The results were seemingly contradictory: One found that the drink promoted glycogen rebuilding; the other found it did not. But the studies also had very different methods, which makes it hard to compare them directly or draw overall conclusions from them. The one that found that the drink promoted glycogen, for example, gave some athletes a big intravenous infusion of glucose in addition. Athletes will have to weigh whether HVMN Ketone’s purported benefits justify the steep price tag. They may also want to consider whether, in general, ketosis via a ketogenic diet is truly worth aspiring to. Experts said the vast majority of people are better off sticking to a normal diet, and that endurance athletes need carbs in their system for fuel. The body can’t convert fat to energy fast enough to keep up during most kinds of exercises that involve high-intensity sprinting and a high heart rate, Matheny said. One possible exception are ultra-runners, who are traveling very long distances. “If you are trying to do a ketogenic diet with athletic performance in mind, you’re going to see a decrease in your performance,” he said. This isn’t the first time a low-carb diet has been in fashion: The ketogenic diet isn’t so different from the Atkins diet that became popular in the early 2000s. But it’s probably healthier to cut down on carbs without entirely cutting, or nearly cutting, them out.
Then we try to encourage the patient to continue the diet for another 10-14 days, which means about 2-3 weeks of a ketogenic diet. Shubrook: Tell me more about the cyclical diet. Mehta: By definition, a cyclical ketogenic diet means that you do a ketogenic diet from Monday to Saturday and you take Sunday off, and then you go back again Monday to Saturday. I have redefined ketogenic for our patients because we have a different goal. The traditional cyclical ketogenic diet works best for weight loss. We are trying to work on our patients' diabetes to see if we can help reduce the number of medications, improve glycemic control, and maybe even, in the long run if the individual can sustain it, try to reverse their diabetes. Shubrook: So it's a metabolic diet. Mehta: Correct. We are putting the individual into ketosis for 2-3 weeks. Then we pull them out of the ketogenic diet with an initial week of low-carb diet (50-100 g/day), and then an iso carb period (approximately 200 g/day).
A few weeks later, we put them back into ketosis for another 2 or 3 weeks. For example, in a 12-week period, they would do a ketogenic diet for roughly 5 or 6 weeks. During and again at the end of each cycle, we change their medications. During the time in which they are on the ketogenic diet, most of my patients do not require any medications. It's amazing. They love it and they really enjoy being off the medications for those 2 or 3 weeks. Hence, they don't complain about the diet as much. Shubrook: And if the individual feels comfortable that they can keep it up, it is going to make it more possible to do it long-term. Mehta: Absolutely. Plus, having those 2 or 3 weeks off of cycling off the ketogenic diet helps someone to be ready and willing to cycle back on, particularly when they see their medications being reduced even during the time off the ketogenic diet.
They're excited to go back on it and have the possibility of maybe reversing their diabetes. And we add in something else that in my experience works very well: intermittent fasting. We do time-restricted feeding. Patients can eat during an 8-hour window. Then we have 16 hours where they can consume clear liquids, green teas, maybe some black coffee, but they're really not having anything that has calories or is stimulating any metabolic hormones. So far, we have looked at 22 patients with diabetes or prediabetes, with an average duration anywhere from 8 to 10 years, mean A1cs in the 8% range, and an average BMI of 30 kg/m2, which is quite high. We have found, within a 3-month period, that most of these patients were able to bring down their medication use by more than 50%. They dropped their weight, and their A1cs, fasting sugars, and blood pressures all got better. It's very encouraging to see these results, and hopefully we'll be able to sustain them out for a longer time.
These are just initial 3-month results. Shubrook: Long-term results are very critical. Mehta: Yes. It'll be very exciting. Shubrook: The patient that I originally asked you about is vegetarian, a dietary choice that is quite common now regardless of an individual's background. If someone wants to do a ketogenic-like diet but they're vegetarian, how do you approach that? Mehta: There are a lot of myths around this ketogenic diet. It gets beaten up quite often, saying it's very high-fat, bad cholesterol. What we need to keep in mind is that a good ketogenic diet should really not have anything that's deep-fried. You're not trying to eat processed, high-fat foods. We're trying to use good fats. In a vegetarian diet, olive oil is used as the backbone for cooking. We use almond and flaxseed bread, or what we call roti in the Indian diet. Almonds, walnuts, avocado, and chia seeds are a mainstay of the ketogenic diet.
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