Ketogenic approaches encompass dietary strategies characterized by a severe restriction of carbohydrate intake, coupled with moderate protein and high fat consumption, designed to induce a metabolic state known as ketosis. In this state, the body shifts its primary fuel source from glucose to fatty acids, which are then converted into ketone bodies, specifically beta-hydroxybutyrate and acetoacetate. Clinically, these approaches are utilized to modulate insulin sensitivity, support metabolic flexibility, and influence neuroendocrine signaling.
Origin
The original ketogenic diet was developed in the 1920s as a therapeutic tool for managing refractory epilepsy, leveraging the neuroprotective effects of ketones. Its modern application has expanded into metabolic health, weight management, and hormonal optimization, recognizing the profound impact of carbohydrate restriction on insulin and glucagon dynamics. The approach is fundamentally rooted in the body’s ancient survival mechanism to utilize stored fat for energy during periods of food scarcity.
Mechanism
The drastic reduction in glucose availability lowers circulating insulin levels, which subsequently signals the liver to increase fatty acid oxidation and produce ketone bodies. Ketones serve as an alternative, highly efficient fuel source for the brain and other peripheral tissues. This metabolic shift has significant hormonal consequences, including improved insulin sensitivity, reduced systemic inflammation, and a potential for favorable modulation of sex hormone-binding globulin (SHBG) and free testosterone levels, thus impacting the bioavailability of sex steroids.
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