Let’s cut right to the chase. The keto diet doesn’t work for everyone. This diet is supposed to help you make ketones from fats, either from what you eat or from your own stored fat. “Ketogenic” means “ketone-originating.”

Why doesn’t it always work?

Taking a look under the hood of the keto diet provides some explanation.

For starters, the simple description above is generally agreed upon. However, almost nothing else about the keto diet is. Indeed, the keto diet “movement’ has spawned a wide variety of approaches that too often offer conflicting advice.

The main confusion arising about the keto diet is that achieving a state of ketosis—i.e., metabolizing ketones for cellular energy—focuses on food. However, while the right foods are important, achieving a healthy state of ketosis depends on much more than what you eat.

Nevertheless, since food is the easiest component of the keto diet to understand, let’s see what that means in a current medical context.

Eating for Ketogenesis

The keto diet is supposed to be a high-fat, adequate protein, low-carbohydrate diet. The key concept behind it is that limiting carbohydrate intake directs metabolism into fat-burning mode, which generates ketones.

The main question about proportioning the main three food groups is, how much fat? High fat means different things to different people. What it means medically, however, relies on its use for a variety of medical conditions. Two current examples are pediatric epilepsy (2017) and brain cancer (2012).

For both conditions, high fat means 80% of the diet. In other words, a ratio of 4:1, fat to protein-plus-carbohydrate, is what works best.

If you think about that ratio for a moment, you might realize that eating that much fat is a big challenge. Very few foods are that fatty. Commercial formulas, like those used in the two studies cited above, can help. Unfortunately, reading all the chemical gobbledygook on the ingredient labels of such products is not very appetizing.

A better approach is outlined in a recently published book by Dr. Joseph Mercola,

According to Dr. Mercola, getting enough fat requires that you add good fats to your meals. His recommended sources of such fats rely heavily on the following:

  • Butter or ghee
  • Coconut oil
  • MCT oil (i.e., medium-chain triglycerides from coconut oil)
  • Chicken fat
  • Duck fat
  • Avocados
  • Extra virgin olive oil
  • High-fat nuts and seeds (e.g., Brazil nuts, macadamia nuts, flax seeds, chia seeds)
  • Raw cacao powder, nibs, and butter
  • Egg yolks
  • Cream cheese and hard cheeses

Emphasis here is on good fats. Avoiding bad fats and oils is also imperative. These include all processed vegetable oils (e.g., canola, peanut, cottonseed, corn, soy) as well as artificially hydrogenated fats (“trans” fats). The latter show up in salad dressings, most brands of mayonnaise, margarines, and shortening.

In addition, a good ketogenic eating style involves more than which food groups you eat in which proportions. It also includes how often you eat.

These days most people eat too often. Having several meals or snacks a day is nonsensical biologically. Even three meals a day can undermine ketosis.

This is where intermittent fasting can boost ketogenesis. Intermittent fasting elevates ketone levels. It also rescues our overloaded cellular garbage removal system. Cells that are continually overstuffed with metabolic trash are less effective for burning fat into ketones.

By not eating for a few hours, even up to 24 hours at a time, you allow your internal cleanup crew to clear out waste that can gum up the works metabolically. This is my own strategy for intermittent fasting twice a week.

Why a Keto Diet Fails

Taking in a high amount of good fats is just the beginning. Intermittent fasting helps, of course.

However, ketosis will fail you completely if you don’t get enough of the most important dietary ingredient of all: DHA.

DHA (docosahexaenoic acid) is a key fatty acid from seafood (fish and certain marine algae).

The reason that DHA is so valuable is because it gets inserted into something called the inner mitochondrial membrane. Without getting too geeky here, I’ll just say that mitochondria are the powerhouses of the cell. They are where energy is harvested from ketones and carbohydrates.

DHA in your mitochondria acts like a battery, which is fueled by the energy of electrons from ketones. DHA itself is not a source of energy—meaning it doesn’t act like any other component of food. In a simplistic sense, it has no caloric value.

However, if you don’t get enough DHA in your diet, your mitochondrial batteries won’t work well. When that happens, your health can never be optimal, no matter what you eat.

Nope, never.

Good mitochondrial energy metabolism is the key to good health. The underlying protocol in Dr. Mercola’s book entails what he calls Mitochondrial Metabolic Therapy. He mentions the role of DHA, although he doesn’t emphasize its importance enough.

By the way, regarding DHA, fish oil supplements are not as effective as the real thing from whole foods. The biggest consumer of DHA in your body, your brain, simply doesn’t work as well when you take fish oil that has been processed into a supplement. If you are curious about why that is the case, you can find a detailed explanation here: Fish Oils – Industry BS Just Plain Fishy.

One More Thing

The biggest modern challenge for realizing the benefits of a keto diet has nothing to do with food at all.

Yes, eating high-fat, with plenty of whole-food DHA, is the dietary foundation that you need.

To make all that work for you, though, you must live a lifestyle that is in concert with a 24-hour cycle, your circadian rhythm. We are diurnal organisms, meaning that we are supposed to be awake during the day and asleep at night.

The most common violation of this circadian rhythm is exposure to light when we should be in darkness, after sundown. It is particularly problematic with blue light (2017). The underlying drawback of blue light is that it destroys DHA, among other things.

Since scientists get a little nerdy on this topic (like everything else), let me put it in a way that relates to a keto diet:

Blue light is a signal to your mitochondria that you are eating ice cream and cookies all day and into the night.

In other words, a keto diet, no matter how good it is, will not help you if your lifestyle does not match your circadian rhythm.

What are the main sources of blue light in modern times? It is an extensive list that includes digital electronic devices (TVs, laptop computers, cell phones, e-readers, tablets), fluorescent and LED lighting, and compact fluorescent lamps.

If you are looking for the health benefits of the keto diet, you have to address that challenge first.

Making the Keto Diet Work

The few aspects of the keto diet outlined here are just a start to understanding what makes it work. You are on the right track when you pay attention to eating the right fats in high amounts, to adopting intermittent fasting, and to living a circadian lifestyle.

You will have a much smaller chance achieving and maintaining ketosis if you don’t have all of those components in place.