Is the Ketogenic Diet for You? (Part 2)
Read on to discover my favorite Ketogenic Diet Foods.
An 8 minute read.
The ketogenic diet (or “keto” diet) is a 100-year-old diet that is low in carbohydrates and high in fat and often used for weight loss, but it is not the magic bullet that many clinicians and celebrities make it out to be. And although the ketogenic diet is a diet that may benefit you, don’t try it until after you read this blog post and consulted a knowledgeable health care professional who can help you navigate the many challenges of following a ketogenic diet. If you missed My Ketogenic Diet Guidelines, Part 1 Post, click here.
Eating a ketogenic diet will change your metabolism, so it is important to consider your personal medical history and health goals. There are conditions where the diet is not recommended, and a few where it is recommended. It would not be recommended if you have certain lipids elevated in your blood and may be recommended if you have other lipids that are high. If you want guidance on your personal situation, book a free discovery call here.
I may recommend a modified ketogenic diet for clients with high blood sugar issues who are hungry hangry all the time with persistent sugar/carbohydrate cravings. Sometimes it is exactly what they need to get off the sugar roller coaster with the subsequent brain fog, fatigue and weight loss resistance.
The ketogenic diet is a low-carbohydrate, high-fat, moderate protein eating style that forces your body to burn fat as “fuel.” It works because your metabolism switches from using carbohydrates (because you are not eating them) as your body’s fuel to using fat (and ketones) instead. This metabolic change allows your body to maintain energy levels while consuming fewer calories, hence the weight loss.
Food is fuel: carbohydrates vs. fats (and ketones)
Your body and brain prefer using starches, or carbs, as their main fuel source. Carbs are mostly sugars and starches that are found in many foods such as grains, legumes, fruits, and some vegetables as well as most processed foods and beverages. Humans have evolved the ability to use a backup fuel to survive during times when we don’t have enough carbohydrate-rich foods to eat. Our survival in times of starvation depends on our body’s ability to fuel our brains, heart, muscles, and other critical organs we need to stay alive. So, what does your body do when there aren’t enough carbs to use? It turns to your backup fuel: fat.
It may sound counterintuitive, but the ketogenic diet mimics the effects of fasting without the bother and discomfort of fasting (Click here for my blog on intermittent fasting). This happens by reducing the amount of carbohydrates you consume so your body adapts and starts burning fat. When this happens, our bodies naturally produce ketones. The word ketogenic means that our body is generating ketones and this can continue for as long as you eat a ketogenic diet.
Issues to consider before going Keto
The keto diet is not for everyone because it can be very restrictive and requires a lot of measuring of your macro nutrient intake (fats, carbs, and proteins). A small number of people have metabolic reasons why it’s medically recommended that they do eat a ketogenic diet (e.g., they have glucose transporter 1 deficiency syndrome or pyruvate dehydrogenase deficiency). That is some complicated sounding biochemistry that I can help you with…just ask (book a discovery call here). Other people with drug-resistant epilepsy may also be recommended a ketogenic diet because it can help reduce the number of seizures (although this has mainly been studied in children, not adults). In fact, the seizure-reducing ability of the keto diet was first studied in 1921 and was a common treatment until science developed anti-epileptic medications.
There are conditions that are contraindicated with the keto diet, as it can make things worse. If you have any of these metabolic conditions, don’t try a ketogenic diet without consulting a healthcare professional first:
● Liver failure
● Primary carnitine deficiency
● Carnitine palmitoyltransferase deficiency
● Carnitine translocase deficiency
● Beta-oxidation defects
● Pyruvate carboxylase deficiency
● Acyl dehydrogenase deficiency
● Long- or medium-chain 3-hydroxyacyl-coenzyme A deficiency
● Porphyria
Fortunately, most of us don’t have the above conditions, but the ketogenic diet does have some potential side effects. The most common ketogenic diet side effect is constipation and dysbiosis or disruption of the microbiome. Constipation is something that you can work around with careful planning and the right fiber supplement.
Other side effects of a keto diet can include:
● Nutrient deficiencies (e.g., failure for children to grow, low bone density)
● Lethargy, “fuzzy thinking,” and mood swings
● Metabolic issues (e.g., dehydration, hypoglycemia, excessive ketosis, metabolic acidosis, and electrolyte imbalance)
● Digestive issues (e.g., constipation, nausea, vomiting)
● Liver, pancreas, and kidney issues (e.g., hepatitis, pancreatitis, kidney stones)
● Heart and blood fat issues (e.g., cholesterol)
It can take two or three weeks of eating a strict keto diet before your body fully adapts to ketosis and uses fat for fuel. During this transition time you may experience something referred to as the “keto flu.” It’s not an official term, nor is it related to an influenza infection. The keto flu can feel like a headache, fatigue, nausea, sleep difficulties, and constipation.
Be careful because, as you can see, there are many reasons to consult a knowledgeable healthcare professional before starting a ketogenic diet. Need help and meal plans? Tasty, easy to prepare digital customizable meal plans are included in both of my packages, here is a sample creative recipe from my colleges over at Living Plate Rx at the end of this post below.
If keto is right for you, here is how to get into ketosis
There are a few different low-crab high-fat ways to get your body into ketosis. The first is with the classic ketogenic diet, and there are three modifications that can also work. As you’ll see below, there is very special attention paid to the exact amounts of fats and carbohydrates to eat each day to achieve and maintain ketosis on these diets.
How do you know you have achieved ketosis and are burning fat as your primary fuel? You can measure the ketones in your blood with a home ketone meter (like a glucose meter). This is the preferred method by many hard-core ketogenic dieters and is the more accurate than a urine test. It can be expensive and there is no magical number that tells you if you are in ketosis. How you feel is more important than a number on a meter.
If you feel good, have plenty of energy, can go hours without eating, you are not hangry, have good mental energy and your blood sugar levels have improved then the ketogenic diet is working for you.
1 - The classic ketogenic diet (Really not for most people)
The classic or standard ketogenic diet requires about 90 percent of your calorie intake to be fat and 4 percent carbohydrates. This leaves just 6 percent for proteins. Many very healthy and nutrient-dense foods contain more than 5 or 10 percent carbohydrates (think: vegetables). And if you don’t eat a lot of vegetables, you can become deficient in many nutrients.
That’s why this diet often comes with a recommendation to take vitamin and mineral supplements and careful monitoring by a knowledgeable health care professional. This is a diet that is most likely prescribed in a hospital setting.
2 - Three modified ketogenic diets (Better options for most people)
There are three modifications to the classic ketogenic diet that may maintain the state of ketosis without eating 90 percent of your calories as fat.
The first is the medium-chain triglyceride diet (MCTD). This modification allows 73 percent of calories from fat and 17 percent carbohydrates (and 10 percent protein). However, you have to include a specific kind of fat called a medium-chain triglyceride, or MCT. The MCTD recommends that MCTs make up about half of the fats ingested. This means that if you don’t use concentrated MCT oil, which is purchased as a nutritional supplement, as part of your keto diet, coconut oil would be your main daily fat source because, unlike other fats like olive oil, it contains MCTs.
The second modification to the ketogenic diet is called the Modified Atkins Diet (MAD). This reduces the fat intake to 65 percent of calories from fat as long as the carbohydrate intake stays below 5 percent of calories. This means that the remaining 30 percent can be protein.
The third modification, and the one I recommend most often to my clients, is the Low Glycemic Index Diet (LGID). This targets 60 percent of the calories from fat, 10 percent from carbohydrates, and 30 percent from protein. It is a much more tolerable ketogenic diet. It allows a higher intake of carbohydrates, the carbohydrates eaten must be low glycemic (which means they have little impact on your blood sugar).
What does the keto diet look like from a food and meal perspective?
So…what do you eat on a healthy ketogenic diet?
First of all, don’t search the grocery store for expensive, processed ketogenic diet junk food. There are a lot of packaged foods using “keto” as a marketing tool. And while some of these foods may make your life easier, they are not the foundation of a health keto diet.
Instead…
You would eat from this list of my favorite higher-fat, lower-carbohydrate foods:
● Berries (in small amounts)
● Leafy greens (kale, spinach, Swiss chard)
● Broccoli, cauliflower, Brussels sprouts
● Asparagus
● Bell peppers
● Onions and garlic
● Mushrooms
● Cucumber
● Celery
● Summer squashes
● Avocados
● Full-fat dairy (cheese, plain Greek yogurt)
● Meat
● Eggs
● Fish
● Nuts (almonds, walnuts)
● Seeds
● Tofu
● Oils (olive, coconut, palm)
● Fats (lard, butter, cocoa butter)
● Drink plain or sparkling water, and unsweetened coffee or tea
Here is a list of foods to avoid on a keto diet:
● Breads and baked goods
● Pasta
● Breakfast cereal
● Starchy vegetables (potatoes, corn, peas, beans)
● Fruit (except berries)
● Sweets, Sugar, most all processed foods
The most important thing is to ensure that any diet you eat—whether it’s keto or otherwise—is nutritionally balanced and provides you with enough of all the essential nutrients you need every day.
The Bottom Line About Ketogenic Diets
The keto diet is very popular now and it may (or may not) be for you.
The keto diet may be beneficial for some people, but not everyone, no diet is. Because it is restrictive, it can result in nutrient deficiencies, metabolic issues, digestive symptoms, as well as blood lipid concerns, to name a few.
There are several ways to get into the state of ketosis and start burning fat as fuel. One is with the classic keto diet, or one of three modifications that can also work. Whichever method you go with, it’s going to require a lot of measuring of the fats and carbs in the foods you eat and might feel very restrictive.
Wondering if the keto diet may work for you, I can help. Here is my link to book a chat about making sure to meet your dietary needs.
Waldorf Collard Wraps
Here is a keto diet friendly recipe from my colleagues over at Living Plate Rx.
Chicken Waldorf Collard Wraps
Ingredients:
4 collards, leaves, trimmed
10 oz chicken breast, canned, drained
1/4 cup mayonnaise, unsweetened
2 scallions, chopped
2 Tbs parsley, chopped
1/3 cup Walnuts, raw, chopped
salt, to taste
black pepper, to taste
1/2 avocado, sliced
Directions:
Prep
Drain chicken and place in a large bowl.
Chop scallions and walnuts.
Remove stems of collards. Place each leaf a flat surface and, using a sharp knife or vegetable peeler, shave off some of the spine to make it more flexible. Rinse in very hot water to soften and set aside.
Make
To the chicken, add mayonnaise and stir with a fork until the chicken is flaky. Season with salt and pepper and stir in scallions and walnuts.
Add chicken mixture to collards, top with some avocado, and wrap.
References
Campos, M. (2018, October 18). Harvard Health. What is keto flu?
https://www.health.harvard.edu/blog/what-is-keto-flu-2018101815052
Harvard Health. (2020, August 31). Should you try the keto diet?
https://www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet
Martin, K., Jackson, C.F., Levy, R.G. & Cooper, P.N. (2016). Cochrane. Ketogenic and other dietary treatments for epilepsy. Retrieved from http://www.cochrane.org/CD001903/EPILEPSY_ketogenic-and-other-dietary-treatments-epilepsy
Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. [Updated 2020 Dec 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
https://www.ncbi.nlm.nih.gov/books/NBK499830/
Mayo Clinic. (2020, January 3). Is the keto diet right for you?
https://www.mayoclinic.org/is-the-keto-diet-for-you-a-mayo-expert-weighs-in/art-20457595
Schoeler, N.E. & Cross, J.H. (2016). Ketogenic dietary therapies in adults with epilepsy: a practical guide. Practical Neurology. 16(3):208-14. doi: 10.1136/practneurol-2015-001288.
http://pn.bmj.com/content/16/3/208.long
