Book Review: Ketogenic - The science of therapeutic carbohydrate restriction in human health

Ketogenic: The science of therapeutic carbohydrate restriction in human health. Edited by Nutrition Network. Published: 2023, London, Elsevier

---

The preface is written by Professor Tim Noakes, founder of the Noakes Foundation and co-founder of the Nutrition Network. In it he describes how his discovery of a book describing the Atkins Diet changed his view of human nutrition and ultimately put his type-2 diabetes into (medically impossible) remission. His story resonated strongly with me.

“…this is an indispensable text for anyone interested in the metabolic and health effects of carbohydrates in the human diet.”

In the early 2000s, I experimented with Atkins just for the fun of investigating if it could induce weight loss as easily as claimed. I followed the diet for a few weeks and my weight loss was frighteningly dramatic. I switched back to my regular diet and didn’t give it any more thought, because I did not need to lose weight. Sadly, I didn’t take the time to understand the metabolism underpinning the low carbohydrate approach. In 2017 when I was diagnosed with advanced heart disease despite following my doctor’s dietary, exercise and medical advice, I started to read about potential alternative causes of the disease. When I encountered the extensive literature on the effects of high carbohydrate diets and so-called chronic disease, I recalled my experience with Atkins and weight loss. From that point on I reduced as much as possible my exposure to processed foods, including bioavailable carbohydrates and seed oils.

“Ketogenic: The science of therapeutic carbohydrate restriction in human health” advocates for the therapeutic use of a ketogenic diet. A ketogenic diet is one in which the intake of carbohydrates does not exceed 20g to 50g per day. At that rate of intake, our metabolism uses ketones for energy and our body is described as in ketosis.

I’ll give the game away now; this is an indispensable text for anyone interested in the metabolic and health effects of carbohydrates in the human diet.

“I found the first section on nutritional fundamentals fascinating and indispensable. It provides a first-principles basis for understanding diet and disease from an evolutionary perspective.”

There are four major sections and nine sub-sections as follows:

1. Nutritional fundamentals

   1. Understanding human diet, disease, and insulin resistance: scientific and evolutionary perspectives

   2. Nutritional aspects

2. Medical nutritional therapy

   1. Endocrine

   2. Cardiovascular disease and its association with insulin resistance and cholesterol

   3. Neurology

   4. Cancer

   5. Musculoskeletal and immunological considerations

   6. Gastrointestinal health and therapeutic carbohydrate restriction

3. Therapeutic carbohydrate restriction for health and fitness

   1. Exercise and sports performance

   2. Therapeutic fasting

4. Managing the patient

   1. Psychological, behavioural, and ethical considerations

I found the first section on nutritional fundamentals fascinating and indispensable.  It provides a first-principles basis for understanding diet and disease from an evolutionary perspective.  That basic framework provides the backdrop for a description of the therapeutic carbohydrate restricted diet.

The second section provides excellent insight into the nature, potential causes and treatment of a range of maladies.  These include ALS, Alzheimer’s, autism, autoimmunity, cancer, epilepsy, gout, IBD, IBS, metabolic syndrome, migraine, multiple sclerosis, obesity, polycystic ovarian syndrome, stroke, traumatic brain injury, Type-1 diabetes, and Type 2 diabetes.

“This is an absolute treasure trove of information that I have not found elsewhere… It is…essential…for the motivated lay person who, like me, wants to take the time to understand their own health.”

Any textbook is only as good as its index.  This book’s index is comprehensive and, for me at least, intuitive.  It has allowed me to read through the larger foundational topics and dip in and out of the disease- and method-specific sections at will.

The book was produced by the Nutrition Network to record the extensive literature underpinning their novel ketogenic medical discipline.  It contains 540 pages of information backed by thousands of carefully documented academic references from 62 contributors and organized by 12 editors and reviewers.

This is an absolute treasure trove of information that I have not found elsewhere.  It is probably aimed at credentialled professionals in the medical and nutritional communities and it’s not a light read.  But it is a very important one.  It is an essential book for the motivated lay person who, like me, wants to take the time to understand their own health.

---