A Rebuttal, Part 1 – Ketosis, Epilepsy, and More

I mentioned in my very first post that while I had been thinking about starting a blog to share my keto diet journey, the final push I needed to get this blog started was when another blogger used me personally as a keto “case study” in which she tries to steer people away from the keto diet.

So while this blog will mostly be about me sharing my personal keto diet journey (I have about 85 more pounds I want to lose), and possibly sharing some of my favorite recipes along the way, I do want to start off with three rebuttal posts in response to what she wrote.

And just to be clear, I do not see any reason at all to be mean to Debi, the author of those posts. She seems to be perfectly nice, and I don’t want people being rude to her. I’d just like to keep the comments and discussion to the topic at hand — the ketogenic diet. That’s it. Please. 🙂 We need to be able to talk about and discuss things rationally without making it personal.

First, I’m going to address some things that she wrote in her initial post about the keto diet, which you can find here, and which came right before her four-post series using me as a case study. And I will just warn you ahead of time that this post is going to be long, but hopefully it will be chock full of good info that will help some of you fence-sitters decide whether keto is right for you.

(I’m probably supposed to tell you to check with your doctor first, but if your doctor is giving opinions without having done any kind of deep dive research into keto, or can’t even tell you the difference between ketosis and ketoacidosis, then find a new doctor first.)

Ketosis is unnatural. True or false?

I’m going to skip right over the several errors that Debi makes just in her very first paragraph, and I’m going to skip to the big one. Here’s what she says:

To begin with, “keto” is short for “ketogenic.” The short explanation of what this term means is that it is simply a more extreme version of the low-carb or Atkins diet. Its defining factor, however, is that you’re following it in order to “trick” your body into functioning unnaturally.

So she gets one thing right.

The keto diet is more extreme (she loves that word, but it’s not the one I would use) than a low carb diet. In other words, keto is low carb, but not all low carb diets are keto. While doing the keto diet, most people try to stick with 20 grams of net carbs (that’s total carbs minus dietary fiber) or less each day. A “low carb” diet could be two, or three, or four times that much and still be considered low carb.

But then she gets it wrong.

The keto diet is not, however, a more extreme version of the Atkins diet. The Atkins diet didn’t stress any kind of balance (if you wanted nothing but a big plate of bacon for dinner, fine), it didn’t warn against processed or industrial farmed meats, and it also didn’t explain good fats vs. dangerous fats. But the Atkins diet had an “induction” phase where one limited their carbs to 20 grams per day. That’s the same as keto.

The main differences are that keto stresses balance (high fat, MODERATE protein, low carb), and stresses healthy sources of protein and fat (throw that “vegetable” (i.e., corn), canola, and soybean oil in the garbage).

And then she gets it VERY wrong.

Debi says that ketosis “tricks” your body to functioning unnaturally, but I’m here to tell you…

Ketosis is not unnatural.

I can’t stress that enough, so let me say that another way…

There is absolutely nothing unnatural about the human body using ketone bodies as a source of fuel instead of glucose.

In fact, without this very NATURAL ability to use two different fuel sources, humans would have gone extinct a very long time ago. Here’s what Peter Attia, MD, says about this, from the article entitled Is Ketosis Dangerous?

Why do we make ketones? For starters, it’s a vital evolutionary advantage.  Our brain can only function with glucose and ketones.  Since we can’t store more than about 24 hours’ worth of glucose, we would all die of hypoglycemia if ever forced to fast for more than a day.

Westerners today are rarely, if ever, forced to fast for a day (although it’s interesting to note that almost every major world religion includes fasting), but do you think the same could be said for our hunter-gatherer ancestors? Think about those living in the frozen north of America or Siberia, surrounded by feet of snow for months at a time. Where would they get all of this glucose they supposedly need when it’s -30 degrees (or colder) and there’s very little or no vegetation?

It’s very simple: The human body is made to burn two fuel sources because that’s what we have needed as a species to stay alive and not go extinct.

Side note: This article and this article, also by Dr. Attia, are well worth the read if you truly want to understand this topic even more at a biochemical level. He also describes his own journey, from warning and admonishing low carb patients as a young doctor, to spending two years reading every scientific paper he could find on the topic, to doing keto himself and staying in a strict state of dietary ketosis for three years, which he credits for taking his body from metabolic syndrome to metabolic health. And he had metabolic syndrome even though he was eating a “healthy” diet, and looked to be in great physical condition from getting plenty of exercise as a marathon swimmer.

So which one is better? Ketones or glucose? Well, I have an opinion, based on my own personal experience, and I’m sure you can guess. But let me continue.

Let’s talk about babies.

Human babies, shortly after they’re born, go into ketosis. And they stay in mild ketosis as long as they’re consuming a diet of only breastmilk, which is about 55% fat. And what happens during this time of life? A baby’s brain grows to over half of its adult size in the first three months of life alone. (See here and here.)

So let me break this down…

  • Human babies go into ketosis shortly after being born.
  • The food that nature has provided for newborn babies is breastmilk, which is 55% fat.
  • As long as a baby stays on a diet of only breastmilk, he/she will stay in ketosis.
  • It is during this time that the baby’s brain grows the fastest, growing to half of its adult size during the first three months of life alone.

Does that sound unnatural to you? Or does it sound like nature kind of likes ketones for fueling human brains?

Okay, but what about adults?

Here are some interesting facts.

The human body can only store about 1600 to 2000 calories worth of glucose at a time, and it stores it like this…

  • About 400 calories of that is stored in the liver, and can be released into the bloodstream for use by the brain.
  • The rest is stored in the skeletal muscles, and those muscles are very stingy because they hoard that glucose for themselves and won’t allow it to be released for use by the brain. (source)

By contrast, the body (even that of a fit person with relatively little body fat) has about 40,000 calories worth of ketone bodies that can be used both by the muscles and the brain.

So if glucose is the preferred fuel source of the body, why can it store so little, and why does it have to be replenished so often?

Let’s look at how this plays out in the real world in the example of a marathon runner. An entire marathon will use about 2600 calories. (Source)

  • A person fueling their body with fat (ketone bodies) is set with plenty of fuel for the entire race at the outset. Actually, they have enough for 15 marathons.
  • A person running their body on glucose starts out with a deficit. They need 2600, but their body only has about 2000. So what does this mean?
    • Carb loading before the race, which includes consuming sugar-filled food or drink before the race begins. That carbohydrate load will last 40 minutes to an hour.
    • After that, the runner needs to take in 100 to 250 calories (or 25 to 60 grams of carbs) per hour. That’s 16 to 40 ounces of a sugar-filled sports drink, like Gatorade per hour.

So Debi claimed she was going to take a “common sense” look at this topic. What does YOUR common sense tell you about this? Does the body prefer glucose or ketone bodies?

But wait! There’s more! Because this efficiency improves performance. There are so many articles explaining this both from a biochemical level as well as anecdotally. Here’s one person’s experience:

I didn’t just beat my best time running on a keto diet — I crushed it.

And speaking of performance, there’s an awesome story in this podcast about an ultra marathoner named Mike Nanaszko (who happens to be a neurosurgeon) who eats a keto diet. He ran the Monument Valley ultra marathon (50 miles) in 2017 and not only won, but he did so well (finishing more than an hour before the #2 person) that they accused him of cheating. He had to pull out his GPS watch and show that he actually did run the entire thing.

These stories aren’t outliers, by the way. And I’ve only touched on the physical performance. There’s plenty of info about improved cognitive function when burning ketones instead of glucose as well, but that will have to wait. (But here’s a little taste of what new research shows about the effects of ketones on brains with Alzheimer’s and other brain disorders, and then she shared this.)

So we can add at least one more “common sense” question onto the pile.

If glucose is the body’s preferred fuel, then why does the body’s physical endurance and mental acuity improve when burning ketones? 

Okay, let’s move on.

Keto for epilepsy. But is that it?

Let me paraphrase what Debi says about this: Keto has been used in the treatment of children with epilepsy since the 1920s, but only in certain situations and under close medical supervision. But then it somehow caught on, it became a craze, and people started twisting the facts in order to make a buck.

Hmmm…that’s interesting.

So I thought you might be interested in what an actual epilepsy doctor thinks about keto for general use.

Let me introduce you to Dr. Kris Smith.

Dr. Kris Smith is a neurosurgeon at Barrow Neurological Institute in Phoenix, which is the world’s largest neurological disease treatment and research institution, and is one of the best neurological training centers in the U.S.

Dr. Smith is the primary epilepsy surgeon at Barrow, and is the director of their Epilepsy Surgery Fellowship. His other areas of specialty include brain tumors, such as glioblastomas, but he has many other specialties as well.

And Dr. Kris Smith eats a ketogenic diet.

This is an awesome interview with him from beginning to end, but let me share a small excerpt from the interview.

Dave Asprey: I’m interested in not getting a glioblastoma, or frankly, any other kind of cancer. Given what you know, which is more than most…uh, in fact, let me ask you this, what do you do in order to reduce your odds of getting brain cancer?

Dr. Smith: Right. So, I am trying to avoid getting Alzheimer’s disease. I’m trying to avoid getting any degenerative neuro disease, including glioblastoma, and that means that I am an avid follower of the ketogenic diet….”

He goes on to list other things, like getting out in nature, etc. Be sure and listen to the whole interview. It’s amazing.

And don’t miss the part in the interview where he says that half of his fellow neurosurgeons at Barrows are also on the ketogenic diet.

So there you have it, right from the mouth of an actual epilepsy doctor.

So what about that poor hypothetical woman (PHW)?

Debi ends her first post giving some example of what she calls a “poor hypothetical woman” trying to stay on a keto diet.

Look, all I can tell you is that from my own personal experience, keto is the only diet I’ve ever done that seems absolutely sustainable for the rest of my life (which, hopefully by now, we all realize would be perfectly safe and not unnatural in the least).

I love how keto makes me feel, and the mental and physical differences in my body (other than just simple weight loss) have been ASTOUNDING. I’ll write more about that in detail in a later post.

I’ve done other diets. LOTS of other diets. And I don’t even know if I can explain it, but the biggest difference is this…

On other diets, I can eat and feel full. But I never feel satisfied. My belly might have food in it, but my brain wants more. It wants something different. Therefore, on other diets, I was always thinking about food. When can I eat next? What am I going to eat? Can I have a snack? What am I going to eat tomorrow? My body was dissatisfied, so my mind was consumed.

Doing the keto diet is literally the first time in my entire life I’ve ever experienced the feeling of being truly satiated. I never knew what that word truly meant, or what that actually felt like, until doing keto. But the difference between “full” and “satiated” is so vast, and it’s the key.

On keto, I eat my one meal per day (I’ll share more on that later, as well), and I honest to goodness don’t even think about food for the rest of the day. That feeling of being satiated is both physical and mental, and it’s something that only keto has ever delivered to me.

And for that reason alone, keto is the easiest diet I’ve ever done. Ever. So I wish I could meet this “poor hypothetical woman” in person, because if she’s struggling, I have a feeling she’s doing it wrong.

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  • Reply
    February 1, 2019 at 4:04 pm

    Hi Kristi,

    Personally if I were you I would read up on and download a “Cease and Desist” letter to this woman who is trying to capitalize on your good name and brand in order to enrich herself at your expense. What she is doing is illegal. I would not respond, I would get serious and I would put a plug in her efforts to derail you. I am serious. What she is doing is not legal and not cool at all. You own no one an explanation. She would not bother to do this if you were not a known and respected blogger. Protect your good name now, the law is on your side.

    • Reply
      February 1, 2019 at 4:10 pm

      She’s fine. 🙂 I believe very strongly in our First Amendment rights, so she can write whatever she wants. I just view it as a good starting off point to address some of the main objections held by thousands of people who refuse to look at the actual science, but have some emotional knee-jerk reaction to hearing about keto after reading some article in Popular Science or Vox, or listening to Jullian Michaels bash keto, when she’s very obviously trying to protect her financial interests.

  • Reply
    February 1, 2019 at 6:01 pm

    Nobody bats an eye when you’re eating unhealthy, but throw the word “keto” in conversation and people lose. their. minds. 🙄
    I do a loose keto after being diagnosed as having “non-celiac gluten sensitivity”. If I consume too much gluten, I essentially feel like I have the flu. I got diagnosed with that after 6 months of testing for literally everything. I’m not kidding. They were even testing cancer markers. I had every single symptom of hypothyroidism but my thyroid levels were well within normal range. We even tried therapeutic doses of thyroid meds just to see if it helped and nothing. Only a GF diet has given me my life back and only keto has given me any weight loss. You do you, girl. I’m disappointed that the person used you by name as a case study without doing her due diligence by actually interviewing you, studying your actual diet over time, taking note if changes in mental and physical well-being. It’s pretty shady to use someone as a “case study” without actually studying. I’m sorry that happened to you and I really respect your willingness to respect her right to free speech and handle this in an adult manner.
    I’ve been reading A2D since, gosh, maybe the condo and I will be peeping along on this one for recipes.

  • Reply
    February 1, 2019 at 6:09 pm

    Thanks for adding an email sign-up for this site. Didn’t want to miss anything.

  • Reply
    February 1, 2019 at 7:43 pm

    I’m keto too. Down 27 pounds in five months. It’s not fast but it’s working and I feel great!! Like you, it’s a diet I feel like I can stick to for the rest of my life. Looking forward to seeing your recipes!

  • Reply
    February 5, 2019 at 6:10 pm

    This was so great and I am so happy you among others on the web are putting the facts about Keto out there. I’ve been Keto since June 9th and I have never felt better and had more control over my food intake. I have lost weight but more importantly I am not stuck in some vicious cycle of food abuse and depression over not being able to control myself when it comes to food. This is a lifestyle diet not a temporary diet as western culture has come to know and it is completely natural. After about 2 months I felt like how have we not known about this for so long?? All those years of suffering and I could have been eating the way my body intended. Thank you Kristi I hope others read your blog and see for themselves how natural this is and their bodies will thank them 🙂

  • Reply
    February 5, 2019 at 10:41 pm

    Thanks for this, I’m really looking forward to reading it. I’ve been on my own modified Keto journey, given me by my very credible and highly respected doctor (I realize everyone will just have to take my word on that). I smiled as I read your posts because they are just as comprehensive and organized as your decorating posts. Big win! The ‘blogger’ lost me with her rambling criticism but if it spurred you on that’s great, I’ll stick with this right here. I welcome a Keto community that I can be part of; this feels like it will be just right.

  • Reply
    February 6, 2019 at 1:28 am

    P.S. I saw your IG stories and I think you look fabulous! Congratulations on your weight loss!

    • Reply
      February 6, 2019 at 1:31 am

      Thank you, Nancy! And that’s with 85 pounds left to lose. I won’t even recognize myself when I’m finished. 😀

  • Reply
    Guerrina Hernandez
    February 8, 2019 at 6:44 pm

    Just catching up! I started Atkins in the 70s. It’s been revised at least once. My son and his girlfriend are doing Keto last year so I read up on that. My son started out Keto with 50 grams carbs per day (highest allowable) and his girlfriend at 30. They both slowly and steadily lost weight and their docs said keep up what you’re doing.

    I find the Keto more relaxed than Atkins, but more difficult to break the sugar addiction.

    My doctor is all for me continuing Atkins at each level based on my bloodwork labs. Nope, lol, I don’t consume plates of bacon or other high fats in large amounts consistently. Only the first 2 weeks if I’m in weightloss mode do I have more fat
    On Atkins you learn your carb grams that will maintain your weight.

    For me it’s personal preference whether one chooses low carb like Atkins or Keto. They work.

    Now on to your Rebuttal 2!

  • Reply
    April 12, 2019 at 6:52 pm

    I’ve been doing Keto-OMAD for one month and am down 15lbs (which included one week when I lost nothing at all – seemingly). I have to agree that once you get into the mode of understanding what you can and can’t eat it is the easiest WOE that I have ever done – and it helps me to manage (eliminate?) my gluttony. I’m full after eating for many hours, I’m not hugely hungry even at the end of the 23 hours, and my aches and pains have completely disappeared. I had a little blip ensuring I was getting in my electrolytes but with a bit of a tweak (this past week) I’m feeling great. At this point, it seems that this will be a completely sustainable way of eating in the long term – so far I haven’t fallen off the wagon or cheated. I’ve put a few things in the freezer to manage things when days slide off the schedule so I’m not caught out. I think it’s ok for somebody to disagree with this WOE and I woudn’t mind them even mentioning it – I’m both British and Canadian but would agree (counter to both sets of country-men, largely) with freedom of speech. What puzzles me is why your opposer would waste time being so indignant about someone she doesn’t know – what would she get out of it? But I suppose people can spend their time how they like too. I wish you continued success, Kristi. I’d like to go down by 120lbs and your meals have given me a couple more ideas to get to that point. Best wishes for your Keto and your decorating.

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