Dr.Fox, the lifting dermatologist, asked me 3 amazing questions, and today I'm delighted to answer them.
How many people are using ketogenic diets?
That is an excellent and truly scientific question. In order to answer it properly we would need a good epidemiological study that uses an extensive and well-defined survey methodology. I did a quick literature search (that turned out to be not-so-quick) and realized that there is not much literature of this kind out there. There are some large prospective studies on nutrition, but, unfortunately, they report their carbohydrate intake in quintiles and seem to use “lower” carbohydrate intake groups where participants would still report high quantities of carbohydrate consumed i.e. <40% of dietary intake would come from carbohydrates. Yes, it's lower than average, but it's not even close to a classical low-carbohydrate of ketogenic diet.
After several hours of searching, I came across the study of Blanck et al1 published in 2006 and based on a telephone survey of 9,300 Americans. The authors reported that among their respondents 12.5% reported ever used a low-carbohydrate diet and 3.4% reported current use, which I think is a good snapshot of low-carbohydrate diet use. This study is of decent size, but it's limited to one geographic area and somewhat outdated. That's the best I have at the moment, but I promise to keep my eyes open and making a follow-up report is I come across something new.
As a side note I would like to say that low-carb diets provide a certain metabolic or hormonal advantage in comparison to a simple low-calorie diet, but at the same time you still need to be in a caloric deficit to lose weight and you still need certain macronutrients in order to build muscle, which brings us to the next question.
What are the advantages of ketogenic diet for a weightlifter?
I think that the most important part of this question is how do we build muscle and work out with minimal amounts of carbohydrates, which are well-known to be a fast fuel for working out? I must say, that I've been using low-carb diets for a long enough time to say that after a couple of weeks on a diet your body completely switches to using fat as a source of energy, the process called ketoadaptation. Also, some tissues do require glucose and our body can create it from certain amino acids. In addition to that, as a weightlifter, you would want to maximize the anabolic effects of insulin. The good thing is that carbohydrates are not the only macronutrient that increases insulin levels, protein has a similar effect and thus, my main suggestion would be to increase the amount of protein you consume as it will serve three functions:
1. Building blocks for you muscles
2. Increase of insulin
3. Converted into glucose for our red blood cells
I would say that this would be the best solution in my opinion, but there is also another one – you can use planned refeed days or meals when you will consume limited quantities of carbohydrates paired with intensive workouts. Carbohydrates will be used up as energy, they will cause a spike of insulin and also they will be used to replenish the glycogen storages in your muscles, thus making them bigger and more pumped. Having said that, I would recommend not overusing these refeed meals too much as they tend to break your ketogenic status and slow down weight loss. But that brings us to the third question.
How do I manage a ketogenic diet with all the high-carb temptations in my family?
The original study provided us with a valuable set of data, It looks like adherence to the low-carbohydrate diets is their major flaw. We are exposed to multiple sources of carbohydrates on daily basis and many of these sources are very tempting. I love ice cream, I really enjoy good artisan breads and sandwiches, I love fries and burgers, and I totally enjoy a plate of nachos with my movies. But, we have to set our priorities straight, yielding to these temptations sets us back in our progress, sometimes it takes several days or even more to get back on track. Again, I don't think that being on a ketogenic diet is the fix-it-all solution, being in caloric deficit is, but if you decide to go on a low-carb diet, it's better to stick to it religiously. One solution is to convince your family to use this approach, which might be fair as the low-carb dieting has a number of health advantages overall, but at the same time, again, it doesn't solve all the problems and you don't want to deprive your whole family from lots of amazing meals they might like.
Here, we can use the refeed meals strategy again – just plan them thoroughly: they should be paired with an intense workout, and I would suggest limiting the total amount of carbs you consume to the approximate amount of glycogen / energy you use up during your workout. Somewhere around 150-200 g of carbs would do, but the amounts would vary from person to person. Again, I would not recommend doing it too often and I would only suggest using refeeds if you are already at your goal body fat percentage.
These were my answers and I would like to thank my colleague, Dr.Fox, for these amazing questions and for his hard work. For the rest of my followers – as always, feel free to ask questions, to make comments and to explore my website and to subscribe to my YouTube channel for updates.
Sincerely Yours,
Dr.Sam
Video: Inspirational Q&A #3 Three keto questions from Dr.Fox
References:
Blanck HM, Gillespie C, Serdula MK, Khan LK, Galusk DA, Ainsworth BE. Use of low-carbohydrate, high-protein diets among americans: correlates, duration, and weight loss. MedGenMed : Medscape general medicine. 2006;8(2):5.