The ‘Keto Diet’, the latest buzz word in the health world…so much so you may get people roll their eyes at you if you mention it! Is there sincerity behind it to make it worth a try? A look into the structure and purpose of ketosis.
When deprived of food, the body begins to burn body fat to provide it with fuel. This process is known as ketosis. If we trick our body into believing it is starving by the removal of carbohydrates (its primary fuel), and force it to exist on an all-fat diet it would consistently be in ketosis. This is not a newly discovered concept. Ketosis was first utilised as a medical treatment for epilepsy in the 1920’s, based on work passed down from Hippocrates who touched on the subject 2,500 years ago!
The problem is that, even though this works for people suffering from seizures, in some cases it is such a strict and unhealthy diet in its own entity that supplements are necessary to prevent our bodies from breaking down. Scientists are not fully aware of how our cells react during ketosis. The biological mechanisms as to why this works neurologically for epilepsy, and potentially Parkinson’s, tumours, and Alzheimers, are still under scrutiny and thus far not entirely understood.
As a weight-loss or health-orientated diet the ‘keto diet’, as it has been shortened to, due to the familiarity of it in the media, involves a high-fat, low-carb intake to encourage the process of ketosis; to enforce that the body rely on fat for fuel as opposed to carbohydrates. When we consume less carbohydrates the body produces ketones – small fuel molecules made by the liver.
What to eat (and not to eat) on the keto diet
Natural fats are encouraged for consumption on the keto diet plus foods that are rich in omega-3 fatty acids, like fish and seafood. Proteins should be also incorporated as well as a healthy dose of above ground vegetables. Some cheeses are also acceptable. Foods containing high levels of carbohydrates are to be avoided – and kept at under 50g per day. The fewer consumed, the more effective the diet.
The basic set up is:
- Fewer carbohydrates—about 5 to 10%
- Protein—maximum of 20%
- More healthy fat—about 60 to 80% of your diet
Because of the high fat requirement it must be consumed at every meal. In a daily 2,000-calorie diet, that may look like 165g of fat, 40g of carbs, and 75g of protein. However, the exact ratio depends on your particular needs.
Some healthy unsaturated fats are allowed on the keto diet — like nuts (almonds, walnuts), seeds, avocados, tofu, and olive oil. But saturated fats from oils (palm, coconut), lard, butter, and cocoa butter are encouraged in high amounts.
Protein is part of the keto diet, but it doesn’t typically discriminate between lean protein foods and protein sources high in saturated fat such as beef, pork and bacon.
And then there’s the question of fruits and vegetables which are generally high in carbohydrates. All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, peppers, onions, garlic, mushrooms, cucumber, celery, and squashes.
Due to the complex nature of the ratios specific to you personally it is recommended to incorporate a keto calculator to help achieve the necessary levels for ketosis to occur.
Potential ‘pros’ of the diet
The health benefits are widely controversial however many experience weight loss. Blood-sugar levels may be lowered considerably which may assist those managing type-2 diabetes. As previously mentioned it has proved highly successful (yet intense and challenging) for those suffering from seizures and epilepsy.
The ketones produced during the diet can increase energy and focus, physical endurance, improve cholesterol and control glucose.
Ketosis has been shown to help prevent and starve cancer cells.
Ketosis may improve certain forms of cellular healing, including mitochondrial biogenesis (the making of new, bigger, and higher energy-producing mitochondria), so that your cells are stronger and have more stamina, particularly when it comes to exercise. But there is limited data on the subject.
Potential ‘cons’ of the diet
Due to the lack of long-term studies on the effects of the diet it is unknown as to whether it is safe to continue the diet over time.
To encourage the production of ketones in the liver as the body’s main source of fuel is not as easy as it may sound.
Both saturated and unsaturated fats are encouraged in abundance during the diet. Fruits and vegetables are restricted to those low in carbohydrates. The high-fat intake could potentially lead to a higher risk of heart disease and bad cholesterol.
If you’re not eating a wide variety of vegetables, fruits, and grains, you may be at risk for deficiencies in micronutrients, including selenium, magnesium, phosphorus, and vitamins B and C.
Liver problems. With so much fat to metabolise, the diet could make any existing liver conditions worse or in fact cause problems.
Kidney problems. The kidneys help metabolise protein, and the keto diet may overload them. (The current recommended intake for protein averages 46 grams per day for women, and 56 grams for men).
The keto diet is low in fibrous foods like grains and legumes and so constipation could be an issue.
The brain needs sugar from healthy carbohydrates to function. Low-carb diets may cause confusion and irritability, people have complained of dizziness and feeling a lack of energy as well as mood swings due to the hormonal imbalance caused by the initial conversion.
There are more safety concerns for people trying keto for fat loss or performance. In humans, there are reports of adverse reactions to keto, including menstrual irregularities, gut dysbiosis, change in circadian rhythm, hair loss, mood disorders, and thyroid dysfunction; and in rodents, insulin resistance and nonalcoholic fatty liver.
If on a strict keto diet you should monitor your cholesterol, haemoglobin, inflammation, thyroid function, hormone levels, electrolyte and mineral levels.
The diet is very specific to the individual and must be constructed uniquely to suit each body. The diet depends on exact ratios pertaining to your personal needs which must be followed precisely in order to achieve and maintain ketosis. It relies on a fair amount of attention to macronutrient quantities for it to work effectively.
You must also adapt the diet to suit your activity level, for example, extra protein would get converted into glucose, and so based on how much exercise you take, the protein intake must relate to this. If a person were to waiver or take a day off, the process may be disrupted and need to be restarted.
To sustain this diet could come with health risks and is difficult to maintain. The main lure for the keto diet is weight (loss), which, on return to an alternative diet, is likely to return.
How long should you stay on a keto diet?
To begin with it is suggested to try for 6-12 weeks ensuring that an experienced doctor is on board and available to check your blood. If you maintain stable ketosis it is possible to remain this way for up to six months, under consistent expert observation, but it is unknown as to how long it is safe to remain under ketosis.
How do you know if you’ve reached a ketogenic state?
Your blood ketones need to be checked, this can be done at home with a kit (ketone meter) which is fairly costly but purchasable online, and ketone test strips which require a drop of blood to check your levels. Less accurate versions are urine tests and breath tests.
Other things to note if considering a keto diet
You can not drink alcohol, this will negate the process until you are in a full state of ketosis, and then you can have a very limited intake.
You will need to monitor your nutrient intake due to the high-fat nature of the diet and ensure you receive the correct amount of nutrients to maintain a healthy body.
You must refrain from overeating. You need to be accurate with your ratios to your body. It is very possible to gain weight if you get the levels wrong.
If you suffer with any of the following you must be sure to check in with a doctor to see if the diet is suitable for you: pancreatitis (history of), active gallbladder disease, impaired liver function, impaired fat digestion, gastric bypass surgery, decreased gastrointestinal motility, pregnancy and lactation.
Be very cautious with ketosis if you have, or suspect you have, thyroid problems.
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