In this lesson, you will learn about the ketogenic diet! The ketogenic diet, commonly known as the keto diet, is all about science! It is a high fat, super low carb Way of Eating (WOE). This shift in your diet places your body in a state called ketosis. In ketosis, your body burns fat for energy instead of carbs.

On the keto diet, your diet should contain about 75% fat, 20% protein, and 5% carbohydrates.

Truthfully, this diet is difficult to maintain. It takes 100% dedication for it to work. It involves a lot of macro counting. Macro counting is keeping track of the macronutrients in everything you eat. You must then maintain the proper balance of fat-to-protein-to-carbs to remain in ketosis. If you exit ketosis, you’re simply consuming a high fat diet without much benefit.

Normally, your body uses carbs as a primary energy source. Carbs become blood sugar which is then turned into glycogen for storage. Glycogen can be converted into blood sugar when you need energy. This cycle is mediated by the hormones insulin and glucagon.

When in ketosis, your body doesn’t rely on glycogen for energy. It begins to rely on ketones. Your liver turns stored fat into ketones which can be used as energy. Instead, your body uses fat stores as the main energy source.

It takes your body about 2-6 weeks to fully switch over to ketosis. Then, to see results, you should stick to this diet for at least 3 months.

Benefits of the Keto Diet

The most significant benefit is weight loss. The keto diet burns body fat if done right. As your body uses fat as energy, excess body weight is lost. Ketones are a really efficient energy source; in ketosis, you begin to feel more energetic.

As you know, weight loss can help with chronic pain. Losing weight removes some pressure from weight-bearing joints.

Along with weight loss, you may feel less hungry. Eating a large amount of fat can suppress your appetite. You’ll also begin to crave sugar less and less. This can further contribute to weight loss.

The keto diet may reduce inflammation, too. Ketone metabolism produces less factors that cause inflammation, compared to glucose metabolism. Ketosis also increases adenosine. Adenosine is an anti-inflammatory molecule.

Further, you can choose several foods with high levels of omega-3 fatty acids in this diet. This helps contribute to reduced inflammation.

There are several more benefits related to other conditions. For example, studies have shown that heart disease, Alzheimer’s disease, epilepsy, and diabetes have been improved by the keto diet.

What to Eat

On the keto diet, incorporating whole foods is beneficial.

Choose high protein meats like steak, chicken, and turkey. You may also eat high fat meats like bacon and sausage. However, these meats have high levels of saturated fats, so eat them in moderation.

Fish, like salmon, trout, tuna, and mackerel, are great sources of omega-3 fatty acids. These fish provide protein and healthy fats. Eggs, fortified with omega-3s, are also a good choice. Additionally, avocados are a high-fat, low-sugar fruit that is chock full of omega-3s, antioxidants, and fiber.

It’s tempting to choose foods with high saturated fats, however, make sure to include healthy fats, too. Use oils like extra virgin olive oil, coconut oil, and avocado oil. They’ve got antioxidants and monounsaturated fats.

Dairy is allowed and encouraged in this diet. You’ll want to choose high-fat content dairy, like cream and butter. However, milk has a high level of carbohydrates so avoid milk. Choose unprocessed cheese (not plasticky-looking). This includes cheddar, mozzarella, and goat cheese. When you can, try to find dairy options that come from grass-fed cows.

Nuts and seeds are keto-friendly. They are high-fat and low carb. They’ve got fiber, antioxidants, and several vitamins and minerals. As you know, they are a great snack, too! Especially, if you need more fat in your diet. They can easily be incorporated into any dish.

You can have some carbohydrates in the keto diet; although, only 5% of your daily calorie intake should be carbs. You would need to avoid high sugar foods and refined carbs as they would likely surpass the 5% limit. For this reason, fruit is not allowed in the keto diet as it has too much sugar. Legumes and potatoes have a lot of starch, so they are also not appropriate for this diet.

You can have low-carb vegetables, like your usual salad ingredients (e.g., lettuce, kale, and spinach). You can also have tomatoes, onions, and broccoli. This is where a large portion of vitamins, minerals, fiber, and antioxidants will come from. For this reason, try to eat a large variety of vegetables.

Foods to Avoid

As your carb intake should only be 5%, avoid foods with added sugar. Grains, starch, fruit, beans, and root vegetables would also exceed the 5% limit.

Some alcoholic drinks are very high in carbs. For example, beer and wine have lots of sugar. Rum, vodka, gin, and tequila, however, have 0 grams of carbs. This is only if they are consumed in their pure form (not mixed with soda or juice). Do not drink alcohol if your doctor advises against it.

Processed foods are not included in this diet. Also, avoid diet or low-fat products. They are highly processed and are usually high in carbs, too.

Although you are trying to eat a lot of fat, choose healthy fats. Avoid eating processed vegetable oils or even mayonnaise. They are processed and have saturated and trans-fats.

Issues with the Keto Diet

The keto diet has some negative consequences. The nature of the diet is that it is high in fat, low in fiber, and low in vitamins and minerals. Constipation on this diet is very common. Further, your healthy gut flora can be negatively affected. These issues cause digestive problems.

It’s important to note that there’s an adjustment period at the beginning. The first few days or weeks can be hard. These days might include poor energy, increased hunger, sleeping issues, and nausea. After this period, the benefits become more obvious and you’ll feel much better!

The high fat content can be bad for your heart in the long term. High fat, low carb diets can impair artery function.

For these reasons, the keto diet is not ideal for a very long-term WOE. It’s common to explore the keto diet for a few months or years and then transition off it. Some of the negative effects can be improved by eating a mostly plant-based keto diet; however, this can be difficult.

Another issue is the challenge of staying strict with the diet. There is a learning curve involved. There are several companies online that will create a personalized meal plan for you. This can help you stick to the diet in the beginning. However, if you are someone who loves to dive into a new interest, this may be a fun experiment!

Due to these side effects/risks, it’s important to talk to your doctor about this diet. They can better advise you. Further, a referral to a nutritionist would be ideal!

Example Meals

In this section, you will see some examples of dishes in the keto diet. We’ll analyze one in detail and include more for you to consider.

This recipe, Creamy Chicken Broccoli, comes from the Charlie Foundation. They are an organization that supports research around the ketogenic diet. The recipe page includes the grams of fat, protein, and net carbs for the dish.

The main fat sources in this dish are heavy cream, butter, and olive oil. The protein source is skinless chicken breast. The carbs come from the broccoli and lemon juice.

The heavy cream and butter are excellent sources of calcium, B-vitamins, and fat-soluble vitamins (A, D, E, and K). Additionally, olive oil provides healthy monounsaturated fats and omega-3 fatty acids. Skinless chicken breast is a great lean protein source. Further, the broccoli and lemon provide antioxidants and several vitamins.

This keto meal has the right ratio of fats to proteins to carbs. It also provides several added benefits like vitamins, minerals, antioxidants, and omega-3s.

Other example meals are Keto Kung Pao Chicken (Food Network) and Keto Thai Red Beef Curry (Bulletproof).

Many keto meals can be found online. However, it’s most helpful to find meals that include the grams of fats, proteins, and carbs.

Reflect

Take a moment to reflect on what you’ve learned. Have you ever tried the keto diet? If so, what were your personal experiences? Was it hard to stick to? Did it make a difference in your pain and well being?

If you haven’t tried it, would you ever try it? Do you think the keto diet is too extreme?

To continue forward, take the next quiz.

References

Charlie Foundation For Ketogenic Therapies. (n.d.). Creamy Chicken Broccoli. https://charliefoundation.org/chicken-creamy-broccoli/

Felson, S. (2018, November 12). What are ketones and their tests? WebMD Medical Reference. https://www.webmd.com/diabetes/ketones-and-their-tests

Joseph, M. (2019, December 6). Heavy Cream 101: Nutrition Facts and Health Effects. Nutrition Advance. https://www.nutritionadvance.com/heavy-cream-nutrition/

Kim, Soo. (2019, May 22). Kung Pao Chicken Recipe That is Better Than Takeout. Food Network. https://www.foodnetwork.ca/healthy-eating/blog/keto-kung-pao-chicken-recipe/

Masino, S. A., & Ruskin, D. N. (2013). Ketogenic Diets and Pain. Journal of Child Neurology, 28(8), 993-1001. doi:10.1177/0883073813487595

Mawer, Rudy. (2018, July 30). The Ketogenic Diet: A Detailed Beginner’s Guide to Keto. Healthline. https://www.healthline.com/nutrition/ketogenic-diet-101#4

Mcclernon, F. J., Yancy, W. S., Eberstein, J. A., Atkins, R. C., & Westman, E. C. (2007). The Effects of a Low-Carbohydrate Ketogenic Diet and a Low-Fat Diet on Mood, Hunger, and Other Self-Reported Symptoms*. Obesity, 15(1), 182-182. doi:10.1038/oby.2007.516

Nickols-Richardson, S. M., Coleman, M. D., Volpe, J. J., & Hosig, K. W. (2005). Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet. Journal of the American Dietetic Association, 105(9), 1433-1437. doi:10.1016/j.jada.2005.06.025

Pie, Jordan. (n.d.). Thai Red Beef Curry. Bulletproof. https://www.bulletproof.com/recipes/keto-recipes/beef-curry-recipe/

Westman, E. C., Mavropoulos, J., Yancy, W. S., & Volek, J. S. (2003). A review of low-carbohydrate ketogenic diets. Current Atherosclerosis Reports, 5(6), 476-483. doi:10.1007/s11883-003-0038-6