The ketogenic or “keto” diet is a low-carbohydrate, fat-rich eating plan that has gained considerable attention as a potential weight-loss strategy. It eliminates nearly all carbohydrates and relies on calories from fat for fuel, a process called ketosis. Given how challenging the keto diet can be, it’s no surprise that manufacturers have created keto supplements claiming to help you boost energy, burn fat, and lose weight fast.
Understanding the Keto Diet and Ketosis
The premise of the ketogenic diet for weight loss is that if you deprive the body of glucose-the main source of energy for all cells in the body, which is obtained by eating carbohydrate foods-an alternative fuel called ketones is produced from stored fat (thus, the term “keto”-genic). The brain demands the most glucose in a steady supply, about 120 grams daily, because it cannot store glucose. During fasting, or when very little carbohydrate is eaten, the body first pulls stored glucose from the liver and temporarily breaks down muscle to release glucose. If this continues for 3-4 days and stored glucose is fully depleted, blood levels of a hormone called insulin decrease, and the body begins to use fat as its primary fuel. The liver produces ketone bodies from fat, which can be used in the absence of glucose. When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during periods of fasting (e.g., sleeping overnight) and very strenuous exercise.
Macronutrient Ratios in the Keto Diet
There is not one “standard” ketogenic diet with a specific ratio of macronutrients (carbohydrates, protein, fat). The ketogenic diet typically reduces total carbohydrate intake to less than 50 grams a day-less than the amount found in a medium plain bagel-and can be as low as 20 grams a day. Generally, popular ketogenic resources suggest an average of 70-80% fat from total daily calories, 5-10% carbohydrate, and 10-20% protein. For a 2000-calorie diet, this translates to about 165 grams fat, 40 grams carbohydrate, and 75 grams protein. The protein amount on the ketogenic diet is kept moderate in comparison with other low-carb high-protein diets, because eating too much protein can prevent ketosis.
Foods to Eat and Avoid on the Keto Diet
Many versions of ketogenic diets exist, but all ban carb-rich foods. Some of these foods may be obvious: starches from both refined and whole grains like breads, cereals, pasta, rice, and cookies; potatoes, corn, and other starchy vegetables; and fruit juices. Some that may not be so obvious are beans, legumes, and most fruits. Most ketogenic plans allow foods high in saturated fat, such as fatty cuts of meat, processed meats, lard, and butter, as well as sources of unsaturated fats, such as nuts, seeds, avocados, plant oils, and oily fish. Strong emphasis on fats at each meal and snack to meet the high-fat requirement. Some dairy foods may be allowed. Although dairy can be a significant source of fat, some are high in natural lactose sugar such as cream, ice cream, and full-fat milk so they are restricted. Protein stays moderate. Certain fruits in small portions like berries. Fruits other than from the allowed list, unless factored into designated carbohydrate restriction.
The "Lean Start" Phase
Lean Start Keto is essentially a modified version of the traditional ketogenic diet. It's designed specifically for individuals who are new to the keto lifestyle and are looking for an easier way to get started. The main difference lies in the initial phase of the diet, aptly named the "lean start" phase. During this phase, you gradually decrease your carbohydrate intake while increasing your fat consumption.
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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.
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.
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Potential Risks and Side Effects of the Keto Diet
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.
When you first start Lean Start Keto, you might experience what's commonly known as the "keto flu." It's a collection of symptoms that can include fatigue, headaches, dizziness, and irritability.
Keto Supplements: Pills, Powders, and Gummies
Given how challenging the keto diet can be, it’s no surprise that manufacturers have created keto supplements claiming to help you boost energy, burn fat, and lose weight fast. The three most common types of keto diet supplements are:
- Keto pills: Many keto pills contain BHB salts or BHB esters and are promoted as a natural weight loss supplement. Ketone beta-hydroxybutyrate (BHB), a compound that the liver produces from fats. “In theory, taking extra ketones in the diet may help the body lose weight by using ketones for energy and, therefore, burn fat,” explains Erin Holley, a registered dietitian at the Ohio State University Wexner Medical Center in Columbus. “The claim is that you can take these keto diet pills and not have to follow a low-carb diet.”
- Keto powders: Similar to keto pills, keto powders contain some form of BHB. Many keto powder supplements may also include electrolytes to help people stay hydrated and remain in ketosis.
- Keto gummies: One of the newer keto supplements on the market, keto gummies are deceiving because many don’t actually contain any ketones. Instead, they are often made with apple cider vinegar, which companies say boosts metabolism and, therefore, promotes weight loss. However, there’s not enough scientific evidence to support this claim. Some keto gummies may also contain MCT oil, and most are sweetened with a non-nutritive sweetening agent, such as stevia.
Do Keto Pills Work?
There’s not enough research on the efficacy of keto supplements to support the claim that taking keto pills, powders, or gummies will help you achieve ketosis.
One small 2021 study, for instance, found that people with obesity who followed a low-calorie ketogenic diet and took 24 grams of a BHB salt supplement per day for six weeks experienced enhanced ketosis. However, having higher levels of ketones in the blood didn’t seem to boost these participants' weight loss when compared to other groups, such as those following only the keto diet without the supplement.
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Other research, such as this 2020 study, suggests that taking exogenous ketones can help boost concentrations of ketones in the blood quickly. Whether they have an appreciable effect on weight loss, however, is still murky, and more robust studies with strong evidence are lacking.
One of the reasons why supplementation may not be all that effective is because the body seeks to maintain an even level of ketones to prevent a potentially toxic buildup of these chemicals in the bloodstream. When the body senses that ketone levels are high, the liver stops making its own and will try to flush out excess ketones in your urine, a process called ketonuria.
Ultimately, the jury is still out on whether or not these supplements work. Experts do not recommend keto pills - or any diet pill, for that matter.
Potential Risks of Keto Supplements
Even if there are no reported risks of taking keto pills, keep in mind that dietary supplements, including keto pills, are not regulated by the Food and Drug Administration (FDA) and may not do what they claim, may not contain quantities of ingredients listed on the label, or may not contain the ingredients in listed on the label at all. Some may contain additional ingredients not listed. Many don’t work as advertised, and some may even be dangerous.
In addition to health concerns, there’s a risk of scams with some keto products, namely supplements being pushed heavily on social media. Also, keep an eye out for certain words and phrases in any marketing text, such as “quick fix,” “guaranteed results,” and “scientific breakthrough.” They’re usually a red flag of false advertising.
Ingredients Found in Keto Gummies
Most keto gummies typically contain medium-chain triglycerides (MCTs), a type of saturated fat that helps give your body energy, in addition to exogenous ketones. Sometimes, keto gummies may contain gelatin or natural sweeteners like Stevia. It’s not like eating a traditional gummy. It’s not going to have any additional sugars because if it did, then it would throw you out of ketosis.
Potential risks of keto gummies include:
- Nausea and vomiting.
- Gastrointestinal issues, like diarrhea.
- Low blood sugar.
Considerations Before Starting the Keto Diet
If you’re considering the keto diet, ask yourself why you’re doing it and if it’s really worth it. Very restrictive diets are hard to follow, and they’re not sustainable. With the keto diet specifically, when we look at it for weight loss, most of that weight you’re losing quickly at the beginning is water weight. You’re not losing fat.
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