People already experiencing cognitive decline are advised to try a therapeutic ketogenic version of KetoFLEX™ that is very low carb overall. A well-designed ketogenic diet includes things like five or more servings of low-carb non-starchy vegetables (as tolerated) daily as well as high amount of healthy fat, including foods like avocado, nuts, seeds, eggs, fatty cold-water fish, and olive oil (see photo below). Healthy fats are prominent at most every meal. KetoFLEX™ doesn’t look like a typical “keto” diet, as you may have gathered from the photos of KetoFLEX™ foods here.
If you’re aiming for a therapeutic sustained mild ketosis, I recommend in-depth preparation so that you’ll have a good experience. It takes several days to weeks for metabolism to adapt from garnering energy from mostly sugar and starch to fueling mostly from consumed good fats and stored bodyfat. To prepare, you may read about the ketogenic diet in the recommended books on my recipes webpage, discuss it at my free meetups (in San Diego), learn more in my Brain Health Revitalization program, or work one-on-one with a dietician, nutritionist, or health coach (like me) specializing in ReCODE™ and KetoFLEX™.
In general, you may want to wait to aim for therapeutic nutritional ketosis until after (a) your diet predominantly consists of the “lots” and “some” foods listed on the KetoFLEX Eating webpage, (b) you’re quite comfortable eating 100 grams or fewer carbohydrates per day (exceptions made for the slim minority who do lots of anaerobic physical activity for relatively long durations), (c) you have no problem fasting for 12 hours every night, and/or (d) your fasting glucose routinely falls in the 70-90 mg/dl range. Of course, a better understanding of each individual is required for more personalized coaching beyond these general guidelines. While adjusting to this way of eating, proceed with another aspect of the ReCODE™ program—brain training, physical activity, restorative sleep, stress reduction, detox, and/or ReCODE™ supplements.
Carbohydrate intake needs to be low enough to register at least 0.5 mM β-hydroxybutyrate on a blood ketone meter. Dr. Bredesen recommends purchasing and using a home blood ketone meter to keep ketones within a 0.5-4.0 mM range. An experienced Qualified ReCODE™ practitioner such as myself can be especially valuable to guide you through the transition phase into ultra low carb therapeutic ketosis so that you don’t get caught in what could otherwise be a miserable experience in between. For example, in the wake of decades spent shunning too much fat, a common mistake is not adding in enough wholesome high-fat foods, often around 70% of total calories from good fats. Another common error is not paying enough attention to the accumulated carb intake. Home ketone monitoring can help avoid the transitional quagmire of not cutting the carbs enough, moderating protein, and raising your fat intake enough.
For most everyone who tries it, a fully ketogenic KetoFLEX™ diet brings an end to cravings, significant hunger, and irritability between meals. Most also experience more sustained energy throughout the day.
Sustained nutritional ketosis can be therapeutic
Some people experience significantly more mental sharpness and enhanced cognitive functioning while in ketosis so they seek to sustain a nearly constant state of mild ketosis.
A well-formulated ketogenic diet combined with coaching is a very effective therapy to reverse type 2 diabetes and pre-diabetes (see this 2018 clinical study). By fueling the brain with ketones you also side-step the insulin-resistance in brain cells commonly contributing to cognitive decline. You can read about the anti-inflammatory and additional therapeutic benefits in Dr. Bredesen’s 2017 book.
After successfully reversing their symptoms/health issues while in a prolonged duration of sustained ketosis, some introduce carb cycling. After that, they benefit from regular shorter periods of ketosis on a schedule that matches their goals and constitution. For instance, modestly increasing carbs two days each week or following ketosis expert Dr. Dom D’Agostino recommendation for an occasional 5-7 days of ketogenic eating with 50% calorie restriction as a stimulus to reduce insulin, suppress mTOR, and stimulate autophagy.
Tips for creating a well-formulated keto diet
Choose the most healthful, highest quality fats that you can afford. Nourish your brain with health-promoting fatty foods like those pictured here—wild-caught Alaskan salmon, pasture-raised eggs, high poly-phenolic extra-virgin olive oil, grass-fed organic ghee, hulled hemp seeds, olives packed in olive oil, and a diversity of tree nuts, like macadamias, walnuts, and hazelnuts/filberts. Compared to other popular keto diets, KetoFLEX™ steers you toward higher quality and less controversial fats. Especially for people with elevated LDLp or who are ApoE4+, this can mean choosing one strip of pasture-raised sugar-free bacon rather than lots of bacon or adding a tablespoon rather than a half-cup of coconut milk to your beverage. While adopting this high fat diet, you’ll shun industrial oils, like soybean oil, in processed foods. Because a ketogenic diet is high in fat, it’s essential to keep concomitant carbohydrate intake quite low. Avoid the combination of high-fat and high-carb and excess calories in the disastrous standard American diet.
Please consult your physician, qualified dietician, nutritionist and/or health coach before starting a strict ketogenic diet as it might be contraindicated or require additional supplementation for individuals who are quite thin, frail, or have certain health conditions.
For most people, a well-designed ketogenic KetoFLEX™ diet promises more health rewards than risks. It can even help preserve, optimize, and restore memory and cognitive functioning. Readers worried about coronary heart disease (CHD) from eating more fat may find comfort in a 2017 meta-analysis that found no significant difference in CHD mortality with total fat or saturated fat intake. While this is generally true, a physician should monitor your cardiovascular disease markers to ensure you are not a hyper-responder to a high fat diet.
Books, such as the 2018 book “Superfuel“, can offer sound information for composing a well-formulated, nourishing ketogenic diet. Individuals benefit from a qualified, experienced professional to help them adjust their overall eating plan for the most health and enjoyment for them.