Keto and Fat Metabolism
Keto Medicine
Keto, Disorders of Fat Metabolism, and Metabolic Disorders
Article by the Keto doctors Dr. Brigitte Karner and Dr. Wolfgang Karner
A big, fat misconception that has lasted for decades.
Entire generations have followed false dietary recommendations.
Do you feel the same? Do you also divide fats into “good” and “bad”?
Do you think fat metabolism disorders are caused by eating too much fat?
Insulin and Fat Burning: Misconceptions in Nutrition
Researchers at the University Clinic in Tübingen recently discovered that the more disrupted fat burning becomes, the more insulin is present in the blood. Even after a small, carbohydrate-rich meal, blood sugar and insulin levels rise rapidly. The stronger this rise, the more fat burning is blocked. Disorders of fat metabolism therefore arise primarily from a high-carbohydrate diet – not, as claimed for decades, from too much fat. The body stores excess carbohydrates as fat in the form of triglycerides, which leads to the development of “love handles.”
Our cell membranes contain both saturated and unsaturated fatty acids, which are essential for many vital processes in the body. Some fatty acids, known as essential fatty acids, must be obtained through food. Fat and protein are vital nutrients for our bodies, while carbohydrates are required only in very small amounts.
False Beliefs About Fats and Cholesterol
In addition to a high-carbohydrate diet, stress, lack of physical activity and chemical food additives negatively affect fat metabolism. The belief that saturated fats are worse than unsaturated fats has led to a “no-fat craze,” which resulted in increased consumption of excessive carbohydrate-rich foods. This contributed to a rise in chronic, metabolism-related diseases.
The dogma of “good” HDL and “bad” LDL cholesterol persists to this day. In reality, these lipoproteins are simply transporters that carry fats through the body and are neither good nor bad. LDL cholesterol is not inherently “bad”; what matters is its size and density. Only small, dense LDL particles can adhere to vessel walls and contribute to the development of arteriosclerosis.
Studies Confirm the Benefits of Fats
A groundbreaking study from Spain, the Predimed Study, showed over seven years that fat not only tastes good and doesn’t make you fat, but also protects against heart attacks and strokes. Because the clear results showed that a higher-fat diet reduced the risk of cardiovascular disease, the study was stopped early in order to protect participants in the low-fat group from further health damage. The fat metabolism markers also improved in the high-fat group.
Despite these clear findings, the study received little attention. Another widely recognized study, the PURE Study with over 130,000 participants, confirmed that it is not fat, but carbohydrates that increase the risk of death. People who ate a high-fat diet had a 23% lower risk of death than those who ate a low-fat diet.
LDL Particle Size and Insulin Resistance
A simple method to determine the size of LDL particles is the ratio of triglycerides to HDL cholesterol. A value under 2.0 indicates large, “fluffy” LDL particles, which are considered less harmful. The amount of small, dense LDL particles increases with high carbohydrate intake and insulin resistance, which raises the risk of arteriosclerosis, strokes, and heart attacks.
In summary, a high-fat diet can protect the heart and lead to improved health. The belief that fats—especially saturated fats—are harmful is scientifically unsustainable. Increasingly, research shows that excessive intake of carbohydrates is what is harmful in the long term.
Notes on
Statin Therapy:
Statins are used to lower cholesterol levels because it is assumed that they reduce the risk of cardiovascular disease. In a rare, genetically determined defect in cholesterol synthesis—such as in familial hypercholesterolemia—this certainly applies. For all other people, however, the benefit of statins is noticeably low.
This may be because statins increase the amount of the unfavorable LDL particles, meaning the dense and small LDL particles. In addition to the general side effects of statins on, for example, the muscles, physical strength, and mental well-being, they also have an effect that increases insulin resistance. This effect is likely due to the muscle-damaging properties of statins and their inhibitory effect on the insulin sensitivity of cells.
Other Metabolic Disorders: When "Acidic" Makes Everything But Happy
Avoiding Over-Acidification: The Right Balance for Your Metabolism
Protect your metabolism from acidic metabolites and avoid an over-acidification that can arise from a diet too heavy in meat, ketogenic eating without enough salad and vegetables, and too little physical activity. For optimal function, our body relies on a pH level of around 7.0, which can vary slightly in different parts of the body. Strictly regulated buffering systems keep the blood in balance and prevent dangerous over-acidification.
Acidic breakdown products from food are excreted via the kidneys. But if these are not sufficiently neutralized, this can—aside from insulin resistance—pose a significant health risk. In the worst case, the body draws on alkaline minerals stored in the bones, which can be a major underlying cause of osteoporosis. Acid stress can also worsen insulin resistance and, in people who want to lose weight, lead to weight-loss plateaus, because fat burning is halted by over-acidification.
Alkaline Treatments and Alkaline-Rich Nutrition for Fat Burning
To get fat burning going again, we advise affected individuals to undergo an alkaline treatment, either with alkaline medications or—better yet—with alkaline infusions. An alkaline-rich diet is also an essential part of a healthy ketogenic diet according to Dr. Karner. Particularly alkaline foods such as salads, vegetables, and herbs—especially wild herbs—provide important bases and minerals that help neutralize acids. Therefore, we recommend a plant-based keto diet with around 700g of vegetables per day.
Chemicals and Their Impact on Metabolism
In addition to diet, chemicals such as bisphenols and parabens—which are used in plastics, artificial foods, and cosmetics as preservatives—can also cause metabolic problems. The body recognizes these substances as foreign and has difficulty eliminating them. One example is Bisphenol A (BPA), which is present in large quantities in our environment, for instance in plastic products and even in cash register receipts. BPA can now be detected in both the air and seawater and poses a serious problem for our health.
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Your Dr. Brigitte Karner & Dr. Wolfgang Karner
Keto specialists and keto physicians
Scientific studies on cholesterol, lipid metabolism disorders, and metabolic disorders
The PREDIMED study
The Keto Study →
The Prospective Urban Rural Epidemiology (PURE) study: examining the impact of societal influences on chronic noncommunicable diseases in low-, middle-, and high-income countries.
The Keto Study →
HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events.
The Keto Study →
Small, dense low-density lipoprotein particles as a predictor of the risk of ischemic heart disease in men. Prospective results from the Québec Cardiovascular Study.
The Keto Study →
Triglyceride/high-density lipoprotein cholesterol ratio: a surrogate to predict insulin resistance and low-density lipoprotein cholesterol particle size in nondiabetic patients with schizophrenia.
The Keto Study →
Statins and all-cause mortality in high-risk primary prevention: a meta-analysis of 11 randomized controlled trials involving 65,229 participants.
The Keto Study →
Statins Do Not Decrease Small, Dense Low-Density Lipoprotein.
The Keto Study →
Statin use and risk of diabetes mellitus in postmenopausal women in the Women’s Health Initiative.
The Keto Study →
Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs.
The Keto Study →
Impaired glucagon suppression and reduced insulin sensitivity in subjects with prediabetes undergoing atorvastatin therapy.
The Keto Study →