Dr. Osborn: Do You Need to Workout on a Ketogenic Diet?
January 20, 2017
“In my practice, I do not recommend a classic ketogenic diet, as there tends to be muscle loss in the context of the low insulin signal. Remember, insulin is a very potent anabolic hormone and in its absence, bodily tissues are broken down or catabolized, fat and muscle alike. Yet muscle is the tissue that you desperately want to spare! Why? Aesthetics aside, muscle mass confers resistance against disease. That’s right, the stronger do live longer according to a 2008 publication in the British Medical Journal. In the study cohort of over 8500 men, all cause mortality was significantly lower across incremental thirds of muscular strength, including cancer and independent of cardiovascular fitness. Bottom line? Spare muscle at all costs.
This trend is echoed in my critically head-injured ICU patients. Muscular individuals nearly always fare better than those without reserve. Reserve? You read that right. Muscles serve as protein depots from which antibodies (immunoglobulin) can be synthesized, allowing one to fend off invasive bacteria. Remember, infection is a leading cause of mortality in the ICU setting. So in addition to the sex appeal of muscles, they confer both metabolic and survival advantages.
In the same vein, I am reluctant to utilize a classic ketogenic diet in my practice. There is some emerging data suggesting that ketones exert anti-catabolic effects, in essence sparing muscle. Unfortunately, this has not been my observation in the clinical setting, in real people. In order to temper muscle loss therefore, I default to a “modified ketogenic diet” that uses higher daily loads of carbohydrates: 50-100g. The resultant insulin signal, while still small, drives the needle towards anabolism, while still permitting lipolysis. And you know what? Strength training works similarly. Electively traumatizing your muscles (because that’s what strength training truly is, right?) causes a robust hormonal response: growth hormone and testosterone primarily are poured into the bloodstream to drive repair of the damaged muscles, the former of which works in a similar manner to insulin mechanistically. For those of you familiar with the mTOR pathway, this should ring a bell.
The upshot? Strength training is integral to any fat loss program. Muscle is the body’s metabolic machinery, remember. It burns fat while you’re sleeping! So spare it at all costs by stimulating it. Should you opt for a classic ketogenic diet, consider sticking to a classic 5×5 workout as opposed to one incorporating higher reps. This will lessen the burden on the glycolytic energy system that, to some degree, will be inadequately supplied due to induced glycogen-depleted state (ketosis). So use the phosphocreatine system as an alternative!
To fuel your phosphocreatine (P-Cr) system optimally, use a pre-workout creatine supplement such as BPI Sports Best Creatine™. On endurance days, the same principle applies: fuel the trained energy system – oxidative phosphorylation (in type I muscle fibers). Implement “fasted cardio” to deeply tap into bodily fat stores or utilize BPI Sports Best Pre Workout™ that not only provides the often-needed caffeine but also exogenous ketones, augmenting the body’s ability to utilize these fat breakdown products as an energy source.
Stay lean. Train hard. Stay safe!”
Dr. O is a Team BPI Sports’ fitness and nutrition expert.
Ruiz JR, et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ 2008 Jul 1; 337:a439.