The long-term studies relative to the ketogenic diet are not very encouraging. They all point out the likelihood of heart disease. Basically, the body is not meant to consume that level of fat on a regular basis.
But that doesn’t mean that the ketogenic approach is not useful.
Let me explain. I do 19:5 intermittent fasting. I eat a big meal at 11 am and stop eating at 4 pm sharp. It is just the way I eat now. Don’t even think about it. Habit.
But I want to do 48-hour and longer fasts on a fairly regular basis for the sake of enhanced autophagy. Not that hard to do a 48-hour fast — just means not eating for one full day. But longer fasts are a real test for me, and yet they would provide even better autophagy.
So longer than a 48-hour fast is where a “keto day” comes in. I just did a 48-hour fast, but the next day afterward, I did what I call a keto day. The keto day was 2000 calories, mostly fat, a small amount of protein, but only 22 grams of carbohydrates.
The tiny amount of carbohydrates means that the deep ketosis of the longer fast will continue for another day, with all the benefits of deep ketosis.
Relative to enhanced autophagy, the small amount of protein is a more serious issue, as protein tends to halt autophagy. (A major reason for autophagy is the body is scavenging for amino acids, so if you provide protein with food that ends the need for scavenging.)
Bottom line: on that third day, one needs to keep the carbohydrates tiny for continued ketosis, but also keep the protein very low, and that — keeping the protein low — is a challenge in using a keto day for greater autophagy in a longer fast.