Ketogenic Diet - The Basics
The ketogenic diet appears to be ALL the rage right now. I must admit - I am part of this fan club! I have just seen so many incredible changes in patients, and myself using a ketogenic diet. I want to just go over a few basics in regards to this diet to give you a clear idea of what the heck I am talking about - and also my take on it, because I feel like it has been interpreted in a lot of different ways, leading to unclear (and unhealthy) eating patterns and beliefs.
what is it?
The ketogenic diet was originally popular in the 1920's-1930's as a treatment for epilepsy. Once anticonvulsant medications reached mainstream medicine - the use of this diet decreased. Though, certain patients weren't responding to these epilepsy medications (especially children), and this diet was reintroduced and used successfully. Now - the ketogenic diet has become a popular one for weight loss and hormone balancing.
The ketogenic diet is a way of eating that is:
- HIGH fat
- MODERATE protein
- LOW carbohydrate
The idea is to transform your body from burning sugar as fuel, to burning fat as fuel. When you eat sugar, or any carbohydrates that turn into sugar - your body converts it to glucose. Since glucose is easy for your body to produce and use, it is utilized preferentially over fat - therefore your fat is stored.
When we lower the amount of carbohydrates we consume - your body starts to preferentially burn fat as fuel, which causes ketones to be produced. When these ketones accumulate in low amounts in your body, you are said to be in nutritional ketosis. After a while, your body learns to primarily burn fat instead of sugar - leading to the many benefits of a ketogenic diet.
calculating your macros
Your "macronutrient ratios" (or "macros" as the cool kids call it 😎) are reflective of the amount of each of carbohydrate, protein and fat that you should be eating in a day. A common goal in terms of the % of your daily calorie intake when following a ketogenic diet is:
- 60-75% from healthy fat
- 15-30% from protein
- 5-10% from NET carbs*
I don't have one, specific target that I use when I am calculating macros for a patient. This is because everyone is different, has different health concerns and goals, and will require different amounts of each!
Additionally - just because a certain amount of carbohydrates works for you for a little while - doesn't mean that is what you have to stay on permanently (especially for women), so in my opinion your "macro ratios" are fluid and open to change. This is another reason why I recommend being supervised by someone who has experience, and can address and adjust as necessary.
Lastly - specifically your protein intake - is dependant on your body weight, and your exercise level, so it needs to be calculated individually.
*NET carbs is the total carbs minus the fiber content.
WHAT IT ISN'T
The ketogenic diet has a reputation of being all the bacon, butter, cream and meat you can eat. This is just NOT the case.
It is also not the same as the atkins diet - some of the principles are similar, but the ketogenic diet is not high protein.
The ketogenic diet done properly is basically a whole food diet that emphasizes high quality fats and proteins, and lots of low carbohydrate vegetables (hint - most that grow above are the ones that are emphasized). I also don't recommend high quantities of dairy products to my patients in general - so the version of the ketogenic diet that I follow and recommend does not contain a lot of dairy products.
stay tuned for more "keto myths" in an upcoming blog post!
WHY DOES IT WORK?
Multiple studies have been done on high fat, low carbohydrate diets - and these are just a few of the results:
- High fat diets lead to more significant weight loss than low fat diets
- Patients are more compliant on high fat vs. low fat diets
- Patients lost more fat and maintained muscle mass on high fat diets
- Patients cardiovascular disease risk decreased (increased HDL and decreased LDL)
IS THIS FOREVER?!
I often use the ketogenic diet as a reset for patients - as a way to help them feel incredible, and to provide motivation to change unhealthy habits that have developed in their life. People feel lighter (physically and mentally), have improved focus, increased energy and more. The nice thing about being in ketosis, or fat adapted, is that once you are stable, often you can consume a glass of wine, or an occasional treat and your body will digest these carbohydrates and revert back to ketosis and its fat burning mode. Once my patients have done a temporary 'keto cleanse' I work with them to transition into a maintenance program that fits their lifestyle and feels like a easy to follow, way of living, and not a diet.
STay tuned for more info on the ketogenic diet including:
5 COMMON MYTHS OF THE KETOGENIC DIET
DETAILS ON THE HEALTH BENEFITS OF THE KETOGENIC DIET
Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials (British Journal of Nutrition - Volume 110, Issue 7; 14 October 2013 , pp. 1178-1187)
Successful Weight Loss with Low Carbohydrate Ketogenic Diet (LCKD) Significantly Reduced Visceral Fat and Increased Fat Free Mass in Obese (Gastroenterology - Volume 152, Issue 5, Supplement 1; April 2017)
A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia: A Randomized, Controlled Trial
Ketogenic diets for weight loss: A review of their principles, safety and efficacy (Obesity Research & Clinical Practice- Volume 2, Issue 1, March 2008, Pages 1-13)
The Keto Diet - The Complete Guide to a High-Fat Diet ; With more than 125 Keto Recipes and Meal Plans; Leanne Vogel