A popular diet for weight loss is the “keto” diet. There has been some question whether this is a safe diet. It only a fad or a reasonable diet for long-term weight management?
The ketogenic diet was initially proposed almost 100 years ago for control of seizures. It has recurred in various forms over the years since then. These diets are all based on reducing carbohydrates to the point where the body is forced to rely on fat stores to provide energy. The keto diet emphasizes reducing carbohydrates (starch and sugar) to an absolute minimum of 5-10% of the diet.
As the blood sugar falls the insulin goes down and the fat stores start releasing free fatty acids. Some of the free fatty acids are converted in the liver to ketones to fuel the brain. The ketones can be detected in the urine with keto sticks which can be obtained at the drugstore. It may take up to 3 or 4 days for the body to adjust and switch over to producing ketones.
In some ways a keto diet makes a lot of sense. Most of our carbohydrates are “empty calories” which our body could do without. About 50% of our daily calories are from carbohydrates. Most of these could be eliminated without harming our health. The net result is a diet with calories supplied by fat (70%), protein (20%) and carbohydrates (10%). It has been noted that there are people with epilepsy and communities who live in areas with no vegetation that do quite well with a diet high in fat and protein and low in carbohydrates.
Some nutritionists object that by eliminating many fruits and vegetables from the diet we may be depriving ourselves of vitamins and minerals and fiber. This is a legitimate concern but so far there have not been many reports of people doing major harm to their metabolism by going on a keto diet. This may be due to the fact that the diet is not easy to stay on and most people use it only for a short period of time.
The diet relies on mostly eliminating sources of carbohydrate which includes vegetables and fruits with natural sugars and grains and root vegetables with natural starches. Processed foods that contain carbohydrates are also eliminated. Foods with protein and fat and oil like meat and some dairy products and fatty vegetables are on the diet.
A good list of foods that are on the ketogenic diet are found in the website forkly.com. Their list includes eggs, avocados, dark chocolate, cheese, fish, snacking sausage, nut and seed butters, raspberries, grass fed beef, nuts and seeds, coconut oil, low carbohydrate vegetables (broccoli, cauliflower, KL, spinach, cucumber, zucchini sprouts and spaghetti squash), flaxseed, mayonnaise, almond flour, coffee with butter and oil added, Stevia, Shirataki noodles, unbreaded chicken wings, dips (without chips).
As you can see, eating a diet mostly with the above foods can become boring or unappetizing after a short period of time. This brings up the point that all successful diets rely on reducing calories. The keto diet is no exception. Monotonous diets are a proven way to reduce calories and decrease weight. There is no magic to producing ketones. It is simply an indicator that we have entered a semi-starvation state and the body is converting to using fat stores for as much of our energy needs as possible.
Potential adverse effects of the diet include hypoglycemia, dizziness, nausea and loss of energy. On the other hand, advocates point to potential benefits including improved complexion, less craving for food and more energy. People with diabetes should closely monitor the blood sugars because they may need to change their diabetes regimen. People with liver disease or kidney disease should not go on the diet.
If you do decide to go on a keto diet you should be aware that there may be a period of time early on when you feel quite ill. This feeling should pass but some people do get dramatic symptoms. Some people prefer to start with a modified keto diet with a little more fruits and vegetables and less production of ketones. Any diet that helps with weight loss is probably good for health and the keto diet is probably not much worse than any other unbalanced diet. The alternative, of course, is to reduce calories by restricting portions and eating healthful low-calorie foods of all types. Good luck with your weight loss endeavor.
Kort C. Knudson M.D., FACE