The Ketogenic Diet is all the rage right now. People are claiming that this diet can be used for everything from getting healthy, disbanded serious illnesses, increasing brain function, and even to lose excess body fat for ripped abs. The basis is simple - eat lots of fat, and as few carbs as possible.
This blog will be covering a variety of things to help you determine whether this popular diet might work for you.
I'll be answering:
- What does the ketogenic diet look like?
- What are ketones? What is ketosis? The why.
- Who does this diet work best for?
- What does the research say about these claims?
What does the keto diet look like?
The keto diet consists of having large portions of fat, with some protein, and as close to zero carbs as possible in order to allow ketones to be released into the blood stream for energy. A standard mixed meal might look like 30% protein, 30% fat, and 40% carbs. A keto diet looks like 20% protein, 75% fat, and 5% carbs.
The lack of carbs is one of the main factors of a keto meal. The suggested intake for carbs daily is around 10-15g. That's about 10-15 grapes for the entire day, for some perspective.
The high fat intake is the other main factor of a keto meal. The energy intake of fat should be nearly 90% of the daily intake. This is somewhat easier to manage since there are 9 calories per gram of fat, compared to 4 calories per gram of both protein and carbs.
As you might imagine, the diet can become very restrictive in order to maintain such low carb intake and high fat intake. It looks something like this:
Here's a quick list of foods that are off limits:
- Most dairy - except those high in fat, like some cheeses and butter
- Beans and legumes
- Slightly-sweet vegetables (winter squash, beets, carrots)
- Starchy vegetables (sweet potatoes)
- Most processed foods
What are ketones? What is ketosis? The why.
This is going to get a little science-y, but it's important to understand why you're undertaking a diet and what's happening in your body to better understand how to fuel yourself if you choose this route. So bare with me here.
Ketones are organic compounds created by the body, typically in starvation mode, that can be used as an energy source. There are two types of ketones that can be used as energy sources: acetoacetate and D-β-hydroxybutyrate. These are created through a complicated biochemical pathway that we won't worry about discussing here.
The term "keto" was coined in 1850 by Leopold Gmelin, a German chemist. If you thought this was a new diet, surprise! This concept has been around for a long time and was heavily studied in the 1950's. What they found was that in extreme scenarios, such as fasting or starvation for extended periods (2-3 days minimum), the body creates ketones for energy. This process can also be created through nutrition in which carb intake is low with a high fat intake.
Here's what it looks like, in the case of fasting/starvation, or a ketogenic state:
- The body releases fatty acids from stored body fat.
- These fatty acids enter in other cells, and are combined with co-enzyme A to form acetyl-CoA chains.
- These chains move into the mitchondria of our cells (the energy plants of the cell) and are broken down into acetyl-CoA units by a sequence of reactions known as β-oxidation.
- This is where the magic happens. Acetyl-CoA forms the ketones: acetoacetate and β-hydroxybutyrate, as well as acetone.
- The ketones are released into the blood stream by the liver and are then available for any cell to use the energy from the ketones. The brain loves these and usually absorbs most of them. (Think about being in starvation mode - you need to preserve the brain first and foremost).
Ketosis is a state of being when this process happens in the body. Ketones must be present in the blood stream to be in a state of ketosis, and this is usually measured through keto sticks (sort of like pregnancy sticks that you pee on to measure if your body is excreting ketones). This measurement can be somewhat faulty in that it measures if you are excreting ketones, not whether the ketones are present in your blood stream.
So how do we get into ketosis? There's a few ways.
- Ketogensis - Simple, starvation. This energy creating pathway came about through our ancestors starving, since food was not always readily available. It takes about 72 hours to reach ketogenesis. This is basically our body's back up system to helping us maintain the health of our brains in times of low food intake. Glucose (carbs) is the standard energy source for our body.
- Ketogenic diet - This is the nutritional course of action, since starvation isn't exactly appealing. By removing the carb intake form the diet and focusing on high fat intake with some protein, the body goes into the same mode as starvation and ketosis is achieved.
Who does this diet work best for? And what does the research say about these claims?
It's important to know that the ketogenic diet is not beneficial for everyone. This section will cover some known benefits and some populations who see now added benefit so that you can make an educated decision when deciding whether or not to implement this if your life.
Research suggests that the ketogenic diet may be beneficial for a short-term treatment or a "boost" for returning metabolism back to a normal state in the case of type-2 diabetes. This does not mean that the diet is a cure all, but that it should be conducted in conjunction with medical supervision and possibly in addition to medication. Conducting this diet for this purpose, should be clearly defined and well-monitored, rather than a cure for most people.
Neurodegeneration and Brain Injuries
The ketogenic diet originally came about as a result of the search for curing and moderating epilepsy. Recent research shows that neurogenerative diseases (such as Alzheimer’s and Parkinson’s) are related to metabolic disorders like diabetes and obesity through inflammation of the gut. Alzheimer's is now being referred to as "diabetes of the brain" or "Type-3 diabetes." By removing carbohydrates and introducing high levels of fat, the brain is able to have amble energy in addition to the presence of ketones. In the case of epilepsy, seizures have been dramatically reduced through the ketogenic diet.
The presence of ketones have also been shown to improve the outcomes of traumatic brain injury, though it's important to note that most studies have been conducted on rats.
Even so, the presence of ketones looks to be a low-risk treatment for neurodegenerative diseases, and even prevention, for improving brain health.
One of the claims surrounding the keto diet is that if will improve lifespan and keep you healthy. Studies have shown that calorie restriction and fasting are beneficial for the lifespan of cells, but it's unclear if ketosis works the same way. And the real question is, who's willing to maintain this diet for their entire lifespan to find out. In addition to this, it's difficult to prove that the keto diet is the only variable between two people to truly test the outcome.
Athletes need fuel to perform. You've probably seen me talk about eating carbs for pre- and post-workout meals in order to not only perform well, but recover well. So how does this work with ketosis?
Ketosis avoids glycogen depletion (that point where you feel like crap or muscles stop functioning properly), because you aren’t using glycogen (from carbs) as your energy source. Instead the body uses fat and ketones for energy. In the process, fat oxidation increases, you produce less lactate and use less oxygen at submaximal rates. Sounds great right?
Unfortunately, the consensus from exercise psychologists is that the problem with fat and ketone bodies as fuel, you won't be able to perform as well as when you are using glucose and carbohydrates as fuel. If your purpose is to be an athlete, you want to perform well. This might not be the best diet for you. There has, however, been one study released that shows a small improvement in cyclist's performance with ketone supplement in combination with carbohydrates.
Losing Fat and Weight Loss
One of the benefits to the low-carb approach is that your intake reflects higher levels of satiating food (aka the stuff that keep your brain happy and telling you that you're full). If we're hungry less often, it means we will eat less. Eating less in general will lead to some weight loss.
When beginning this diet, you might also notice an initial weight drop. This is due to the depletion of glucose and glycogen happening in the body. Storing glucose is a relatively heavy compound to be stored in the body, which is why our body converts it into body fat for later energy use. For this reason, when we deplete it through not getting carbs in the diet, you'll see an initial weight drop.
This doesn't necessarily lead to long-term weight or fat loss results. Chances are you'll grow tired of eating a very restricted diet of protein and fat.
It's also important to note that eating low-carb can be particularly harmful for women. Women's bodies are much more sensitive to the depletion of energy and nutrients. In many cases, women see the disappearance of the menstrual cycle in this process.
So here's the recap:
- If you're an athlete, you need to be in tune with your body and it's energy needs. Unless you're an endurance athlete, there's a good chance that this diet won't be beneficial for your performance.
- If you're a regular person look for weight/fat loss, the keto diet is not a sustainable long-term solution. You might find short-term results and an initial weight loss, but these will likely plateau.
- If this is something you want to try, nutrition coaching is strongly recommended to ensure a smooth transition. Have you ever stopped eating carbs outright? Spoiler alert, it's going to feel rough, so having a coach help ease you into the process can be a game-changer.
- If you have a neurodegenerative disease or brain injuries, this might be a good resource for experimenting with your diet to help mitigate certain effects. Always consult your doctor before beginning a new nutrition plan.
- If you have type-2 diabetes, this might be a good jump start for creating a healthy metabolic system, but consult your doctor to ask make sure this won't interfere with any current medications.