The ketogenic (‘keto’) diet is in fashion, but is it right for you?
You’ve probably read the headlines over the summer and wondered whether you should take the plunge if the results are really that dramatic and that easy. But are they, though?
Here's the inside line on what the diet involves, whether it’s healthy and even sustainable for ‘normal’ people. Here goes…
WHAT IS THE KETO DIET AND WHY
The main objective of the ketogenic diet is to get the body to start relying primarily on fat for energy. It is the ultimate low carb diet. It is also moderate in terms of protein and very high in fat.
There are similarities to the Atkins diet, but its fans like to describe it as a more modern version of it - now with a solid scientific basis and with moderate protein inclusion when Atkins prescribed a high amount of protein.
Recent research over the last decade or so has provided strong evidence of the therapeutic potential of ketogenic diets in many health conditions, including:
type 2 diabetes
polycystic ovary syndrome (PCOS)
neurological conditions such as epiliepsy
the management of respiratory and cardio-vascular risk factors.
Although dieters tend to lose weight, there is more of an emphasis of the ketogenic diet as a therapeutic diet, which may improve compliance for those that follow it for health reasons.
Like the Atkins diet, the ketogenic diet aims at keeping the body in permanent ketosis. Let’s take a look at what that actually is:
Glucose is the easiest molecule for your body to convert and use as energy so that it will be chosen over any other energy source. Insulin is produced to process the glucose in your bloodstream by taking it into the cells. Insulin, nicknamed the 'fat storage hormone' is produced in direct proportion to the type and quality of carbs consumed.
But when you lower the intake of carbs in your diet, you force the body into a state of ketosis. Ketosis is a natural process that helps you survive when food intake is low.
When in this state, you produce ketone bodies or ketones, which are produced from the breakdown of fats in the liver. They are an alternative source of energy, when glucose is not available.
Energy from ketones works just as well and feels no different – better, if anything, and the brain actually prefers ketones.
WHAT DO YOU EAT
Meat, fish, poultry, eggs.
Leafy Greens like spinach and kale.
Above-ground vegetables like broccoli, cauliflower, etc.
High-fat dairy like hard cheeses, cream, butter, etc.
Nuts and seeds
Berries – raspberries, strawberries, blueberries blackberries, and other low GL berries
Other fats – coconut oil, high-fat salad dressing, saturated fats, etc.
All grains like wheat, corn, rice, barley
All sugars: honey, agave, maple syrup, and all sweet treats like chocolate, cookies
The majority of fruit including apples, bananas, oranges
Below ground starchy veg: Potato, yams, beetroot, carrots
Seeds and legumes such as quinoa, beans, lentils, peas are also hard to be part of the ketogenic diet
As you can see, the ketogenic diet is largely based on protein and fat, and is filling and satisfying. This means no hunger cravings and consistent energy levels.
The downside is the diet is very strict. Cutting out carbs means more than just avoiding the bread, pasta, rice and potatoes that we think of as carbohydrates, but also other foods including many fruits and a number of starchy vegetables and even some nuts, such as cashews.
I believe to do keto well, you still need to focus on the quality of foods and it isn't enough to purely focus on the macros. Just because something fits your macros (think sausages, bacon, and other processed meats in this instance) doesn’t mean it’s super healthful and providing a balance of nutrients. To reduce consumption of toxic fats, you need to choose foods with relatively lower toxin levels, such as organic cuts of meat, organic produce, and wild fish. However, note that just choosing organic foods doesn’t completely protect you from all contaminants, but it’s a relatively better choice.
Another thing you might not be prepared for is having to cut back on alcohol (it’s not cut it out entirely – spirits are OK but watch the sugary mixers, and champagne and wine are not so bad in moderation but it very much depends on your sensitivity to carbs).
GETTING INTO KETOSIS
Although the chart here gives you a rough indication, there are no fixed percentages for macronutrient distribution (ie not a specific ratio of fats, carbs, etc.) as not everyone is equally sensitive to carbohydrates. This means you’ll have to test where your carb threshold lies by measuring ketone bodies in the urine, blood or breath.
You might be reading this thinking, ‘I can do this’, but the reality can be very testing. One client was committed for 16 days and didn’t, during that time, ever reach ketosis. It can, in fact, take 4 weeks to get there and during the transition period many experience ‘keto flu’ – flu-like symptoms, headaches, tiredness, and weakness. This happens when the body runs out of glucose and has not yet learned to switch to using fat for energy – that’s because it hasn’t had to for such a long time.
Until you become ‘fat adapted’ (i.e. your body has re-learned to use fat) there is a period of low energy. It is this taxing time that can put people off.
A GUT HEALTH PERSPECTIVE
I love encouraging my clients to enjoy an abundance of colourful plant foods in their daily diets for their overall health and because the gut microbiome loves variety in our diets: a diverse diet means diverse flora and this is associated with better health outcomes.
The benefits of consuming vegetables and fruit is one research point in nutritional science that can't be argued with. Numerous studies demonstrate a decreased risk of chronic disease and mortality in those who consume more fruits and vegetables, thanks to their high levels of essential vitamins, minerals, antioxidants, and other phytochemicals. Studies have found that the health benefits rise with the more vegetables and fruits consumed.
However, fruits and vegetables also inherently have some amount of carbohydrates. When you consume a diet that is supposed to have only 25 to 50 grams of carbs per day as per keto, it becomes very difficult to consume the recommended 9 to 14 servings of fruits and vegetables per day.
A ketogenic diet typically incorporates less fibre than I advocate which I believe could negatively impact the gut microbiome and lead to dysbiosis. It may be possible to reduce potential issues through consuming a prebiotic fibre, such as oligofructose-enriched inulin.
It is important to take care when creating your meal plans for this type of diet that you include quality fruits and vegetables as much as possible, especially those high in fibre, rich in nutrients, and lower in carbohydrates.
IS IT FOR YOU?
The people that do well on a ketogenic diet are those with a really compelling reason to do it, perhaps one of the chronic health conditions this diet can help.
I do believe the rest of us mere mortals will struggle to be committed enough to get into and stay in ketosis for long.
So, if your primary goal is weight loss, be assured there are other, more balanced approaches, to achieve the end results you seek.
When you are thinking about a plan like this, you might also want to consider your own nature! I believe there is a risk with some people that what starts as a healthy new dietary approach could develop into an unhealthy fear of carbs, even what I consider to be healthy ones. There can be a fine line between dietary vigilance and obsession - so that's one to watch depending on your personality type.
Finally, you also need to be aware of how your body might respond if you try a ketogenic plan for some time and then decide to come off it. If you want to help ensure you don't regain lost weight quickly, it may not be quite as a straight forward as adding carbs back in on top, but a process of rebalancing the whole 'macro picture'.
If you choose to embark on following a ketogenic diet, it is best to educate yourself as much as possible to determine the healthiest, best way to make sure it works for you.
And if you are keen to find out more about ketogenic diets or if you'd like to book a complimentary call to discuss which approach to weight loss would best suit you, please do get in touch.
WHAT DO YOU THINK? HAVE YOU TRIED KETO?
We'd love to hear your thoughts and experiences so feel free to post here :)