What Is A Ketogenic Diet?

Dr. Allison Lesko

Allison Lesko RD LD

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What Is A Ketogenic Diet?

A ketogenic (keto) diet is a very high fat, low carb, and moderate protein diet. It has many medical benefits for children with epilepsy, and some people follow a keto diet for its potential weight loss benefits. A keto diet results in ketosis—a state in which ketones, formed from fatty acids, are burned as the main energy source by the body and brain rather than glucose (glucose, or blood sugar, is the broken down, usable from of carbohydrates).

 

What is ketosis?

Ketosis is the result of a ketogenic diet in which the body produces ketones for fuel instead of using glucose. While in ketosis the body switches to fat for almost all energy needs.

 

What are ketones?

Ketones are an alternative fuel to blood sugar (glucose) for the body. There are three different ketones (or “ketone bodies”) used by the body for fuel (acetone, acetoacetate, beta-hydroxybutyrate). Ketones are produced in the liver from fat as a byproduct formed during the conversion of fatty acids to fuel.

 

What do you eat on a ketogenic diet?

Someone following a ketogenic diet will consume moderate amounts of protein, high amounts of fat, and very low amounts carbohydrates (less than 50g/day); a rough macronutrient ratio would be 15-25% protein, 70%+ fat, and 10% carbs. This usually includes natural fats (butter, olive oil), meat, seafood, eggs, cheese, and primarily green vegetables. People on a keto diet will avoid sweet, sugary, and starchy foods such as potatoes, pasta, rice, and bread.

 

What’s the difference between keto and low carb?

They are very similar; in most low carb diets, however protein is not restricted whereas for a keto diet protein is restricted to moderate amounts. Additionally, many low carb diets don’t require the majority of calories to come from fat.

 

How do you get into ketosis?

The easiest way is to fast for a short period of time and then slowly decrease carbohydrate intake and increase fat intake over 1-2 weeks. Work with a professional to figure out how much protein you need.

It is not usually necessary to supplement with MCT oil/Bulletproof coffee or exogenous ketones for the body to enter ketosis.

 

How do you know you’re in ketosis/how do you measure?

Urine pH strips, breath ketone analyzers, or blood ketone meters for ketones in mmol/l.

 

What is the optimal phase of ketosis?

Ketosis has different degrees, it is not simply black and white. Optimal ketosis occurs around 1.5-2 mmol/l; it is the optimal range for weight loss, physical performance, and mental focus. Ketoacidosis occurs when abnormally high amounts of ketones are present and demands immediate medical attention; symptoms include nausea, vomiting, abdominal pain, and confusion. Ketoacidosis is rare and the most likely candidates are those with Type 1 Diabetes.

 

What are the side effect of ketosis?

In the initial 1-2 weeks that the body transitions to ketosis, you may experience difficulty concentrating, headaches, and irritability (referred to as the ‘keto flu’). Other symptoms include dry mouth and increased thirst, increased urination, keto breath (can make breath smell fruity or similar to nail polish remover), reduced hunger, increased energy, constipation, high cholesterol levels in the blood, dehydration.

The keto diet does not provide all necessary vitamins and minerals found in a balanced diet, so supplements may be necessary to get adequate amounts of calcium, vitamin D, iron, and folic acid.

 

What are the benefits of ketosis?

Every person responds to things differently. Based on testing, people can experience low insulin levels, lower levels of hunger, steady energy supply, potential weight loss, potential increased physical endurance, potential increased mental focus, potential decrease of epileptic seizures, normalized blood pressure, and reduced sugar cravings.

 

How does ketosis effect epilepsy?

A ketogenic diet has been shown to reduce the occurrence of epileptic seizures. A keto diet is usually recommended for children whose seizures have not responded to seizure medications. A keto diet is prescribed by a physician and carefully monitored by a dietitian. In some cases, the diet can allow children to reduce medication.

Keto is usually not recommended for adults because the food restriction makes it difficult to follow, however with proper adherence the diet has been shown to be effective in reducing epileptic seizures in adults.

 

Will my cholesterol raise on a keto diet?

Many food choices in a keto diet that are low in carbohydrates are also high in saturated fats (red meat, butter, cheese, coconut oil). Some people will experience elevated levels of LDL cholesterol as a result of increased consumption of these foods, while others will not. This is partially dependent on your genetic background and family history. Work with a professional to monitor your cholesterol levels.

 

Should I follow a ketogenic diet to lose weight?

The honest answer is maybe. Overall, we stand by the philosophy of a balanced diet consisting of lean proteins, low glycemic carbohydrates, and healthy fats to form long term habits and sustain weight loss results. Every person is unique though, and what works for one person may not work for another. If you are curious about trying a keto diet, obtain guidance and monitoring from a professional.

 

Who should follow a keto diet?

Most people can safely adhere to a keto diet. Do not follow a ketogenic diet if you are on medication for diabetes or high blood pressure, or if you are breastfeeding.

 

How long can I stay on a ketogenic diet?

This is different for every person. Work with a professional to monitor your body’s response to a ketogenic diet and to determine a duration. For the average person to form long term habits and sustain weight loss, we recommend lean proteins, low glycemic index and complex carbohydrates, and healthy fats.


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