Lately I’ve had to defend matters that just shouldn’t need defending. This time, the “keto” diet has caught a bad rap. But as with every other topic on this blog, the most unfavorable allegations have come from the most uneducated people.
This is a semi-lengthy post which explores a body of research I’ve compiled on ketogenic diets, as well as my own experience. Grab some coffee, get comfortable, and dive into this truly fascinating (and underappreciated) ability we have.
What is “Keto?”
The ketogenic diet, colloquially known as “keto,” is a (rigorously) strict low-carbohydrate, moderate-protein, high-fat diet. Some call the ketogenic diet a low carb diet, low-carb/high-fat diet, etc., which is technically true, but there are other diets in these categories—and they often have different restrictions. There are different types of ketogenic diets such as standard, cyclical, targeted, and high-protein variations.
The general concept is to aggressively restrict carbohydrate intake (ex. ≤25 grams/day, or 5-10% of total calories) and increase fat intake to force the body into a state of ketosis. Ketosis is a natural metabolic process where the liver converts fat into fatty acids and ketone bodies. A prolonged lack of carbohydrates forces the body to use ketones as an energy source rather than glucose (metabolized from carbohydrates). It is important to note that insulin is also produced after intake of high-carbohydrate foods, as insulin is used to process glucose from said carbohydrates.
Blood glucose remains normal on a ketogenic diet, as it can be derived from certain amino acids and metabolism of fatty acids.
Ketosis occurs naturally in the body, regardless of the amount of carbohydrates one consumes. When the body runs out of glucose or stored glycogen—excess glucose converted/stored in the liver and muscles—ketosis begins. For example, the body burns fat and creates ketones while sleeping, switching up metabolism to utilize the most readily available energy source. Eating a low-carb, high-fat diet speeds up ketosis, a completely safe and normal process.
If we look back at the diets of our ancestors—often high in animal fats and proteins—ketosis as a process starts to make a lot more sense.
Ketogenesis is NOT Ketoacidosis
I get this one on a regular basis. There is a difference between ketogenesis, a perfectly normal metabolic state, and (diabetic) ketoacidosis, a life-threatening metabolic state seen in those with type I/II diabetes. During ketosis, the body produces low levels of ketones which are completely safe in the average person. In diabetic ketoacidosis, the blood turns acidic due to an extremely high concentration of ketones—usually a result from poor disease management.
But those with type II diabetes often see a dramatic reduction in their symptoms after switching to a ketogenic diet. A recent study conducted by the Indiana University Health, published via JMIR: participants placed on a ketogenic diet saw improved glycemic control, increased weight loss, lowered A1c—some were able to completely discontinue their medication. Individuals with diabetes aren’t the only ones who can benefit from a ketogenic diet, however.
While in ketosis, the body will begin to metabolize excess adipose tissue (body fat). This leads to increased weight loss by using preexisting fat stores as a source of energy.
Ketogenic diets have also been shown to increase energy levels, improve cholesterol, improve insulin sensitivity, treat diseases such as type 2 diabetes, and decrease seizures by more than 50% in over half of children with epilepsy (up to a 90% decrease in one third). People also report feeling fuller for longer periods of time, and a reduction in acne & skin inflammation over a twelve-week period.
Recent research suggests the brain and body prefer ketones over glucose, of which the brain may run up to 70% more efficiently. This is due to production of BHB (a type of ketone), which provides more energy per unit of oxygen. Furthermore, a ketogenic diet also increases the number of mitochondria in neurons through increased gene expression. This may also play a significant role in neurodegenerative diseases such as Alzheimer’s, where increased production of energy in neurons could help battle the stressors of these conditions.
Sticking to any diet is hard, but some find that ketogenic diets are considerably more difficult. It is extremely easy to knock one’s body out of ketosis—all it takes is one “cheat meal” to hamper progress for up to a week. However, this depends on if one is “fat-adapted,” or one’s metabolic “clamp,” as Dr. Osborn calls it.
Essentially, there are zero cheat days on a ketogenic diet—unless one is completely “keto adapted,” which can take up to three months. This is more of an all-or-nothing diet, and it can be incredibly difficult to maintain progress if one does not plan their meals, count their macronutrient intake (fats, carbohydrates, & protein, at minimum), and of course, keep track of overall calories (when trying to gain or lose weight).
Another drawback is the comparatively higher cost of ingredients for “keto-friendly” recipes. Instead of worrying about price tags, I find it’s easier to think of them as investments in my health. A proper diet and exercise, after all, are two of the most important things we can do for our health.
Ask Your Doctor if Keto™ is Right for You!
Of course, it’s always a good idea to ask your primary care provider about beginning a ketogenic diet. Many doctors recommend those with liver and/or kidney conditions to steer clear, and some professionals also argue that little is known about the long-term effects of high-fat/low carbohydrate diets in general.
But I’ve heard the “unknown, long-term effects” argument countless times in similar situations… I’ve known people who have been on a ketogenic diet for years, and their results have been nothing short of stellar. Here’s one person’s incredible 4-year journey (plus some tips and tricks!). Honestly, I think that rationale (pertaining specifically to a ketogenic diet) is more of a catch-all used by certain medical professionals to cover their asses—or just their lack of knowledge about ketogenic diets. (I love my docs, but let’s agree to disagree just this once.)
I browse the keto subreddit on a weekly basis, and there are some interesting experiences people have had with their doctors. It seems many professionals don’t fully understand ketogenic diets, but there are some who have embraced their patients’ new lifestyle.
In college, I was constantly stressed and overworked, so of course I ate poorly and occasionally used junk food to cope. While I’ve always had perfect vitals, great labs, and been in semi-decent shape, I can’t deny I’ve been a little overweight for some time now.
I was surfing Wikipedia one day and saw “ketogenesis” as a related article. Enter “keto,” a promising diet that I learned was backed by favorable studies and legitimate, scientific research. The more I read, the more confident I became in the effectiveness of a ketogenic diet—and it looked remarkably easy! (I was wrong about that last part.)
So I prepped one week’s worth of food, and took the plunge.
The first few days or so were slightly uncomfortable—I was experiencing “keto flu.” But after acclimating myself, I noticed massive improvements in my concentration, increased energy, and above all, weight loss. Considerable, yet healthy weight loss. I was also fasting intermittently, which is commonly paired with a ketogenic diet. This allowed me to consume half of the calories I would normally eat, while maintaining a state of satiety.
I was on a ketogenic diet for about a month and a half before I went on vacation—I had to try all the delicious food/drink Kansas City had to offer! (For the record, I was far from disappointed in my choice.) Plus, I didn’t know when I’d get a chance to visit again! (New post coming soon!)
I am currently back on track, and meeting the goals I have set for myself.
If you’re looking for a meal plan, check out Ruled.Me. I am not affiliated in any way with the site—just a satisfied patron. Look for the 30 Day In-Depth Ketogenic Meal Plan. The guide is behind a (small) paywall, but it is one of the cheapest, most straightforward guides I have seen so far—truly worth the cost. Of course, there are endless recipes, resources, and numerous communities out there just waiting to help! Here’s a handful of links to get you started: (as well as all the other links throughout this post)
- RuledMe (of course)
- Diet Doctor
- “A Guide to Ketosis”
- Linda’s Low Carb Recipes
- Keto Macronutrient Calculator
- Keto subreddit
- Ketorecipes subreddit
- Ketoscience subreddit
- Vegetarianketo subreddit
Have you ever been on a ketogenic diet? Any advice for those looking to start one? Questions, comments, thoughts—leave them in a comment below!