The ketogenic (‘keto’) diet is in fashion, but is it right for you?
You’ve probably read some very enticing headlines about keto 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 most people. If you want to know my conclusion, please skip to the last part of the blog. 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)
acne
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.
ABOUT KETOSIS
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, and some advocates argue the brain actually prefers ketones.
WHAT DO YOU EAT
As you will see, keto means 'diet rules’:
IN...
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
Avocado
Berries – raspberries, strawberries, blueberries blackberries, and other low GL berries
Other fats – coconut oil, high-fat salad dressing, saturated fats, etc.
OUT...
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. Some people find this to be filling and satisfying, and report benefits such as no more hunger cravings and consistent energy levels.
Cutting out carbs means more than just avoiding the bread, pasta, rice and potatoes that we think of as the primary carbohydrate sources, 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 may need to choose foods with relatively lower toxin levels, such as organic cuts of meat, organic produce, and wild fish. However, just choosing organic foods doesn’t completely protect you from all contaminants, but it’s a relatively better choice when consuming significant volumes of animal products.
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 you would need to watch the sugary mixers. Champagne and wine may work in moderation but it very much depends on your sensitivity to carbs whether it will impact your ketosis.
GETTING INTO KETOSIS
Although the chart above 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. This is a taxing time that can put people many people off following through.
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 planning your meals 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?
In my view, the ketogenic diet is without a doubt best reserved for those people with a compelling medical reason to try it, such as one of the chronic health conditions this diet is evidenced to help.
Most mere mortals will struggle to be committed enough to get into and stay in ketosis for long. And with good reason - this is a dietary approach which takes superhuman levels of will power.
If you’re tempted to try Keto for weight loss, please think again, particularly if you have a history of yoyo dieting or disordered eating habits. I believe there is a high risk that what starts as a healthy new dietary approach could develop into an unhealthy fear of carbohydrates and set the scene for eating disorders. There can be a fine line between dietary vigilance and obsession - so this is definitely one to watch depending on your nature and relationship with food and your body image.
Finally, you also need to be aware of how your body might respond if you try a ketogenic plan for a while and then decide to come off it. It is a highly restrictive approach to eating which can facilitate quick weight loss, which means, like most weight loss diets, when you do start eating normally again, your body may be in a hurry to regain any weight lost. Protecting against this is difficult as it’s the body’s way of responding to what it perceives as coming out of a famine, and it’s not as a straight forward as simply adding carbs back in to your daily diet, but a process of rebalancing the whole 'macro picture' with consideration of proteins too.
If you do choose to embark on following a ketogenic diet, it is best to educate yourself as much as possible to determine the healthiest way to make it work for you.
If your interest in keto is due to concerns around your weight, please talk to me. I can help you shift how you relate to food and your body in a healthy, sustainable and intuitive way, without dietary restriction. Please contact me here.
