It is very common for fad diets to come and go. Some can be effective if implemented properly while others can be a complete waste of time. For the diet topic of the week we will examine the Ketogenic diet and see if it is right for you.
With the rising popularity of the Ketogenic diet, and especially being a nutrition coach, one of the questions I have been asked countless times over the years is “What are your thoughts about Keto?”.
First before we get to that answer I think that understanding the background of the Ketogenic diet is really important. Even though the Ketogenic diet has recently gained explosive popularity, it has actually been around for nearly 100 years. In 1921, Rolland Woodyatt ran trials on the Ketogenic diet to help regulate epilepsy in children. Keto became popular in the 1920s and 1930s for therapeutic uses until it was later abandoned due to an increase of drugs to help regulate symptoms. The ketogenic diet has also been studied to help with other neurological disorders such as Alzheimer’s disease, ALS, Autism, headaches, Parkinson’s, and sleep disorders.
What exactly is the Ketogenic Diet?
The Ketogenic Diet Consists of a macro nutrient profile of high fat (75% of daily calories), moderate protein (20%), and extremely low carbohydrates (5%) in which most of them should be from green and/or cruciferous vegetables with high fiber and low sugar contents. Essentially, what the Ketogenic diet will do, if adhered to consistently, is it forces the body to burn fat as its main fuel source in the body.
How does this occur?
When we eat a carbohydrate source, our body breaks down carbs into glucose, AKA sugar. Even though the brains main fuel source is glucose, our bodies can effectively operate with extremely low carbohydrates in the diet. In the body we store carbohydrates in the form of glycogen. Approximately 75% of our glycogen is stored in our muscle tissue, and about 25% in the liver. When you implement a Ketogenic diet, our body will slowly burn through those glycogen stores. Once we run out of glycogen, similar to the gas in a fuel tank, the liver then turns to stored fat and will convert fat into fatty acids and ketone bodies which we then use as our main fuel source. When the body gets into ketosis from low levels of carbohydrates present in the body, our body then will then circulate fatty acids and ketones in the blood. This will provide energy for muscles and other various tissues of the body to operate as needed.
What are the Pros of the ketogenic diet?
- Supports weight loss. When your body enters ketosis, it goes into fat-burning mode, which supports weight loss. Cutting carbs also causes your body to retain less water, which can lead to weight loss [2, 4, 6, 7, 9,18].
- Suppresses appetite/enhances satiety. One of the best things about the keto diet is that you won’t feel hungry. Say goodbye to hunger pangs. The high amount of fats in the keto diet minimizes carb cravings, provides steady energy for hours, and suppresses appetite [2, 6,18].
- Lowers cholesterol. Studies show the keto diet can improve “good” cholesterol (HDL) and lower “bad” cholesterol (LDL). Eating fat increases blood levels of HDL. The higher your levels of HDL, the lower your risk of heart disease. But that’s not all. Eating low-carb can also change your LDL cholesterol, altering it from “bad” to “benign” cholesterol. It does this by turning LDL particles from small (high risk of heart disease) to large (low risk of heart disease) while also decreasing the number of LDL particles in the bloodstream [2, 3, 6, 9, 10, 11,18].
- Reduces risk for heart disease. Reducing carb intake can lower blood triglycerides, which are fat molecules in the blood. High levels of blood triglycerides can put you at higher risk for heart disease [3, 4, 6, 7, 9,18].
- Reduces insulin levels and insulin resistance. Studies show the keto diet can reduce blood sugar and insulin fluctuations due to reduced carbohydrate consumption. Better insulin control can also help improve the associated metabolic disorders and symptoms linked to high insulin and blood sugar [2, 4, 9,18].
- Lowers blood pressure. Research shows eating a low-carb diet can have positive impacts on blood pressure. Hypertension is a risk factor for many diseases, including heart disease, stroke, and kidney failure [4, 6, 7, 9,18].
- Improves cognitive function. The keto diet has been used for decades to treat epilepsy in children. And it is currently being studied for its potential beneficial impacts on other neurological diseases, such as Alzheimer’s and Parkinson’s [1, 12,18].
- Enhances mood, mental focus, and sleep. After a few days of cutting carbs, many keto dieters report feeling more alert, being in better moods, and needing less sleep [12, 13,18].
- Boosts energy levels. The sluggishness and lethargy you feel after a heavy carb-filled meal is due to the insulin spike and reactive sharp drop in blood sugars. Eating a high-fat diet provides steady energy and helps you avoid crashes that are associated with eating a high-carb diet. Additionally, since ketones are the brain’s preferred source of energy, a ketogenic diet leaves you feeling more alert and mentally energized without having to supply a steady stream of caloric intake [13,18].
What are the Cons of Keto?
- Requires an adaptation process. Getting keto adapted can take one to two weeks and the transition can be uncomfortable for some people. The “Keto Flu” is commonly used to describe flu-like symptoms associated with the transition process: headaches, fatigue, nausea, etc. Due to restricted carb intake, your body is not retaining as much water so loss of electrolytes is common. This can easily be rectified with taking mineral supplements or exogenous ketones, such as the beta hydroxybutyrate mineral salts [16,18].
- May cause irregularity. Dramatically increasing your fat intake while drastically cutting your carb intake may cause gastrointestinal issues, ranging from constipation to diarrhea. This is something that should resolve itself when your body gets fat-adapted . There is also the potential for nausea, particularly when switching from a low-fat diet to the ketogenic diet. It can take a while for the gall bladder, pancreas, and liver to adapt to digesting high amounts of fat [17,18].
- Bans or puts restrictive limits on certain food groups. Some people simply don’t like banning entire food groups, and the keto diet requires you to give up all forms of sugar (no more candy, ice cream, and donuts), and popular carbs such as bread, rice, and pasta (no more pizza and burgers). Keto also limits most fruits due to the fructose content, as well as starchy vegetables such as potatoes and corn. The good news is that as your body becomes keto-adapted, your sugar cravings will dramatically fall or disappear altogether.
- May cause high cholesterol for those who are genetically predisposed. While most people will see their cholesterol fall along with their weight, there are some that may see the opposite due to the meat-heavy nature of the diet. This is typically a genetic predisposition and means the keto diet is not right for everyone [11,18].
- Makes social gatherings harder. Dining out at restaurants will require more planning and research due to hidden carbs on restaurant menus. Attending birthday parties, weddings, and other social events will require more self-discipline. If you want to drink alcohol, you’ll have to limit yourself to one or two low-carb drinks. This means dry wines (the dryer the better!) and unflavored clear liquors, such as vodka, gin, and tequila. There are a surprisingly number of keto-friendly alcoholic beverages that won’t knock you out of ketosis. For dessert, dark chocolate (at least 70% cocoa) is okay in moderate amounts. Stick to keto-friendly chocolates that are naturally sweetened with zero-calorie sweeteners such as stevia and erythritol. You can have sugar-free candies on occasion, just be aware that the sugar alcohols may cause digestive discomfort if you have too much. 
What does a ketogenic diet look like?
Since the ketogenic diet is very high in fat and very low in carbs, you will not be permitted to be eating grains, processed carbohydrates, sweeteners, most alcohols, etc. Here is a list of foods that are Keto-Friendly:
- Low carb vegetables
- Coconut oil
- Full fat Greek yogurt/cottage cheese
- Olive oil
- Nuts and seeds
- Butter and cream
- Shirataki noodles
- Unsweetened coffee and teas
The ketogenic diet has been researched well enough to show many positive benefits of using the diet. The Ketogenic diet if administered properly and consistently will deliver weight loss results without question. However, even with there being numerous health benefits of going Keto, the biggest issue with the diet from my observation is it is very difficult to stick to consistently and long term. It takes a decent amount of time to get into ketosis to begin with, and if you have one meal with too many carbs and sugar you will be immediately kicked out of ketosis, which is one of the main points of the diet to begin with. There are many things that are really positive about this diet though. One of the biggest things is it completely restricts processed foods, refined sugars, and low-quality foods which is really important. Most people eat too much of these foods to begin with and by cutting them out your energy will improve, you will most likely lose body fat, your fitness and performance will increase, and your body will surely thank you. Generally speaking when dieting, you will certainly have to make changes. Making too many changes initially however more often than not leads to failure. From experience, finding a diet that fits more within your lifestyle as well as a diet that you can adhere to long term is where the real results come. If Keto is it, excellent. If not, there are also many other variations of dieting you can implement and be very successful. At the end of the day, if you eat in a caloric deficit, you will lose weight.
Lastly, for individuals who are focusing on athletic performance, strength, etc. I highly recommend NOT following a ketogenic diet. Glycogen is the muscles main fuel source, when we lift weights, run, and workout we burn through glycogen. When we restrict carbs, we will not be able to refill the “fuel tank” so to speak. Without adequate levels of glycogen in the body, performance and endurance can drop dramatically which is the opposite of what you need as an athlete. Carbohydrates can also trigger the release of insulin, a powerful hormone secreted by our pancreas. Insulin is a double-edged sword as it can be very beneficial and also very negative. The benefit of Insulin for athletic performance are that it acts as a shuttling hormone, or a taxi for nutrients. As an athlete trying to recover from training and building new muscle mass utilizing this hormone can be incredibly beneficial. If you trigger insulin after training from higher levels of carbohydrates, insulin helps drive amino acids (broken down proteins) into muscle tissues to help with growth and also drives glucose (sugar) into replenishing glycogen stores that were used. This not only helps with building new tissues, but also replenishes glycogen to prepare you for your next training session.
Is Keto right for you? You decide. Thanks for reading.