Are you right for the Keto diet?

These days, it seems like everyone is talking about the keto diet (in short, keto) – the very low carb, moderate protein, high fat diet plan that transforms your body into a fat burning machine. Hollywood stars and professional athletes have publicly touted the benefits of this diet, from losing weight, lowering blood sugar, fighting inflammation, reducing the risk of cancer, increasing energy, and delaying aging. So is keto something you should consider taking on? The following will explain what this diet is all about, the pros and cons, as well as the issues to be aware of.

What is keto?

Normally, the body uses glucose as the main fuel source for energy. When you’re on a keto diet and you’re eating too few carbohydrates with only moderate amounts of protein (excess protein can be converted to carbohydrates), your body changes its fuel supply to run primarily on fat. The liver produces ketones (a type of fatty acid) from fats. These ketones become a fuel source for the body, especially the brain which consumes a lot of energy and can work with glucose or ketones.

When the body produces ketones, it goes into a metabolic state called ketosis. Fasting is the easiest way to achieve ketosis. When you’re fasting or eating too few carbohydrates and only moderate amounts of protein, your body turns to burning stored fat for fuel. That is why people tend to lose more weight on the keto diet.

Keto Diet Benefits

The keto diet is not new. It began to be used in the 1920s as medical therapy to treat epilepsy in children, but when antiepileptic drugs hit the market, the diet fell into obscurity until recently. Given its success in reducing the number of seizures in epileptic patients, more and more research is being done on the ability of the diet to treat a variety of neurological disorders and other types of chronic disease.

• Neurodegenerative diseases. New research indicates the benefits of keto in Alzheimer’s, Parkinson’s, autism, and multiple sclerosis (MS). It can also be protective in traumatic brain injuries and strokes. One theory for the neuroprotective effects of keto is that ketones produced during ketosis provide additional fuel to brain cells, which can help those cells resist damage from inflammation caused by these diseases.
• Obesity and weight loss. If you are trying to lose weight, the keto diet is very effective in helping you access and remove body fat. Constant hunger is the biggest problem when trying to lose weight. The keto diet helps prevent this problem because reducing carbohydrate intake and increasing fat intake promote satiety, making it easier for people to adhere to the diet. In one study, obese test subjects lost twice as much weight in 24 weeks on a low carb diet (20.7 lbs) compared to the low fat diet group (10.5 lbs).
• Type 2 diabetes. In addition to weight loss, the keto diet also helps improve insulin sensitivity, which is ideal for anyone with type 2 diabetes. In a study published in Nutrition & Metabolism, researchers noted that diabetics who ate keto diets. Low carbohydrates were able to significantly reduce your dependence on diabetes medications and could even eventually reverse them. In addition, it improves other health markers, such as lowering triglycerides and LDL (bad) cholesterol and increasing HDL (good) cholesterol.
• Cancer. Most people are unaware that the main fuel for cancer cells is glucose. That means eating the right diet can help suppress cancer growth. Since the keto diet is very low in carbohydrates, it deprives cancer cells of their main fuel source, which is sugar. When the body produces ketones, healthy cells can use that for energy, but not cancer cells, so they starve. As early as 1987, studies on ketogenic diets had already shown reduced tumor growth and better survival for various cancers.

Comparison of the American standard, paleo and ketogenic diets

(As% of total caloric intake)

__________________________Carbohydrates__________Protein_________Fat

Standard American Diet_____ 40-60% _________ 15-30% _________ 15-40%

Paleo diet_________________ 20-40% _________ 20-35% _________ 25-50%

Keo Diet________________ __5-10% __________ 10-15% _________ 70-80%

The key distinction between the keto diet and the American or paleo standard diets is that it contains much less carbohydrates and much more fat. The keto diet results in ketosis with circulating ketones ranging from 0.5-5.0 mM. This can be measured using a home blood ketone monitor with ketone test strips. (Note that the urine ketone test is not accurate.)

How to formulate a keto diet

1. carbohydrates

For most people, achieving ketosis (getting ketones above 0.5 mM) requires restricting carbohydrates to between 20 and 50 grams (g) / day. The actual amount of carbohydrates will vary from person to person. In general, the more insulin resistant a person is, the more resistant they are to ketosis. Some vigorously exercising insulin-sensitive athletes may consume more than 50 g / day and remain in ketosis, while people with type 2 diabetes and insulin resistance may need to be closer to 20-30 g / day.

When calculating carbohydrates, one can use net carbohydrates, which means total carbohydrates minus fiber and sugar alcohols. The concept of net carbohydrates is to incorporate only carbohydrates that increase blood sugar and insulin. Fiber does not have any metabolic or hormonal impact, like most sugar alcohols. The exception is maltitol, which can have a non-trivial impact on blood sugar and insulin. Therefore, if maltitol is on the ingredient list, sugar alcohol should not be deducted from total carbohydrates.

The level of carbohydrates that one can consume and remain in ketosis can also change over time depending on keto adaptation, weight loss, exercise habits, medications, etc. Therefore, one should measure their ketone levels on a routine basis.

In terms of the general diet, foods high in carbohydrates such as pasta, cereals, potatoes, rice, beans, sugary sweets, soft drinks, juices and beer are not suitable.

Most dairy products contain carbohydrates in the form of lactose (milk sugar). However, some have fewer carbohydrates and can be used regularly. These include hard cheeses (Parmesan, cheddar cheese), soft, high-fat cheeses (Brie), full-fat cream cheese, thick whipped cream, and sour cream.

A carbohydrate level less than 50 g / day generally breaks down into the following:

• 5-10 g of carbohydrates from protein-based foods. Eggs, cheese, and seafood will carry a few residual grams of carbohydrates from natural and marinade sources and added spices.

• 10-15 g of non-starchy vegetable carbohydrates.

• 5-10 g of carbohydrates from nuts / seeds. Most walnuts contain 5-6 g of carbohydrates per ounce.

• 5-10 g of carbohydrates from fruits such as berries, olives, tomatoes, and avocados.

• 5-10 g of carbohydrates from various sources, such as low-carb desserts, high-fat dressings, or drinks with very small amounts of sugar.

Drinks

Most people require at least a half gallon of total fluid per day. The best sources are filtered water, organic coffee and tea (regular and decaffeinated, without sugar) and unsweetened coconut and almond milk. Soft drinks and diet drinks are best avoided since they contain artificial sweeteners. If you drink red or white wine, limit to 1-2 glasses, the dryer the better. If you drink liquor, avoid sugary drinks.

2. Protein

A keto diet is not a high protein diet. The reason is that the protein increases insulin and can be converted to glucose through a process called gluconeogenesis, thus inhibiting ketosis. However, a keto diet should not be too low in protein, as it can lead to loss of muscle tissue and function.

The average adult requires about 0.8-1.5 g per kilogram (kg) of lean body mass per day. It is important to calculate based on lean body mass, not total body weight. The reason is because fat mass does not require protein to maintain itself, only lean muscle mass.

For example, if an individual weighs 150 lbs (or 150 / 2.2 = 68.18 kg) and has a 20% body fat content (or 80% lean mass = 68.18 kg x 0.8 = 54.55 kg), the protein requirement may vary from 44 (= 54.55 x 0.8) to 82 (= 54.55 x 1.5) g / day.

Those who are insulin resistant or who are ketogenic for therapeutic reasons (cancer, epilepsy, etc.) should try to be closer to the lower protein limit. The highest limit is for those who are very active or athletic. For everyone using the keto diet for weight loss or other health benefits, the amount of daily protein may be somewhere in between.

The best sources of high-quality protein include:

• Organic grazing eggs (6-8 g protein / egg)

• Grass-fed meats (6-9 g protein / oz)

• Sources of omega-3 fats of animal origin, such as wild Alaskan salmon, sardines, anchovies and herrings. (6-9 g protein / oz)

• Nuts and seeds, such as macadamia, almonds, walnuts, flax, hemp, and sesame seeds. (4-8 g protein / quarter cup)

• Vegetables (1-2 g protein / oz)

3. Fat

Having discovered the exact amounts of carbohydrates and protein to eat, the rest of the diet comes from fat. A keto diet is necessarily high in fat. If enough fat is eaten, body weight is maintained. If you want to lose weight, you must consume less fat in the diet and rely on stored body fat for energy expenditure.

(As% of total caloric intake)

_________________________Keep in weight_______Lose weight

Carbohydrates____________________ 5-10% ________________ 5-10%

Protein__________________ 10-15% _______________ 10-15%

Diet fat_____________ 70-80% _______________ 35-40%

Fat from stored body fat___ 0% ___________________ 35-40%

For people who consume 2,000 calories a day to maintain their weight, the daily fat intake ranges from 156-178 g / day. For large or very active people with high energy requirements that maintain weight, fat intake can even exceed 300 g / day.

Most people can tolerate high intakes of fat, but certain conditions, such as gallbladder removal, can affect the amount of fat that can be consumed in a single meal. In which case, more frequent meals or the use of bile salts or pancreatic enzymes with high lipase content may be useful.

Avoid eating undesirable fats, such as trans fats, highly refined polyunsaturated vegetable oils, as well as high amounts of omega-6 polyunsaturated fats.

The best foods for high-quality fats include:

• Avocados and avocado oil

• Coconuts and coconut oil

• Grass-fed butter, butter and beef fat

• Organic thick grazing cream

• Olive oil

• Pastured lard

• Medium chain triglycerides (MCT)

MCT is a specific type of fat that is metabolized differently than regular long-chain fatty acids. The liver can use MCT to rapidly produce energy, even before glucose, allowing for increased ketone production.

Concentrated sources of MCT oil are available as supplements. Many people use them to help achieve ketosis. The only food that is high in MCT is coconut oil. About two thirds of coconut fat is derived from MCT.

Who should be cautious with a keto diet?

For most people, a keto diet is very safe. However, there are certain people who must take special care and discuss with their doctors before following such a diet.

• Those who take diabetes medications. The dose may need to be adjusted as blood sugar falls with a low carbohydrate diet.
• Those who take medications for high blood pressure. The dose may need to be adjusted as blood pressure falls with a low carbohydrate diet.
• Those who are breastfeeding You should not follow a very strict low carbohydrate diet as the body can lose around 30 g of carbohydrates per day through milk. Therefore, have at least 50 g of carbohydrates per day while breastfeeding.
• People with kidney disease You should check with your doctors before doing a keto diet.

Common concerns with a Keto diet

• Not being able to reach ketosis. Make sure you don’t eat too much protein and that there are no hidden carbohydrates in the packaged foods you eat.
• Eating the wrong types of fat such as highly refined polyunsaturated corn and soybean oils.
• Symptoms of a “keto-flu”, such as feeling dizzy, dizzy, headaches, fatigue, brain fog, and constipation. When in ketosis, the body tends to excrete more sodium. If one is not getting enough sodium from the diet, symptoms of a keto-flu may appear. This is easily solved by drinking 2 cups of broth (with added salt) per day. If you exercise vigorously or your sweating rate is high, you may need to add even more sodium.
• Dawn effect Normal fasting blood sugar levels are less than 100 mg / dl, and most people in ketosis will reach this level if they are not diabetic. However, in some people, fasting blood sugar tends to rise, especially in the morning, while following a keto diet. This is called the “sunrise effect” and is due to the normal circadian increase in cortisol (stress hormone) that stimulates the liver to produce more glucose. If this happens, make sure you are not consuming too much protein at dinner and not too close to bedtime. Stress and lack of sleep can also lead to higher levels of cortisol. If you are insulin resistant, it may also take longer to achieve ketosis.
• Low sports performance. Keto adaptation usually takes about 4 weeks. During which, instead of exercising or intense training, switch to something less vigorous. After the adaptation period, sports performance generally returns to normal or even better, especially for endurance sports.
• Keto-rash It is not a common side effect of diet. Probable causes include the production of acetone (a form of ketone) in sweat that irritates the skin, or nutrient deficiencies, including protein or minerals. Take a bath immediately after exercise and be sure to eat nutrient-dense whole foods.
• Ketoacidosis This is a very rare condition that occurs when blood ketone levels exceed 15mM. A well-formulated keto diet does not cause ketoacidosis. Certain conditions such as type 1 diabetes, taking medications with SGLT-2 inhibitors for type 2 diabetes, or breastfeeding require additional caution. Symptoms include lethargy, nausea, vomiting, and rapid, shallow breathing. Mild cases can be resolved with baking soda mixed with diluted orange or apple juice. Serious symptoms require immediate medical attention.

Is Keto long-term safe?

This is an area of ​​some controversy. Although there have been no studies indicating any long-term adverse effects of following a ketogenic diet, many experts now believe that the body can develop a “resistance” to the benefits of ketosis unless one enters and exits regularly. Also, a very high-fat long-term diet may not be suitable for all body types.

Cyclical keto diet

Once you can consistently generate more than 0.5mM ketones in your blood, it’s time to start reintroducing carbohydrates into your diet. Instead of eating only 20-50 g of carbohydrates / day, you may want to increase it to 100-150 g on those carbohydrate feeding days. Usually 2-3 times a week will suffice. Ideally, this is also done on strength training days where your protein intake really increases.

This approach to cycling can make the diet plan more palatable to some people who are reluctant to permanently eliminate some of their favorite foods. However, it can also decrease resolution and commitment to the keto diet or trigger binge eating in susceptible individuals.

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