 The ketogenic diet has helped many people lose weight and gain control of their health, but like any diet strategy there are things you need to know before you embark upon it. Is the ketogenic diet right for you? Read about the concept, benefits and drawbacks and how it might help you lose weight. *All nutritional and fitness info must be discussed with your doctor before any changes to diet or exercise regime are implemented. The Concept The ketogenic diet was originally developed for treatment of paediatric epilepsy in the 1920s and has since been adopted as a dietary/lifestyle choice for many people. It is a high fat, adequate protein and low carbohydrate diet which helps your body switch from using glucose (carbs) for fuel, to using ketone bodies. If there is little glucose in the blood, the liver starts to convert fats into fatty acids, and then into ketones. The ketones pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood leads to a state known as ketosis; once ketosis is achieved the body will keep using fat, either from diet or from storage (our fat cells) as fuel. This state of ketosis can have many health benefits, but it can also pose health risks. If you plan on following a ketogenic diet you must consult with your doctor fist, who will determine if it is safe for you and establish a follow up schedule. Macros If you decide to go ahead with the ketogenic diet then planning is a must. Ideal macros for attaining ketosis are: 5-10% carbs, 15-20% from protein, 70-75% (or more) from fat. On a 1400 calorie diet this would be about 35g carbs (10%), 70g protein (20%), and 109g fat (70%). As these parameters are pretty rigid it is advisable to either follow a set diet plan or to track everything you eat with an online tracker such as www.myfitnesspal. Once you are familiar with the diet you will likely not need to track everything but how long this will take will vary by person; eating the same thing every day will make it easier but might lead to diet fatigue. Testing for Ketones There are methods to determine levels of ketones in your system, and although it is not necessary it can give you at least a rough idea if you have achieved ketosis. The most accurate way is to use a blood ketone meter as this is actually measuring ketone levels in the blood, but they are expensive and more invasive. Breath testing is the next accurate, measuring acetone in the breath, although can be affected by certain factors such as hydration levels. Urine strips are the cheapest and easiest to use, although they only measure the level of excess ketones being excreted via urine. Ideal Foods As your diet will comprise of mainly fat it is essential to stick to food sources that are high in fat, low in carbs, and contain some protein. These are some foods to include:
Potential Benefits: Weight loss Many people have had weight loss success while following a ketogenic diet. Once ketosis is reached people often report reduced hunger, and this, combined with the fat burning potential of the ketone bodies can lead to fat loss. Kick the cravings Not relying on carbs for either fuel or sustenance can help kick reliance on them, as well as cravings for carbs such as sugar, bread and other comfort foods. As carbohydrates produce the biggest insulin spike, virtually eliminating them will ensure that blood sugar levels stay stable throughout the day, no peaks or drops. Often it is the drop in blood sugar that leads us to crave sugar, once we have stabilized our blood sugar and eliminated the drops our cravings should diminish. Mood stabilizing Following a ketogenic diet can often have a stabilizing effect on mood, due both to the ketones in the brain as well as stabilizing blood sugar. Diabetes and Metabolic Syndrome This stabilization of blood sugar can also make the ketogenic diet an effective diet to help treat Type II Diabetes, along with Metabolic Syndrome (talk to your Doctor is this applies to you). Brain health Elevated ketones in the system seem to be beneficial for brain health. Although researchers still don’t fully understand the mechanisms involved, scientists believe the ketones provide a more efficient fuel for the brain and offer an increased degree of protection against damage to brain cells. As the ketogenic diet has proven potentially effective to reduce epilepsy (under certain and specific conditions) , a team of U.S. researchers urged clinical tests to see if ketogenic diets could be helpful in patients with Alzheimer’s, Parkinson’s, stroke and traumatic brain injury. Keto diet and Intermittent Fasting Many people combine both the Keto Diet and Intermittent Fasting (IF) for maximum benefits. IF involves fasting for at least 12hrs, generally at least 14-18hrs, then eating only in the remaining hours, ie fast 18hrs, eat during 6hrs. Ketones are also produced after our body enters a fasted state due to the lack of glucose, (read more about the fasted state) and keeping this elevated state of ketones in the blood can be beneficial to attain and stay in ketosis (read more about Intermittent Fasting). Potential Drawbacks: “Keto flu” Adapting to a ketogenic diet can take some time, and can be fairly unpleasant until ketosis is achieved. Almost everyone goes through a state often called “keto flu” while the body is not receiving enough energy from carbs, but has not yet adapted to using fats as fuel. This can result in flu like symptoms – headache, brain fog, body aches – as well as extremely low energy. This is likely to interrupt your daily life, as well as workouts, and takes dedication to ride it out. This “flu” usually lasts about 3-5 days – sometimes longer – and often leads to disbandment of the diet. There are exogenous ketone supplements available for purchase that could potentially help; these are beta-hydroxybutyrate (BHB) salts, which are produced in the liver as it breaks down fatty acids into acetoacetate, the first ketone produced in the fasting state. However, these powdered supplements are expensive and although studies show that they do elevate ketones in the blood, they are inconclusive as to whether this will actually help you achieve ketosis and get through the keto flu. The Keto flu can also be caused by lack of magnesium and potassium. Carbo-hydrates are called that for a reason; for every gram of carbohydrate it takes 3-4 grams of water to store it and process it within your body. Ergo, lowering carbs will lead to water loss, and in fact this is a lot of the initial weight loss that people see while starting a low carb diet. Be sure to drink plenty of water, if you start feeling weak or low in energy you might not be drinking enough water. This loss of water also leads to loss of electrolytes, which could cause flu-like symptoms. Eating a diet rich in magnesium, as well as ensuring you are using adequate salt (like salted butter and broth, as well as salting your food), will help ensure you maintain high levels of electrolytes. You can also talk to your doctor about magnesium supplements. Restrictive The ketogenic diet is fairly restrictive and often hard to follow. Straying from your set macros will kick you out of ketosis which could take a few days of “keto flu” before re-entering ketosis. While on other diets an occasional cheat such as a piece of cake on your birthday will not set you back too far, cheating on the keto diet could cause days of discomfort and regression. This however could potentially be a benefit for some people; forcing you to stick to your diet - or suffer the consequences! - could be one of the reasons that people have success. Too much protein Protein consumption is tricky, as consuming too much protein can kick you out of ketosis and is one of the common pitfalls of trying to follow a keto diet. Following calorie restrictive diets inherently leads to muscle loss, and trying to mitigate this as much as possible while on the keto diet it is virtually impossible. Using this keto calculator I tried to work out my protein needs based upon the parameters of being in a calorie deficit while still performing resistance training, however as soon as you choose “lose weight” you are immediately defaulted to the “sedentary” level of protein (0.6g/lean body mass). At 60g of protein a day I would surely lose muscle mass – as well as strength - and forget being to build muscle. This calculator however allowed me to choose the category of “athlete/bodybuilder” which kept my protein at 100g even while in a calorie deficit which while is not enough to actually build muscle, should help decrease potential muscle loss. Ketones, however could potentially have a “protein sparing effect” on muscles, meaning that if there are adequate ketones in the system the body will use these for fuel instead of drawing on the protein in our muscles (catabolizing them). However, the studies showing this effect have been on individuals on a very low carb/high protein diet: “it appears, from most literature studied, that a VLCARB is, if anything, protective against muscle protein catabolism during energy restriction, provided that it contains adequate amounts of protein”. Vegetables variety and quantity As vegetables are carbs you will find the amount of vegetables you can eat quite small. Starchy vegetables are obviously not allowed (potatoes, sweet potatoes, squashes) as well as root vegetables such as carrots, beets, parsnips etc. Vegetables higher in sugar are pretty much not allowed, such as tomatoes, beets, peppers, sweet onions, leeks etc. Leafy vegetables are good and can be eaten in larger quantities: swiss chard, bok choy, spinach, lettuce, chard, chives, endive, radicchio, as well as cucumber, cellery and zuchinni. Cruciferous vegetables (broccoli, cauliflower, cabbage, brussel sprouts) are ok eaten in small quantities. If you like to eat a large variety and quantity of vegetables this will be an adjustment and you run the risk of missing out on valuable nutrients. Talk to your doctor about the kinds of vegetables you will and will not be eating to see if they will recommend a supplement to compensate. Fruit (or lack thereof) As you can see from the list, there is no fruit on the list (with the exception of avocado, technically a fruit but also a healthy fat). Berries are lowest in sugar and you may be able to fit them into your macros, although many people report that even if they fit they are more sugar than they are used to and it will kick them out of ketosis. Again, talk to your doctor to see if you should take a supplement to make up for the nutrients missing through no fruit intake. Food volume Fats are the most calorie dense macronutrient, with 9 cals/gram for fats, and 4 cals/gram for both carbs and protein. Combine this with a lower volume of vegetables, this will mean that to stay within your calorie goals your actual amount of food will decrease. If you are used to snacking on low calorie fruits and vegetables or high protein snacks to keep you satisfied between meals you may find it hard to find an alternative. Hunger often does decrease while in ketosis, so this should help you stay more satisfied on a smaller food volume. However, studies on appetite suppression while in ketosis have been inconsistent and inconclusive. As fats are also the least satiating vs protein and carbs, many people struggle with hunger until ketosis is reached. Once in ketosis this usually improves although it is also possibly from your body adapting to its new caloric and macronutrient state. Diet fatigue As the foods you can eat are quite restrictive people often struggle finding interesting ways to eat the same foods. Luckily there are a lot of online resources and recipes to choose from; finding ones that work for you will be key to staving off diet fatigue. Digestive system Usually our digestive system functions well on a diet high in fibre from whole grains, fruits and vegetables. On a keto diet these are limited so you need to take measures to avoid constipation and other dietary issues due to low fibre; adding psyllium husk is usually necessary, either in the form of Metamucil (unflavoured) or plain – ground or whole – psyllium husks, usually sold in bulk food or health stores. Saturated fats One of the reasons you will need to discuss a keto diet with your doctor is because the diet is typically high in saturated fats. For years saturated fat has been vilified, taking butter, cheese, bacon, eggs and full fat yogurt off the table, however studies have been mixed about how much saturated fat we should eat. However, most doctors agree that saturated fats should comprise no more than 10% of your total calorie intake, and the remainder of your fats should be unsaturated, however your doctor will confirm if this ratio is right for you given your and your family’s health history (read more: Nutrition 101: Master the Basics). Sources of saturated fats include:
Sources of non-saturated fats include:
“Keto breath” Many people on the keto diet report what is known as “keto breath”. This acetone-like breath is often caused by high levels of protein – which produce ammonia as it is broken down in the gut – and can be combated with lowering protein in the diet. It is also sometimes caused by dry mouth as it is imperative to stay well hydrated while on the keto diet. Sometimes the keto breath is more pronounced as you enter ketosis and might go away after a few weeks or months in ketosis. Ketoacidosis vs Ketosis Ketosis is the state you will enter when your body has reached a certain level of ketones in the blood and your body has adapted to burning fat as fuel instead of glucose. Ketoacidosis refers to diabetic ketoacidosis (DKA) and is a complication of diabetes. It’s a life-threatening condition resulting from dangerously high levels of ketones and blood sugar. This combination makes your blood too acidic, which can change the normal functioning of internal organs like your liver and kidneys. It’s critical that you get prompt treatment. However, if you are not diabetic you are highly unlikely to reach ketoacidosis, but this is another reason you must discuss this with your doctor. If you have a personal or family history that might include markers of diabetes then they will be sure to advise you if a keto diet is advisable for you. Summary After doing your research, you need to:
*All nutritional and fitness info must be discussed with your doctor before any changes to diet or exercise regime are implemented. Related Articles: Nutrition 101: Master the Basics Fasted Cardio: Yes it can help you shed some body fat, but is there a better way? Broccoli the Wonder Food Change nothing and nothing will change; without change, there can be no progress!
6/3/2022 03:23:35 pm
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