A Flex Success Coach Response To The Ketogenic Diet Potential Benefits To Warfighter Health And Performance
I thought I would write out a response to this as I am studying some advanced physiology this year in which we look at a lot of the metrics that are being discussed here so I am getting a good chance at really understanding the results, but also the metabolism and bioenergetics that are involved in this discussion are a little complicated and I think I really want an attempt at communicating that. Plus, also I am the only one in the Flex Success coaching team that was in the Australian Army (5RAR) and have been trained as a warfighter, so I can talk pretty accurately on the demands of the role.
Recently an article has come to be published by the infamous Jeff S. Volek and two other authors Richard and Parker. Now I want to outline that Jeff has been involved in a lot of Low-Carb/Ketogenic diet (KD) studies that promote the use of those in sports. Now I won’t go into that much detail today but essentially his own data was skewed due to low number of participants and get a false positive. It is an extremely controversial topic and still gets debated heavily to this day.
Anyway, these recommendations that are being made to convert the Warfighter into a Ketogenic fuel selection is as follows and we can discuss it as we go.
“KDs deviate from traditional high-carbohydrate diets, as well as differing from many popular low-carbohydrate approaches (e.g., Paleo diets) that do not elevate ketones. A well-formulated KD includes limited carbohydrates (typically 50g/day or less) and adequate protein (1.2-2.0 g/kg Reference Weight). The remaining calories are derived from fat, which is consumed to satiety (~70-80 percent total kcal/ day on a eucaloric weight-maintenance KD) (see Figure 1).“
Now that is true, nothing that is being written there is wrong or misleading in anyway. Whilst I will indicate that original KD’s have had lower protein in their medical treatment an altered KD approach for sports performance would push up protein requirements. This can impair how long ketosis can take to be achieved and as well as how easy it is to lower yourself out of ketosis.
“KDs result in reduced availability of glucose and stimulation of insulin. This metabolic and hormonal state stimulates adipose tissue lipolysis and enhanced fatty acid delivery to tissues that manifests in profound increases in fatty acid oxidation and hepatic ketogenesis. “
By definition a KD is restricted in carbohydrates. That reduction in carbohydrates results in a reduction in availability of glucose but stimulation of insulin is something I would argue may even remain the same. If a Warfighter was easting a high carbohydrate amount of food and low protein but swapped over to a larger amount of protein and lowered their carbohydrates it in fact could remain close, if not the same depending on the amounts. For those that are unaware protein is insulinogenic but not to the same degree as carbohydrates (especially simple carbohydrates).
A lowered amount of glucose in the blood stimulates the body to release Adrenalin and Noradrenalin in an attempt at stimulating the body into a sympathetic state (think fight or flight state). This increase in Heart Rate, Blood Pressure, breathing rate is a result of both this stimulation and the force demand from the body to fuel exercise at a given intensity. This level of intensity will have a range of mixed fuel contributions of carbohydrates, free fatty acids, amino acids. There will be some metabolic by-products as well such as lactate and ketones. This sympathetic state also drives lipolysis (the breakdown of fats). So, this exercise metabolism which happens to anyone who is partaking in exercise at any fitness levels, when restricting carbohydrates and increasing fats in a diet just increase the number of ketones that are produced and converted in the body.
Now that may sound like a great thing, you have all these fuel sources ready to use. But these fuel sources are limited in their application. These fuel sources cannot produce the same amount of ATP to fuel exercise fast enough to sufficiently provide enough fuel to maintain that intensity.
Remember that the body must maintain a blood glucose levels for the brain and some other tissues to have energy.
Fatty acids cannot contribute to gluconeogenesis or glycolysis. Amino acids can be converted to some of the intermediates which become Oxaloacetate which is an intermediate in both Glycolysis and Gluconeogenesis.
So, what does that mean? Well think about the role of a soldier. Think about what they would do when they are on patrol. They are carrying about 30-50kgs in gear on their bodies, slowly walking and patrolling an area for any enemies or enemy materials. This isn’t a terribly intense activity and though the loads are quite heavy there isn’t the ability to patrol at a fast pace. This is done slowly so as to catch enemy movement, identify enemy vehicles and traverse more quietly. So this level of intense exercise could quite possibly be low enough for people to benefit from the reduced carbohydrate availability and be fuelled through ketosis.
But what isn’t is what happens as soon as there is ‘contact’. This term ‘contact’ literally means contact with enemy, and what results is an insane amount of fast paced activity that happens in a matter of seconds possibly lasting to minutes in the 10-30-minute range.
The immediate action drill of a soldier that is in ‘contact’ is to drop down to the floor immediately and look for signs of someone shooting at you. That is a very real, a very intense level of arousal and requiring a lot of ATP. Then from there is the attack or counter-attack depending on the situation. This is then a run of 10m, a dive to the ground, a crawl for another 1-5m looking for cover, and then returning fire upon the enemy. This is then repeated for as many times is needed to either take out the enemy, clear the area or until you are dead. This is a really good incentive to have a lot of energy available to use in these times in which that level of response is needed.
Also, there is good evidence that shows athletes limiting their carbohydrate availability over a short period of time leads to a down-regulation of an enzyme PDH which is required for the breakdown of glucose into the Krebs cycle. If this enzyme is limited due to restricting carbohydrate amounts, then even if you are: adequately fuelled for the lower intensity exercises through fats, even if you have some carbohydrates on you that you can eat in preparation for an attack (I don’t know how you’re going to guess when an attack comes), you are still limited in your body’s ability to use those carbohydrates and efficiently convert them into ATP that would be needed to survive, fight back and return to continuing the mission.
There is so much more to respond to this article that it will come out in serious so as to keep it easily digestible. So, stay tuned.
Diet Smart. Not Hard.