The ketogenic diet, or "keto" diet, has gained popularity as a weight-loss strategy. It's a low-carbohydrate, fat-rich eating plan used for centuries to treat specific medical conditions. The premise of the keto diet for weight loss is that when the body is deprived of glucose, its primary energy source, it turns to an alternative fuel called ketones, produced from stored fat.
To better understand how to structure your meals on a keto diet, many resources use a visual aid called the Keto Pyramid. This article will explain the keto pyramid chart, contrasting it with traditional food pyramids and detailing the different food groups and their importance in achieving and maintaining ketosis.
The Downfall of the Traditional Food Pyramid
In 1992, the US Department of Agriculture (USDA) developed a food pyramid that reinvented how most people thought about their diet. At the bottom of the pyramid were grains and starches, telling us that the bulk of our diet ought to consist of carbohydrates like cereal and bread. Up at the top-in very moderate amounts-was fat. We were told that low-fat would ensure a healthy life (although not one ounce of good science backed up this claim).
But even while the pyramid was being developed, dietitians knew that fat is essential to our health and can reduce the risk of cardiovascular disease. They also found little evidence that a high intake of carbohydrates is beneficial. Still, the USDA pyramid was released, and the public adopted it. What happened next was staggering. Obesity rates tripled in 30 years, and with it, cases of type two diabetes and heart disease. Today, 2/3 of Americans are overweight or obese. A growing body of research indicates that the USDA pyramid was grossly flawed.
The notion that fat should be avoided mainly stems from observations that Western countries have both high intakes of fat and high rates of coronary heart disease. But correlation does not equal causation. Pinning the blame on fat does not account for other factors that contribute to heart disease and poor health, such as:
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- Sugar intake
- Inactivity
- Smoking
- Overeating
- Fast food and processed foods
On the other side of the world, The Greeks on the island of Crete live off of relatively large portions of fat (fatty fish and olive oil) and tend to have lower rates of heart disease. This leads us to believe that there’s more at play than just limiting fat.
Aside from speculation about its design, the biggest criticism to the USDA food pyramid asserts that dietary fat is an essential nutrient that should not be restricted.
The Keto Pyramid: An Inverted Approach
The keto food pyramid is starkly different from the Food Guide Pyramid. If you take a look at the pyramid below, you’ll notice it’s inverted or upside-down compared to the traditional one. Instead of relegating fats to the top, fats form the base. Fat is the main source of calories on Keto. Why? Because fat provides energy without raising blood sugar and insulin levels like carbohydrates do.
Keeping blood sugar and insulin low is the key to releasing stored body fat (a process called lipolysis), burning it for energy (called fatty acid oxidation), and producing ketones in the liver (called ketogenesis). The name for this fat-burning metabolic state is ketosis. A glance at the literature reveals that Keto is a promising weight loss intervention for various populations. Not only does Keto have the potential to increase fat burning, but it can also curb hunger hormones. Less hunger, less overeating.
This keto food pyramid diagram is designed to get your body into a state of nutritional ketosis and keep you there.
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Understanding the Layers of the Keto Pyramid
The Keto macros pyramid is a useful tool for structuring meals. It encourages you, for instance, to favor fatty protein sources (salmon, ribeye, chicken thighs, eggs, etc.) because these foods are more ketogenic than leaner options.
Let’s explore the different levels of the Keto food pyramid now. (Note: serving recommendations are fairly broad for some categories since different people have different caloric needs).
Base: Healthy Fats
Healthy fats like olive oil, avocado oil, coconut oil, butter, ghee, lard, and tallow form the base of the Keto food pyramid. This doesn’t mean, however, that dinner is a stick of butter. It just means that most of your calories will come from these sources.
This means cooking with coconut oil, dumping olive oil on your salad, making fat bombs, etc. Be creative. Remember you’ll also get some healthy fats from other foods in higher portions of the pyramid, like animal proteins, nuts, seeds, and dairy products.
Serving recommendation: 2-6 tablespoons per meal
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Level 2: Protein Sources
Next up are healthy protein sources like meat, fish, and eggs. Protein is crucial for maintaining muscle, balancing hormones, and supplying the raw materials to build the brain chemicals known as neurotransmitters. Protein is also highly satiating. This is probably why high-protein diets tend to be effective for weight loss.
Serving recommendation: 3-12 ounces per meal
Keep in mind that foods contain a certain percentage of fat content i.e. Fatty fish i.e. tuna, salmon and mackerelFatty cuts of red meat i.e. steak, lamb, pork, salami and pepperoni or organ meatSeafood i.e.
Although you shouldn’t shy away from fattier meats, they shouldn’t become your daily staple if you have hit a plateau. On the other hand, super lean meats with high protein levels but little fat are more difficult to work into a normal keto diet meal plan. A healthy balance with a daily target in mind is the way to go and will include a mix of fatty and lean cuts of meat.
Level 3: Low-Carb Vegetables and Avocados
Your Keto meals should be rich in low-carb vegetables and avocados. These Keto-friendly plants supply loads of micronutrients without kicking you out of ketosis. Here’s a partial list:
- Avocados
- Kale
- Spinach
- Cauliflower
- Broccoli
- Asparagus
- Lettuce
- Bok choy
- Cabbage
- Green beans
Keep in mind that starchy vegetables like sweet potatoes, carrots, cassava, and parsnips are largely forbidden on Keto. Too many carbs. As carbs are such a small percentage of your daily intake, it’s important to avoid ALL high-carb vegetables (such as potatoes, corn and carrots) and rather include larger portions of non-starchy vegetables (like avocado, spinach and cauliflower) at every meal. Here are some of the best non-starchy vegetables to eat on a keto diet.
Serving recommendation: 2-4 servings per meal. (Keto veggies aren’t a significant source of calories, so be liberal.)
Level 4: Nuts, Seeds, and Dairy
You can enjoy almonds, macadamia nuts, hazelnuts, pumpkin seeds, sunflower seeds, and other nuts and seeds as an occasional Keto snack. They’re rich in fiber, protein, and healthy fats. However, If you’re trying to lose weight, be aware that nuts, seeds and nut butters are calorically dense and easy to overeat. Enjoy in moderation. Also, feel free to dabble in dairy products if you can tolerate them. Whey protein, for instance, is high in amino acids like leucine (for muscle growth) and immune-boosting compounds like lactoferrin. You’ll notice full fat dairy and nuts, which are usually associated with being high fat, aren’t included in this list.
Certain nuts, and seeds that can be eaten in small amounts as snacks i.e. almonds, pecans, pili nuts, chia seeds, flaxseeds, and all full-fat dairy.
Serving recommendation: 1-2 servings per day
Level 5: Keto Fruits and Sweets
Atop the Keto pyramid are berries and other semi-low-carb treats. Enjoy these Keto tidbits occasionally and in moderation:
- Berries like blueberries, raspberries, and blackberries
- Dark chocolate (with a minimum of 85% cocoa solids)
- Citrus fruits
- Coconut meat
- Tomatoes
Small quantities of low-sugar fruit i.e.
Serving recommendation: One small handful per day
Keto Macros: The Foundation of the Pyramid
On a Keto diet, you consume 55 to 75 percent of your calories from fat, 15 to 35 percent from protein, and under 10 percent from carbs. Bear our Keto macros pyramid in mind each time you build your plate.
Beverages on Keto
If a beverage doesn’t contain carbohydrates, assume it’s Keto-approved. Without calories from carbs or sugar, a drink won’t inhibit fat burning and kick you out of ketosis. This means that beverage selection on Keto is a fairly binary process. It’s either allowed or it isn’t. Keto-friendly beverages include:
- Water
- Coffee
- Tea (black, green, white, or herbal)
- Lemon water
- Bone broth
- Naturally flavored zero-calorie water or soda
Alcohol is an edge case. While alcohol itself doesn’t contain carbs, most alcoholic beverages (beer, cocktails, wine) do. And even if you drink zero-carb distilled spirits, your body will still regard alcohol as toxic. More than one or two per day is not recommended. What about diet sodas? They won’t shut down fat burning, but some evidence suggests that artificial sweeteners like saccharin interfere with gut microbiome health. If you want to play it safe, it’s best to avoid them.
Structuring Keto Meals: Key Principles
To structure your Keto meals, follow these three principles:
- Ensure you’re hitting your Keto macros (i.e., the Keto macros pyramid)
- Favor whole food sources of fat and protein
- Eat lots of non-starchy vegetables for vitamins, minerals, and menu variety
You’ve probably heard of a dirty Keto diet. It’s a species of Keto that follows the correct macros but ignores food quality. Dirty keto is high in processed meat and vegetable oils-and low in nutrient-dense vegetables. It might help with weight loss, but it’s not geared towards longevity. If you care about your long-term health, it makes sense to adopt a whole foods Keto diet. That’s the operating principle of the Keto food pyramid displayed above. Just eat whole foods, healthy fats, and plenty of low-carb veggies to satiety. Keto sounds simple when you put it that way, doesn’t it?
Potential Benefits of the Keto Diet
The ketogenic diet has been shown to produce beneficial metabolic changes in the short-term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. There is also growing interest in the use of low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes.
- A meta-analysis of 13 randomized controlled trials following overweight and obese participants for 1-2 years on either low-fat diets or very-low-carbohydrate ketogenic diets found that the ketogenic diet produced a small but significantly greater reduction in weight, triglycerides, and blood pressure, and a greater increase in HDL and LDL cholesterol compared with the low-fat diet at one year.
- A systematic review of 26 short-term intervention trials (varying from 4-12 weeks) evaluated the appetites of overweight and obese individuals on either a very low calorie (~800 calories daily) or ketogenic diet (no calorie restriction but ≤50 gm carbohydrate daily) using a standardized and validated appetite scale. None of the studies compared the two diets with each other; rather, the participants’ appetites were compared at baseline before starting the diet and at the end. Despite losing a significant amount of weight on both diets, participants reported less hunger and a reduced desire to eat compared with baseline measures.
- A study of 39 obese adults placed on a ketogenic very low-calorie diet for 8 weeks found a mean loss of 13% of their starting weight and significant reductions in fat mass, insulin levels, blood pressure, and waist and hip circumferences. Their levels of ghrelin did not increase while they were in ketosis, which contributed to a decreased appetite.
- A study of 89 obese adults who were placed on a two-phase diet regimen (6 months of a very-low-carbohydrate ketogenic diet and 6 months of a reintroduction phase on a normal calorie Mediterranean diet) showed a significant mean 10% weight loss with no weight regain at one year.
Potential Risks and Considerations
Following a very high-fat diet may be challenging to maintain. Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included. It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)-nutrients typically found in foods like whole grains that are restricted from the diet.
Available research on the ketogenic diet for weight loss is still limited. Most of the studies so far have had a small number of participants, were short-term (12 weeks or less), and did not include control groups. A ketogenic diet has been shown to provide short-term benefits in some people including weight loss and improvements in total cholesterol, blood sugar, and blood pressure. However, these effects after one year when compared with the effects of conventional weight loss diets are not significantly different.
Eliminating several food groups and the potential for unpleasant symptoms may make compliance difficult. An emphasis on foods high in saturated fat also counters recommendations from the Dietary Guidelines for Americans and the American Heart Association and may have adverse effects on blood LDL cholesterol.