Lecture Notes: Energy Balance and Ketogenic Diets

Overview of Energy Balance

Humans possess a highly evolved instinctive mechanism regulating energy balance.
This mechanism operates autonomously, beyond intellectual control.
During periods of privation, the body enters a conservation mode.
Overfeeding generally increases resting metabolism.
- Variability exists among individuals; some increase metabolism more than others.
- Some individuals store extra energy rather than burning it off.

Individual Variations

There is interindividual variation in metabolic responses to overfeeding.
Everyone has autonomous regulatory mechanisms for energy balance.

Ketogenic Diets

Ketogenic diets reduce the insulin storage signal.
- This allows the body to increase its rate of fat oxidation.
Initially, increased fat oxidation is not countered by increased hunger.
After reaching a new homeostatic level, the body signals a preference for high-fat foods.
- People on ketogenic diets often find high-fat foods more appealing.

Physiological Adjustments

The body adjusts food preferences to meet physiological needs.

Research and Experiments

Experiments conducted on people with metabolic syndrome (pre-diabetes).
- Associated with insulin resistance and inflammation.
A well-formulated ketogenic diet results in:
- Prompt reduction in insulin resistance.
- Reduction in inflammation biomarkers.
Weight loss without calorie counting:
- Carbohydrates held low, protein in moderation.
- Results in significant weight loss (10-20% of initial body weight).

Study with Virta Health

Proof of concept study on well-formulated ketogenic diets.
Participants with type 2 diabetes:
- Testing glucose and ketone levels.
- Observations include reduction in glucose levels, reduction in medication use.
- Improvement in hemoglobin A1c levels, even after long-term diabetes.
Patients often reduced or eliminated medications, leading to cost savings.
Empowerment from seeing tangible health improvements.
- Success in controlling diabetes through diet rather than medication.

These notes summarize the key points from the lecture on energy balance and the impact of ketogenic diets on metabolic health, especially in individuals with metabolic syndrome or type 2 diabetes. The lecture highlights individual variability in metabolic responses and the physiological adjustments that occur with dietary changes.