Keto diet: what it is, what to eat and not to eat, recipes , and more

https://www.dietdoctor.com/low-carb/keto

"Keto diet: what it is, what to eat and not to eat, recipes , and more

https://www.dietdoctor.com/low-carb/keto

"1. What is a keto diet?

The keto diet is a very LOW-CARB and higher-fat diet. It’s similar in many ways to other low-carb diets.

While you eat far fewer CARBOHYDRATES on a keto diet, you maintain moderate levels of PROTEIN INTAKE and may increase your intake of fat. The reduction in carb intake puts your body in a metabolic state called KETOSIS, where fat, from your diet and from your body, is burned for energy.

You can quickly learn more about the basic ideas behind the keto diet in this video course:

Watch the entire 8-part video course 

What “keto” means

The “keto” in a KETOGENIC diet comes from the fact that it allows the body to produce small fuel molecules called “KETONES.”

There are three different ketones, or “ketone bodies” used as fuel by the body. They are: ACETONE ACETOACETATE BETA-HYDROXYBUTYRATE

Learn far more than you’ll ever need about ketones here:.

Dr. Peter Attia: Ketosis – advantaged or misunderstood state? (Part I)

 This is an alternative fuel source for the body, used when blood sugar (glucose) is in short supply.

When you eat very few carbs or very few calories, the liver produces ketones from fat. These ketones then serve as a fuel source throughout the body, especially for the brain.

It’s a common misconception that all of the body only runs on ketones when on a keto diet. The truth is that most of the body – including the muscles – can burn fat directly. It would be a waste to have the liver first convert them into ketones. This is mostly necessary for the brain." 

The brain is a hungry organ that consumes lots of energy every day, and it can’t run on fat directly. It can only run on glucose – or ketones.

The brain consumes about 20% of the body’s required energy every day, despite only representing 2% of the body’s mass.

This could be a good bonus for weight loss, if your hungry brain burns fat for you.

Another note: ketosis is why the old idea that “the brain needs carbohydrates” is wrong – the brain requires limited amounts of glucose even in ketosis, but the body can create that glucose from protein and fat in a process called GLUCONEOGENESIS.

Learn more:

Food for thought: Does the brain need carbs?

Critical Care 2011: Clinical review: ketones and brain injury [overview article; ungraded]

On a ketogenic diet, your entire body switches its fuel supply to run mostly on fat, burning fat 24-7. When INSULIN levels become very low, fat burning can increase dramatically. It becomes easier to access your fat stores to burn them off.

Low-carb diets have been demonstrated to result in more weight loss than other diets:

PLOS ONE 2015: Dietary intervention for overweight and obese adults: comparison of low-carbohydrate and low-fat diets. A meta-analysis [strong evidence]

Low-carb diets might even increase METABOLISM – potentially increasing fat burning – by between 200 and 500 calories per day:

British Medical Journal 2018: Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial [moderate evidence] Analysis

As a SIDENOTE, the increased fat burning can use either body fat, or dietary fat, or (usually) both. This means that eating more fat than you need to stay satisfied can slow down the burning of body fat stores. If you’re aiming to lose weight, only eat when you’re hungry. Learn more

 This is great if you’re trying to lose weight, but there can also be other, less obvious benefits, such as less hunger and a steady supply of energy (without the SUGAR PEAKS AND VALLEYS we can get from high carb meals). This may help KEEP YOU ALERT AND FOCUSED.

This is something that is often reported by people on a keto diet [very weak evidence].

The scientific support is not strong. Here are references showing minor signs of improvements:

European Journal of Clinical Nutrition 2013: Ketosis and appetite-mediating nutrients and hormones after weight loss [randomized trial; moderate evidence] Neurobiology of Aging 2012: Dietary ketosis enhances memory in mild COGNITIVE IMPAIRMENT [moderate evidence for verbal memory improvement in people with early Alzheimer’s] Epilepsy Research 2012: The effects of the ketogenic diet on behavior and cognition [overview article; ungraded]

Journal of the Association of Nurses for AIDS Care 2019: Cognitive Effects of a Ketogenic Diet on Neurocognitive Impairment in Adults Aging With HIV: A Pilot Study. [randomized trial; moderate evidence]

When the body produces ketones, it enters a metabolic state called ketosis. The fastest way to get there is by FASTING – not eating anything – but nobody can consistently FAST forever.

The ketosis experienced after a longer period of fasting is called STARVATION KETOSIS. But since starvation is not sustainable, we focus more on NUTRITIONAL KETOSIS. However, INTERMITTENT fasting may have a role as an ADJUNCT to diet for HEALTH GAINS AND WEIGHT LOSS. Read more in our guides on intermittent fasting and time restricted eating." 

A keto diet, on the other hand, also results in ketosis and can be eaten indefinitely. It has many of the benefits of fasting – including weight loss – without having to fast long-term.

The ketosis experienced on a ketogenic diet is often called nutritional ketosis. This seems to be sustainable long term.

Studies have demonstrated that ketosis can be maintained for years, e.g. in children treated with a ketogenic diet for epilepsy, and for at least a year or two when treating obesity or type 2 diabetes.

Developmental Medicine and Child Neurology 2006: Long-term use of the ketogenic diet in the treatment of epilepsy [non-controlled study; weak evidence]

FRONTIERS in Endocrinology 2019: Long-term effects of a NOVEL continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: A 2-year non-randomized clinical trial [weak evidence]

It may even be possible to stay on a ketogenic diet indefinitely. There is no obvious or proven UPPER LIMIT for how long nutritional ketosis can be maintained. This is based on clinical experience of low-carb practitioners and was unanimously agreed upon by our low-carb expert panel. You can learn more about our panel here [weak evidence].

Learn more about ketosis 

 

Who should NOT do a ketogenic diet?

There are controversies and myths about a keto diet, but for most people it appears to be very safe.

The main fear about lower-carb and higher-fat diets has always been an increase in the risk of heart disease. However, interventional studies so far indicate that IF ANYTHING the risk appears to decrease: British Journal of Nutrition 2016: Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials. [strong evidence for improved risk factors] PLOS ONE 2015: Dietary intervention for OVERWEIGHT AND OBESE ADULTS: comparison of low-carbohydrate and low-fat diets. A meta-analysis. [strong evidence for improved risk factors] Obesity reviews 2012: Systematic review and meta‐analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors [strong evidence for improved risk factors] Circulation 2010: Dietary intervention TO REVERSE CAROTID ATHEROSCLEROSIS [moderate evidence for a reduction in atherosclerosis]

 However, three groups often require special consideration: Do you take medication for diabetes, e.g. insulin? More Do you take medication for high blood pressure? More Do you breastfeed? More 

For more details about pros and cons in different situations, check out our full guide: Is a keto diet right for you?

Are you a doctor or do you need your doctor to help you with medications on a keto diet? Have a look at our low carb for doctors guide.

 

Disclaimer: 

While the ketogenic diet has many proven benefits, it’s still controversial. The main potential danger regards MEDICATIONS, e.g. for diabetes, where doses may need to be adapted (see above). Discuss any changes in medication and relevant lifestyle changes with your doctor. Full disclaimer 

This guide is written for adults with health issues, including obesity, that could benefit from a ketogenic diet.

Controversial topics related to a keto diet, and OUR TAKE ON THEM, include SATURATED FATS, cholesterol, whole grains, red meat, whether the brain needs carbohydrates and restricting calories for weight loss."

Keto recipes on Facebook:

- In Bulgarian: Кето рецептите на Мая;

- Low carb and keto recipes by Irena