A quick look at what’s trending in Google searches will tell you that the ketogenic diet, or “keto” as it’s been nicknamed, continues to be a hot topic. So what’s up with the keto diet? That’s a question I get asked a lot. What people really mean by that is, does it work? Let’s take a look at what the ketogenic diet is and whether it’s something I would recommend.
What is it?
The ketogenic diet is a very low carbohydrate and high fat eating plan that was developed in the early 1900s as a last-resort treatment for children with epilepsy. Today, the keto diet is generally used by people who are pursuing weight loss.
The keto diet is different from other popular low-carbohydrate diets such as Atkins, Paleo and South Beach, because it’s extremely low in carbohydrates. Generally, 70-80% of total daily calories come from fat, 10-20% from protein, and the leftover 5-10% comes from carbohydrate.
How does it work?
The idea behind the ketogenic diet for weight loss is that if you deprive the body of glucose, which is obtained by eating carbohydrates, then your body will mobilize stored fat to use as fuel in the form of ketones.
This is how the process goes: in times of famine your body will first use glucose stored in the liver, then will break down muscle to release glucose. Once the stored glucose is depleted and your body continues to be deprived of carbohydrates for more than three or four days then the body starts using fat as fuel. When ketones accumulate in the blood, this is known as ketosis. Every person is different as far as how long this process takes and how soon ketosis is reached (Paoli, 2013).
Does it work?
How do you define a diet “working”? I find I’m a little pickier than most people on defining whether something works, as I’m looking at a lifetime, not just a few months or a year. As with most diets, there is research that supports people who follow the ketogenic diet can lose weight, but again, like most diets after 6-12 months weight regain starts to occur. Even with persistent adherence to the diet, the body fights back by slowing metabolism and increasing the appetite. The fact that people typically regain weight at 6-12 months into a diet is usually the reason diets aren’t studied for years and years like they should be.
Would I recommend it?
Spoiler alert: no, I wouldn’t. But read on, because I’ll tell you why. In fact, I’ll put it in bullet points so it’s easier to read.
· The ketogenic diet is extremely restrictive. Ketosis requires a person follow this diet to the “T”; one slip and you’re out of ketosis. This would certainly affect its ability to “work”. Is that something you really want to have to constantly worry about for the rest of your life?
· Like most diets, the rigidity of the keto diet makes it impossible to listen to and honor your body’s cues of hunger and satiety. Research is incredibly supportive of intuitive or attuned eating as being the most sustainable approach to eating, aka, you can practice that for the rest of your life.
· Putting yourself in ketosis is serious business. I wouldn’t recommend doing it without the supervision of a trained clinician, and only if you have a medical reason to do so. Possible side effects include: kidney damage, increased risk of kidney stones, osteoporosis and gout, nutrient deficiencies and an upset in blood sugars and blood cholesterol (Schwingshackl, 2013). Not to mention you’d be dealing with daily symptoms of hunger, fatigue, irritability, constipation, headaches and difficulty concentrating. Sounds fun, huh?
Bottom line: stick to a balanced diet. Let your body be your guide in deciding when, what and how to eat. Enlist the help of a registered dietitian (me!) in finding what your body’s preferred style of eating is. And eat those carbs, darn it!
References:
Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013 Aug;67(8):789.
Schwingshackl L, Hoffmann G. Comparison of effects of long-term low-fat vs high-fat diets on blood lipid levels in overweight or obese patients: a systematic review and meta-analysis. J Acad Nutr Diet. 2013 Dec 1;113(12):1640-61.
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