The ketogenic diet, often called the "keto diet," has gained popularity as a weight-loss strategy. This dietary approach, initially used in a clinical setting to manage drug-resistant seizures in children with epilepsy, is now recognized as an effective method for weight loss and potentially other health benefits. But is it right for you? This article explores the ketogenic diet, its benefits, risks, and how to implement it effectively, making use of the latest research and insights.
What is the Ketogenic Diet?
The ketogenic diet is a high-fat, moderate-protein, and very low-carbohydrate diet that shifts the body's metabolism into a state called ketosis. In ketosis, the body burns fat for fuel instead of carbohydrates. This process shouldn't be confused with ketoacidosis, a dangerous condition typically caused by a lack of insulin in the body.
According to Dominic D’Agostino, a researcher specializing in ketogenic diets at the University of South Florida, the classic ketogenic diet used for managing drug-resistant seizures involves a 4:1 ratio of fats to protein and carbohydrates. This translates to roughly 80-90% fat, 5-15% protein, and 5-10% carbohydrates.
Different Types of Keto Diets
There are several variations of the ketogenic diet:
- Standard Ketogenic Diet (SKD): This is a very low-carb, moderate-protein, and high-fat diet, typically containing 70% fat, 20% protein, and 10% carbs.
- Cyclical Ketogenic Diet (CKD): This diet involves periods of higher carb refeeds, such as five ketogenic days followed by two high-carb days.
- Targeted Ketogenic Diet (TKD): This diet allows you to add carbs around workouts.
- High-Protein Ketogenic Diet: Similar to the standard ketogenic diet but includes more protein, with a ratio of often 60% fat, 35% protein, and 5% carbs.
The standard and high-protein ketogenic diets have been studied most extensively. Cyclical and targeted ketogenic diets are more advanced methods primarily used by bodybuilders or athletes.
Read also: Easy Low-Carb Cheese Crackers
How Ketosis Works
Ketosis is a metabolic state where the body uses fat for fuel instead of carbs. It occurs when carbohydrate consumption is significantly reduced, limiting the body’s supply of glucose (sugar), which is the main energy source for cells.
Following a ketogenic diet is the most effective way to enter ketosis. Generally, this involves limiting carb consumption to around 20 to 50 grams per day and filling up on fats, such as meat, fish, eggs, nuts, and healthy oils. It’s also important to moderate protein consumption because protein can be converted into glucose if consumed in high amounts, potentially slowing the transition into ketosis.
Intermittent fasting can also help accelerate entry into ketosis. A common method involves limiting food intake to around 8 hours per day and fasting for the remaining 16 hours.
Blood, urine, and breath tests can determine if you’ve entered ketosis by measuring the ketone levels produced by your body. Symptoms such as increased thirst, dry mouth, frequent urination, and decreased hunger or appetite may also indicate ketosis.
Benefits of the Ketogenic Diet
Advocates of the ketogenic diet highlight several potential benefits, especially for weight loss and managing certain health conditions.
Read also: Keto Calorie Counting: A Detailed Guide
Weight Loss
Research suggests that the keto diet can help people cut calories because the diet doesn't include many foods that people are likely to overeat. The ketogenic diet can be an effective way to lose weight and lower risk factors for disease. Research indicates that it may be as effective for weight loss as a low-fat diet. Moreover, the diet is so filling that you can lose weight without counting calories or tracking your food intake.
A review of 13 studies found that a very low-carb, ketogenic diet was slightly more effective for long-term weight loss than a low-fat diet. People on the keto diet lost an average of 2 pounds (0.9 kg) more than those on a low-fat diet. Another study in 34 older adults found that those who followed a ketogenic diet for 8 weeks lost nearly five times as much total body fat as those who followed a low-fat diet. The increased ketone levels, lower blood sugar, and improved insulin sensitivity may also play a key role in weight loss.
Diabetes Management
Diabetes is characterized by changes in metabolism, high blood sugar, and impaired insulin function. The ketogenic diet has shown promise in improving insulin sensitivity and blood sugar management.
One study found that the ketogenic diet improved insulin sensitivity by 75%. A small study in women with type 2 diabetes also found that following a ketogenic diet for 90 days significantly reduced levels of hemoglobin A1C, a measure of long-term blood sugar management. Another study in 349 people with type 2 diabetes found that those who followed a ketogenic diet lost an average of 26.2 pounds (11.9 kg) over a 2-year period. They also experienced improved blood sugar management, and the use of certain blood sugar medications decreased among participants.
Other Health Benefits
Studies have shown that the ketogenic diet may offer benefits for a wide range of health conditions:
Read also: Magnesium Supplements for Keto
- Heart Disease: The ketogenic diet can help improve risk factors like body fat, HDL (good) cholesterol levels, blood pressure, and blood sugar.
- Cancer: The diet is being explored as an additional treatment for cancer because it may help slow tumor growth.
- Alzheimer’s Disease: The keto diet may help reduce symptoms of Alzheimer’s disease and slow its progression.
- Epilepsy: Research has shown that the ketogenic diet can cause significant reductions in seizures in epileptic children.
- Parkinson’s Disease: One study found that the diet helped improve symptoms of Parkinson’s disease, although more research is needed.
- Polycystic Ovary Syndrome (PCOS): The ketogenic diet can help reduce insulin levels, which may play a key role in managing PCOS.
- Brain Injuries: Some research suggests that the diet could improve outcomes of traumatic brain injuries.
Risks and Considerations
Despite its potential benefits, the ketogenic diet is not without risks. It's crucial to be aware of these before making significant dietary changes.
Nutrient Deficiencies
The keto diet is very low in carbs, which means you can't eat many fruits and vegetables. This can lead to nutrient deficiencies, as low-carb diets may lack fiber, necessary vitamins, minerals, and iron. To mitigate this, it's crucial to choose low-carbohydrate foods rich in fiber, such as leafy greens, nuts, berries, and resistant starchy vegetables.
Potential Negative Effects on Heart Health
There are mixed results in studies examining the specific effects of the keto diet on heart health. Results likely depend on individual food choices. It's important to get a blood test to look at your lipids before starting the keto diet. Some people may find that their high-density lipoproteins (HDL) - the good cholesterol - go up, and their triglycerides go down.
Constipation and Gastrointestinal Issues
Constipation is a common long-term complication of the keto diet due to low fiber intake. Fiber, a form of carb digested by microbes in our gut, is found in high-carb foods (like beans, whole grains, and certain fruits), which are typically restricted on the keto diet.
Bone Health Issues
There can be issues with bone health when people switch to low-carb keto diets. Researchers have observed that markers for bone breakdown are higher, and markers for bone building are lower.
Keto Flu
When people start the keto diet, they often experience the "keto flu," with symptoms appearing a few days after starting the diet. These symptoms eventually go away once your body adjusts to the eating changes.
Long-Term Risks
Staying on the keto diet long-term may have some negative effects, including risks of:
- Low protein in the blood
- Extra fat in the liver
- Kidney stones
- Micronutrient deficiencies
Foods to Eat and Avoid on a Ketogenic Diet
Knowing what to eat and avoid is crucial for successfully implementing a ketogenic diet.
Foods to Avoid
Here’s a list of foods that need to be reduced or eliminated on a ketogenic diet:
- Sugary Foods: Soda, fruit juice, smoothies, cake, ice cream, candy, etc.
- Grains or Starches: Wheat-based products, rice, pasta, cereal, etc.
- Fruit: All fruit, except small portions of berries or strawberries.
- Beans or Legumes: Peas, kidney beans, lentils, chickpeas, etc.
- Root Vegetables and Tubers: Potatoes, sweet potatoes, carrots, parsnips, etc.
- Low Fat or Diet Products: Low-fat mayonnaise, salad dressings, and condiments.
- Some Condiments or Sauces: Barbecue sauce, honey mustard, teriyaki sauce, ketchup, etc.
- Unhealthy Fats: Processed vegetable oils, mayonnaise, etc.
- Alcohol: Beer, wine, liquor, mixed drinks.
- Sugar-Free Diet Foods: Sugar-free candies, syrups, puddings, sweeteners, desserts, etc.
Foods to Eat
You should base the majority of your meals around these foods:
- Meat: Red meat, steak, ham, sausage, bacon, chicken, and turkey.
- Fatty Fish: Salmon, trout, tuna, and mackerel.
- Eggs: Pastured or omega-3 whole eggs.
- Butter and Cream: Grass-fed butter and heavy cream.
- Cheese: Unprocessed cheeses like cheddar, goat, cream, blue, or mozzarella.
- Nuts and Seeds: Almonds, walnuts, flaxseeds, pumpkin seeds, chia seeds, etc.
- Healthy Oils: Extra virgin olive oil and avocado oil.
- Avocados: Whole avocados or freshly made guacamole.
- Low Carb Veggies: Green veggies, tomatoes, onions, peppers, etc.
- Condiments: Salt, pepper, herbs, and spices.
Sample Keto Meal Plan
Here’s a sample keto meal plan to give you an idea of what a week on the ketogenic diet might look like:
- Monday
- Breakfast: Veggie and egg muffins with tomatoes
- Lunch: Chicken salad with olive oil, feta cheese, olives, and a side salad
- Dinner: Salmon with asparagus cooked in butter
- Tuesday
- Breakfast: Egg, tomato, basil, and spinach omelet
- Lunch: Almond milk, peanut butter, spinach, cocoa powder, and stevia milkshake with a side of sliced strawberries
- Dinner: Cheese-shell tacos with salsa
- Wednesday
- Breakfast: Nut milk chia pudding topped with coconut and blackberries
- Lunch: Avocado shrimp salad
- Dinner: Pork chops with Parmesan cheese, broccoli, and salad
- Thursday
- Breakfast: Omelet with avocado, salsa, peppers, onion, and spices
- Lunch: A handful of nuts and celery sticks with guacamole and salsa
- Dinner: Chicken stuffed with pesto and cream cheese, and a side of grilled zucchini
- Friday
- Breakfast: Sugar-free Greek, whole milk yogurt with peanut butter, cocoa powder, and berries
- Lunch: Ground beef lettuce wrap tacos with sliced bell peppers
- Dinner: Loaded cauliflower and mixed veggies
- Saturday
- Breakfast: Cream cheese pancakes with blueberries and a side of grilled mushrooms
- Lunch: Zucchini and beet “noodle” salad
- Dinner: White fish cooked in olive oil with kale and toasted pine nuts
- Sunday
- Breakfast: Fried eggs with mushrooms
- Lunch: Low carb sesame chicken and broccoli
- Dinner: Spaghetti squash Bolognese
Tips for Eating Out on Keto
When eating out, select a meat-, fish-, or egg-based dish. Order extra veggies instead of carbs or starches, and have cheese for dessert. Here are a few more tips:
- Order this and replace any high carb food with extra vegetables.
- Egg-based meals are also a great option, such as an omelet or eggs and bacon.
- Another favorite is bun-less burgers. You could also swap the fries for vegetables instead. Add extra avocado, cheese, bacon, or eggs.
- At Mexican restaurants, you can enjoy any type of meat with extra cheese, guacamole, salsa, and sour cream.
- For dessert, ask for a mixed cheese board or berries with cream.
Managing Side Effects
Although the ketogenic diet is usually safe for most healthy people, there may be some initial side effects while your body adapts. There’s some anecdotal evidence of these effects often referred to as the "keto flu." Reported keto flu symptoms include diarrhea, constipation, and vomiting. Other less common symptoms include:
- Poor energy and mental function
- Increased hunger
- Sleep issues
- Nausea
- Digestive discomfort
- Decreased exercise performance
To minimize these effects, you can try a regular low-carb diet for the first few weeks to help your body burn more fat before completely eliminating carbs. A ketogenic diet can also change the water and mineral balance of your body, so adding extra salt to your meals or taking mineral supplements may help. At least in the beginning, it’s important to eat until you’re full and avoid restricting calories too much.
Supplements for Keto
Although no supplements are required, some can be useful on a ketogenic diet:
- MCT Oil: Added to drinks or yogurt, MCT oil provides energy and helps increase ketone levels.
- Minerals: Added salt and other minerals can be important when starting out due to shifts in water and mineral balance.
- Caffeine: Caffeine can have benefits for energy, fat loss, and performance.
- Exogenous Ketones: This supplement may help raise the body’s ketone levels.
- Creatine: Creatine provides numerous benefits for health and performance, which can help if you are combining a ketogenic diet with exercise.
- Whey: Use half a scoop of whey protein in shakes or yogurt to increase your daily protein intake.
The Ketogenic Diet and Fitness Pal
MyFitnessPal can be a valuable tool for tracking your food intake and ensuring you meet your macro goals on the ketogenic diet. The app can help you monitor your carbohydrate, fat, and protein intake, making it easier to stay within the recommended ranges for ketosis.