• Scott Sohn, MS, RDN, LD

The Skinny on Ketogenic Diets

Updated: Jul 16, 2019

#Keto # Weight-loss #Mens-health #Low-carb

You’ve probably heard about the ketogenic diet. There’s been a lot of buzz about this diet recently, but you need to know the facts before you embark on any new journey. Let’s take a look at the details and break it down for you.

The Ketogenic diet is a low carbohydrate diet that forces your body to burn fat instead of carbs as its main fuel source.

  • A typical balanced diet contains approximately 45%-65% carbohydrates, 20%-35% fats, and 10%-35% protein.

  • A Keto diet aims for a ratio of around 5%-10% carbohydrates, 60%-80% fats, and 15%-30% protein.

Under a typical diet the body uses mostly carbohydrates (sugars), which are released as glucose into the blood to provide energy for movement and brain function. With a keto diet, carbohydrates are restricted and the body turns to fat stores for its major energy source. Fats are broken down in the liver creating substances called ketones, which are then released into the blood stream. Circulating ketones can then be used as an alternate energy source for organs such as the brain, heart, kidneys and muscle when glucose is not available. Ketones are in fact the only other energy source that can be used by the brain in the absence of circulating glucose.

It usually takes 4-5 days of carbohydrate restriction to force the body to begin breaking down fat instead of carbohydrates for energy. This is called ketosis.The amount of carbohydrate restriction necessary to achieve a ketogenic state can differ between individuals based on how efficiently their bodies use energy. Athletes and some people with healthy metabolisms may be able to consume 100 grams or more of carbohydrates and still maintain a good level of ketosis, while older, sedentary individuals with type 2 diabetes may require less than 30 grams. For most people using this diet for weight loss and diabetes, the carbohydrate level will be at the low end. Typically, eating less than 50 grams of carbs per day will cause the body to burn fats instead of glucose.

Why do people use a ketogenic diet?

Weight loss- A ketogenic diet may help you to lose more weight faster during the first 3-6 months as the body is forced to burn off excess fat stores to use as energy. Additionally, it takes more calories to convert fat into energy than it does to convert carbohydrates into energy. Thus more energy is used burning fat compared to carbohydrates.1, 4

Heart Disease- Ketogenic diets may lower bad cholesterol and increase good cholesterol. Increasing fat intake seems counterproductive when dieting, however the decreased insulin levels seen with ketogenic diets may prevent your body from producing excess cholesterol.2, 3

Acne- Carbohydrates have been linked to this condition. Lower insulin levels experienced with this diet may prevent outbreaks.4

Epilepsy- This diet has been used since the 1920s to control seizures in epileptic patients.4

More Nervous System Disorders- Research has shown that ketogenic diets may be helpful in the treatment of Alzheimer’s and Parkinson’s disease.4

Diabetes- Ketogenic diets are shown to be effective at controlling blood sugar levels in people with type 2 diabetes. Studies have shown decreased hemoglobin A1C numbers in those following a ketogenic diet. Additionally, some study participants were able to decrease diabetes related medications.4, 5

· Avoiding the carbohydrates that raise your blood sugar may decrease your need for medication to lower it.

· Taking the same dose of insulin as you did prior to adopting a keto diet might result in hypoglycemia (low blood sugar).

· Do not try a strict low carb diet without consulting your doctor first.

If your goal is to lose some weight quickly and/or lower blood glucose levels, this diet can be very effective. But remember that this type of diet is not usually sustainable for the long term. Drastically reducing an entire nutrient from the diet is very difficult maintain. Slow and steady weight loss through Calorie reduction, increased physical activity and behavioral therapy is still the best long term strategy to lose and maintain a desired weight. Unfortunately, in today’s fast paced world, we have become accustomed to immediate gratification. Studies have shown that early substantial weight loss can have a positive effect on commitment level. So those who lose more weight in the beginning of a diet plan are more likely to stick to it for the long run. That makes ketogenic diets very appealing for some people who want quick results. However, most people who start out on this diet will find it too difficult to stick with indefinitely.

Whatever type of plan you decide to try, make sure you’re ready to make a commitment. Start out strong to ensure your early weight loss achievements motivate you to stick to your plan. That being said, slow, steady weight loss is still the most effective long term strategy for sustained weight management. While the early diet phase may produce quick results, be prepared to continue with a gradual weight reduction following that initial bump. Healthy plans aim for a weight loss of no more than 1 to 2 pounds per week. Remember, in order to lose 1 pound of fat you need to burn approximately 3500 calories. Cutting 500 calories per day x 7 days will equal a 3500 calorie reduction per week. That calorie reduction in conjunction with calories burned through increased physical activity will give you the results you desire within a healthy, steady, sustainable time period.

If you lose weight too quickly, you may lose muscle, bone, and water, and you will be more likely to regain the pounds later on.

Reducing sugar intake is always a good idea whether you are trying to lose weight or not. Many people find they are able to substantially reduce their carbohydrate (sugar) intake by simply eliminating soft/sports drinks, juices and mixers from the diet. One drink can contain over 150 calories and 40 or more grams of sugar! Just by dumping those extra, unhealthy calories, you will have a positive effect on your health and reduce your risk of developing several chronic diseases.

If you feel that a ketogenic diet may benefit you, here are some of the key points.

Keto Basics:

· Typically, headache, weakness, fatigue, constipation, light-headedness and mild irritability are common in the first couple weeks.

· Vegetables growing above ground are normally low carb and can be eaten freely.

· Vegetables growing below ground contain more carbs, so you’ll have to be more careful with them (especially potatoes).

· Peas, corn, beans, lentils and quinoa are not recommended.

· Grains and pure sugar are off limits. Bread, pasta, rice, cookies and anything made with wheat flour contains lots of rapidly digestable carbs. Avoid these as much as possible when on a ketogenic diet.

· Generally, those following a ketogenic diet aim to consume mostly foods containing monounsaturated and saturated fats such as butter, olive oil, avocado and cheeses (Butter derived from grass fed cows is highly recommended).6

1. Foster G., Wyatt H. et al. A Randomized Trial of a Low-Carbohydrate Diet for Obesity.N Engl J Med 2003; 348:2082-2090 DOI: 10.1056/NEJMoa022207

2. Sperling L., Nelson J. History and future of omega-3 fatty acids in cardiovascular disease. Current Medical Research and Opinion. Volume 32, 2016

3. Dashti HM, Mathew TC et al. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol. 2004 Fall; 9(3):200-5

4. Paoli A., Rubini A. et al.Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013 Aug; 67(8):789-96.

5. Saslow L., Daubenmier J. et al. Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes.Nutrition & Diabetes. Volume 7, Article number: 304 (2017) doi:10.1038/s41387-017-0006-9

6. Diet Doctor. A Keto Diet for Beginners. (2018) Retrieved from https://www.dietdoctor.com/low-carb/keto

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