The Ketogenic diet was all the rage in 2018! But was it a fad or fab?
Was to Ketogenic diet just another weight loss diet that was endorsed by many celebrities and other health and fitness bloggers... OR... Is there real evidence that shows that the Ketogenic diet actually works?
Well let's have a look shall we?
What is the Keto(genic) Diet?
The Ketogenic diet (or Keto, for short) is a diet that involves altering the distribution of your macronutrient intake. This means changing up how much Fat, Protein or Carbohydrates makes up the total energy that's comes from the foods we eat. The Keto diet comes from the low-carb family as it shares similarities with the Atkins Diet and other low-carb diets!
The Keto Diet is based on:
Very-low Carbs (or carbohydrates)
High fat
Moderate Protein
Basically, it involves drastically reducing the amount of carbohydrates you eat and replacing it with fats! Like swapping bread or pasta for meat or avocados.
The whole idea of the keto diet is to change the bodies main fuel source, from carbohydrates and glucose to fat and ketones.
Let me explain...
Glucose is the bodies main source of fuel, especially to the brain!! Usually, the body uses glucose (broken down from carbohydrates and stored in muscles and the liver as glycogen) to fuel the body.
In the absence of glucose and carbohydrates the body produces ketones. The body breaks down fat (in the liver) into ketones (or ketone bodies) for fuel. The only other fuel source the body will use and can actually enter the brain!! This is known as the metabolic state of ketosis (hence where it got its name!) The idea behind this diet is that the body will convert to burning fat and use up it's fat stores for energy.
The state of ketosis happens when you consume less than 50g of carbohydrates (or carbs) per day (with moderate protein because protein can be converted to glucose and therefore switching the energy systems back to carbs).
The difference between the Ketogenic diet and other low-carb diets is that the Ketogenic diet contains 20-50g carbs per day and less than 10% total energy, everyday! Which aims to keep the body in a state of ketosis!
More specifically, the Ketogenic diet ranges between:
20-50g carbs
15-20% total energy from protein
70-80% total energy from fats
Consistently eating fewer than 25g carbs per day would mean you can't eat any more than one banana OR one small tub of yoghurt each day!
The keto diet is a low-carb, high-fat diet and shifts the bodies metabolism away from carbs and towards fat and ketones as the main source of energy!
What can is involved?
The keto diet is a highly restrictive diet. Meaning there are certain things you can and can't eat!
Generally, the keto diet involved limiting and saying goodbye to foods that are high in carbs and swapping these to high fat options! So if you are a pasta lover, then forget it... This diet is not for you!
Included foods
Meat: red meat, steak, ham, sausage, bacon, chicken, etc
Fatty fish: salmon, tuna
Eggs
Butter and cream
Nuts and seeds
Healthy oils
Avocado
Low carb veggies: mostly green veggies and typical salad veggies
Herbs and spices
Foods to avoid
Sugary foods: soda, fruit juice, smoothies, cake, ice-cream, etc
Grains and starches: wheat-based products including bread, rice, pasta, cereals, etc
Fruit: all fruits should be avoided
Beans and legumes: peas, kidney beans, lentil and chickpeas
Root vegetables: potatoes, sweet potato, carrots, parsnip, etc
Low fat or diet products
Condiments and sauces
Unhealthy fats!!
Alcohol (due to the high carb content)
As you can see this is quite an extensive list of what you cannot eat!!
The keto diet mostly includes foods such as meat, fish, eggs, butter, nuts, healthy oils, avocados and plenty of non-starchy vegetables.
You can say goodbye to most fruits, grains and even potatoes, breads and pasta!
What does the evidence say?
In reality the ketogenic diet is literally another way of eating… originally for epileptics. Interestingly, the infamous keto diet has been around since the 1920s to treat children with epilepsy. ketogenic diet has actually been found to reduce the severity and frequency of seizures.
There is also evidence linking the ketogenic diet and cancer. According to evidence tumour kells have a relicance on glucose and many cannot use ketones effectively. So they believe that the keto diet may be beneificial in people who already have cancer as a way od disrupting cellular metabolism of the tumour or may be toxic to them. However, research is limited and more needs to be done to be able to make any conclusions.
One of the biggest things the keto diet has become increasingly popular for is for weight loss!! Evidence has suggested that following the diet will cause short-term weight loss. However this is probably due to a reduction in total energy/calories consumer, the depletion of liver and muscle glycogen stores and water losses and because of a reduced appetite due to the effects of ketosis and satiety caused by eating food containing protein and fat.
Evidence has also highlighted that long-term weight loss is associated with following a diet long term! So if you were able to follow the diet long term then sustainable weight loss is very likely! However, humans are very different! Everyone is unique in their own way and dietary advice should be tailored to the individual. Unfortunately there is no one-fots-all approach when it comes to weight loss and maintaining a healthy diet. If weight loss is your goal and you have been struggling to keep the weight off or sick of following diet after diet please go seek advice from an accredited dietitian! They are there to help you achieve your goals in a way their suits your needs!!
There is also limited evidence of the effects of following the Ketogenic diet in the healthy population!!
Limitations of the Keto diet
1. Keto flu and other physical symptoms
Whist the keto diet is considered safe for healthy people, there are many side effects that can occur while your body adapts. According to many blogs, this is referred to as the keto flu and is over within a few days.
These health and fitness blogs describe the keto flu as “poor energy and mental function, increased hunger, sleep issues, nausea, digestive discomfort and decreased exercise performance.
Ketones are the only other source of energy that the brain can use as energy. So when there is nil glucose available the brain will use ketones. When the brain uses ketones often the major symptoms are fatigue, reduced mental functions, confusion and dizziness.
Other symptoms of using ketones as a source of fuel include:
Bad breath – almost like a bad or fruity smelling breath. This is because your body then produces acetone, which is a ketone that exits your body in your urine and breath.
o Insomnia – reported to experience insomnia for the forst few weeks of starting the ketogenic diet
2. Gastrointestinal symptoms
Due to the massive changes to the types of foods you eat, Constipation and diarrhoea are common side effects of starting the keto diet. This can be due to completely cutting out food groups that are important bowel regulating nutrients, i.e. grains and fruits. These contain both soluble and insoluble fibre, both of which are important for regulating bowel motions! Also the bacteria in your gut are also ideal for maintain a healthy bowel. Avoiding fibrous foods essentially starves the bacteria in your gut, possibly creating a poor environment and leading to futher digestive issues
Eating carbohydrate foods that ae high in fibre including fruits, vegetables and whole grains are important for maintaining bowel motions. Limited carbohydrates, reduces fibre intake and therefore can cause symptoms like constipation.
The lack of fibre also highlights the potential for an increased risk in bowel cancer in the long-term. Eating whole grains and fruits and vegetables is linked with lowered risks of diabetes, heart disease and bowel cancer.
3. Strict restrictions and poor compliance
The ketogenic diet is very strict, and many people find it difficult to stick to because it drastically reduces a number of food groups including fruits, vegetables, dairy and gains. It Has high drop-out rates due to restrictive nature. This is even experiences during the epileptic interventions.
Due to the restrictiveness of the ketogenic diet there is a potention for negative effects on the social aspect of eating such as enjoying food with family and social situations such as eating out, as people are too worried about what they are able to eat rather than enjoying food.
4. Unlikely to meet your nutritional needs
Excludes essential food groups and limits food choice. Again, because of ketos restrictive nature and avoiding food groups, it is near impossible to meet nutrient needs without supplementation. Nutrients of concern include fibre, calcium, folate and vitamin C
.
Body relies on carbs to stay healthy and function normally. Absence of whole grains fat can increase the risk of heart disease and diabetes and bowel cancer. The types of fat, saturated fat and trans if eaten inappropriately can negatively impact our heart health. There is meixed evidence that the keto diet improves heart health. Some studies have found that a high fat low carb diet can actually increase your LDL (bad) cholesterol and therefore negatively impart your heart health!
However, there is not enough evidence about the long-term effects of following a diet such as this and the full long-term side effects or benefits are not yet fully known or understood.
5. Weight regain
Weight loss – although this is a positive for some people that have the goal to lose weight. General calorie restrictions will cause weight loss and because of the high restrictive nature of the diet it is hard to follow long term. Meaning that most people will regain the weight when they stop following the diet. Also some of the weight loss experienced durng the first few weeks of following the diet is most likely just water losses. As carbohydrates and water are best friends, where ever, carbs go, water will follow. So if you are not eating carbs you are likely to use up all your stored carbohydrates and water.
Weight gain - Ketones are the source of energy that the body uses when it is burning fat. However, ketones are produced in weight loss regarless of the type of diet they are following. It also doesn’t matter wether your body is burning fat from its stores of from the high fat meal you just ate, your body will prodice ketones. By adding additional fat into the diet, you will most likely remain in a positive energy balance (regardless of the fuel, CHO, fat or protein) there is a change you will gain weight!
Potential benefits
1. Weight loss
Initial weight loss, although this Is due to decreased muscle glycogen and therefore lower water stores in the body. May be useful to a sedentary person who doesn’t use many carbs and enjoys the keto lifestyle.
May help to lose weight due to high satiation (feeling full and satisfied) from fat and protein, which may lead to reduced energy intake. Reduction in hunger may be due to an increased protein and vegetable intake and altering your bodies hunger hormones. Some studies suggest tht ketones may also affect your brain and reduce your appetite. Meaning you feel full and don’t need to eat as often as before.
This reduces energy intake could also be due cutting out carbs you used to frequently overconsume (i.e. cakes, pastries, chocolate, soft drink, etc).
The keto diet will help you lose weight initially because it forces you to cut excess calories that you used to eat from junk foods and other high-carb foods. It is not because of ketosis itself. You will also lose a noticeable amount of water weight!
Any sort of weight loss auomatically improve health markers!
2. Help manage certain medical conditions
As mentioned above, the ketogenic diet has some evidence to support the following:
Reducing frequency and severity of seizures in children with epilepsy
Limited but emerging evidence regarding cancer patients benefitting from keto for those with camcer not as a preventative measure
Possibility to manage and lower blood sugar levels. However, research is limited to support the ketogenic diet to treat diabetes and PCOS, as it can lead to hormonal changes within the body.
My thoughts: Fad or fab?
The keto diets sounds too good to be true. It claims to adapt your body to burning fat, upstarting your metabolism and boosting brain function.
But... the ketogenic diet is basically THE definition of a fad diet!!
Like most fad diets, the ketogenic diet required dramatic and unnecessary food restrictions to achieve weight loss and all the other benefits it promises and for most people, they are not able to maintain the diet long-term.
The ketogenic diet is a fad diet because it unsustainable and too restrictive!
I don’t think this is a good or a bad diet. What I do think is there just isn’t enough research and information about the long-term effects of following this diet. Evidence suggests that the diet it not recommended for the general healthy population.
I aso believe that following a low carbohydrate diet, rather then a no carbohydrate diet is much more practical, as it is less restrictive and yu are able to enjoy whole grains including pasta, and rice, fruits and vegetables and their many health benefits!!!
The Ketogenic diet may offer short-term weight loss but you also need to look at the potential effects it has on your health. A ketogenic diet isn't recommended for the general population, as there is just not enough evidence of the long-term effects of following this diet
If you are interested in following something like this please do not do it alone. Seek help from an accredited dietitian and they can point you in the right direction and truly assess if this is the right diet for you!!
Enjoy xx
If you would like to know more here is a list of sites you can check out to find out more:
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