Why Do I Need The Keto Diet?

Many of us keen to shed a few pounds of weight and even keep them off permanently must have taken a long hard look at the keto diet or ketogenic diet. This is the one mentioned in all the popular press articles that many of the celebrities and models are using like Kim Kardashian or Halle Berry for example.

The keto diet is also one of those diets which have consumers flocking to because they can personalise their nutrition. In 2018, 6 per cent of American consumers claimed they followed a keto diet whilst 7 per cent followed another lifestyle trend – a high protein diet.

What Is This Keto Diet Then?

The keto diet is essentially the low-carb diet relying on the body’s metabolism to convert fat into much needed energy to keep cells going.

It has a proven track record in helping us shed pounds of weight and there are many who consider it the best of all the diets to follow. It means that we eat lots of ‘good fat’ which curbs our hunger pangs but we cut out the carbohydrates (carbs) and eat quite moderate amounts of protein.

The main claim behind the diet is that we not only help to speed up our fat loss and thus our weight, but we also boost our energy levels.

One of the best clinical studies to show the diet worked was a comparative study of three different types of diet – the low-carbohydrate (keto diet by another name), the Mediterranean diet and the low-fat diet (Shai et al., 2008). Based on their meta-analysis, they were able to show that the low-carbohydrate or low-keto diet was as good as any other diet in helping people lose weight. The issue was the lack of high quality, longer-term studies.

A Mediterranean diet with a moderate amount of fat from olive oil with a high proportion of monounsaturated fat provides cardiovascular benefits (Covas et al., 2006).

What Is Does The ‘Keto’ In the Keto Diet Mean ?

The term keto is short for ketogenic. This is a metabolic state when the body produces small molecules called ketones or ketone bodies in some textbooks which are useful fuel for the body. These ketones are alternative fuel when carbohydrates in the form of glucose found in the blood are not available.

In evolution, it is a way for the body to survive when there is a glucose shortage. It is a physical adaptation to starvation that allows the tissues in the brain to keep functioning.

We produce ketones if the diet is low in carbohydrates which are broken down to form blood sugar. In doing this diet we put our body into a state where we are starved of carbs. as a result our fat reserves are burnt off instead. Unfortunately, protein can also be metabolised and when in excess as in the diet, can also be converted into fuel.

Ketones are produced in the liver from the breakdown of fat. The brain is one organ which relies heavily on fuel of all sorts but it can only feed on glucose or the next alternative, ketones. Fat is not an option in its own right unless it is broken down.

When we enter a metabolic state of producing ketones, we call this ketosis or ketogenesis. It is probably achieved quickest by fasting which is a case of not eating anything. However, at least some food must be eaten as this situation cannot be maintained indefinitely without harming the body.

The diet was known for some of its clinical benefits a number of years ago. Did you know that it was recommended for those who suffered with epilepsy?

For healthy people without diabetes and are not pregnant, the ketosis starts to happen about three or four days of following the plan. We are also eating less than 50g of carbs per day. That amounts to something like three slices of bread, a low-fat yogurt or a couple of bananas and small ones at that.

The diet then is based on eating fat. It should be about 60 to 80 per cent of our total daily calories. Protein makes up 10 to 15 percent and carbs will only be less than 10 per cent.

We cannot eat as many calories as we like by the way. Anybody doing the plan must cap their daily intake of calories to 1,800 every day and no more. 

Keeping Focus

Keeping to any diet is difficult for everyone simply because it makes you so food obsessed. The ketogenic diet has also meant some peculiar practices followed by those trying to make it more palatable. Remember – no carbohydrates or very little of them. And so, cereals , bread, pulses including beans, fruit and so on are avoided to be replaced with eggs, cheese, fish, oils, vegetables, avocados, butter, ketone drinks and the like.

We’ve come across this diet before because it is not that far removed from the Atkins Diet which is one of the most famous of all the low-carbohydrate diets. The big difference is that in the keto diet the protein amount consumed is limited on a daily basis.

Entering ketogenesis is said by some to be a metabolic advantage. It means 10 times more fat is burnt than normal to provide about 400 to 600 calories daily.

The main scientific theory for the diet comes from the ‘carbohydrate-insulin hypothesis’. Here, consuming carbohydrates means that insulin is produced to ensure blood sugar levels are regulated. Linked to this are a host of metabolic pathways relying on hormonal and neural signals for hunger. When we are hungry, we seek our food especially energy rich types to assuage this hunger. The body however keeps its fat reserves if carbohydrate is available because it is the preferred energy source. When carbohydrates are depleted and replaced with fat molecules, not so much insulin is produced which in turn as a very basic level suppresses the feelings of hunger. With only fat to rely on, the body adjusts to metabolising fat by breaking it down to the ketones we have been discussing.

A reduction in production of insulin has other metabolic effects too. In response to the reduction in insulin production, more free fatty acids which are the components of fat are released from our fatty (adipose) tissue. To generate free fatty acids, there are greater levels of fat oxidation along with higher levels of energy expenditure. The body fat loss is greater than achieved through reducing the intake of fat (dietary fat).

For many, maintaining a keto diet for a relatively short time of say a month is possible. Not everyone enjoys it and it can be a personal turn-off. Ketone bodies on the breath produce a sickly sweet smell which is frankly objectionable.

If you are already obese then the keto diet is for you. For many of us, losing fat is a more important objective than losing weight. After all, losing muscle mass is not desirable.

The Health Benefits Of The Keto Diet

The most notable benefits of the keto diet other than weight loss are:

• Improving blood sugar control
• Lowering total cholesterol levels
• Reducing triglyceride levels

What Foods Do You Eat?

• meat: any red meat such as steak, chops, bacon and sausage, poultry such as chicken, turkey, duck and ostrich
• vegetables such as peppers, tomatoes, onions, chili
• eggs
• dairy foods: natural and processed cheese, cream
• avocado and that also includes guacamole
• dietary oils: extra virgin olive oil, avocado oil, coconut oil
• nuts and seeds: walnuts, almonds, peanuts
  

  

What Foods Do I Need To Avoid With The Keto Diet?

All foods which are high in carbohydrates need to be kept to a minimum!

There are particular foods that should be cut out or reduced when on the keto diet:

• High sugar foods – reduce intake of fruit juices, cake, candies and confectionary, ice cream, high sugar beverages.
• Fruit – only small portions of fruit like raspberries and strawberries.
• Root vegetables – cut out potatoes, carrots, parsnips
• Alcohol – no wine or beer or cocktails
• Sauces – particular sauces based on sugar are not consumed. No barbecue, sweet and sour or honey mustard sauces.
• Legumes and beans – cut out lentils, chickpeas, soya, pea and any other beans
• Grains – anything with high starch so wheat-based foods in particular, pasta, rice, granola, high-sugar muesli.

Supplementation Really Helps Too!

Supplements may be a great help although they are not necessary unless the diet is highly restrictive. We suggest these:

• Caffeine – highly useful for energy use, reducing fat and improving both exercise and mental performance.
• Creatine – often taken too for improving physical performance and especially if you are doing lots of exercise whilst on the ketogenic diet.
• Minerals – clearly salt especially potassium is important as the body adjusts to the new diet regime. 
• MCT Oil – not obvious but it helps produce more ketone bodies. Usually added to yogurt or other dairy food
  

  

The Challenges Of Going To Keto

We’ve mentioned a few already but one of the main issues is suffering what people on the diet call ‘keto flu’. This is a general feeling of feeling unwell because the body is adjusting its metabolism to the new dietary situation. The symptoms usually last a week but for some it can last up to a month.

Some dieters suffer not only halitosis but constipation, muscle cramps, a general tiredness and there is a risk of developing kidney stones.

Most dieticians recognise the practical challenges too of this diet. Dietary management is problematic if you don’t have a good understanding of macronutrient breakdown.

Food choice is limiting!

Some keto dieters really struggle with compliance and easily come off it.

One of the other issues is that there is no long-term data, or certainly any over 2 years worth about the effects of keeping to this type of diet. This is an area of clinical research which needs to be addressed.

What Mistakes Can You Make With The Keto Diet

(1) Cutting The Carbs Too Quickly Or Too Much

Some people will cut their carbohydrate content too quickly and end up doing a version of ‘cold turkey’. In a number of cases people who start the keto diet will have been consuming moderate or high amounts of carbs. They then stop eating all those carbs and the body reacts drastically to the change. Keto flu occurs when the body adapts to a new situation where there is wholesale depletion of glucose. 

The symptoms are headaches, even nausea, insomnia, fatigue and tiredness, constipation and reduced ability to want to exercise or have a low tolerance to it.

It is best to reduce the carb intake by degrees rather than reduce it by a rate that is too extreme for the body.

(2) Not Drinking Enough Water

Drinking water when on a keto diet is essential for maintaining good health. When the intake of carbohydrates is severely reduced, there is a change in the fluid and electrolyte balance. As fat disappears, so does the water content. The ketones produced are flushed out in the urine which not only removes water but electrolytes such as sodium.

Making sure fluids like water and electrolytes like sodium are critical for maintaining good health.

(3) Eating The Correct Type Of Vegetables

Vegetables contains lots of carbohydrates and so anybody on the keto diet needs to watch what type and how much vegetable is being consumed. Eating potato for example means that the keto diet is broken and they will not remain in a ketosis state. bear in mind though that a ketogenic diet is a ‘low carbohydrate diet’ not a ‘no carbohydrate diet’.

(4) Not Seeing A Doctor Whilst On The Keto Diet

Always check with a physician (doctor) or dietician when embarking on the keto diet for the first time. Not everyone is suited to this type of diet and people need to be reasonably healthy before starting it as we state below.

Who Should Not Do The Keto Diet

The keto diet however is not for everyone. Those of us dealing with diabetes and relying on medication to treat it need to be careful as do those with hypertension or high blood pressure. Women who are breast feeding should also be mindful that this diet is not suitable because of the impact on the infant.

Does The Keto Diet Fight Off Alzheimer’s?

I know this is a dramatic title but there is some evidence that a low-carb and high-fat diet might just reduce the risk of developing Alzheimer’s. However before we get too excited, the research was conducted in mice. Research at the Society for Neuroscience has revela ed some interesting findings which suggest the keto diet may be a good thing when it comes to brain health.

What might be happening is that in the early phase of Alzheimer’s, the brain becomes too excited. This is possibly due to loss of inhibitory, or GABAergic, interneurones. These are nerve cells that suppress other neurones so they do not oversignal.

The interneurones need more energy compared to other types of neurones. They are more susceptible to dying when they are bound to a the protein amyloid beta which is overproduced in the disease. Amyloid beta is known to damage mitochondria. These organelles as they are known, are the metabolic engine for cells. The amyloid beta protein interferes with SIRT3, a protein that preserves mitochondrial functions and protects neurons. 

The mice were bred with lower levels of SIRT3. Mice with low levels of SIRT3 experienced a much higher mortality rate, more violent seizures and increased interneuron death compared to the mice from the standard Alzheimer’s disease model and control mice. 

These mice with reduced levels of SIRT3 though also experienced fewer seizures and were less likley to die when they were fed ketones in their diet. Ketones are produced when we are on a keto diet. 

The researchers also noticed that the levels of SIRT3 increased when they were placed on the keto diet as well. It appears that increasing SIRT3 levels via ketone comsumption may be a way to protect interneurones an delay the progression of Alzheimer’s disease.

What Books Are There Which Talk About The Keto Diet?

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The number one book on the keto diet at the moment is by Brittany Williams which is called Instant Loss: Eat Real, Lose Weight: How I Lost 125 Pounds. This one is also leading the lists for wheat-free diet cookbooks and gives over a 100 recipes too. She reached a peak weight of 260 pounds and with it a life of yo-yo dieting, coping with autoimmune diseases and chronic fatigue. Not a happy existence all told. Then she did her research and developed this follow-up to a best selling book called Instant Loss Cookbook. 

Another relatively simple recipe book which does a Jamie thing with five ingredients is currently number one in the listings on Amazon for low carbohydrate diets. This book is by Jen Fisch and called The Easy 5-Ingredient Ketogenic Diet Cookbook: Low-Carb, High-Fat Recipes for Busy People on the Keto Diet.

Look for the Keto Air Fryer: 100+ Delicious Low-Carb Recipes to Heal Your Body & Help You Lose Weight by the guru of keto diets, Maria Emmerich. This one makes use of all those air fryers which have become a must have appliance for the kitchen. It makes sense to exploit this particular piece of kitchenware because it allows for the production of healthy options without using too much cooking fat.

Suzanne Ryan has published a book Simply Keto: A Practical Approach to Health & Weight Loss, with 100+ Easy Low-Carb Recipes which she has developed because of her ongoing battle with weight. She not only describes her own transformation when she first started using the diet in 2015 but also giving us a rundown on it with her popular blog, Keto Karma. It hands out advice on grocery tips, many FAQs about the keto diet and weight loss. I like the 100 or so recipes. 

Just take a look at the world famous, Dr. Josh Axe who brought out in early 2019, the book, Keto Diet: Your 30-Day Plan to Lose Weight, Balance Hormones, Boost Brain Health, and Reverse Disease. This is a very good romp through the process of dieting and gives some useful insights into the nature of inflammation and what he claims is reversal of disease. The ideas may seem a bit far-fetched in some aspects but the recipes make perfect sense.

The final recommendation would be the Keto Diet For Dummies which is part of the Dummies range. The style of writing is something worth emulating and it presents the diet in a straightforward, highly entertaining manner.

References

Covas, M.I., Nyyssonen, K., Poulsen, H.E., et al. (2006) The effect of polyphenols in olive oil on heart disease risk factors: a randomized trial. Ann. Intern. Med. 145 pp. 333-341 (Article) 

Gardner, C.D., Trepanowski, J.F., Del Gobbo, L.C., Hauser, M.E., Rigdon, J., Ioannidis, J.P.A., Desai, M., King, A.C. (2018) Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin SecretionThe DIETFITS Randomized Clinical Trial. JAMA. 319(7) pp. 667–679 (Article). 

Shai, I., Schwarzfuchs, D., et al., (2008) Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. N. Engl. J. Med. 359: pp. 229-241 (Article) 

Revised: 11th December 2019 to include greater detail about the nature of the diet, the effect on Alzheimer’s and add affiliate links. Originally published 12th February, 2019.