Wednesday, October 17, 2018

Zone, Keto, Paleo and Deflame

Comparing lower carbohydrate and Ketogenic type eating plans
This post will explain the general process of nutrient assimilation and the various drawbacks
following a “traditional food pyramid” or “my plate” diets recommended by the FDA vs. a low
carbohydrate diet proposed by a multitude of researchers. While these low carb researchers have
found slight variations in their diets or eating styles, there are a great many similarities found as well.

Barry Sears’ “Enter the Zone” diet, David Seamen’s “Deflame diet”, the Ketogenic diet and of
course Loren Cordain’s “Paleo” diet, all contend that lowering carbohydrate intake can alleviate
medical conditions like type two diabetes, chronic inflammatory disorders, nonalcoholic fatty liver
disease, hypertension, fat free mass (FFM) and coronary artery disease.

It is my hope that you as the reader gain appreciation of how our meal choices affect our overall health, body image, satiety, energy level and even lab levels.  Armed with this new information you may change your views of certain foods dramatically.

          In analyzing the effects of various low carbohydrate eating plans, including but not limited to the ketogenic diet, we must first discuss metabolism.  Metabolism is a chemical process in which the body receives nutrition.  This assimilation of nutrients results in the delivery of macro and micro nutrients to the individual cells, so that cellular metabolism can occur.  This process provides energy in the form of ATP, building blocks for muscles (amino acids), the materials needed for the framework of the body (collagen, bone minerals) as well as the walls of each individual cell (fatty acids).
Metabolic processes
          The first step in carbohydrate metabolism is glycolysis, this chemical reaction allows the body to utilize the simple sugars (glucose) or store them.  The body utilizes a glucose in a variety of ways.  It’s used as a primary source of energy for our movements (glycolysis, Krebs cycle and electron transport chain), and energy source for brain cell function (exclusively). When taken in excess, it’s combined to form glycogen(glycogenesis), during that process insulin is released and the liver later stores the glycogen in the fatty cells.
Fat metabolism occurs if there’s a lack of available carbohydrates to metabolize.  There are a variety of reasons this may occur; fasting, a low carbohydrate diet and untreated diseases like diabetes.  The result of fat catabolism is glycerol and fatty acids, but we should keep in mind that high insulin levels inhibit fat catabolism.  Nevertheless, the body synthesizes enzymes called lipases, and maintains the ability to catabolize fat in the correct environment.  Fat catabolism is similar to carbohydrate catabolism, energy production from fat also occurs in the mitochondria via the citric acid cycle & the electron transport chain.  To break down the fatty acid chains, the body utilizes a process called beta-oxidation, which cleaves the long fatty acid chain groups and converts them to usable segments.
Protein metabolism the least plentiful source of energy in the traditional “food pyramid”.  The traditional role of protein consumption is anabolism, which is responsible for synthesizing the proteins and needed for our soft tissues.  The body can produce various proteins (and amino acids), but a select few several amino acids must be consumed (essential amino acids). Therefore, but all not only is protein essential to a diet it can also serve both; as a source of energy, and a source of building blocks.
Lower carbohydrate eating plans

In Barry Sears is Enter the Zone diet, a 40:30:30 caloric intake ratio is utilized (Carbohydrate: Fat: Protein).  Dr. Sears contends that foods that have lower amounts of sugar or “lower glycemic index” foods allow for less fluctuations of insulin levels.  This in turn lowers cravings as well as improving wellbeing through reduction in inflammatory responses.  Like most diets, the zone diet is dependent on the individual’s metabolic requirements. BMR is the rate of caloric expenditure for an individual per day and is reliant upon the individual’s fat free mass (FFM)(Sears, 1995.).  The FDA’s recommendation for protein is .38 g/lb. FFM, while Dr. Sears calls for .7 to 1g/lb. This makes it a higher protein diet.  The amount of fat in this plan is determined by the caloric intake, and that in turn is reliant on the BRM (Sears, 1995.). The amount of fat in this diet is also higher than FDA recommendation of 10% (Total Fat, 2018.). Dr. Sears’ work has been heavily scrutinized, and the results of his eating plan has had have been impactful on improving FFM (Ebbling, 2007.; Fontani, 2005.; Skoy, 1999.) Dr. Sears also reported that his plan had positive implications regarding cholesterol and cardiovascular profile factors. The Zone diet is also been found to improve fasting glucose levels for type II diabetics (Hamdy, 2008.). As mentioned before, the mechanism in the zone diet is to limit foods to lean meats, some unsaturated fats and most importantly fibrous or low glycemic carbohydrates. The increase in protein results in a positive nitrogen balance (only protein contains nitrogen versus fat and carbohydrates) and an anabolic state. The lack of carbohydrates also induces the body to metabolize the fat and protein taken in. Metabolizing fatty acids leads to a slight ketogenic state. The lack of insulin fluctuations is the reason someone following a Zone type system would feel satiated, as a spike in insulin has a reactive dip shortly after (Hyman, 2018) and this dip is why your body craves another meal.
The brain also has a part to play in how we react to food. There is a concept involving anorexigenic responses, which are triggered by a high fat diet, and promote satiety (fullness). The hypothalamus controls these types of responses and Resveratrol (a natural polyphenol that promotes anorexigenic responses) is present in high protein eating programs (Drummen, 2018.; Safahani, 2017.).

Dr. Seamen’s DeFlame is another diet or eating system that calls for a reduction in starchy carbohydrates. The focus is to replace “pro-inflammatory” starchy carbohydrates with “anti-inflammatory” fibrous carbohydrates and replace trans fats with unsaturated fats.  The mechanism Dr. Seamen describes is one where glucose causes a hyperglycemic state, combined with trans fats, resulting in the bacteria in the gut to release endotoxins. These endotoxins have a detrimental effect on cells causing them to release inflammatory chemicals. The end result is chronic inflammation that can cause and contribute to a variety of maladies (Seamen, 2002. ; Totsch, 2015.). The net effect of the DeFlame diet is a de-facto ketogenic state (mild compared to strict Ketogenic plans). While Dr. Seamen’s aim is to reduce inflammation, he also alters the metabolic pathways at the same time, resulting in an anabolic effect. The de flame diet also was shown to decrease fatty liver disease and type II diabetes, which has been consistent with the variety of lower carbohydrate type eating programs (Pérez-Guisado, 2011. ;  Khondkaryan, 2018.; Drummen, 2018.).
The Paleo diet is yet another eating program that calls upon ketosis and fatty acid catabolism by harkening back to our paleolithic roots. This plan features many ieterations, so a range of protein intake is available.  By avoiding starchy, low glycemic index and processed food, while placing an emphasis on fibrous foods and animal products (excluding dairy), the individual can maintain a ketogenic state. The Paleo diet’s main theme is to not consume any food that wouldn’t have available to our ancestors and to “mimic the pre-agricultural time”, to when we were hunter-gatherers (Cordain, 2018.). This program has no guidelines, making it more of a philosophy than a structured program. A study conducted by Pastore et al. found that after only a 4-month trial on the Paleo diet, the subjects (who had prior hypercholesteremia) had significantly lowered total cholesterol and triglycerides, and even improved FFM (2015).

The Ketogenic eating plan features fat metabolism more than any other program. This plan is best used for lowering the amount of insulin and is not ideal for long term usage as it has been found to raise lipoprotein content (Kwiterovich, 2003). This plan should be supervised and performed for specific medical outcomes in question (Klara, 2017.). Its lower levels of carbohydrates increase some stress hormones (cortisol) and decrease anabolic hormones like testosterone, and lower anabolism in athletes due to the lowered protein content could be an issue (Miller, 2017.). Fat loading has also been found to be inferior to carbohydrate loading for athletic endeavors as a mode of event preparation (Zajac, 2014.).
The following chart outlines the various carb restricted eating plans and the benefits and drawbacks of each, it also outlines the macronutrient break down and the effect of some of the lab values.
While the metaphor “many roads lead to Rome” applies here, the mode of eating program you utilize does not seem to have a major bearing on your FFM, cholesterol profile (excluding Ketogenic) or satiety, so long as you adhere to the major guidelines outlined by these various authors. These programs are here as tools, allowing the individual to maintain a healthy frame, feel satiated and ensure that their lab work will be within normal limits.  In making our meal selections, we are deciding what effect we are having on our bodies and lives

Comparison of the various low carbohydrate plans (Keto and Paleo, 2018).

Enter the Zone
Macronutrient breakdown
Carbs: 5-10%
Fat: 60-80
Protein: 20-30
Can fluctuate between a Keto and Paleo
Carbs: 40%
Fat: 30%
Protein: 30%
Carbs: 10-15%
Fat: 55-75%
Protein: 15-30%
Avoid Carbohydrates; Burn fats in lieu of carbs
Avoid processed or refined sugars, grains and trans fat
Avoid high glycemic index foods, balance macro’s
Avoid post agricultural period products (dairy, refined sugars, grains)
increased FFM, improved satiety
increased FFM, improved satiety
Increased FFM, improved satiety
Increased FFM,
Improved satiety
Decreased athletic performance
No limitations due to no guidelines, expense
Lab value impact
Lower insulin levels, Lower testosterone, increased inflammation, higher lipoproteins
Lower insulin levels, decreased inflammation, lower cholesterol/heart disease
Lower insulin levels, lower inflammation, lower cholesterol/heart disease
Lower insulin levels, lower inflammation, lower cholesterol/heart disease

Cordain, Loren. “The Paleo Diet Premise |Reduce Risk of Chronic Disease | Dr. Cordain.” The Paleo Diet™, 2018,
Drummen, Mathijs, et al. “Dietary Protein and Energy Balance in Relation to Obesity and Co-Morbidities.” Frontiers in Endocrinology, vol. 9, 2018, doi:10.3389/fendo.2018.00443.
Ebbeling, C. B., Leidig, M. M., Feldman, H. A., Lovesky, M. M., & Ludwig, D. S. (2007). Effects of a Low–Glycemic Load vs Low-Fat Diet in Obese Young Adults. Jama, 297(19), 2092. doi:10.1001/jama.297.19.2092
Fontani, G., Corradeschi, F., Felici, A., Alfatti, F., Bugarini, R., Fiaschi, A. I., . . . Berra, B. (2005). Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with Omega-3 polyunsaturated fatty acids. European Journal of Clinical Investigation, 35(8), 499-507. doi:10.1111/j.1365-2362.2005.01540.x
Hamdy, O., & Carver, C. (2008). The why WAIT program: Improving clinical outcomes through weight management in type 2 diabetes. Current Diabetes Reports, 8(5), 413-420. doi:10.1007/s11892-008-0071-5
Hyman, M. (2012). The blood sugar solution: The ultrahealthy program for losing weight, preventing disease, and feeling great now! New York, NY: Little, Brown and.
Khondkaryan, L., Margaryan, S., Poghosyan, D., & Manukyan, G. (2018). Impaired Inflammatory Response to LPS in Type 2 Diabetes Mellitus. International Journal of Inflammation, 2018, 1-6. doi:10.1155/2018/2157434
Pastore, Robert L., et al. “Paleolithic Nutrition Improves Plasma Lipid Concentrations of Hypercholesterolemic Adults to a Greater Extent than Traditional Heart-Healthy Dietary Recommendations.” Nutrition Research, vol. 35, no. 6, 2015, pp. 474–479., doi:10.1016/j.nutres.2015.05.002.
Pérez-Guisado, J., & Muñoz-Serrano, A. (2011). The Effect of the Spanish Ketogenic Mediterranean Diet on Nonalcoholic Fatty Liver Disease: A Pilot Study. Journal of Medicinal Food, 14(7-8), 677-680. doi:10.1089/jmf.2011.0075
Seaman, D. R. (2002). The diet-induced proinflammatory state:. Journal of Manipulative and Physiological Therapeutics, 25(3), 168-179. doi:10.1067/mmt.2002.122324
Safahani, Maryam, et al. “Resveratrol Promotes the Arcuate Nucleus Architecture Remodeling to Produce More Anorexigenic Neurons in High-Fat-Diet–Fed Mice.” Nutrition, vol. 50, 2018, pp. 49–59., doi:10.1016/j.nut.2017.10.019.
Sears, B., & Lawren, B. (1995). Enter the Zone. New York, NY: Regan Books.
Skov, A., Toubro, S., Rønn, B., Holm, L., & Astrup, A. (1999). Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. International Journal of Obesity, 23(5), 528-536. doi:10.1038/sj.ijo.0800867
Totsch, S. K., Waite, M. E., & Sorge, R. E. (2015). Dietary Influence on Pain via the Immune System. Progress in Molecular Biology and Translational Science Molecular and Cell Biology of Pain, 435-469. doi:10.1016/bs.pmbts.2014.11.013
Zajac, A., Poprzecki, S., Maszczyk, A., Czuba, M., Michalczyk, M., & Zydek, G. (2014). The Effects of a Ketogenic Diet on Exercise Metabolism and Physical Performance in Off-Road Cyclists. Nutrients, 6(7), 2493-2508. doi:10.3390/nu6072493

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