What is the truth about the keto diet? Everybody is talking about it. I bet you have many questions about the so-called “ketogenic diet” aka the “low-carb, high-fat diet (or LCHF diet)”. Let’s call it KD for the sake of this article.
Is this a new fad? Is this working? Is this for everyone? There are websites, special snacks, recipes, gurus, books, Facebook groups and Pinterest pages. Even medical conventions now. Everybody who wants to lose weight is now asking me about this.
Let me say this immediately:
It is not a new type of diet. It is, in fact, a version of the Atkins diet: low in carbohydrates but with a very high content in fat.
It is not an easy diet to follow as up to 60% – 90% of what you eat is plain fat! And it is not for everybody. As expected, there are pros and cons.
Clinical data shows improvement in children with epilepsy while they are carefully monitored nutritionally. It diminishes the frequency of seizures. It works.
Data on KD suggests benefits, and some people swear by it, for individuals with Type 2 diabetes, cancer, polycystic ovary syndrome (PCOS), or neurological issues such as Parkinson’s. But the data, especially for the long term, is not as clear as it is for epilepsy.
As a nutritionist, I have only recommended KD a few times to clients who are diabetic or seriously pre-diabetic, who are addicted to carbohydrates and sugar and can’t lose weight. They also usually have a serious amount of weight to lose. And I always recommend this protocol be followed by their physician.
What is the Ketogenic Diet?
This diet is a very low or almost no-carb food program. I am talking possibly as low as 20-30g of NET carbohydrates (carbohydrates minus the fiber content), including fruits and vegetables, a day! To give you an idea, a slice of whole bread provides 10-15g of NET carbs, and an average apple offers 21g of NET carbs.
A typical KD will promote these macronutrients ratios:
– 10 to 20% protein
– 5 to 15% carbohydrates
– 60 to 90% fat – yes! We are talking of potentially 100 to 150g of fat a day for a 1,500 calorie a day diet. As an example, a 3oz steak contains 17g of saturated fat, and 3oz of Swiss cheese will provide 24g of fat.
As a baseline, a rather balanced diet that provides necessary macronutrients requires:
– 20 to 30% protein
– 40 to 60% carbohydrates
– 20 to 35% fat
For my clients who want to lose weight, I usually recommend sticking to a max of 40% of carbohydrates, or 100-150g max daily, mostly from vegetables and fruits (2 servings a day). This is far from the KD guidelines!
How Does it Work?
Normally your body uses carbohydrates as fuel for your cells, including in your brain. This is what gives you internal and external energy.
But excessive carbohydrate diets, and/or insulin resistance health problems, create a situation where the carbohydrates are not processed correctly and as a consequence, extra unburned glucose – which cannot stay in your blood – is stored as fat in your body (read my book, Chapter 2 on Sugar). That is what leads to weight gain and eventually Type 2 diabetes and other health issues.
Even excess protein can raise insulin when there is a deficiency in carbohydrates and it is called GLUCONEOGENESIS.
The only source of food that DOES NOT RAISE INSULIN, because it DOES NOT NEED INSULIN TO BE PROCESSED is FAT!
The KD plan forces the body into a state of ketosis, which is when your body burns fat for energy instead of carbohydrates. Keto diets will limit the amount of food you should eat in calories to a certain extent, like any other weight loss plan, but with KD, the type of food you are allowed to eat is very important, as it is mostly fat.
Cheating on your macronutrients ratio will not work in KD, even if you stick to your 1,500 calories a day regimen for instance. You need to monitor your intake scientifically.
Get ready to:
– Eliminate almost all carbohydrates including alcohol, sugar, desserts, bread, pizza, pasta, fruits and vegetables
– Learn new recipes like the “keto bread” or cheesy crackers. It usually involves a lot of cheese. And plan your meals carefully because you can’t cheat!
– Eat mostly fish, seafood, cheese, meat, poultry, eggs, plain yogurt, and of course fats.
The challenge is that all sources of FAT are encouraged in this diet including saturated fats, such as butter, coconut oil (yes it is a saturated fat with serious controversy now), cheese and dairy.
Special keto snacks, to give you a crunch and pleasure, have been created of course such as very cheesy chips or bacon bits – oh yes, some people eat a lot of bacon on that diet. But you need to favor unsaturated fats instead, such as avocado, olive oil, nuts etc.
And you must watch your calories because fat is double the calories per gram (9 cals) than protein (4 cals) or carbohydrates (4 cals).
If you’re thinking that this is not an easy diet, you’re correct. The huge amount of fat you eat will make you feel satiated very rapidly. It will keep cravings at bay.
However, it is not a type of diet that will make you feel happy. It is a diet without a “crunch” factor, except for the nuts or snacks. It will leave you with a lack of palate satisfaction. You will miss fruits and vegetables, especially in season.
KD Will Help You Lose Weight
The KD delivers results in weight loss, at least in the short term. An article by Antonio Paoli ” Ketogenic Diet for Obesity: Friend or Foe” was published in February 2014 by the International Journal of Environmental Research and Public Health. It recognizes its positive impact on weight for its followers. Serious obesity centers are specialized in guiding patients with this protocol such as the Duke University Medical Center led by keto pioneer, Dr.Eric Westman.
The key here is that a doctor should be monitoring your health including your lipids panel – a chance is your cholesterol will go up. But it can also go down, as you eliminate sugar! How confusing but true. Anyhow, something to monitor carefully.
You also have to watch for your kidneys because of potential over-consumption of proteins.
The good news is that your glucose levels and A1c data can be spectacularly decreased and get you out of a pre-diabetes or even Type 2 diabetes diagnosis. This is an amazing benefit. But can you sustain that diet?
Finally, the elimination of carbohydrates, especially good ones that are full of fiber, vitamins, and anti-oxidants is not healthy and can trigger nutrient deficiencies.
The Side Effects
People can feel unwell when they first start the keto diet and experience a phenomenon described as the beginner’s “keto flu.”
You may feel headaches, fatigue, dizziness, light nausea, brain fog, lack of motivation and irritability, all signs of carbohydrates restriction. But it will go away.
But people also report loss of hair, constipation (lack of fiber), and dehydration. Hmm, not that pleasant!
As a Conclusion
This is a diet that must be discussed with and monitored by your doctor. For me, it is the diet of last resort that I reserve for “carboholics” or seriously insulin-resistant clients. Benefits and risks must be assessed. You cannot do this on your own. Long-term benefits and sustainability have not been proven yet.
Let me know if you want to discuss this with me!
Have a healthy day, Veronique
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