The Keto Diet


I get a LOT of questions on the keto diet, given that I work as a diabetes educator in my 9-5.  So WTF is this diet really ALL about? Let me break it down for you in a neutral a viewpoint:

Contrary to popular belief, the keto diet is not a high protein diet, but rather a high fat diet.  Ketosis occurs when our brain and body begin to run on a byproduct of fat breakdown called ketone bodies. The typical ketogenic diet comprises 70-80% of total daily calories from fat, 5-10% carbohydrate (which should primarily come from vegetables and some fruits), and only 10-20% from protein.   To break this down into more useable information, for a 2000-calorie diet, this translates to about 165 grams of fat, 40 grams of carbohydrate, and 75 grams of protein.   To achieve this high fat intake, it would be recommended to incorporate less inflammatory unsaturated fat sources such as nuts, seeds, avocado, and plant oils. 

The research thus far has shown the keto diet improves more than just weight, but several other metabolic indicators.  We see an improvement in insulin resistance, high blood pressure, as well as elevated cholesterol and triglyceride levels.  The keto diet has also been found to provide a satiating effect due to the high-fat content of the diet and presence of ketones.  We also see a decrease in appetite-stimulating hormones such as ghrelin.  One theory as to why the ketogenic diet promotes weight loss is due to the promotion of fat loss versus lean body mass due to a decrease in circulating insulin.   This is obviously very appealing to people.

Now, listen up: here's the downsides.  We haven’t had the long term studies exemplifying the efficacy and safety of the keto diet (most were only 12 weeks or less) for use in weight loss and improvement in metabolic syndrome.  We do know there are several potential pitfalls, mainly being that it is incredibly challenging to maintain.  Many people experience the “keto flu,” which includes symptoms of fatigue, irritability, and headaches.  For most this will last a week or less.  Due to the lack of whole grain and fiber in the diet, we also see a lot of constipation.  We also obtain a significant amount of fluids from the carbohydrates we consume which also impacts digestion, as well as our fluid status.  Carbohydrate is stored as glycogen alongside fluid in our muscles, which impact our hydration status. (Ever heard of carb-loading before races – this is the system we are impacting) This can lead to dehydration and electrolyte imbalances, so consuming adequate fluids and perhaps even an electrolyte supplement or bone broth is recommended.  Other significant potential side effects of a long-term keto diet is an increased risk of kidney stone development and osteoporosis.  Working with a Registered Dietitian will also help prevent possible nutrient deficiencies such as iron, magnesium, and zinc, as well as B vitamins, not to mention fiber.

Typical foods that would be off limit in the keto diet would include any type of whole grain or grain-based product (such as bread, cereal, or rice), most fruits (excluding small portions of berries, such as blueberries, blackberries, raspberries, or strawberries), root vegetables such as potatoes, sweet potatoes and carrots, and large portions of beans and legumes such as chickpeas, lentils, and peanut butter. 

Main foods to include in a keto diet would be meat, fish, shellfish, eggs, nuts and seeds, healthy fats including avocados, olive oils and MCT oils, non-starchy vegetables include leafy greens, broccoli, tomatoes, peppers, asparagus, cauliflower, cucumber, zucchini, mushrooms, and many more.  Small amounts of cheese, cream, and plain greek yogurt could also be included.

It’s always recommended to consult with your doctor or dietitian before starting a new, restrictive diet.  This diet is not recommended for those who are pregnant or breastfeeding, the elderly, or those with multiple health conditions or kidney disease.

Want to know more?  Or perhaps you're curious as to my humble opinion on this diet?  Leave a comment or send me an email.  I'd love to chat more!