The Fundamentals Of Keto Diets (2)

(Being the concluding part of the article featured last week) 

Micronutrients on a Keto Diet

Conversely to macronutrients, micronutrients must be obtained in the diet in small quantities, but are essential to health. Vitamins and minerals are examples of micronutrients.

When following a ketogenic diet, it is important to be mindful of micronutrient intake because:

• Reducing carbohydrate intake can lower consumption of micronutrient-rich foods (i.e. fruits and vegetables)
• In the initial 28 days of following a ketogenic diet, the balance of some micronutrients (such as sodium, potassium, magnesium, and calcium) can become disturbed due to an increase in their excretion.
• The body resolves this issue naturally after adapting to the diet

Sodium is the principal cation in extracellular fluid. Its functions are related to blood volume maintenance, water balance, and cell membrane potential. Sodium is also essential for acid-base balance and nerve conduction. 

The level of sodium can fall at the start of a ketogenic diet.
Adding extra sodium to meals (like adding salt or consuming bouillon/ bone broth) can reduce the chances of feeling the common side effects associated with low sodium (like cramps).

Potassium is the principal cation in the intracellular fluid. Its primary functions are related to maintaining cell membrane potential and electrical activity in cells such as neurons and cardiomyocytes. As with sodium, levels of potassium fall at the initiation of a ketogenic diet due to increased excretion. When starting a ketogenic diet, include sources of potassium like nuts, dark green vegetables, and avocados.

Magnesium is an essential element in biological systems, especially for nerve, muscle, and immune function. Levels of magnesium also fall at the initiation of a ketogenic diet due to increased excretion. When starting a ketogenic diet, include sources of magnesium like oily fish, dark green vegetables, and seeds.

Calcium has a role in muscle contraction and is important for cardiovascular and bone health. Calcium deficiency is less common during a ketogenic diet, as staples of the diet such as fish, cheese, and leafy greens are rich sources of the mineral.

Considerations When Starting a Keto Diet

As with any new diet or way of life, it's important to look at the lifestyle change from all angles.

Who Should Avoid a Keto Diet?

Based on certain risk factors, following a ketogenic diet may not be suggested for people with the following medical considerations:

• Pregnancy
• Kidney failure
• Impaired liver function
• Impaired fat digestion (gallbladder disease, gastric bypass, pancreatitis)
• Genetic defects in metabolism (CPTI/II deficiency, beta-oxidation defects, fatty acyl dehydrogenase deficiency).

Potential Side Effects

When starting a ketogenic diet there can be a period of 2 - 3 days where blood glucose levels are low, but ketone production has not reached a sufficient rate to provide enough fuel for the brain.
This can result in a series of symptoms, known as the keto flu, which include:

• Headache
• Muscle cramps
• Fatigue 
• Nausea
• Dizziness

Exogenous ketone supplements, such as HVMN Ketone^, and medium-chain triglycerides can be used to reduce symptoms of keto flu. They provide the brain with a source of energy without carbohydrate consumption. These supplements increase the levels of ketones in the blood artificially. Exogenous ketones do not increase the body’s ketone production (of endogenous ketones) and can actually inhibit the release of fatty acids from adipocytes.
It can be initially tricky to adjust food intake to ensure adequate nutrition when following a ketogenic diet. Also, some people find the diet isn’t sustainable due to individual differences in metabolic state or lifestyle. If the diet does not provide the correct balance of macro and micronutrients, some individuals develop other symptoms beyond the keto flu after the adaptation period. These include:

• Constipation
• Bad breath
• Difficulty in maintaining physical performance
• Hair loss
• Gallstones
• Elevated blood triglycerides or cholesterol

To treat these symptoms, ensure the diet provides enough calories and micronutrients. Many people reduce fruit and vegetable consumption on a ketogenic diet (due to carbohydrate content). This means it is easy to become deficient in vitamins and to under-consume fiber.

The ketogenic diet can alter the way that the kidneys excrete electrolytes (such as sodium), so electrolyte supplementation can reduce the side effects of an electrolyte imbalance. A silver lining here is the loss of excess water weight (and thus weight loss) with the decrease in stored water.

Possible Clinical Applications for Ketosis

Some of the earliest reports of the ketogenic diet describe its use in a clinical setting.
In the early 20th century, ketogenic diets helped treat drug-resistant epilepsy. Doctors also prescribed ketogenic diets to treat type 1 diabetes (different than type 2 diabetes, in which people have insulin resistance or don’t respond to insulin) before the invention of insulin.
As analytical techniques progressed, scientists learned that ketones themselves might be a crucial part of the success of the ketogenic diet to treat disease. From this finding stemmed a field of research to examine the potential benefits of ketosis in a range of disease states:

• Weight loss
• Diabetes and metabolic syndrome
• Neurological disease: epilepsy, Alzheimer’s disease, Parkinson’s disease, migraine, concussive disease, and traumatic brain injury
• Cancer
• Inflammatory diseases

While the ketogenic diet is not yet a first-line treatment recommended by doctors for any of these diseases, it’s a relatively easy and tolerable step that patients with these conditions can take to improve their health. Emerging research suggests there may be beneficial effects of ketosis for some people, and further studies are required to confirm how best to use the diet in these clinical settings.

Should You Start a Keto Diet?

We've provided an in-depth look at the keto diet, hopefully giving you all the tools you need to make the best decision for your health. Think about your goals, your lifestyle and how feasible keto is for you (and consult a healthcare professional). While many people have found success on keto for weight loss or performance—everyone is different.

Not seeing results from the keto diet?

You’re not alone. Many think they’re in ketosis but aren’t–the newness of the diet leads to misinformation online. HVMN provides the latest science around meal-timing, supplements and macronutrient composition. Subscribe and be first to know the newest techniques for keto diet results. 

This article is from HVMN, an organization that researches and presents articles discussing health, nutrition and diet, among other topics related to human optimization.