As soon as a new diet hits the media, it becomes a buzz word that is posted everywhere. However, if you are not a nutrition professional, it may be difficult to decipher what is scientifically proven information vs. creative marketing, which is okay! This article’s purpose is to provide evidence-based information so that you can decide if this diet is right for you.
Let’s Begin with the Basics
The ketogenic diet was first created to treat pediatric epilepsy in the early 1900s (1). When the body is deprived of carbohydrates, which are the preferred and primary macronutrient specific for energy production, insulin secretion is reduced significantly within our bodies. Insulin helps regulate blood sugar levels within our bodies. After we eat, carbohydrates break into sugar molecules called glucose. We need glucose for many primary functions within the body. Insulin is produced by the pancreas in response to glucose within the bloodstream to allow the cells to utilize glucose for energy (2). Insulin is the key that helps our bodies unlock the door to our cells for proper functioning. We also need carbohydrate intake to spare our protein pool. Our body may begin to pull from protein sources within the body if glucose is not present.
This is not a new idea in the diet culture. Many past low carbohydrate diets include Atkins, South Beach, Dukan and some ties to Paleo as well. Keto is a buzzword that is surfacing as a “new” fad diet.
The goal of the ketogenic diet is to cut carbohydrates drastically and increase fat intake. The diet recommends anywhere from 20-50 grams of carbohydrates per day depending on the person. To give you a visual, a medium-sized banana has around 30 grams of carbs.
When we cut carbohydrates from the diet, our glycogen storages deplete. Glycogen is the stored form of glucose that our body can pull from when we are low in energy. When glycogen is depleted occurs, our bodies will change metabolically. The two metabolic changes that can occur are gluconeogenesis and ketogenesis.
Gluconeogenesis
“Gluco” translates to glucose, “neo” translates to new, and “genesis” translates to create. Together this word translates to the body creating new sources of glucose from the liver. When the demand in the body for glucose outweighs the ability for the body to keep up with gluconeogenesis, that is when ketogenesis will kick in.
Ketogenesis
Similar to gluconeogenesis, our body is creating new energy forms. However, instead of glucose, our body is now creating ketone bodies. Ketones are produced by the liver when glucose is not available (3). Your body can break down fat which produces ketones as the byproduct. This occurs over 2 to 3 days of consuming fewer than 20 – 50 grams of carbs. (4). When ketones replace glucose as a primary energy source, insulin secretion is diminished. If insulin is not responsive within the body, there will be no stimulus for fat and glucose storage within the cells. When the ketogenic diet is sustained, ketone bodies will build up in the bloodstream. If this nutritional ketosis state is managed and maintained well, it is safe. However, ketoacidosis is a life-threatening condition that can occur from large amounts of ketone bodies within the bloodstream altering the bodies pH.
It is important to remember that each body and their metabolism is unique, and the state of ketosis can differ between each individual.
Weight loss is usually the number one reason individuals begin this diet. There is research to support that this diet can aid in weight loss (5). The ketogenic diet has also been shown to help control blood sugar ranges in individuals with type 2 diabetes. Mental clarity and a possible increase in energy may occur on this diet as well.
Foods You Would See on a Ketogenic Diet
Since this diet recommends 70-75% of daily calories to come from high-fat sources, foods that would be included would be:
- Red meat
- Butter
- Cream
- Cheese
- Coconut Oil
- Avocados
- Nuts and Seeds
When consuming an abundance of these foods, there is a risk for high saturated fats. Not all high-fat foods consume saturated fat, but many sources do. Saturated fat is not recommended to incorporate into the diet because it can lead to an increase in “bad” LDL cholesterol and a decrease in “good” HDL cholesterol. Less than 10% of calories each day should be from saturated fat (6). This is difficult to do when 70-75% of total calories is coming from a fat source.
Foods You Would Not See on a Ketogenic Diet
To stay within the recommended guidelines for the diet, you would not be able to consume high-carbohydrate or high-protein foods including:
- Pasta
- Oatmeal
- Bread
- Cake/Cookies
- Legumes
- Fruits and many vegetables
These foods listed above are scientifically shown to aid in a healthy long life, great for digestive health and beneficial for the body’s microbiome health. Dietary Guidelines recommend eating 6 ounces of grains per day to improve overall health and decrease future health risks (7). Research supports that incorporating high fiber carbohydrate foods can also reduce the risk for type 2 diabetes and improve insulin sensitivity.
Keto Bottom Line
There is emerging and recent research that focuses on the ketogenic diet, but there are few long-term studies of the diet’s effect on future health outcomes. There is research that supports that this diet is not recommended for pregnant or nursing women and any individual that has struggled with an eating disorder. This is a restrictive diet that could spark negative eating habits. This diet is also not recommended for individuals with pancreatic, kidney or liver issues because of the overall stress that this diet places on these organs (4).
There may be some short-term weight loss benefits. However, research shows the unhealthy negative long-term effects of eating a diet high in saturated fat, red meat and processed food. This diet is difficult to maintain, and many individuals may experience “yo-yo dieting” when attempting keto.
A balanced, rule-free diet that incorporates unprocessed foods, rich in color and variety for increased micronutrients, high vegetable intake, lean meats, whole grains and healthy fats and oils are recommended. Having a variety of foods in your diet will not only allow a diverse micronutrient intake beneficial for overall health but also gives you a healthy relationship with food that has no boundaries.
I hope this information was helpful and if you are thinking the keto diet is for you, please consult your primary physician.
Lacey Bertram
Registered Dietitian
MS Nutrition and Dietetics
Certified Personal Trainer