Last week, I introduced you to the ketogenic diet and how it can benefit brain health, especially after a traumatic brain injury.

This week, I’d like to offer up some important considerations when implementing the ketogenic diet including foods to choose and foods to lose, power foods to eat in abundance, and how to achieve a state of ketosis.

The dietary therapy offered by the ketogenic diet may have far-reaching effects. It can help a brain injury survivor with cognitive and motor impairments, oxidative stress, damaged DNA, and the metabolic changes that occurred upon injury. It can also help improve cognitive performance and prevent age-related cognitive decline in anyone - from those who have a strong family history of Alzheimer’s who would like to prevent getting the disease to executives wanting to improve performance to students looking to improve focus.

In a nutshell, the ketogenic diet is a high fat, low carb, moderate protein approach to eating that switches the body’s metabolism. Where a normal, healthy brain can use glucose for energy, a damaged brain struggles to do so. By restricting carbohydrates and eating the right healthful fats, the body’s metabolism switches to using fat as a main source of fuel. When this fat is metabolized, ketones or ketone bodies are created and used to fuel cells in a much more efficient manner.

Keto: Foods to Choose and Foods to Lose

When eating keto, it’s best to focus on abundance - what you can eat - rather than feeling deprived by thinking about everything you can’t eat. The mindset you take when adopting a ketogenic eating plan, as with everything else in life, can make a huge difference in the outcome.

So, what can you eat? An abundance of fresh low-carb vegetables, berries, meat, poultry, fish, pork, butter, oils, nuts, nut butter, seeds, herbs, and spices.

In addition, the following are some keto “Power Foods” that should be eaten (often) while on a ketogenic diet.

Foods to Choose:

These foods offer many nutrients and various health benefits, while being delicious! For these reasons, they should be enjoyed regularly.

Foods to Loose:

Artificial Sweeteners - are toxic to our bodies and brains.
Corn - is usually a highly genetically modified food that is poorly digested and rapidly spikes blood sugar levels.
Dining out/Restaurant food - damaged and manmade fats are commonly used by restaurants.
Gluten - from all sources, including wheat, flours, condiments, and some spices.
Processed, refined, and packaged foods - are full of refined sugars and flour, additives, and poor-quality ingredients our bodies were never meant to consume.
Starchy Carbohydrates - create a rapid rise in blood sugar levels and make it difficult to stay under 50 grams of net carbs per day.
Sugar - is highly toxic, spikes blood sugar levels rapidly, and contributes to many diseases.

Other things to loose:

Dental amalgams (silver-mercury fillings) - The long-term effects of mercury seeping into your body can be bad news. It can cause depression and a variety of mental disturbances. Remember the Mad Hatter from Alice in Wonderland? His “craziness” seemed from the mercury in his beaver hat being absorbed into his body (and brain). If you do have mercury fillings, find a good dentist who knows how to safely remove them.
Harsh chemical cleaning agents and personal hygiene products - When we stop to think about the chemicals and poisons we put into our body from the food we eat, we shift our thinking and start choosing organic and good quality foods. But have you ever stopped to think about your skin as being the body’s largest organ? The chemicals and products we slather on our skin daily can also have a profound effect on our health.

Important Considerations About the Ketogenic Diet

The keto diet, if done properly, seems to enhance the ability of mitochondria, energy producers of our cells, to deliver our bodies’ energy needs in a way that reduces inflammation and oxidative stress. By optimizing the way our body uses energy, we can also strengthen our bodies’ ability to handle stress.

When I say “done properly”, I’m referring to several considerations - most notably about food quality and cooking methods. Remember theses tips when adopting a keto lifestyle:

Choose non-GMO, organic fruits and vegetables when possible - The best type of vegetables are dark and leafy. These are vegetables high in nutrients but low in carbohydrates like spinach, kale, collard greens, and Swiss chard. Cruciferous vegetables and those that grow above ground are also great choices. Of course, choose organic when possible, as they contain less pesticide residues.
Beef should come from grass-fed animals raised humanly.
Increase consumption of wild caught fatty fish — Wild Alaskan salmon is a great choice to help you get plenty of vital essential fatty acids for your brain.
Chicken, poultry, and pork should be pasture-raised without the use of antibiotics or hormones.
Butter should be grass-fed or clarified.
Bacon should be nitrate-free with no hormones, additives or unnatural preservatives.
Different fats and oils can be cooked or heated at different temperatures, so pay close attention to the note on fats that follows.

Fats:

Since you will be increasing your fat intake on keto, it is important that you use proper fats for various cooking methods.

Olive oil, for example, should never be heated past medium on the stove top, or 400F in the oven. In fact, your best bet is to never heat it, and only use it to drizzle atop salads or foods that have already been cooked.
Butter should not be heated past medium, but ghee can withstand higher temperatures without being damaged.
Fats that can withstand higher heats are coconut oil, grass-fed tallow, avocado oil, and bacon fat. These are the fats to “fry” in or bake on high heat. They are more resilient to heat and do not oxidize quickly.

Dairy:

Though dairy products and cheese is allowed on the keto diet, the lactose in dairy is not-well tolerated by most. If you do consume dairy products, stick to grass-fed butter, full-fat milk from grass-fed cows, or raw milk if it’s available to you. As for cheese, try to choose cheeses that are raw, and less processed (yes, that means stay away from “Laughing Cow” and Velveeta - if these can even be considered cheese!). Raw milk cheddar, parmesan, and other aged cheeses are better options. Harder cheeses also tend to have fewer carbs - a thoughtful consideration when eating keto.

Resistant starch:

These are the carbohydrates or starches our bodies cannot fully digest, so they end up feeding our intestinal microbiome. This helps us maintain a diverse gut microflora, which translates into improved anxiety, IBD, and depression. As resistant starches have such an important job, they should be included in our diet every day. They also have the added benefits of improving satiation, digestion, and insulin sensitivity.

TIP: Cook, cool, and reheat potatoes or rice to increase the amount of resistant starch these foods contain.

MCT oil:

MCT (medium chain triglyceride) oil is a great choice of fats while on keto. It converts to ketones faster than other fats, works to improve cognition and mental clarity, encourages weight loss, and improves blood sugar regulation.

Net Carbs:

“Net carbs” refer to the amount of digestible carbohydrates consumed. Fibre is a carb that cannot be digested and does not have the same effect on the body as other carbohydrates. Subtract the amount of fibre in a food from its total carbohydrates to determine the amount of net cabs.

For example, if you are eating something that has a total carb count of 12 grams, but 5 of those grams are from fibre, the net carb count would be 12 - 5 or 7 grams.

How do I get into Ketosis?

If you think the ketogenic diet may be a good fit for you, you may wonder how to get into ketosis, or how to know your metabolism has shifted from burning sugars to fat for fuel. There are basically three different ways for your body to make this shift from burning glucose to using ketones for energy to achieve a state of ketosis.

One way is through diet. For most, following a high fat, moderate protein, and low carb plan should result in ketosis within about 2-3 weeks. This can vary and is as individual as we are. Be patient. Stick to the diet. And it will happen!

Another way to kick-start ketosis is by fasting. Fasting means different things to different people, but it basically boils down to restricting calorie intake. If done daily for several hours at a time, it is considered “intermittent fasting”. Most people who practice intermittent fasting do a 12-16 hour fast which starts after dinner and extends through the night. That allows for an 8-12 hour window during the day in which to eat. It’s often the least invasive way to fast. For example, if you finish dinner at 6 pm, then refrain from eating until 6 or 7 the next morning, you will have undergone an almost-effortless 12 or 13 hour fast.

Other people like to fast for 24 or 48 hours at a time, and may do this occasionally. This longer period of calorie restriction allows your body and digestive system a break from daily work so that it can devote its energy to cleaning up metabolic debris. For most adults, a 48 hour fast will generally result in ketosis, which can kick-start your efforts. After this fast, following a ketogenic diet will allow you to remain in ketosis.

For someone who has a brian injury, an immediate 24 hour fast can help protect the brain by decreasing oxidative stress at the injury site. It can also improve mitochondrial function (for energy production) and reduce the risk of cognitive decline. However, in order to reap these benefits, it must be done immediately after injury.

Regardless of which type of fast you may be inclined to try, please increase your water consumption (water should be consumed liberally during any fast) to avoid dehydration. Some people also opt for black coffee or plain tea wile fasting to maintain focus. Remember, it’s always best to fast under medical supervision, especially if you have any health issues or concerns.

““A word of caution: Fasting is not recommended for anyone who is underweight, already malnourished, or suffering an illness.” ”

— Kelly

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What the keto diet looks like

Once you have entered ketosis, which takes the average person about 2-3 weeks after following a strict regiment, you may consider 1-2 days each week where you increase carbs to 20%, decrease fat to 60%, and keep protein at 20%. These “carb ups” can be helpful and even healthful if done on occasion - especially if you start to feel too weak or need more carbs to fuel a solid exercise program. Otherwise, you should stick to 70-75% fat, 20-25% protein, and 5% carbs.

What does this look like? (Enter the math teacher in me.)

Each gram of carbohydrates and protein contains 4 calories, while each gram of fat contains 9 calories. To calculate the number of grams of each macronutrient you should eat, start by multiplying your total daily calories by the percentages you’d like to aim for. This will give the total number of calories you should eat of each macronutrient (fat, protein, and carbs). Then divide by the number of calories per gram to figure out how many grams of that macro it’s equivalent to.

For example, if your goal is to eat 2,000 calories per day with 75% fat, 20% protein, and 5% carbs, you would do the following:

Fat: 2000 x 75% = 1,500 calories / 9 = 167 grams of fat per day
Protein: 2000 x 20% = 400 calories / 4 = 100 grams of protein per day
Carbs: 2000 x 5% = 100 calories / 4 = 25 grams of carbs per day

If this is too much for you (if you have a brain injury, it likely will be), don’t worry! There are some great (free) macro trackers available that will do all these calculations for you.

If this is still too much, you can talk to your nutritionist for help, or generally stick to the notion that extremely low carb means you should stay under 50 grams of carbs per day. Some people do best staying under 20 grams, while others can handle 100 grams and still be in ketosis. It all depends on you metabolism and activity level. You may need to experiment to discover what works best for you!

As mentioned in last week’s blog post, the ketogenic diet shows promise for brain injury victims and those suffering from most neurodegenerative disorders. Following a ketogenic plan can improve memory and cognitive function, strengthen the immune system, improve insulin sensitivity, support balanced hormones, and do so much more. However, as with any change in diet or lifestyle, it is always best to check with your doctor or health care provider to see if this diet may be right for you.

If you are already following a keto plan or practice intermittent fasting, I’d like to hear about your experiences. Please drop me a line or write a comment below. I’d love to hear from you!

Coming Soon to HappiHuman.com…

An exciting new program is in the works for anyone looking to improve cognitive performance, prevent Alzheimer’s disease, slow or reverse the signs of age-related cognitive decline, or wanting to learn more about nutrition for the brain!

Benefits of a Ketogenic Diet for Brain Health: Continued