If you’re in the habit of searching for new diets or keeping up with the latest nutrition trends you’ve probably heard about the ketogenic diet (known as “keto” for short). Keto diets have been all the rage in the fitness, wellness, and nutrition world.
Wondering what it’s all about? Let’s break it down here!
What is the keto diet?
The keto diet is a very low-carb, high-fat diet, with moderate protein intake.
Its goal is to limit the amount of daily carbohydrate intake to shift the body into using fat as fuel rather than glucose or stored glycogen (which both come from carbs).
When the body shifts to rely on fat rather than carbs for energy it goes into a state known as ketosis.
Keto diets are becoming more and more mainstream in the health and wellness industry, and many nutritionists, doctors, and specialists are recommending this approach to treat several conditions. Many studies suggest that being in a state of ketosis can support your metabolism, lose weight, enhance athletic performance, and improved brain health.
Despite their popularity, keto diets are notoriously restrictive and require a lot of planning. The super low carb nature of the diet makes many common grocery list items unsuitable and can make it quite difficult to maintain, which is why even among health and nutrition enthusiasts there is a tendency to cycle in and out of ketosis periods, and many of those who attempt the diet end up dropping it after a while. However, for those who have stuck through and reap the benefits of the diet, the pros far outweigh the difficulties of maintaining this restrictive yet beneficial regime.
Where did keto come from?
Here is a fun fact: The origin of ketogenic diets comes from epilepsy treatment.
When the body is in ketosis the liver starts to create ketones to break down fat for energy. The production of ketones has been shown to reduce epileptic seizures and is commonly recommended by healthcare professionals to children with certain types of epilepsy.
This diet has been shown to reduce the frequency of seizures in children by 50%, and around 10-15% of children become seizure-free when following a keto diet.
If you’re interested in reading more about the use of keto diets in the treatment of epilepsy check out these resources from the Epilepsy Foundation.
We know what you’re thinking: How did an epilepsy treatment become a popular health and fitness trend?
When doctors started ordering epilepsy patients to follow a low carb, ketogenic diet, they started noticing a range of other beneficial effects that were widespread throughout the patients including weight loss, improved blood sugar levels, elevated mood, and improved cognitive functions.
With all of these benefits, it is no wonder that the keto diet quickly became popular among athletes, nutritionists, and health enthusiasts.
Is keto healthy?
Like most diets out there, the keto diet is somewhat controversial.
Some experts state that carbohydrates should be the main source of energy. If you look at the American Heart Association guidelines, for example, you will find a big push to reduce fat intake and focus on whole grains, fruits, and vegetables instead, some of which are big sources of carbs. Most common government health agencies recommend having at least 50% of total dietary intake from carbs and less than 35% from fat.
Despite all of this push against dietary fat, many studies have shown that the keto diet may be a great approach to regulate blood sugar, reverse and prevent diabetes, improve brain function, lose weight, and even reduce the risk of heart disease.
Confusing, right? You’re not alone. Nutrition is a tricky subject to research and deep studies in different diet protocols are fairly new. The studies around specific diets like keto are limited and its effects have only been evaluated in short term. But the short term benefits of the diet that have been observed so far are very promising, and paradigms around the role of dietary fat in a healthy diet are shifting.
Benefits of keto diets
The biggest appeal of the keto diet in mainstream culture is most likely its claims to help lose weight even for those who have historically found it difficult to do so.
There are a few reasons why you can quickly shed off extra weight when going keto:
- Water weight loss: A lot of the initial weight drop you see when starting a keto diet is not actually fat loss, it is water. When you eat a high carbohydrate diet your body retains more fluids as part of the storage process of glucose. When glucose is stored in the body as glycogen it retains fluid in the tissues of your liver and muscles. For every gram of carbohydrates that are stored in your body, you will retain 2-3 grams of water. There is nothing wrong with this water retention, it is a natural process. But cutting carbs drastically like you would on a keto diet explains why the first weeks of keto show such a quick drop in the number on the scale.
- Reduced appetite: Studies have repeatedly shown that hunger levels are curbed when consuming more healthy fats and reducing carbohydrate intake. The hormones that control your hunger levels (Ghrelin and Leptin) are affected by dietary habits. Leptin is in charge of signaling feelings of satiation, so when leptin kicks in you feel full. The keto diet increases Leptin levels, which means you are less likely to overeat.
- Less blood sugar crashes: When cutting out carbs and consuming more fats and protein there are fewer spikes in blood sugar levels. Consuming high levels of carbohydrates produces a spike in dopamine (a neurotransmitter linked to feelings of reward and pleasure). We know this as a sugar high and it is the reason why we turn to carbs or sweets as a comfort food when we are feeling down. But like with any other substance, the body can build a tolerance and start craving more carbs and sugars, feeding a vicious cycle of sugar highs, crashes, and overeating, which leads to weight gain and disrupted blood sugar regulation that can potentially lead to metabolic disorders and diabetes.
Blood sugar regulation and Diabetes Reversal
More and more doctors are recommending keto diets or lower-carb diets as a way to treat or prevent type 2 diabetes and other metabolic and blood sugar issues.
As we covered above, low-carb diet approaches can help regulate the spikes of blood sugar. Disordered blood sugar regulation long term can lead to metabolic issues like insulin resistance and hyperinsulinemia, both of which are markers of type 2 diabetes. Studies show that a ketogenic diet can reduce the glycemic responses that come with a high-carb diet. Going keto can also improve insulin resistance, supporting the body in properly metabolizing glucose.
Brain function and mental health
Keto diets have been shown to boost brain power. From bulletproof coffee to MCT oil there is a wide range of trends that fit a keto approach and claim to support brain function.
One of the main reason why the keto diet can improve brain health is that being in a state of ketosis can increase the production of GABA (Gamma aminobutyric acid).GABA is a neurotransmitter that regulates activity in the central nervous system. GABA is known to reduce anxiety, inprove mood, and enhance focus.
Another reason why keto can be considered brain healthy is its emphasis on healthy fats including Omega-3 fatty acids (found in fatty fish and some nuts and seeds) and monounsaturated fats (found in olive oil, coconut oil, avocado, and nuts). These good fats help keep hormone levels in balance which improves mood and energy levels. They also work as antioxidants and help reduce LDL cholesterol levels (aka bad cholesterol), which supports your body’s overall performance, and has been shown to relieve cognitive decline, symptoms of mood disorders, and attention difficulties.
Keto side effects
Although the benefits of keto diets are promising for many individuals, there are some short term side effects that can be quite debilitating as your body gets used to the transition from using carbs to using fats as the main source of energy.
The common symptoms that many people fae in the first couple weeks of transitioning to ketosis are known as the keto flu. These symptoms, although potentially quite strong, are a natural response.
Keto flu symptoms:
- Confusion/brain fog
- Muscle cramps
These symptoms normally clear after a couple days after which you can start to feel the benefits of the diet.
There is little research on the long term effects of ketosis, and though many health benefits have been observed and seem promising, there is still a lot of controversy around this diet. If you’re considering going keto it is always a best option to work with your health care provider and a registered dietitian or nutritionist to evaluate the best approach for you.
Types of keto diets
There are many ways you can approach a keto diet and many health care providers vary in the ways they recommend it depending on the person. Here are a few of the common approaches to keto diets:
Standard Keto Diet:
The standard keto diet is characterized by very low carb and moderate protein intake. You get most of your calories from healthy fats and limit carbs to 10-15% which on a standard 2000 calorie diet is around 50 grams of carbs. To put that into perspective, a single banana contains around 27 grams of carbs, so that would take half of your carbohydrate allowance. Needless to say bananas are not a keto staple, but some low-carb fruits like berries and melons can be eaten in moderation.
Macro distribution: 65-70% fat, 20% protein, 10-15% carbs
The cyclical keto diet is possibly a more sustainable approach for many and allows for some leniency while still getting some of the benefits of going keto. Normally a cyclical keto approach has some days of the week on a traditional keto diet and makes space for a few days off. This not only allows you to stay sane and be able to enjoy some non-keto treats sporadically, but it also makes space for other healthy foods that don’t fit the keto requirements including fruits, startchy vegetables, and whole grains.
Macro distribution: 75% fat, 15-20% protein, 5-10% carbs on keto days; 25% fat, 25% protein and 50% carbs on off days.
Hight Protein keto:
This approach is common with athletes and other populations that seek a higher protein intake. There is however a limit to how much protein you can consume and still be in ketosis. The average person can only process around 30 grams of protein per meal. If you go far beyond that your body will take any extra protein and convert it into glucose. Once it is converted into glucose it is stored just like carbohydrates, so as you can probably guess now, excess protein will take you out of ketosis. This threshold depends entirely on the specific individual and their protein needs, but the average macro ratio would look like this:
Macro distribution: 60-65% fat, 30% protein, 5-10% carb
Though not totally impossible, going keto while on a vegan diet is quite an endevour. High quality meats and animal products are a staple of the keto diet not only for their macro nutrient profile, but also for their richness in bioavailable nutrients. Many vegan sources of protein including beans and legumes are high in carbs and don’t really fit a keto regime. Vegan protein sources that work for keto would be low carb sources like tofu, tempeh, nuts, and seeds. The options here are quite limited and a comprehensive supplement regime would be encouraged to make up for any nutrients that would be missing in the diet.
What to eat on a keto diet
As you probably know by now, your main sustenance on a keto diet will come from fats. But what does that actually look like and what kind of fats are we talking about? You don’t want to simply be taking shots of olive oil to go keto. The whole purpose of the diet done well is to properly nourish your body while in ketosis. This means that a variety of vegetables, animal products, fruits, seeds, and healthy fats is necessary to really thrive in this diet.
Here is a list of common nutritious foods you can enjoy in keto regimes:
- Leafy greens (kale, spinach, chard, lettuce, etc.)
- Cruciferous vegetables (broccoli, cabbage, cauliflower, Brussels sprouts, etc.)
- Low carb root vegetables (radish, jicama)
- Berries (raspberries and blackberries have the lowest sugar content)
- Kiwi (in moderation)
Nuts and seeds
- Brazil nuts
- Pumpkin seeds
- Chia seeds
- Hemp seeds
Protein (ideally grass-fed or wild-caught)
- Fish (fatty fish high in Omega-3 is best)
- Game meats
Dairy & Eggs
- Eggs (ideally free-range and organic. Eat the yolk!)
- Milk (unsweetened and ideally grassfed)
- Almond milk (unsweetened)
- Soy milk (unsweetened)
- Yogurt (unsweetened)
- Grassfed Butter
- Heavy cream
- Clarified butter/ghee
- Olive oil
- Flaxseed oil
- Avocado oil
- Coconut oil
- MCT oil
- Clarified butter/ghee
There is promising evidence that keto diets can be beneficial for many health conditions as well as a tool for general health and wellbeing. With benefits like improved brain function, reduced blood sugar, the potential reversal of diabetes, weight loss, and potentially lower risk of heart disease, keto is definitely one of the most popular diets among health and wellness enthusiasts. Despite this, keto diets are notoriously challenging to maintain and not necessarily sustainable for everyone.
Like most other specific diets, the keto diet has less research than it deserves, and there is not a lot of research done on its long term effects. Hopefully, further research in the ever-growing world of health sciences and natural nutrition will eventually provide more understanding of how we can use diets like keto to optimize our health and wellbeing and give us guidelines on how to execute them appropriately for risk-free health benefits.
Lastly, although beneficial, keto doesn’t necessarily work for everyone. We are all incredibly different in our needs, lifestyles, and medical history, and our approach to diet should be individualized and unique to each person For this reason working with a professional when approaching targetted diets like this is a great idea. A registered dietitian or nutritionist can help evaluate what the best diet is for you taking into consideration your entire history, goals, and unique body.
References and further reading:
Diet Review: Ketogenic Diet for Weight Loss. 22 May 2019, www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/ketogenic-diet/.
Westman, Eric C et al. “Implementing a low-carbohydrate, ketogenic diet to manage type 2 diabetes mellitus.” Expert review of endocrinology & metabolism vol. 13,5 (2018): 263-272. doi:10.1080/17446651.2018.1523713 https://pubmed.ncbi.nlm.nih.gov/30289048/
Publishing, Harvard Health. “Protect Your Brain With.” Harvard Health, www.health.harvard.edu/mind-and-mood/protect-your-brain-with-good-fat.
Marcelo Campos, MD. “What Is Keto Flu?” Harvard Health Blog, 18 Oct. 2018, www.health.harvard.edu/blog/what-is-keto-flu-2018101815052.
MD, Authored By: Eric Kossoff, and Authored Date: 10/2017. “Ketogenic Diet.” Epilepsy Foundation, www.epilepsy.com/learn/treating-seizures-and-epilepsy/dietary-therapies/ketogenic-diet.