Here is my lecture from the 3rd DogRisk seminar arranged by the University of Helsinki - Faculty of Veterinary Medicine. This is for humans though ;)

1. HIGH CARB standard diets vs. HIGH FAT
ketogenic diets and their physiological effects
on the body
Evidence-based review & historical perspective
on the ketogenic diets and ketosis
06.09.2019, Helsinki
Dr. Olli Sovijärvi, M.D.

2. Free download: biohack.to/keto

5. 1921The birth year of the modern ketogenic diet (Woodyatt, Dr. Wilder).
Woodyatt, R. (1921). Objects and method of diet adjustment in diabetics.
Archives of Internal Medicine 28: 125–141.

6. POTENTIAL HEALTH BENEFITS OF KETOSIS

7. Paoli, A. & Rubini, A. & Volek, J. & Grimaldi, K. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-
carbohydrate (ketogenic) diets. European Journal of Clinical Nutrition 67 (8): 789–796.

8. Original ketogenic diet model:
• 10-15 grams CHO
• 1 gram PRO / kg bodyweight
• Rest calories from FAT
• FAT to PRO&CHO ratio = 4:1

9. Composition of ketogenic diets and variants. KD, ketogenic diet; LGIT, low glycaemic index
treatment; MAD, modified Atkins diets; MCT, medium-chain triglyceride; MKT, modified ketogenic
therapy.

10. KEEP IT CLEAN

13. THREE DIFFERENT KETONE BODIES
The ketone bodies produced by the
liver are released into the circulation
and delivered into the mitochondria
of the brain, internal organs and
muscles for use in energy
production (ATP). BHB is restored to
acetyl coenzyme A which is utilized
in the citric acid cycle.

14. • Capric acid (C10) goes to
the liver for ketone formation
• Caprylic acid (C8), if not
converted to ketones in the
liver, can travel to the brain
(crosses BBB) and is
converted to ketones by
astrocytes
MCT-oil benefits

15. Glycogen stores serve as a
fuel tank for glucose needed
in the body.
For 70 kg adult:
• Liver stores (100-120 g)
• Muscle stores (about 400 g)
The more muscle mass, the bigger
the muscle glycogen stores.
Ketone bodies increase
mitochondrial metabolism and
decrease glycolysis.

16. Substrates used for
gluconeogenesis when
glucose intake from food is
scarce:
• Lactic acid
• Glycerol (from triglycerides!)
• Alanine (liver)
• Glutamine (kidneys, small
intestine)
• Acetone (ketone body)

17. Source: Virta Health

19. We are all fat burners when
given the chance:
• During sleeping
• During fasting
• During exercise
• During ketogenic diet

20. Ketosis needs to be activated for a high fat
diet to have beneficial effects in the body.

22. THREE PHASES OF KETO-
ADAPTATION:
• Short-term adaptation (7–14 d)
• Medium-term adaptation
(14–35 days)
• Long-term adaptation (2–12
months)

23. Ketosis and ketones increase mitochondrial
biogenesis and mitochondrial volume & mass
(particularly in the brain)

24. β-hydroxybutyrate (BHB) has several metabolic
functions in the body other than energy production
Endogenous inhibition of histone
deacetylases (HDACs)
Ligand for several cell surface
receptors
Downstream products of BHB (acetyl-
CoA, succinyl-CoA and NAD+) have
signalling activities
All these regulatory functions of BHB
have an effect on cellular function
and gene expression
They have important implications for
the pathogenesis and treatment of
metabolic diseases

25. A ketogenic diet extends longevity and
healthspan in adult mice
Ketogenic diets extends longevity in
adult male mice by 13.6 %
Motor function, memory and muscle
mass are preserved in aged ketogenic
mice
Protein acetylation is increased in the
liver and skeletal muscle of ketogenic
mice

26. Mechanisms of action of ketogenic diet in epilepsy
• Ketone bodies possess anticonvulsant
effects
• Ketone metabolism prevents convulsive
promoting effects of glucose in neurons
• Ketone bodies decrease levels of
aspartate and glutamate in neurons
• Ketone bodies increase GABA
• In the gut, ketone bodies increase
Akkermansia and Parabacteroides species
which in turn increase GABA and reduce
inflammation
• BHB reduces oxidative stress in the brain

27. This reduced
glutamatergic signaling
may reduce brain
excitability and potentially
contribute to the
mechanism of the
ketogenic diet.
Ketone bodies inhibit vesicular glutamate transportation.

28. Ketone bodies:
• Decrease glutamate
• Increase GABA
This leads to calmer state of mind
and neurological ”balance”.

29. Low-carb and ketogenic diet is more effective on
weight-loss than other iso-caloric weight-loss diets
Physiological reasons:
• Increased energy expenditure
during weight loss maintenance
• Better insulin sensitivity
• Lower leptin
• Higher ghrelin

30. High carb diets are highly addictive, cause major blood sugar
& insulin swings and are less satiating than high fat diets

31. The primary outcome was total energy expenditure, measured with doubly labeled
water, by intention-to-treat analysis.
Per protocol analysis included participants who maintained target weight loss,
potentially providing a more precise effect estimate.

32. Read reviews of 23 studies comparing low carb vs low fat diets on weight loss:
https://www.healthline.com/nutrition/23-studies-on-low-carb-and-low-fat-diets

33. An open label, non-randomized,
controlled study with 262 and 87
participants with T2D were enrolled in the
CCI and usual care (UC) groups,
respectively.

35. MACRONUTRIENTS AND THEIR EFFECT ON INSULIN SECRETION

36. 24/7 BLOOD SUGAR ANALYSIS ON A KETOGENIC DIET

38. Typical change in blood
sugar regulation when
adapted to ketosis

39. Triglycerides/HDL-ratio
is the most important lipid
measurement on evaluating the
risk for atherosclerosis, CHD, type 2
diabetes, cardiac mortality and
total mortality.

40. EXERCISE AND KETOSIS

42. In conclusion, after a period of 3–4 weeks
with total daily carbohydrates at a level
that induces nutritional ketosis, the human
body adapts to be able to use almost all
fat for its fuel.

43. Conclusion:
Compared to highly trained ultra-endurance athletes consuming
an HC diet, long-term keto-adaptation results in extraordinarily high
rates of fat oxidation, whereas muscle glycogen utilization and
repletion patterns during and after a 3 hour run are similar.

44. High-carb diets, overeating and high fructose intake cause NAFLD

46. High Fructose groups consumed 75g
of fructose per day.
Theoretical estimate of liver triglyceride accumulation

47. Low carbohydrate ketogenic diets work in both isocaloric and
hypocaloric conditions to treat NAFLD

48. High carb and high sugar diets increase AGEs
AGEs can be ingested with high
temperature processed foods, but also
endogenously formed as a
consequence of a high dietary sugar
intake. Animal models of high sugar
consumption, in particular fructose,
have reported AGE accumulation in
different tissues in association with
peripheral insulin resistance and lipid
metabolism alterations.

49. Cancer cells thrive on glucose.
Ketogenic diets may help in treating cancer as an adjuvant
therapy, but more evidence is needed.
Preclinical evidence indicating the effect of a KD on tumor growth and progression. The bar chart
shows the number of preclinical studies, which investigated the effect of a KD on different types of
cancer. Colors of the bars represent the result of each study as indicated in the color key.

50. KETOSIS, FASTING and MOVEMENT have been evolutionary staples in the
history of Homo Sapiens, until recently.
KETOSIS is a natural biological phenomenon which needs to be re-
activated. We can do it.
Thank you :)