“Keto”. It’s sort of a thing as of late. If you haven’t been living under a rock in the past 18 or so months, you’ve at least heard the term, if not fully adopted the diet yourself. Popularized by several credentialed and maybe not-so credentialed folks; the ketogenic diet was first studied and proven effective in 1921 as a therapy for children with seizure disorders.
Although there are variations of the ketogenic diet, generally it provides 70-90% fat, 10-15% protein and about 5% carbohydrate. Severely restricting carbohydrates, while consuming LOTS of healthy fat encourages the body to produce ketones and use them as fuel. Which results in a state called nutritional ketosis, an ability we’re all born with. To provide some context, the standard American diet is roughly 55% carbohydrates, 30% fat and 15% protein. This is a radical shift in macronutrient distribution. With that said, our bodies are amazing machines and can utilize both ketones (from fats), or glucose (primarily from carbohydrates and excess calories) as fuel. Thus the ability to survive on either plan.
The ketogenic diet is all the rage right now, and with good reason, let’s talk about some of these. Though it’s initial research and use was to control epilepsy; more research is proving beneficial for several other conditions. This list includes dementia, migraines, depression and obesity, among others.
Since one in three adults are overweight or obese, weight loss is the main driver of the diets’ recent rise in popularity. The diet works in a few different ways, but regarding weight loss it’s largely due to the lack of insulin produced by the pancreas, and the body’s ability to burn fat as fuel. Since insulin remains low, the diet mimics a fasting state, burning fat, while providing most of one’s essential nutrients.
Let me explain how insulin is so key in the weight loss equation. Imagine a fridge and a freezer. The fridge is your body’s glycogen stores (the storage form of glucose, primarily carbohydrates); and the freezer, those are your fat stores. The hormone, insulin, determines whether you get a meal from the fridge, or the freezer. When your insulin is elevated, you get fuel from your glycogen stores (fridge), this is easily accessible fuel. But, if your insulin is lower, you get fuel from your fat stores, those harder to utilize stores, this results in fat loss.
Additionally, highly refined carbohydrates and sugar tend to create more inflammation, whereas healthy fats can reduce inflammation. This is an important distinction because research is suggesting that chronic, low grade inflammation may be correlated with several diseases, if not all of them. Thus, the resulting weight loss and decreased inflammation improves other ailments like blood pressure, arthritis and cholesterol. Additionally those following the diet tend to experience suppressed hunger, simply due to the presence of ketones in the body.
Let’s talk about some of the downfalls of the diet, because “Doctor Google” has a habit of sharing only the good. I will discuss two of my concerns.
The first, the diet severely restricts carbohydrates and followers can easily get hung up on macronutrients (staying under your carbohydrate count) versus food quality – gobs of mayo, anyone? Due to the restriction of carbohydrates there can be an inadequate consumption of fiber as well. This is no good, because fibrous foods are the lifeblood of our microbiome, and all health (and disease) is rooted in our gut. Therefore, paying special attention to the balance between fiber (plant foods), while keeping a lower carbohydrate intake is essential.
The second biggest concern is that long term, improper use of the diet can lead to a rise in blood sugar. You say what?! I thought this diet was supposed to bring my blood sugars down? Well it does, for a little while. But after long term, uninterrupted ketosis (and an insulin level that is too low), the liver begins to make glucose via a process called gluconeogenesis. A teeny bit of insulin can suppress this (i.e. carbohydrate cycling). Although this is a newer discovery, it is something to keep in mind if you’re a long-term follower.
So, is keto right for you? The answer… a BIG maybe. I know that’s not what you wanted to read, but the truth is that there are 7.5 billion people on this earth and no two are the same, so no two diets will look the same. There’s little doubt the diet can be an improvement from the average American diet, but do you need to go all-out to reap the benefits? You may find you benefit by simply eating more plants, ditching packaged foods, eating more animal protein, or less animal protein, cutting down on the coffee, sugar or alcohol.
While searching for your true diet, be honest with yourself and ask; “do I like this way of eating?”, “do I like the way it makes me feel?” Maybe the answer is a resounding “Yes!”, or maybe it’s a lackluster “No.” Either way, however you achieve your goal better be how you expect to maintain it! Otherwise you’ll forever be seeking out that next great diet that will fix you. We’re going about this food and nutrition thing all wrong…