Fundamentals of Keto (guest post)

[Today’s guest post is part of an editorial collaboration with team at HVMN. Check out their other guest posts on calories on a keto diet and muscle recovery after training. Note: This is NOT a sponsored post.

Editor]

Keto” comes from the word “ketogenic.” This is a scientific term meaning that the body is producing ketones from fat. When blood ketone levels exceed 0.5mM, the body has achieved “ketosis.” Ketosis can be naturally achieved two ways: through diet or fasting (meaning the body is producing its own ketones), or also by consuming products that raise blood ketone levels. Ketosis and ketogenic are two different things; a body in ketosis doesn’t mean that body is ketogenic.

Ketogenic means the body is producing its own ketones, which must happen through diet or fasting. This body is in ketosis because blood ketone levels are over 0.5mM. Someone else may consume ketones through an external means (called exogenous ketones). This body is also in ketosis because its blood levels are over 0.5mM, but it’s not ketogenic—because it’s not producing its own ketones.

Simple enough, right?

Starting a Ketogenic Diet

The keto diet is a moderate-protein, low-carb, high-fat diet. Its goal is to get the body to produce ketones, which are then used an fuel source for both the brain and the body. But because it’s low-carb, high-fat, the keto diet often gets confused with other diets out there.

What Makes Keto Unique?

Just because a diet is low carb doesn’t mean it’s keto. The subtle differences in macronutrients on keto make it unique (more on these later). Keto isn’t Atkins. Keto isn’t paleo. Keto isn’t high protein.

High fat intake is often a concern on keto because, for years, a low-fat diet was equated with fat loss. In Dr. Atkins‘ 1972 book, Dr. Atkins’ Diet Revolution, he began to reshape how we think about fat. The pendulum of public perception continued to swing in favor of diets higher in fat, thanks to the emergence of influential writers and speakers such as Gary Taubes, Robert Lustig, and Nina Teicholtz, and clinicians and scientists such as Professor Tim Noakes, Dr. Jason Fung, and Professor Thomas Seyfried. The fear of fat has only kept decreasing.

Usually, keto is confused with Atkins. On Atkins, the initial aim is to restrict the carbohydrate intake to less than 20g per day. This degree of restriction is likely to lead to ketosis, although this is not an explicit aim. Then, the diet reintroduces carbohydrates to a level “the body can tolerate”. There’s also less restriction on protein compared to a true ketogenic diet: high fat, moderate protein, low carbohydrate.

Tips for Starting a Keto Diet

Don’t try to start the diet gradually. If carbohydrate intake is moderately-low, blood sugar levels may not be enough to fuel the brain, and the presence of carbohydrate in the diet might still be enough to stop the body from making ketones.

The main objective when starting the ketogenic diet is to restrict carbohydrates to 20 digestible grams per day or less (this is what’s considered a strict ketogenic diet) and consume fat until you’re satiated.

Remember to consume plenty of fibre as well. And regarding protein: stay at or below 1 gram of protein per day, per kg of body weight. If your goal is to lose weight, aim for 1 gram of protein per kg of your target weight.

Here are a few tips for when you’re starting keto:

  • Make a keto meal plan. It’s a good idea to establish an eating plan before starting the diet. Make a shopping trip to stock up on a range of foods that are low in carbohydrates and high in fat
  • Use an app to track macronutrient intake. Apps such as MyFitnessPal are great to get an idea of the macronutrients in common foods. There is also a range of special online keto diet calculators
  • Search for a few keto recipes to adapt cooking methods. Due to the high-fat consumption required to get into ketosis, it may be beneficial to change daily staples or cooking methods. You could increase your intake of tasty foods such as coconut oil, heavy cream, and cheese
  • Make an approved list of keto diet foods and eliminate carbohydrate-rich foods. It will be easier to follow the diet by throwing out any foods to avoid. It’s recommended to check the labels for hidden added sugars
  • Consider starting a ketogenic diet with a short period (16-36 hours) of fasting (consuming zero calories). Fasting depletes carbohydrate stores and can accelerate ketone production.
  • Gentle cardio exercise (~30 minutes) or some short high-intensity intervals (10-second sprints) can deplete carbohydrate stores and speed up ketone production

Keto Diet for Weight Loss

The ketogenic diet can be used to help with weight loss.

Recently, the number of positive keto diet reviews, and small-scale science studies has increased. The rising popularity of the diet has led to a demand for further randomized control trials to study its long-term efficacy.

A key reason why the ketogenic diet helps weight loss is that it decreases hunger. This makes it easier to maintain a calorie deficit. It is important to stress that the overconsumption of calories will generally prevent weight loss, regardless of the macronutrient composition.

Cyclical Ketogenic Diet and Cheating on Keto

At the moment, there is not a clear answer as to whether the benefits of the ketogenic diet can be achieved by cycling on and off the diet. It’s best to stick to the diet for one or two months minimum to see benefits. It can take several days to get into ketosis1 and 3-6 weeks to become “fat adapted”.

Some research indicates ~40 days on the ketogenic diet interspersed with periods of healthy eating with more carbohydrates (Mediterranean diet) could maintain weight loss.

“Cheating,” and consuming high-carbohydrate food, quickly stops ketone production by the liver. It can then take a considerable amount of time for the body to get back into ketosis. Time taken to get back into ketosis will depend on many factors including, the amount of carbohydrates consumed, how adapted the body is to produce ketones, activity level, etc.

Who Should Avoid a Keto Diet?

Based on certain risk factors, following a ketogenic diet may not be suggested for people with the following medical considerations:

  • Pregnancy
  • Kidney failure
  • Impaired liver function
  • Impaired fat digestion (gallbladder disease, gastric bypass, pancreatitis)
  • Genetic defects in metabolism (CPTI/II deficiency, beta-oxidation defects, fatty acyl dehydrogenase deficiency).

Should You Start a Keto Diet?

We’ve provided an in-depth look at the keto diet, hopefully giving you all the tools you need to make the best decision for your health. Think about your goals, your lifestyle and how feasible keto is for you (and consult a healthcare professional). While many people have found success on keto for weight loss or performance—everyone is different.

By Nate Martins and Dr. Brianna Stubbs

This article was originally published by HVMN headquartered in San Francisco

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