In this episode of The Diary Of A CEO, Andrew Koutnik discusses the science and impact of the ketogenic diet, drawing from both research and his personal experience with type 1 diabetes and obesity. He explains how the ketogenic diet changes the body's energy production, allowing it to use fat and ketones instead of glucose, and describes how this shift can affect brain function and metabolism.
The conversation explores the broader implications of modern food environments on health, examining how processed foods and liquid calories contribute to widespread health issues. Koutnik shares insights about ketone supplements, the challenges of navigating misleading food labels, and research findings about ketogenic diets in managing various health conditions. The discussion illuminates the connections between diet choices, metabolic health, and chronic disease risk in contemporary society.
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Andrew Koutnik shares his transformative journey from childhood obesity to health through the ketogenic diet. Despite following standard medical advice, his weight reached 255 pounds before discovering keto over a decade ago. The diet not only helped with his weight but also proved beneficial for managing his type 1 diabetes, reducing his [restricted term] needs by over 40%. Koutnik now uses an [restricted term] pump and continuous glucose monitor to maintain exceptional blood sugar control, which his doctor, then president of the American Diabetes Association, praised as remarkable.
The ketogenic diet fundamentally changes how the body produces and uses energy, explains Koutnik. By limiting carbohydrates, the body shifts from glucose to fat and ketones as primary fuel sources. While fatty acids can't cross the blood-brain barrier, ketones can, providing an alternative energy source for the brain. Koutnik notes that ketones offer more than just fuel - they have anti-inflammatory properties and can enhance brain network stability, as demonstrated in a 2020 study.
According to Koutnik, research involving 46,000 patients with type 1 diabetes showed that over 70% of those following very low-carb ketogenic diets achieved normalized glucose control. Beyond diabetes management, Steven Bartlett discusses how exogenous ketone supplements can quickly boost blood ketone levels without strict dietary restrictions, potentially enhancing physical performance and cognitive function. These supplements show promise for conditions ranging from Alzheimer's to various mental illnesses.
Koutnik describes how modern processed foods create a "superstimulus" through combinations of carbs, salt, and fat that drive overconsumption. He warns about liquid calories, like sodas and fruit juices, which can spike blood sugar and [restricted term] levels. Even seemingly healthy foods like smoothies can be problematic, as blending removes components that normally slow digestion. Koutnik emphasizes the importance of whole, unprocessed foods and being mindful of misleading "keto-friendly" labels, particularly given that over 68% of Americans now struggle with obesity.
1-Page Summary
Andrew Koutnik shares his personal experience of overcoming obesity and managing a chronic disease, highlighting the impact of diet and nutrition on his overall health.
Andrew Koutnik speaks about his challenging battle with obesity during childhood, a struggle that persisted despite adhering to doctors' exercise and diet recommendations. He emphasizes the severity of obesity, drawing a parallel to the disturbing statistic that more than 20% of children face obesity today. Koutnik realized that despite the standard advice, his health was declining, leading to obesity and a body weight of about 255 pounds.
More than ten years ago, Koutnik discovered the ketogenic diet and commenced an in-depth exploration of its science. He found that it had significant benefits for chronic conditions such as diabetes, obesity, Alzheimer's, and severe mental illness, suggesting many of these diseases could be not only prevented but potentially reversed. Upon adopting the ketogenic diet, Koutnik experienced transformative effects on his health, noticing improvements in [restricted term] sensitivity and obesity, which he managed in conjunction with type 1 IBS.
Koutnik, living with type 1 diabetes, relies on an [restricted term] pump attached to his arm to deliver the [restricted term] his body fails to produce, effectively acting as an artificial pancreas. He also uses a continuous glucose monitor (CGM) on his stomach, providing real-time tissue sugar levels as an indication of blood glucose.
Koutnik recalls the times he needed to check his blood glucose 6 to 10 times a day with a blood meter before the advent of CGMs. After transitioning to the ketogeni ...
Speaker's Health Journey and Diet/Nutrition Impact
Andrew Koutnik and Steven Bartlett discuss the biological underpinnings and implications of the ketogenic diet and the role of ketones in metabolism and brain function.
The ketogenic diet shifts the body's metabolism from relying primarily on glucose to fat and ketones for energy.
Andrew Koutnik suggests that carbohydrates are the most potent factor that elevates glucose levels with each meal. He points out that a standard diet high in carbohydrates relates to fluctuations in blood sugar levels. In contrast, the ketogenic diet aims to keep carbohydrate intake low so that [restricted term] remains sufficiently low to produce ketone bodies. When glucose spikes, as after consuming oranges, [restricted term] works to moderate the level back to normal, but reducing carbohydrate intake leads to fewer glucose elevations, improving glycemic control.
Koutnik also examines the historical understanding of carbohydrates in sports nutrition. Since 1921, carbohydrates have been known to improve performance by preventing hypoglycemia in marathon runners. However, he identifies that an adaptation period to a ketogenic diet of four weeks or more is necessary for the body to efficiently use ketones.
On a ketogenic diet, the body shifts to using fat as the primary energy source due to the reduction in glucose, which lowers [restricted term] levels and facilitates the breakdown of fat. The liver then converts this broken-down fat into ketone bodies because long-chain fatty acids cannot cross the blood-brain barrier. Ketones can serve as fuel for the brain, mimicking the physiology of fasting and prompting the body to produce ketones for energy. Fiber intake on a ketogenic diet has a lower metabolic impact than other carbohydrates, aligning with the diet's goal of shifting fuel sources. During adaptation, the body produces more ketones, which serve as efficient energy sources for both the muscles and the brain.
Ketone bodies provide not only a fuel alternative to glucose but also exert beneficial effects at the molecular level.
Koutnik explains that while fatty acids can't cross the blood-brain barrier, the liver's ketone bodies can, providing an alternative fuel source for the brain. This ...
Science and Mechanisms of Ketogenic Diet and Ketones
The ketogenic diet and exogenous ketones have been studied for their potential in glycemic control and improving certain health and performance metrics. Andrew Koutnik and Steven Bartlett share experiences and studies highlighting the beneficial impacts.
Andrew Koutnik delves into the impact of the ketogenic diet on diabetes, including a significant case study. This study examines a patient with type 1 diabetes who initially followed the American Diabetes Association diet for six years and then shifted to a ketogenic diet in 2013. Koutnik points out that this patient, under careful observation including DEXA scans and controlled calorie intake, achieved sustained glycemic control, reduced their [restricted term] load by over 40%, and showed remarkable cardiovascular health despite a near doubling of LDL cholesterol levels.
Koutnik's personal experience with type 1 diabetes after adopting a ketogenic diet demonstrates how it can regulate the disease, achieving normal metabolic control, which is uncommon among patients with type 1 diabetes. He mentions that patients are usually expected to never see normal metabolic control after diagnosis and often experience neuroanatomical changes linked to poor glucose control.
Koutnik references the largest analysis of the impact of nutrition, specifically carbohydrates, on over 46,000 patients with type 1 diabetes. This analysis found that in over 70% of all reports, patients adhering to very low-carbohydrate ketogenic diets could normalize their glucose control.
Historically, the ketogenic diet has saved lives of patients with both type 1 and type 2 diabetes. He notes a report from 1796 where a reduced carbohydrate diet was used to effectively manage diabetes mellitus.
Steven Bartlett speaks to the advantages of exogenous ketones, like ketone supplements that swiftly raise blood ketone levels, imitating nutritional ketosis without the strict dietary limitation of carbohydrates. This rapid boost ...
Therapeutic and Performance-Enhancing Uses of the Ketogenic Diet and Ketones
The modern food environment poses significant challenges to health with its emphasis on hyperprocessed foods, and experts discuss the impact of these foods as well as healthier dietary choices.
Experts discuss how hyperprocessed foods, high in carbs, salt, and fat, can hijack the brain's pleasure pathways and drive overconsumption.
Andrew Koutnik, a health expert, discusses how foods like Doritos and Pringles blend components that make you crave more without feeling full. The food industry, aware of this phenomenon, often includes added salt and sugar in products to enhance flavor and increase consumption. Koutnik refers to this issue as "food noise," where individuals never feel physically full due to high sugar and salt content, leading to constant food seeking.
Koutnik also highlights the detrimental effects of consuming liquid calories like soda and fruit juice, which are high in calories and can lead to increased hunger due to spikes in glucose and [restricted term] levels. Blending fruit into a smoothie or altering the structure of food, like making mashed potatoes, can remove components that normally take time to digest. This increases the speed of nutrient absorption, significantly affecting the hormonal response, including altering the [restricted term] response. Steven Bartlett expresses his own surprise upon learning about the health impacts of beverages like orange juice, which are often perceived as healthy.
While the podcast does not directly discuss the role of whole, unprocessed foods, there is an implicit emphasis on the importance of consuming whole foods and avoiding processed options.
Koutnik explains that a well-formulated ketogenic diet includes nutrient-dense, fibrous, and phytonutrient-rich plants, while eliminating sugary starchy carbohydrates due to their negative impact on blood sugar and [restricted term] levels. He also advises caution with fruit for individuals with metabolic diseases or dysfunctions.
Modern Food Environment Challenges and Health Impact
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