Unless you’ve had your head buried in the sand, you’ve probably heard of the Ketogenic or Keto diet. Many people are currently following this diet for weight loss. But what is it really and how does it work…who should or shouldn’t do it?! Let’s get down to the facts.
The Ketogenic diet can be very helpful for weight loss and general health.
So, what exactly is a Ketogenic diet?
A ketogenic diet is when the caloric intake from carbohydrates and protein (yes AND protein) are restricted in order to make the cells use a different primary fuel source. This altered state is known as ketosis. Most people are not following a true Ketogenic diet. This is actually a good thing because the modified version is better for general health anyway.
How does ketosis work?
When you follow a Keto diet your body mimics the state of fasting. This is because you are strictly limiting the amount of glucose your body sees. Glucose is the main source of fuel for the brain, muscles, and nervous system. In this pseudo-fasting state your body quickly burns off the limited glucose and adapts by using fat to make a different fuel. Your fat gets broken down for your liver to generate ketone bodies (ketogenesis) which make up the alternate source of fuel.
How low do you really have to go?
There is much debate over how restricted your carb intake needs to be to maintain the state of ketosis. The original Keto diet was designed to treat drug-resistant seizures in the pediatric population. This version of the diet is about 90% fat caloric intake. This would look like you consuming about 4 parts fat to 1 part protein and carbohydrates combined. This version of the diet is really hard to maintain. When a child with seizures follows this diet they have an immediate sign if they slip out of ketosis…a seizure. The general population does not have this sign.
Given the difficulty of the 4:1 diet most people are following the modified Keto diet. This version is easier to maintain and better adapted for general health. The breakdown is 65-80% (max) fat, 20-30% protein, and 5-10% (max) carbs. Keep in mind though this is fibrous carbs not starchy carbs. Fibrous carbs are 30-50% fibre and don’t have that same effect on blood sugar as the starchy carbs.
The only way for you to know if you are staying in fat burning mode when following the modified Keto diet is to measure your blood or urine levels of ketones. For general health and metabolic disorders you would want your blood ketones to be 0.5 mmol/L or higher, or your urine ketones to be 14-40 or 80 mg/dl. If you are not measuring your ketones this doesn’t mean you can’t achieve results on a modified Keto diet. In many cases the simple act of reducing carb intake can be enough to see benefit. However, you may or may not actually be in a physiological state of ketosis (the super-charged fat burning mode).
Who should be cautious with a Keto diet?
People with Kidney Stones (or a history of them)
It has been noted that when you follow a Keto diet there is 2-5 times higher chance of developing kidney stones. This is largely because thirst tends to be lower on the Keto diet so there’s a tendency towards dehydration. It is very important to stay hydrated. One of the main ways to prevent this development is by supplementing with potassium. When potassium citrate was used with the Keto diet there was no kidney stone development noted.
People with Low Blood Pressure or Adrenal Fatigue
With the Keto diet insulin is being suppressed. Because insulin plays a huge role in sodium reabsorption in the kidneys, your body starts dumping out sodium as a result of this suppression. Water of course goes with it, blood volume decreases and consequently, blood pressure drops. To offset this blood pressure drop it is important to, again, make sure you are staying well hydrated. Salting your food (with a good quality sea salt) for the first couple weeks, at least, will also help replace the sodium that is being dumped.
What can you expect on a Keto diet?
Deficiency in Carnitine
Carnitine is the fat storage molecule of the body. When you are in fat-burning mode there is so much fat being burned that carnitine gets used up. This can be remedied by supplementing with carnitine.
Many people on the Keto diet experience the Keto flu in the first couple weeks. This looks like the blood pressure drop we already discussed, along with potential headaches, fatigue, muscling cramping or soreness, nausea, mood swings, etc. These symptoms are mostly a result of the impact on your immune system while you go through this transition. They are also a result of glucose withdrawal. If you have never fasted before your body is not used to using ketones as fuel. Many of these symptoms can be remedied by staying well hydrated, salting your food, and supplementing with minerals like potassium and magnesium.
If you have questions about support on the Keto diet, need help transitioning to a Keto diet or would like to learn more about options for weight loss or other metabolic conditions give me a call and we can schedule your free discovery call.