The Ketogenic Diet, Inflammation, and Performance With Dr. Stephen Phinney

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ByCrossFit November 19, 2022
Found in:221120,Health

In this interview at the Symposium for Metabolic Health in San Diego, California, Mike Giardina sits down with Dr. Stephen Phinney to discuss how the ketogenic diet can prevent chronic low-grade inflammation to improve health and performance. Dr. Phinney is the co-founder and former Chief Medical Officer of Virta Health.

Dr. Phinney explains how inflammation is very complex and can be damaging but is also essential for health and survival — as long as it is modulated and controlled. Inflammation is a necessary process when healing from acute injury or infection. This type of inflammation is acute and short-lasting. Chronic inflammation is at a much lower grade, meaning there is no fever associated with it, but it lasts for months and up to many years. People with chronic diseases typically have chronic inflammation and run the risk of severe tissue and organ damage.

Doctors tend to prescribe non-steroidal anti-inflammatory drugs (NSAIDs) or steroids to control inflammation, explains Dr. Phinney, but these medications come with a host of adverse side effects, such as lowered insulin sensitivity and catabolism. He has found that the ketogenic diet is a more viable and safer option. In January 2013, a study came out of the University of California San Francisco explaining how beta hydroxybutyrate (BHB) affects cell function. It turns out that BHB is not only a great fuel for the brain, but it also acts as a gene-expression altering signal. There are certain genes that are suppressed because they are wrapped in histones, explains Dr. Phinney, and when they are provided a level of ketones, proteins on these genes unwrap, which allows them to turn on. These genes provide an antioxidant defense we don’t have when we eat carbohydrates, which might explain why antioxidant supplementation is encouraged on a diet consisting of high carbohydrates, explains Dr. Phinney.

This inflammatory protection may apply to exercise as well. We know that vigorous exercise can lead to oxidative damage and muscle inflammation. This is a necessary stimulus to improve muscle strength and resilience. High-intensity training, while adapted to the ketogenic diet, may reduce the post-exercise inflammatory response, reducing recovery time between exercise bouts.

According to Dr. Phinney, CrossFit training while adapted to the ketogenic diet will likely have the same effect. A CrossFit athlete can expect the same training response, possibly with a higher perception of discomfort, but with the added ability to maintain a higher level of intensity with a greater frequency, leading to a greater training volume. As long as we provide an athlete enough time to fully adapt, the ketogenic diet can be used as a way to improve metabolic health as well as performance for both the general CrossFit athlete and the competitor.

Comments on The Ketogenic Diet, Inflammation, and Performance With Dr. Stephen Phinney

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Alex Trump
November 21st, 2022 at 1:59 pm
Commented on: The Ketogenic Diet, Inflammation, and Performance With Dr. Stephen Phinney

Thanks for this interview, lot of knowledge !


However, I was wondering if I could do some rameur Concept 2 https://crosssport.fr/materiel-maison/rameur-concept-2/ ( a really well-known crossfit object) at the same time that Im doing this Diet.


Maybe It could help me get faster and better results.


Thanks for your answer. Have a good day.

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Jenella Herring
November 20th, 2022 at 8:43 pm
Commented on: The Ketogenic Diet, Inflammation, and Performance With Dr. Stephen Phinney

Fantasic. My n1 experience shows lower carb (processed and natural) decrease my aches and pains and my energy increases. Love seeing varying views on health and nutrition.

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Karen Blankenship
November 20th, 2022 at 12:08 pm
Commented on: The Ketogenic Diet, Inflammation, and Performance With Dr. Stephen Phinney

Please stop promoting a low carb or keto diet. While it can be beneficial for a short time for certain individuals, it should not be followed long term, especially in athletes and women. As a certified nutrition coach and someone who experimented with low carb, I can say it will wreck your metabolism. We need carbs. While we shouldn’t eat a standard American diet full of grains and insufficient protein, we shouldn’t be afraid of fruit, tubers, rice and properly prepared grains. Also, keep in mind that most of the studies on keto are short term and only include men. The ones that do include women do not show the same benefits for women. We need carbs for a healthy cycle.

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Tiffanee Kohl
November 20th, 2022 at 10:12 pm

It's unfortunate you had a bad experience, however there are a lot of medical docs, PAs, NPs and other providers (including Dr Ken Berry, Dr Andreas Eenfeldt, Dr Aseem Malhotra, Dr Sara Hallberg, Dr Tim Noakes, Dr Ted Naimen, Dr Robert Lustig, Dr Michael Eades, Dr Jeffrey Gerber, Dr Jason Fung, Dr Dominic D'Agostino, Dr Bret Scher, Dr Eric Westman, and MANY more) who have completed dozens of RCTs, meta analyses, and cohort studies that would prove otherwise. The science does support nutritional ketosis- if done right. There have even been studies done on CrossFit athletes, and some of these docs also do CrossFit.

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Victoria Duke
November 20th, 2022 at 9:46 am
Commented on: The Ketogenic Diet, Inflammation, and Performance With Dr. Stephen Phinney

He’s essentially saying you should cut out the majority of fibre from your diet. That’s not a good idea.

Also, how does he suggest athletes get adequate protein? As when protein is consumed in adequate amounts will knock you out of ketosis.

I really cannot understand the CrossFit philosophy of low carb for so many reasons.

Yes it may have a place in individuals in a diseased state, but stop promoting it for the general public. It’s irresponsible

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Matej Fartelj
November 20th, 2022 at 7:29 am
Commented on: The Ketogenic Diet, Inflammation, and Performance With Dr. Stephen Phinney

Please start explaining what you mean when you say carbohydrates - it's to broad as a term. Not defining it is just lazy and irresponsible.

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