The Lowdown on the Ketogenic Diet, Part 2

The ketogenic diet is rapidly gaining new followers, so we sat down with Scott Bergman, DC to get the scoop on this popular lifestyle option. This is part two of a series, where we learned why the ketogenic diet is particularly suited to athletes. Always work with a healthcare practitioner prior to starting a new diet plan.

What recommendations do you make to athletes considering a ketogenic diet?

Athletes are always willing to try cutting edge, but they don’t want to suffer any setbacks during their training. They want to improve their metabolism, but they don’t want to lose momentum in their training, especially if there’s a race coming up.

I like being up front with them, and I let them know that in order to burn fat more efficiently, we need to take a few steps back in performance, honor the process, allow the body to shift, and then they’ll find that performance and body composition will change. Then they get all the other health benefits that come with the ketogenic diet anyway.

How do you recommend athletes adjust their workouts as they start a ketogenic diet?

I’ll usually have them start by reducing output by about 40-50%. That would include their frequency, duration, and intensity of training. We drop everything down, and then we can raise one of those factors up one at a time. We might add frequency—so instead of two or three times a week, we might then bring it to four times a week—and then we can increase the intensity, which is what I increase last.

I recommend keto-adaptation during the off-season or what’s called the early base phase for endurance athletes or the noncompetition season for strength and power athletes and team sports. You don’t want to try this right in the middle of your season. We want to make sure we have enough time to let the body adapt. I try to promote more of a parasympathetic state of rest and digest and promote recovery and restoration while we get the body into ketosis. We’re also promoting that they go to a yoga class. We have very specific breathing techniques that we promote and teach the athletes to stimulate the parasympathetic nervous system and stimulate digestion and we give them those little tools so that as we start increasing the overall workload again, the body is able to handle it.

How long will it take before they can go back to their normal routine? Does it depend on whether the athlete is a weekend warrior or a top-level athlete?

A normal training routine can take place as soon as keto-adaptation occurs. But that could take a few days for people, a few weeks, and for some it could take a couple of months.

Some endurance athletes, where they have been habitualized to the carbohydrates, they’re not getting enough sleep, and they’re overtraining somewhat; it can take a long time.

Initially there are not enough carbs or ketones to fuel the brain. During that period, training and performance is going to suffer, power output will be lower than normal, running pace is going to be slower than normal. Your perceived exertion goes up in a bad way at all intensities. Everything seems to be a little harder at first. Recovering from training sessions will be hindered.

We have what we call a periodization training and nutrition schedule. You can start increasing that frequency, duration, or intensity starting at that 40-50% initial reduction, and then I recommend increasing one of those factors, the frequency, duration, or intensity, about 10% each week for the first three weeks and then drop the frequency, duration, or intensity down 5-10% on the fourth week. That becomes a net increase of about 20-25% in the month. If you repeat that cycle, in a few months, you’re back to pre-keto-adaptation performance. And then you can reap all the benefits.

Is it possible to build muscle with a diet that includes only a moderate amount of protein?

The ketogenic diet is very muscle- and glycogen-sparing, so we know we’re not going to lose muscle if you’re properly in ketosis. Twenty percent of your calories as protein is a great place to start, and I think it’s a fair amount for endurance athletes, but it may need to change for strength and power athletes.

In our office, we use a BIA, a bio-impedence analyzer, and we measure BMR (basal metabolic rate). As muscle increases, your BMR increases. Your calorie requirements have to increase, so protein goes up anyway. If there’s a stall in the muscle growth that we see on the BIA, we just increase the protein intake, preferably postexercise.

We see an increase in muscle with people who are on a ketogenic diet. If they’re in a strength activity or strength and power sport, we may go into a cyclic ketogenic diet, which is once or twice a week adding a few more carbs and then going back into ketosis. That seems to allow the athlete to maintain their high-end output, which in turn allows muscle to build.

Can people be on keto and still be dairy-free?

Absolutely. Not only can you be dairy free, but you could be vegetarian. You could even be full vegan. Dairy-free options are pretty easy to come by. Coconut cream is something you can purchase. It’s unsweetened. It’s not coconut milk. There’s usually a lot of added sugar to the coconut milks, as well as the nut milks like almond milk, soy milk, and rice milk.

Use a pure coconut cream, MCT oils, avocado oils, olive oils, coconut oils. I’ll make a salad dressing with a combo of olive and avocado oil, and I’ll also add MCT oils and then apple cider vinegar and then seasoning and I’ll drench that on my salad or roasted vegetables and add some salt to it.

Macadamias are an easy way to get fats, as are the avocados. Almond and cashew flours can be used in baking, so you don’t need a lot of binders. A lot of people are using chia to bind in their cooking or avocados or egg whites.

There’s plenty of ways to get fats in without having to eat dairy. A real easy way to do that is a vegetable protein and some MCT oils and you have a nice little protein shake. Throw some coconut cream in there and you’re good to go.

Why is the ketogenic diet so effective for athletes? Can you share some stories for athletes in different sports and how the diet improved their performance?

We know that ketones are a preferred fuel for the brain, also the heart and the diaphragm. Because a state of ketosis can give you improved focus and cognitive performance during difficult mental tasks, a keto diet can be extremely useful during training and competition. Reaction times can go up.

The other reason athletes like it is that it improves body composition. If you improve body composition, your power-to-weight ratio goes up. People will spend thousands of dollars to reduce the weight on their bike. But nothing will improve performance like dropping 3 pounds of fat.

One of the key performance advantages, and this goes along with fasting, as well, is that it allows people to reconsider the definition of hunger. Instead of linking hunger with panic, feeling like food is being denied, or equating hunger to physical or mental weakness, hunger can theoretically be related to success or improved drive. Or hunger can sometimes be simply ignored.

We just had one of our patients who came back from Japan. He did a 1,700 kilometer—that’s about 1,000 miles—cycling. He was keto adapted. He felt like he was recovering faster; he felt he had more mental clarity. He was riding his bike through the middle of the night. In past competitions, he would have to lie down on a park bench and sleep in the middle of the night for a couple of hours. That’s a big deal.

Another young guy is an age-group cyclist, and he does a lot of road and criterium cycling races. What he found is that his energy is maintained throughout the whole ride, anywhere from 60 miles to 100 miles on a road race, or criteriums which are short, very high-intensity. On a criterium race, they’re literally riding 30 miles an hour shoulder to shoulder, and if anyone’s ever seen a cycling race, you know that can be a pretty dangerous situation. He feels that he is much more alert and still has that top-end energy that he needs to break away from a crowd.

What tips would you offer athletes who want to maintain performance while trying intermittent fasting?

What are the goals for the workout? Is it endurance, or is it strength? And it can easily change from day to day. Like triathletes, one day they have an endurance day, and the next day they’re doing intense interval repeats; the next day they’re doing functional strength training. In general, I will have them fast on their off days. Then after they exercise, recover with some protein and some added carbs. I’ll recommend a keto shake with some added berries or something like that.

For endurance athletes, if they’re going out at a steady run, I might have them just wake up and use something with caffeine and green tea catechins. That combination tends to promote fat burning. If it’s a long distance, longer than 90 minutes on their run, they’re going to deplete all of their glycogen, which is fine; it can be replenished during recovery. So I’ll have them add some coconut oil or some MCTs or some ghee or butter into a keto coffee. If it’s speed and strength, like high-intensity, I’d maybe have them think about doing some branch-chain amino acids and then protein and carbs after their workout. I always recommend eating after exercise.

About Scott Bergman: Scott Bergman, DC is a chiropractor, board certified naturopath, and certified Functional Medicine practitioner in Walnut Creek, California. Since 1993 Dr. Bergman has been the director of Chiro Kinetics, an integrative health clinic combining Chiropractic care, rehabilitation, pilates, core yoga therapy, Functional Medicine, and biological resonance. For 25 years, Dr. Bergman has presented edifying health, nutrition and fitness information internationally in business, education, and community settings. Dr. Bergman completed his chiropractic training at Los Angeles College of Chiropractic.

Scott Bergman is a paid consultant and guest writer for Metagenics.

Disclaimer:

This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues.