If you’ve been on your phone or watched some TV during the past two years you’ve probably heard about the ketogenic diet. I remember when my classmates in nursing school would come up to me, “Is this keto? Does this have too much sugar? What are net carbs? What are ketones?” The confusion was widespread. Too many clickbait headlines, an overwhelming amount of supplements and new “keto-friendly” foods, the lay person’s understanding of nutrition was flipped upside down overnight.
My name is Mike Hirthler, and I am a registered nurse. During my nursing program at Thomas Jefferson University, the ketogenic diet gained my attention. I listened to some experts lecture on the topic and it had me floored. After asking a professor about their thoughts on the diet as an intervention for type 2 diabetics, and being blown off like a misguided fool, I decided to do some reading.
It became apparent early on in the curriculum that we would not be learning about the fundamentals of nutrition, the benefits and necessity of physical movement, or the importance of quality socialization and sleep. I realized the tools that we can utilize to leverage our health, and that of our patients, weren’t a primary focus of private medical institutions. After conversations with other pharmacy and medical students, I learned their curriculums had no fundamental lectures on nutrition either.
During my first degree in kinesiology at PSU, I gained an appreciation for the importance of proper nutrition and adequate movement to support health. I expected the same general theme to be embraced in nursing school, as I was soon going to be a healthcare worker. Sadly, I was mistaken. I was seemingly holding the minority mindset. Everyone else was so focused on the reactive interventions of medicine, but could care less about the interventions that could prevent a patient from needing our care in the first place. Now don’t get me wrong. Modern medicine is a marvel and the care we are able to give to those who need it is remarkable. But in a nation riddled with lifestyle related preventable chronic diseases, I felt more emphasis was needed on attention to lifestyle. Mainly, nutrition.
Since we didn’t have any lectures on nutrition, I found myself looking on pubmed for studies about diets being recommended as medical interventions. I repeatedly came across the ketogenic diet being used for a wide array of diseases. In comparison to low fat high carb diets, it seemed more effective in decreasing symptomology in Parkinson’s patients, in decreasing neuroinflammation following traumatic brain injuries, and helping many many people climb their way out of their type 2 diabetes.
I found enough literature that I decided to write my final research paper on the efficacy of the ketogenic diet for type 2 diabetics vs the diet recommended by the American Diabetes Association (ADA). The evidence was, and still is glaring. If implemented properly, and if appropriate for the patient, the ketogenic diet is a viable tool to decrease the patient’s needs for anti glycemics, exogenous insulin, and lower their HbA1c to below diabetic levels.
Despite being in good health, I had to give it a shot. While in nursing school I was coaching at a local CrossFit gym and working out frequently. When I would told other coaches and clients I was switching to a ketogenic diet, no one had anything good to say. In their defense, the science doesn’t currently point to it as being the most effective diet for power/strength/anaerobic activities (aka CrossFit). But my goals changed, and instead of using my nutrition to supplement my fitness goals, I used my fitness to supplement my nutrition goals.
I embarked on an 8 week experiment, with more precision than I’d used before while dieting. Ketosis is a physiological shift in your metabolism. It is a series of calculated chemical reactions that rely on proper macronutrient ratios. Unlike eating paleo, vegetarian, or whole 30, where groups of foods are appropriate or not, this diet required me to hit calculated macronutrient goals in order to help my metabolism make the switch from running on carbohydrates to fats.
The lessons I learned were plentiful. The physical feats I achieved were ones I would not have been able to come close to on my previous diet. My mind benefitted just as much as my body, and I now feel comfortable switching to a ketogenic diet when my goals deem it appropriate. From the conversations I’ve had with patients at the bedside, to the discussions I’ve had with athletes around their nutrition, I believe most people could benefit and learn more about their body from experimenting with a ketogenic diet.
On my next post I’ll discuss the history of the ketogenic diet, its current medical implications, the basic physiology of it, and how you can add it to your toolbox if you so decide. In a time when most people take their information from clickbait headlines, I’d like to clean up some of the confusion and share some of the facts about keto with you.