydrates. Fruit and veggies also mostly contain carbs. The only foods that don't contain carbs are meat (protein) and pure fats, like butter and oils (including olive oil and coconut oil).
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