Author: Casey Thaler

 


The standard American diet is quite high in carbohydrates. French fries, pizza, popcorn, chips, candy, soda - these are (unfortunately) the cornerstones of many American diets. A ketogenic diet turns this approach on its head, as in it completely reverses the macronutrient ratio. High in fat, extremely low in carbohydrates - and great for weight loss. The keto diet is rapidly gaining in popularity, and monthly Google searches have expanded to over one million per month to prove it.

But switching to a keto diet isn’t always easy; the adaptation period can be notoriously bad, especially if you quickly switch from eating tons of carbs to eating none. Or if you don’t carefully consider what nutrients and other elements are needed to support a healthy keto diet. While the high fat nature of the keto diet gets a lot of press, what’s less focused on yet equally as important is the need for electrolytes, and micronutrient deficiencies that can develop (if you fail to follow a carefully crafted plan).

Because starches, fruits, sugar, and other foods are limited in consumption, we must consider what else these foods provide besides carbohydrates. Vitamins, minerals, micronutrients, etc. Since our body is switching from burning glucose for fuel, to using fat, it’s in need of even more nutrients during the transition process. For example, sodium excretion goes up when we switch to a keto approach, which means you need to intake more sodium than usual to support the change.

This adaptation period is commonly referred to as the ‘keto flu.’ Much like the regular flu, there is a laundry list of symptoms that occur when switching from carbs to fat as our main source of fuel. Sleeplessness, brain fog, fatigue, muscle cramps, nausea, irritability, and constipation (to name a few) are all common side effects and symptoms of the keto flu. While there is no established, scientific diegnostic behind the keto flu, everyone who goes keto can attest to how very real it is.

The first thing we need to mention - you’ll want to do all you can to minimize the symptoms, which almost goes without saying. Much like the regular flu, the keto flu is incredibly uncomfortable and will leave you feeling pretty crumby. The best thing to start with? Drink plenty of water. The standard recommendation is 8 glasses (of 8 ounces) of water per day, but shockingly, many of us don’t even hit this relatively low number. While going keto can require more water in general, clearly most of us don’t drink enough of it to start with. 

A better number to shoot for would be 16 glasses, or simply one gallon of water per day. Exercise, a keto diet, and numerous other factors can also increase the need for water consumption. For example, I drink slightly under a gallon and a half of water, per day, I exercise regularly, and I consume a keto diet - so ‘extra’ water helps me maintain optimal health. And this extra consumption of water is even more crucially important during the keto adaptation phase.

That’s because, while less severe in nature, carbohydrate and sugar withdrawal is not all that different than drug withdrawal. Essentially, you are reprogramming and retraining your cells to function in a different way, and without the fuel they have grown accustomed to consuming regularly. Sugar is the most direct element to this drug analogy - as it rewards the brain in the same way as many addictive substances.

As our blood sugar drops in response to fewer carbohydrates, we fall into hypoglycemia (low blood sugar). Then our hormones, water levels, and electrolytes all need to adjust to a much lower carb intake. This sounds easy, but it often takes days or weeks. As we intake more dietary fat, our body takes this fat and breaks it down into ketones, which our body and brain uses for energy. However, if we eat too much protein our body can actually be kicked out ketosis. This is because our body actually takes this excess protein and breaks it down via a process called gluconeogenesis.

This process is different from beta-oxidation, which is the process where dietary fat is turned into energy. Essentially, the keto flu is largely caused by the period where the body doesn’t really know what’s going on, when it’s ultimately just suffering from low blood sugar. Since it automatically thinks more energy is coming via carbs, it doesn’t know what to do with all the extra fat, and as a result you can feel sluggish and cranky. The expected energy - carbs - aren’t actually coming. Eventually your body adapts, but not before the flu period.

Another interesting mechanism is the dopamine system which is altered via regular carbohydrate and sugar consumption. Essentially, over time, our brain becomes more accustomed to these substances and as a result wants more and more. By taking away carbs and sugar (especially when done abruptly) - we notice a change in dopamine, and tend to feel cranky as a result.

Calcium, potassium, sodium, magnesium, and chloride. What do all of these have in common? They are all electrolytes and they’re crucially for our body to function properly. When switching to a keto diet - you guessed it - these may be in short supply. Less insulin is released when we consume fewer carbs, which causes the kidneys to get confused; they store less water, which explains our need for increased water consumption. This is also where more sodium intake is required - since your body naturally expects more, you need to increase sodium intake during the process of shifting into ketosis.

So in summary - what’s the best way to combat and avoid the dreaded effects of the keto flu? Drink plenty of water, eat plenty of fat, rest, avoid strenuous exercise at first, and supplement accordingly. Supplementing with additional ketones, electrolytes, vitamins, and minerals will help your body adapt much more easily, and much faster. And remember - the keto flu isn’t forever. Stick it out for a few days or weeks that it’s there. Soon you’ll reap the rewards of being a certified, ketogenic, fat burner!

 

Scientific References

 

Paoli A., Cenci L., Grimaldi K.A. Effect of ketogenic mediterranean diet with phytoextracts and low carbohydrates/high-protein meals on weight, cardiovascular risk factors, body composition and diet compliance in Italian council employees. Nutr. J. 2011;10 doi: 10.1186/1475-2891-10-112. ]   

Sumithran P., Prendergast L.A., Delbridge E., Purcell K., Shulkes A., Kriketos A., Proietto J. Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur. J. Clin. Nutr. 2013;67:759–764. doi: 10.1038/ejcn.2013.90.   

Johnstone A.M., Horgan G.W., Murison S.D., Bremner D.M., Lobley G.E. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Amer. J. Clin. Nutr. 2008;87:44–55.  

Cahill G.F., Jr. Fuel metabolism in starvation. Annu. Rev. Nutr. 2006;26:1–22. doi: 10.1146/annurev.nutr.26.061505.111258.   

Paoli A., Cenci L., Fancelli M., Parmagnani A., Fratter A., Cucchi A., Bianco A. Ketogenic diet and phytoextracts comparison of the efficacy of mediterranean, zone and tisanoreica diet on some health risk factors. Agro Food Ind. Hi-Tech. 2010;21:24–29.

Tagliabue A., Bertoli S., Trentani C., Borrelli P., Veggiotti P. Effects of the ketogenic diet on nutritional status, resting energy expenditure, and substrate oxidation in patients with medically refractory epilepsy: A 6-month prospective observational study. Clin. Nutr. 2012;31:246–249. doi: 10.1016/j.clnu.2011.09.012.   

Fine E.J., Feinman R.D. Thermodynamics of weight loss diets. Nutr. Metab. 2004;1 doi: 10.1186/1743-7075-1-15. ]   

Davidson T.L., Hargrave S.L., Swithers S.E., Sample C.H., Fu X., Kinzig K.P., Zheng W. Inter-relationships among diet, obesity and hippocampal-dependent cognitive function. Neuroscience. 2013;253:110–122. doi: 10.1016/j.neuroscience.2013.08.044. ]   

Brinkworth G.D., Noakes M., Clifton P.M., Buckley J.D. Effects of a low carbohydrate weight loss diet on exercise capacity and tolerance in obese subjects. Obesity. 2009;17:1916–1923. doi: 10.1038/oby.2009.134.   

Yancy W.S., Jr., Almirall D., Maciejewski M.L., Kolotkin R.L., McDuffie J.R., Westman E.C. Effects of two weight-loss diets on health-related quality of life. Qual. Life Res. 2009;18:281–289. doi: 10.1007/s11136-009-9444-8.   

Vining E.P., Freeman J.M., Ballaban-Gil K., Camfield C.S., Camfield P.R., Holmes G.L., Shinnar S., Shuman R., Trevathan E., Wheless J.W. A multicenter study of the efficacy of the ketogenic diet. Arch. Neurol. 1998;55:1433–1437. doi: 10.1001/archneur.55.11.1433.   

Lefevre F., Aronson N. Ketogenic diet for the treatment of refractory epilepsy in children: A systematic review of efficacy. [(accessed on 14 February 2014)];Pediatrics. 2000 105:e46. Available online: http://pediatrics.aappublications.org/content/105/4/e46.full.pdf.  

Paoli A., Bianco A., Grimaldi K.A., Lodi A., Bosco G. Long term successful weight loss with a combination biphasic ketogenic mediterranean diet and mediterranean diet maintenance protocol. Nutrients. 2013;5:5205–5217. doi: 10.3390/nu5125205. ]   

Volek J.S., Sharman M.J., Forsythe C.E. Modification of lipoproteins by very low-carbohydrate diets. J. Nutr. 2005;135:1339–1342.  

Welle S., Nair K.S. Relationship of resting metabolic rate to body composition and protein turnover. Amer. J. Physiol. 1990;258:990–998.  

Praga M. Synergy of low nephron number and obesity: A new focus on hyperfiltration nephropathy. Nephrol. Dial. Transplant. 2005;20:2594–2597. doi: 10.1093/ndt/gfi201.   

Westerterp-Plantenga M.S. How are normal, high- or low-protein diets defined? Br. J. Nutr. 2007;97:217–218. doi: 10.1017/S0007114507381348.   

Eisenstein J., Roberts S.B., Dallal G., Saltzman E. High-protein weight-loss diets: Are they safe and do they work? A review of the experimental and epidemiologic data. Nutr. Rev. 2002;60:189–200. doi: 10.1301/00296640260184264.

Paoli A., Grimaldi K., D’Agostino D., Cenci L., Moro T., Bianco A., Palma A. Ketogenic diet does not affect strength performance in elite artistic gymnasts. J. Int. Soc. Sports Nutr. 2012;9 doi: 10.1186/1550-2783-9-34. ]   

Paoli A., Canato M., Toniolo L., Bargossi A.M., Neri M., Mediati M., Alesso D., Sanna G., Grimaldi K.A., Fazzari A.L., et al. The ketogenic diet: An underappreciated therapeutic option? Clin. Ter. 2011;162:145–153.  

Noto H., Goto A., Tsujimoto T., Noda M. Low-carbohydrate diets and all-cause mortality: A systematic review and meta-analysis of observational studies. PLoS One. 2013;8 doi: 10.1371/journal.pone.0055030. ]   

Larsen T.M., Dalskov S.M., van Baak M., Jebb S.A., Papadaki A., Pfeiffer A.F., Martinez J.A., Handjieva-Darlenska T., Kunesova M., Pihlsgard M., et al. Diets with high or low protein content and glycemic index for weight-loss maintenance. N. Engl. J. Med. 2010;363:2102–2113. doi: 10.1056/NEJMoa1007137. ]   

Bielohuby M., Sisley S., Sandoval D., Herbach N., Zengin A., Fischereder M., Menhofer D., Stoehr B.J., Stemmer K., Wanke R., et al. Impaired glucose tolerance in rats fed low-carbohydrate, high-fat diets. Am. J. Physiol. Endocrinol. Metab. 2013;305:1059–1070. doi: 10.1152/ajpendo.00208.2013.   

Ellenbroek J.H., van Dijck L., Tons H.A., Rabelink T.J., Carlotti F., Ballieux B.E., de Koning E.J. Long-term ketogenic diet causes glucose intolerance and reduced beta and alpha cell mass but no weight loss in mice. Am. J. Physiol. Endocrinol. Metab. 2014 doi: 10.1152/ajpendo.00453.2013.   

Bielohuby M., Menhofer D., Kirchner H., Stoehr B.J., Muller T.D., Stock P., Hempel M., Stemmer K., Pfluger P.T., Kienzle E., et al. Induction of ketosis in rats fed low-carbohydrate, high-fat diets depends on the relative abundance of dietary fat and protein. Am. J. Physiol. Endocrinol. Metab. 2011;300:65–76. doi: 10.1152/ajpendo.00478.2010.   

Demetrius L. Aging in mouse and human systems: A comparative study. Ann. N. Y. Acad. Sci. 2006;1067:66–82.

Olshansky S.J., Passaro D.J., Hershow R.C., Layden J., Carnes B.A., Brody J., Hayflick L., Butler R.N., Allison D.B., Ludwig D.S. A potential decline in life expectancy in the United States in the 21st century. N. Engl. J. Med. 2005;352:1138–1145. doi: 10.1056/NEJMsr043743.   

World Health Organization Obesity and Overweight, Factsheet No. 311, Updated March 2013. [(accessed on 24 January 2014)]. Available online: http://www.who.int/mediacentre/factsheets/fs311/en/

Koh-Banerjee P., Wang Y., Hu F.B., Spiegelman D., Willett W.C., Rimm E.B. Changes in bodyweight and body fat distribution as risk factors for clinical diabetes in US men. Amer. J. Epidemiol. 2004;159:1150–1159. doi: 10.1093/aje/kwh167.   

Thompson W.G., Cook D.A., Clark M.M., Bardia A., Levine J.A. Treatment of obesity. Mayo Clin. Proc. 2007;82:93–101.  

Paoli A., Moro T., Marcolin G., Neri M., Bianco A., Palma A., Grimaldi K. High-intensity interval resistance training (HIRT) influences resting energy expenditure and respiratory ratio in non-dieting individuals. J. Transl. Med. 2012;10:237. doi: 10.1186/1479-5876-10-237. ]   

Nordmann A.J., Nordmann A., Briel M., Keller U., Yancy W.S., Jr., Brehm B.J., Bucher H.C. Effects of low-carbohydrate vs. low-fat diets on weight loss and cardiovascular risk factors: A meta-analysis of randomized controlled trials. Arch. Intern. Med. 2006;166:285–293. doi: 10.1001/archinte.166.3.285.   

Chahoud G., Aude Y.W., Mehta J.L. Dietary recommendations in the prevention and treatment of coronary heart disease: Do we have the ideal diet yet? Amer. J. Cardiol. 2004;94:1260–1267. doi: 10.1016/j.amjcard.2004.07.109.

Pijls L.T., de Vries H., Donker A.J., van Eijk J.T. The effect of protein restriction on albuminuria in patients with type 2 diabetes mellitus: A randomized trial. Nephrol. Dial. Transplant. 1999;14:1445–1453. doi: 10.1093/ndt/14.6.1445.   

Pijls L.T., de Vries H., van Eijk J.T., Donker A.J. Protein restriction, glomerular filtration rate and albuminuria in patients with type 2 diabetes mellitus: A randomized trial. Eur. J. Clin. Nutr. 2002;56:1200–1207. doi: 10.1038/sj.ejcn.1601474.   

Poplawski M.M., Mastaitis J.W., Isoda F., Grosjean F., Zheng F., Mobbs C.V. Reversal of diabetic nephropathy by a ketogenic diet. PLoS One. 2011;6 doi: 10.1371/journal.pone.0018604. ]   

Demetrius L. Of mice and men. When it comes to studying ageing and the means to slow it down, mice are not just small humans. EMBO Rep. 2005;6:S39–S44. doi: 10.1038/sj.embor.7400422. ]   

Bielohuby M., Sawitzky M., Stoehr B.J., Stock P., Menhofer D., Ebensing S., Bjerre M., Frystyk J., Binder G., Strasburger C., et al. Lack of dietary carbohydrates induces hepatic growth hormone (GH) resistance in rats. Endocrinology. 2011;152:1948–1960. doi: 10.1210/en.2010-1423.   

Bielohuby M., Matsuura M., Herbach N., Kienzle E., Slawik M., Hoeflich A., Bidlingmaier M. Short-term exposure to low-carbohydrate, high-fat diets induces low bone mineral density and reduces bone formation in rats. J. Bone Miner. Res. 2010;25:275–284. doi: 10.1359/jbmr.090813.   

Bergqvist A.G., Schall J.I., Stallings V.A., Zemel B.S. Progressive bone mineral content loss in children with intractable epilepsy treated with the ketogenic diet. Amer. J. Clin. Nutr. 2008;88:1678–1684. doi: 10.3945/ajcn.2008.26099.   

Gower B.A., Casazza K. Divergent effects of obesity on bone health. J. Clin. Densitom. 2013;16:450–454. doi: 10.1016/j.jocd.2013.08.010. ]   

Clifton P. Effects of a high protein diet on body weight and comorbidities associated with obesity. Br. J. Nutr. 2012;108:S122–S129. doi: 10.1017/S0007114512002322.   

Tang M., O’Connor L.E., Campbell W.W. Diet-induced weight loss: The effect of dietary protein on bone. J. Acad. Nutr. Diet. 2014;114:72–85. doi: 10.1016/j.jand.2013.08.021.   

Carter J.D., Vasey F.B., Valeriano J. The effect of a low-carbohydrate diet on bone turnover. Osteoporos. Int. 2006;17:1398–1403. doi: 10.1007/s00198-006-0134-x.   

Skov A.R., Haulrik N., Toubro S., Molgaard C., Astrup A. Effect of protein intake on bone mineralization during weight loss: A 6-month trial. Obes. Res. 2002;10:432–438. doi: 10.1038/oby.2002.60.    

Brehm B.J., Seeley R.J., Daniels S.R., D’Alessio D.A. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J. Clin. Endocrinol. Metab. 2003;88:1617–1623. doi: 10.1210/jc.2002-021480.   

Drewnowski A., Krahn D.D., Demitrack M.A., Nairn K., Gosnell B.A. Taste responses and preferences for sweet high-fat foods: Evidence for opioid involvement. Physiol. Behav. 1992;51:371–379. doi: 10.1016/0031-9384(92)90155-U.   

Yeomans M.R. Psychological approaches to under standing satiation and satiety. Agro Food Ind. Hi-Tech. 2010;21:16–19.

Paoli A., Rubini A., Volek J.S., Grimaldi K.A. Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur. J. Clin. Nutr. 2013;67:789–796. doi: 10.1038/ejcn.2013.116. ]   

Kossoff E.H., Zupec-Kania B.A., Rho J.M. Ketogenic diets: An update for child neurologists. J. Child Neurol. 2009;24:979–988. doi: 10.1177/0883073809337162.   

Bueno N.B., de Melo I.S., de Oliveira S.L., da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. Low-fat diet for long-term weight loss: A meta-analysis of randomised controlled trials. Br. J. Nutr. 2013;110:1178–1187. doi: 10.1017/S0007114513000548.   

Al-Khalifa A., Mathew T.C., Al-Zaid N.S., Mathew E., Dashti H.M. Therapeutic role of low-carbohydrate ketogenic diet in diabetes. Nutrition. 2009;25:1177–1185. doi: 10.1016/j.nut.2009.04.004.   

Dashti H.M., Mathew T.C., Khadada M., Al-Mousawi M., Talib H., Asfar S.K., Behbahani A.I., Al-Zaid N.S. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol. Cell. Biochem. 2007;302:249–256. doi: 10.1007/s11010-007-9448-z.   

Sharman M.J., Kraemer W.J., Love D.M., Avery N.G., Gomez A.L., Scheett T.P., Volek J.S. A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. J. Nutr. 2002;132:1879–1885.  

Freedman M.R., King J., Kennedy E. Popular diets: A scientific review. Obes. Res. 2001;9:S1–S40. doi: 10.1038/oby.2001.113.   

Krebs H.A. The regulation of the release of ketone bodies by the liver. Adv. Enzyme Regul. 1966;4:339–354. doi: 10.1016/0065-2571(66)90027-6.   

Felig P., Owen O.E., Wahren J., Cahill G.F., Jr. Amino acid metabolism during prolonged starvation. J. Clin. Invest. 1969;48:584–594. doi: 10.1172/JCI106017. ]   

Owen O.E. Ketone bodies as a fuel for the brain during starvation. Biochem. Mol. Biol. Educ. 2005;33:246–251. doi: 10.1002/bmb.2005.49403304246.  

Owen O.E., Felig P., Morgan A.P., Wahren J., Cahill G.F., Jr. Liver and kidney metabolism during prolonged starvation. J. Clin. Invest. 1969;48:574–583. doi: 10.1172/JCI106016. ]   

Owen O.E., Morgan A.P., Kemp H.G., Sullivan J.M., Herrera M.G., Cahill G.F., Jr. Brain metabolism during fasting. J. Clin. Invest. 1967;46:1589–1595. doi: 10.1172/JCI105650. ]   

Jitrapakdee S., Vidal-Puig A., Wallace J.C. Anaplerotic roles of pyruvate carboxylase in mammalian tissues. Cell. Mol. Life Sci. 2006;63:843–854. doi: 10.1007/s00018-005-5410-y.   

Hartman A.L., Gasior M., Vining E.P., Rogawski M.A. The neuropharmacology of the ketogenic diet. Pediatr. Neurol. 2007;36:281–292. doi: 10.1016/j.pediatrneurol.2007.02.008. ]   

Fukao T., Lopaschuk G.D., Mitchell G.A. Pathways and control of ketone body metabolism: On the fringe of lipid biochemistry. Prostaglandins Leukot. Essent. Fatty Acids. 2004;70:243–251. doi: 10.1016/j.plefa.2003.11.001.   

Laeger T., Metges C.C., Kuhla B. Role of beta-hydroxybutyric acid in the central regulation of energy balance. Appetite. 2010;54:450–455. doi: 10.1016/j.appet.2010.04.005.   

Veech R.L. The therapeutic implications of ketone bodies: The effects of ketone bodies in pathological conditions: Ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism. Prostaglandins Leukot. Essent. Fatty Acids. 2004;70:309–319. doi: 10.1016/j.plefa.2003.09.007.   

Leino R.L., Gerhart D.Z., Duelli R., Enerson B.E., Drewes L.R. Diet-induced ketosis increases monocarboxylate transporter (MCT1) levels in rat brain. Neurochem. Int. 2001;38:519–527. doi: 10.1016/S0197-0186(00)00102-9.   

Manninen A.H. Metabolic effects of the very-low-carbohydrate diets: Misunderstood “villains” of human metabolism. J. Int. Soc. Sport. Nutr. 2004;1:7–11. doi: 10.1186/1550-2783-1-2-7. ]   

McCue M.D. Starvation physiology: Reviewing the different strategies animals use to survive a common challenge. Comp. Biochem. Physiol. Pt. A. 2010;156:1–18. doi: 10.1016/j.cbpa.2010.01.002.   

Seyfried T.N., Mukherjee P. Targeting energy metabolism in brain cancer: Review and hypothesis. Nutr. Metab. 2005;2 doi: 10.1186/1743-7075-2-30. ]   

Vazquez J.A., Kazi U. Lipolysis and gluconeogenesis from glycerol during weight reduction with very-low-calorie diets. Metabolism. 1994;43:1293–1299. doi: 10.1016/0026-0495(94)90225-9.   

Veldhorst M.A., Westerterp-Plantenga M.S., Westerterp K.R. Gluconeogenesis and energy expenditure after a high-protein, carbohydrate-free diet. Amer. J. Clin. Nutr. 2009;90:519–526. doi: 10.3945/ajcn.2009.27834.   

Bortz W.M., Paul P., Haff A.C., Holmes W.L. Glycerol turnover and oxidation in man. J. Clin. Invest. 1972;51:1537–1546. doi: 10.1172/JCI106950. ]   

Paoli A., Grimaldi K., Toniolo L., Canato M., Bianco A., Fratter A. Nutrition and acne: Therapeutic potential of ketogenic diets. Skin Pharmacol. Physiol. 2012;25:111–117. doi: 10.1159/000336404.   

Atkins R.C. The High Calorie Way to Stay Thin Forever. D. McKay Co.; New York, NY, USA: 1972. Dr. Atkins’ Diet Revolution.

Feinman R.D., Fine E.J. Nonequilibrium thermodynamics and energy efficiency in weight loss diets. Theor. Biol. Med. Model. 2007;4 doi: 10.1186/1742-4682-4-27. ]   

Westerterp-Plantenga M.S., Nieuwenhuizen A., Tome D., Soenen S., Westerterp K.R. Dietary protein, weight loss, and weight maintenance. Annu. Rev. Nutr. 2009;29:21–41. doi: 10.1146/annurev-nutr-080508-141056.   

McLaughlin T., Allison G., Abbasi F., Lamendola C., Reaven G. Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight, and obese individuals. Metabolism. 2004;53:495–499. doi: 10.1016/j.metabol.2003.10.032.   

Rabinowitz D., Zierler K.L. Forearm metabolism in obesity and its response to intra-arterial insulin. Characterization of insulin resistance and evidence for adaptive hyperinsulinism. J. Clin. Invest. 1962;41:2173–2181. doi: 10.1172/JCI104676. ]   

Volek J.S., Phinney S.D., Forsythe C.E., Quann E.E., Wood R.J., Puglisi M.J., Kraemer W.J., Bibus D.M., Fernandez M.L., Feinman R.D. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids. 2009;44:297–309. doi: 10.1007/s11745-008-3274-2.   

McDaniel S.S., Rensing N.R., Thio L.L., Yamada K.A., Wong M. The ketogenic diet inhibits the mammalian target of rapamycin (mTOR) pathway. Epilepsia. 2011;52 doi: 10.1111/j.1528-1167.2011.02981.x. ]   

Freedland S.J., Mavropoulos J., Wang A., Darshan M., Demark-Wahnefried W., Aronson W.J., Cohen P., Hwang D., Peterson B., Fields T., et al. Carbohydrate restriction, prostate cancer growth, and the insulin-like growth factor axis. Prostate. 2008;68:11–19. doi: 10.1002/pros.20683. ]   

Srivastava S., Kashiwaya Y., King M.T., Baxa U., Tam J., Niu G., Chen X., Clarke K., Veech R.L. Mitochondrial biogenesis and increased uncoupling protein 1 in brown adipose tissue of mice fed a ketone ester diet. FASEB J. 2012;26:2351–2362. doi: 10.1096/fj.11-200410. ]   

Chang K.T., Min K.T. Regulation of lifespan by histone deacetylase. Ageing Res. Rev. 2002;1:313–326. doi: 10.1016/S1568-1637(02)00003-X.   

Yoo Y.E., Ko C.P. Treatment with trichostatin a initiated after disease onset delays disease progression and increases survival in a mouse model of amyotrophic lateral sclerosis. Exp. Neurol. 2011;231:147–159. doi: 10.1016/j.expneurol.2011.06.003.   

Kang H.L., Benzer S., Min K.T. Life extension in drosophila by feeding a drug. Proc. Natl. Acad. Sci. USA. 2002;99:838–843. doi: 10.1073/pnas.022631999. ]   

Mammucari C., Schiaffino S., Sandri M. Downstream of Akt: Foxo3 and mTOR in the regulation of autophagy in skeletal muscle. Autophagy. 2008;4:524–526.  

Sandri M. Signaling in muscle atrophy and hypertrophy. Physiology. 2008;23:160–170. doi: 10.1152/physiol.00041.2007.   

Sandri M., Barberi L., Bijlsma A.Y., Blaauw B., Dyar K.A., Milan G., Mammucari C., Meskers C.G., Pallafacchina G., Paoli A., et al. Signalling pathways regulating muscle mass in ageing skeletal muscle. The role of the IGF1-Akt-mTOR-FoxO pathway. Biogerontology. 2013;14:303–323. doi: 10.1007/s10522-013-9432-9.   

Janda M., Zeidler D., Bohm G., Schoberberger R. An instrument to measure adherence to weight loss programs: The compliance praxis survey-diet (COMPASS-diet) Nutrients. 2013;5:3828–3838. doi: 10.3390/nu5103828. ]   

Jeffery R.W. Does weight cycling present a health risk? Amer. J. Clin. Nutr. 1996;63:S452–S455.  

Sumithran P., Proietto J. The defence of body weight: A physiological basis for weight regain after weight loss. Clin. Sci. 2013;124:231–241. doi: 10.1042/CS20120223.   

Wing R.R., Hill J.O. Successful weight loss maintenance. Annu. Rev. Nutr. 2001;21:323–341. doi: 10.1146/annurev.nutr.21.1.323.   

Thomas P.R. Weighing the Options: Criteria for Evaluating Weight-Management Programs. National Academies Press; Washington, DC, USA: 1995.

Paoli A., Grimaldi K., Bianco A., Lodi A., Cenci L., Parmagnani A. Medium term effects of a ketogenic diet and a mediterranean diet on resting energy expenditure and respiratory ratio. BMC Proc. 2012;6 doi: 10.1186/1753-6561-6-S3-P37.  

Veldhorst M., Smeets A., Soenen S., Hochstenbach-Waelen A., Hursel R., Diepvens K., Lejeune M., Luscombe-Marsh N., Westerterp-Plantenga M. Protein-induced satiety: Effects and mechanisms of different proteins. Physiol. Behav. 2008;94:300–307. doi: 10.1016/j.physbeh.2008.01.003.



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