What you need to know about the keto diet before you try
What is the keto diet
The keto diet, or ketogenic diet, is a diet that is low in carbohydrates and high in fat. The keto diet can help lower blood sugar, increase insulin sensitivity, feel better, and lose weight by altering metabolism. [one]
A change in diet induces a state of ketosis, a metabolic regime in which the body receives fuel from animal food [2] . The main source of energy is ketone bodies: acetone, acetoacetate and beta-hydroxybutyric acid. These are substances that are formed in the liver from the body's fatty tissues and consumed fats. Ketone bodies nourish internal organs, muscle tissue and brain instead of glucose [3] , [4] .
The process of ketosis can be triggered by fasting, but the keto diet allows you to enter this state and stick to it all the time without risk to health.
Ketosis is a natural metabolic state of the body, in which fats and adipose tissues of the body become the main source of energy instead of glucose.
Types of the keto diet:
- standard: 75% fat, 20% protein and 5% carbohydrates from the total calorie intake;
- Cyclic: five days on keto alternates with two days on high-carb foods;
- target: suitable for those who go in for sports;
- with a high protein content: differs from the standard version in the ratio of elements (60% fat, 35% protein, and 5% carbohydrates).
Most studies and expert articles are devoted to standard and high protein regimens. Cycling and targeting are less studied and are recommended for athletes and bodybuilders.
The keto diet is a diet high in fat and low in carbohydrates. The body gets its energy from animal food instead of glucose. Such a diet can help lower blood sugar and insulin levels and help you lose weight.
Foods to avoid on a ketogenic diet
The keto diet cannot be called carbohydrate-free: their daily amount is 5% of the diet or 20-50 grams of the product.
But in order to start and maintain a state of ketosis, you need to remove from the menu or reduce the amount of high-carb foods:
- cereals and starchy foods: rice, pasta, flakes, potatoes;
- sugar-sweetened foods and drinks: soda, fruit juices, baked goods, and so on;
- any fruit other than berries;
- beans and beans;
- diet foods and foods with a low percentage of fat;
- sauces and flavors that contain sugar and unhealthy fats ;
- alcohol.
Foods to include in the diet
The main foods that are included in the keto diet [6] :
- meat: steaks, sausages, bacon, chicken and turkey;
- fish: salmon, tuna, mackerel;
- seafood;
- eggs;
- butter and sour cream;
- cheeses: cheddar, goat, cream, mozzarella or blue cheese;
- nuts and seeds;
- olive, coconut and avocado oil;
- fresh avocado and guacamole;
- low-carb vegetables: most green vegetables, tomatoes, onions, peppers;
- seasonings: salt, pepper, spices and herbs.
- 0% carbohydrates: beef, lamb, chicken, eggs, pork (including bacon), jerky, salmon, sardines, trout, butter, olive, coconut and avocado oil, water, coffee, tea.
- 0-5%: liver, shellfish, shrimp, tuna, lobster, cod, tomatoes, cauliflower, cucumber, asparagus, mushrooms, cheese, sour cream, yogurt (including Greek yogurt ).
- 5-10%: Broccoli, onions, Brussels sprouts, kale, eggplant, bell peppers, green beans, avocados, olives, strawberries.
- 10-15%: grapefruit, apricot, walnuts.
- 15-25%: almonds, peanuts.
As a snack, experts advise eating seafood, cheese, olives, meat, hard-boiled eggs, nuts, berries, dark chocolate and small portions of food left over from breakfast, lunch and dinner.
Menu for the week by day
Monday
- Breakfast: bacon, eggs, tomatoes.
- Lunch: chicken salad with feta cheese and olive oil.
- Dinner: salmon and asparagus in oil.
Tuesday
- Breakfast: scrambled eggs with goat cheese, tomatoes, basil.
- Lunch: cocktail of almond milk, peanut butter and cocoa with sugar substitute.
- Dinner: meatballs, cheddar cheese and vegetables.
Wednesday
- Breakfast: A keto milkshake - for example, with peanut butter or strawberries.
- Lunch: shrimp salad with avocado and olive oil.
- Dinner: pork ribs with broccoli, salad and parmesan.
Thursday
- Breakfast: scrambled eggs with avocado, salsa, bell peppers, onions and spices.
- Lunch: nuts, celery sticks with salsa and fresh guacamole.
- Dinner: chicken in pesto sauce with cream cheese and fresh vegetables.
Friday
- Breakfast: yogurt with peanut butter, cocoa and sweetener.
- Lunch: beef in coconut oil with vegetables.
- Dinner: Burger without buns with bacon, cheese and egg.
Saturday
- Breakfast: mushroom omelet with ham and cheese.
- Lunch: ham, cheese, nuts.
- Dinner: white fish, egg and spinach in coconut oil.
Sunday
- Breakfast: scrambled eggs with bacon and mushrooms.
- Lunch: burger with salsa, cheese and guacamole.
- Dinner: steak, salad, egg.
All-natural foods are suitable for the keto diet: meat, fish, butter, eggs, cheese, mushrooms, low-carb vegetables, nuts and seeds.
Effectiveness of losing weight on the keto diet
No diet alone has a long-term weight loss effect and can be harmful to your health. After a temporary weight loss, people return to their previous state, and sometimes they recover more strongly than before the change in diet. A safe and effective way to achieve the desired weight and maintain health and fitness is with the help of specialists to choose the right lifestyle and diet that you can follow on a daily basis [8] .
Experts confirm that a keto diet is 2.2 times more effective for weight loss than a low-fat diet [9] , [10] . Weight loss occurs due to [11] :
- increasing the amount of protein in the diet;
- decreased appetite ;
- changes in eating habits;
- getting energy from fat instead of glucose;
- fast fat burning;
- improved metabolism due to increased insulin sensitivity.
The keto regimen does not require constant calorie counting, creates a feeling of fullness, speeds up the process of burning fat and prevents its formation [12] , [13] .
The harm of the keto diet
In 2018, Polish professor Maciej Banach presented a paper on the dangers of low-carb diets at the Congress of the European Society of Cardiology. Studies have shown that in a control group of 24,000 participants, the risk of dying from heart disease, stroke and cancer was 50%, 51% and 35% higher among those who ate a diet high in fat and minimal in carbohydrates [ 14 ].
In January 2020, the International Physicians' Committee for Responsible Medicine recommended the elimination of low-carb diets, including the keto diet, from Diet Guidelines for Americans 2020-2025. Doctors have indicated that such a diet increases the risk of heart disease [15] .
In addition, being in ketosis has side effects to be aware of [2] , [16] .
The keto diet for diabetes
Scientists have confirmed the benefits of a keto regimen for people with type II diabetes. In one case, 95% of patients cut back or withdrew from medication, compared with 62% of participants who followed a high-carb diet [21] , [22] . In another, 75% of study participants had increased insulin sensitivity.
In addition, research is underway on the potential use of ketosis to fight cancer cell formation, treat acne, childhood epilepsy, heart and brain disease, Parkinson's and Alzheimer's syndromes. But the collected scientific material is still insufficient for a substantiated conclusion [23] , [24] .
The keto diet has been used effectively in the treatment of type II diabetes. Otherwise, the medical benefits of low-carb diets require more research.
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Doctor's review of the keto diet
We asked a few questions to Evgeniya Maevskaya, Candidate of Medical Sciences, gastroenterologist, nutritionist at GMS Clinic.
Is the keto diet good or bad?
"It's all about the dose." Today, this nutritional strategy is not recognized by any global nutritional community, and, accordingly, cannot be recommended by official medicine.
With this type of nutrition, the energy consumption of the diet is more than 80% provided by fats, and the consumption of carbohydrates is limited to 20 g per day or up to 50 g, which is more gentle and somewhat better tolerated. In fact, more often than not, the keto diet is low-carb (and hence the transition to ketosis) and often high-protein. With this type of diet, the body is dominated by saturated fats, including trans fats, as well as protein.
It often happens that most adherents of the keto diet initially do not have a clear understanding of what foods are acceptable in a ketogenic diet, but it is more or less clear what should be avoided. Therefore, meat products are used, which has its consequences.
This can provoke a deficiency of dietary fiber, which is contained just in carbohydrate foods; a deficiency of water-soluble vitamins, such as C, minerals, is possible. Such food can hardly be considered safe. And it is extremely difficult to adhere to it all your life, and after all, only this option allows you to ensure a stable weight, if we talk about losing weight.
What are the consequences and dangers of the keto diet?
Initial weight loss can really be impressive, even before the body goes into ketosis and does not actually start burning fat with water. 1 g of carbohydrates retains four times more fluid in the body than protein, and the first thing you notice is a decrease in body volume. If there is really a lot of excess weight, then the result is initially encouraging.
But it's worth remembering that everything will return if the diet is the same. And not everything is so rosy. Here are some of the negative consequences:
- general weakness, fatigue during adaptation;
- hypoglycemia;
- bad breath and sweat odor (due to the abundance of meat foods);
- stool disorders (constipation or a tendency to diarrhea);
- nausea;
- disruption of the pancreas and gallbladder, especially if there is a gallstone disease of any stage;
- gastric dyspepsia;
- kidney stones (for long-term adherence) and impairment of their function;
- possible deterioration of the lipid profile towards atherogenic;
- return of weight when switching to a conventional mixed meal.
I also associate this strategy of eating behavior with an increased risk of osteoporosis, deterioration of brain activity.
There are a number of authoritative foreign studies, with which cardiologists are more familiar, indicating that replacing carbohydrates with fats and protein in the diet in order to reduce weight significantly increases the risks of cardiovascular diseases, by about 3.5-5%. That is, the risk of stroke and heart attack can increase if you just change the type of diet.
Accordingly, if a person does not have the above violations, then if desired, you can try the keto diet and evaluate the effect.
A similar strategy, but only without being introduced into ketosis, and with a significant limitation of the proportion of carbohydrates (precisely by reducing simple carbohydrates), is advisable to use for starting in patients with impaired carbohydrate metabolism, when, for example, the rate of glucose or insulin is increased. Inspired by the first results in reducing body volume, it is always easier to continue.
Maybe just not eating sweets and simple carbohydrates? Does it also help lower sugar and lose weight without ketosis?
Taking into account the data on long-term and most effective nutritional strategies, as well as my own experience, I can say that if you give up sweets, you can really lose weight: sweet food is not only high in calories, but also stimulates appetite.
But the majority is unlikely to keep the effect and the lost kilograms will return. A person always wants what is forbidden to him, and in a fit of momentary weakness he allows himself this and overeats.
But such a diet, by no means low in carbohydrates, but with a limit in simple sugars, can also lead to weight loss and, accordingly, to normalize blood glucose levels.
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