With keto reaching immense popularity in this day and age, from those pursuing its proposed health benefits to those wishing to get in shape once and for all, comes a lot of intriguing questions surrounding the diet.
Having assisted hundreds of dieters in pursuit of their ideal body weight, there are several questions about the dietary regimen that come up time and time again.
Consequently, we here at Plato Weight Management have set out today to finally answer these questions based on the literature!
In this blog post, I’ll be exploring:
- What exactly is the keto diet
- The difference between ketosis and ketoacidosis
- Types of keto diets
- The difference between keto and Low-carb
- The pros of keto for health
- The cons of keto for health
- How keto is thought to influence weight loss in the short-term
- Keto’s effect on water retention
- The long-term research behind keto for weight loss
- The rules to follow if you do intend to start keto
- The aspects to avoid if undertaking keto
What exactly is the keto diet
The ketogenic diet is a very low-carb, high-fat diet that’s designed to shift your main dietary source of energy from carbohydrates to fat.
With a usual diet, carbohydrates are primarily what we would use to provide ourselves with energy each day with the typical macronutrient proportions being:
- 45 to 65% carbs
- 10 to 35% protein
- 20 to 35% fat
However on a keto diet, one would consume between:
- 5-10% carbs
- 15-30% protein
- 65-80% fat
The reason why there is a variability concerning the percentages is that some people may prefer slightly higher carbs on keto while others may prefer more protein etc. You can try playing with the numbers and seeing what suits you best.
Be aware that all carb values noted here are net carbs, which is total carbs minus fiber. Fiber is often not counted in net carb totals, as the nutrient isn’t digested unlike other food components, such as fats, proteins or carbohydrates.
Now why we want to shift our dietary intake from primarily carbs to primarily fats via the keto diet is because it will switch your body into a state of ketosis.
And what is ketosis?
Well, it is the presence of a higher than usual level of ketones in your body which is the chemical your liver produces when it burns stored fat.
So what this means is that when we consume a lot of carbohydrates along with not so much fat, it is prone to be stored as fat. However in contrast, when dietary fat is primarily consumed with minimal carb intake, like with the ketogenic diet, for example, it—along with fat released from body fat stores—is prone to be burned.
And just to be clear guys, just because you’ll be using fat as your main energy source doesn’t mean you’ll be constantly burning through your stored body fat.
First, you’ll use the fat you eat for energy with body fat afterward. You actually won’t be burning stored body fat all the time with keto – that’s a common misconception.
Moreover, I think it is important to point out that ketosis is not the same as ketoacidosis.
The difference between Ketosis and Ketoacidosis
Despite the similarity in name, ketosis and ketoacidosis are two different things.
Ketoacidosis refers to diabetic ketoacidosis (DKA) and is a life-threatening condition resulting from dangerously high levels of ketones and blood sugar.
It mostly occurs in people with type 1 diabetes whose bodies do not produce any insulin but can also occur in individuals with type 2 diabetes who have little to insulin production. However in a few rare cases, ketoacidosis has been reported to occur in nondiabetic individuals following a prolonged very low carbohydrate diet.
However, not to worry guys, DKA develops when ketone levels are around ten times the levels seen obtained from ketosis. In addition, in healthy individuals, ketones should not reach excess as their brain will use ketones for fuel and their bodies should produce enough insulin to assist prevention.
That said, this is just another reason to talk to your doctor before starting the ketogenic diet, especially diabetics.
To read our blog about Cleanse and Detox diets, please follow the link here.
Types of keto diets
Now there are several types of ketogenic diets.
We have the standard ketogenic diet which was the type we talked about a moment ago which, as a reminder, was a very low-carb, moderate-protein and high-fat diet.
Secondly, we have the cyclical ketogenic diet which involves periods of higher-carb refeeds, such as 5 ketogenic days followed by 2 high-carb days.
Then we have the targeted ketogenic diet which allows you to add carbs around workouts.
And lastly, we have the high-protein ketogenic diet and this is similar to a standard ketogenic diet, but includes more protein. The ratio is often 60% fat, 35% protein and 5% carbs.
Furthermore, let’s take a look at the differences between a ketogenic diet and a low-carb diet.
The difference between Keto and Low-carb
Well as we have gone through, the carbohydrate intake is very low for the ketogenic diet, typically below 50 grams per day.
However, a low carb diet is between 75 and 150 grams of carbs per day.
This difference in carbohydrate intake between the two is noteworthy as the carbohydrate intake from a low carb diet is not low enough to get you into a full state of ketosis. In addition, another difference between the two is that keto diets will often not include as much protein as low-carb diets would.
Examples of low carb diets would include Paleo, Mediterranean and the Atkins diet.
Now that we are a bit clearer on what the Ketogenic diet entails guys, let’s discuss the pros and cons of it!
Please note, however, that I am not endorsing keto as a supplement to or as a replacement for medication in any way and I strongly recommend everyone to again consult with your doctor prior to any new diet regime.
The pros of Keto for health
So the first pro of the ketogenic diet is that it may improve brain functioning.
Originally created about 100 years ago in the 1920s to treat epilepsy, Keto has been suggested to be beneficial to a wide range of other neurological disorders such as neurodegenerative diseases, sleep disorders, bipolar disorder, autism and brain cancer.
Additionally, research suggests that overweight patients who undergo a keto diet may experience fewer headaches than they did before it alongside improved mental clarity throughout the day (Lorenzo, Coppola, Sirianni & Pierelli, 2013).
Secondly, it is effective Against Metabolic Syndrome.
And what is metabolic syndrome?
Well, it is a cluster of symptoms that occur together, increasing your risk of heart disease, stroke and type 2 diabetes. these symptoms include abdominal obesity, elevated blood pressure, Elevated fasting blood sugar levels, High triglycerides in addition to low “good” HDL cholesterol levels.
Next, a greater proportion of fat loss will come from your abdominal cavity
Guys, not all fat within your body is the same. We have two main types of fat. Subcutaneous which is the fat underneath your skin and visceral fat which tends to accumulate in your abdominal cavity and lodge around your organs.
Now it is the Visceral fat presents more hazards to your health as it increases your risk for developing several serious long-term, life-threatening medical conditions such as heart attacks, heart disease, type 2 diabetes, stroke and cancer. So this is certainly good news.
Another pro is that it provides stable energy throughout the day.
Remember guys carbs are mostly made up of sugar.
And the greater amount of sugar in a meal, the greater the blood sugar will spike and then subsequently crash leaving you fatigued and even more hungry for a couple of hours as a result. Therefore guys, the less sugar (or carbs) you consume, the more the blood sugar stays stable.
This is why keto can help as with minimal carbs to burn, your blood sugar will consequently decrease resulting in more stable energy throughout the day.
Moreover, keto may help with inflammation too. Although there are not too many studies backing this up yet, a lot of people report improvements in issues such as arthritis when undertaking a ketogenic diet.
Our final pro is that keto can also be good for endurance training. Some scientists have hypothesized that you become more efficient at using oxygen when you are on a keto diet.
For example, ultra-endurance runners performed as well on keto as their fellow runners did on a high-carb diet, without running out of energy and breaking down from exhaustion (Volek et al., 2016). This means that someone undertaking keto would not need to carbo-load before an endurance event.
To read our blog about The Alkaline Diet, please follow the link here.
The cons of Keto for health
Conversely, let’s check out the potential cons of a ketogenic diet.
So the first con of the ketogenic diet is that the long-term research of it is limited guys.
Even though the diet is immensely popular in society today, there has not been enough studies of its implications on weight loss and health after years or decades of adherence.
Basically, there is still a lot of unanswered questions. Long-term studies are needed to truly answer these questions as the ketogenic diet is still in its infancy.
The second thing to keep in mind is, the dreaded, keto flu!
Following the depletion of your glycogen stores, which takes around 48 hours on a Keto diet, you may go through a period of feeling weak, light-headed, irritable, mentally slow and lethargic.
This happens due to your metabolism starting to burn primarily fat for fuel rather than carbohydrates. These symptoms usually subside within a few days to a few weeks but are a not-so-fun side effect nevertheless.
In addition to this, keto can cause an increase in your stress hormone cortisol during your first week or two which can hamper your sleep and stress your body.
The next concern about partaking in a ketogenic diet is that you are at risk of a deficiency in some nutrients.
As the intake of carbs is limited to a maximum of 10% of your total daily calorie intake to reach ketosis, it is not just a reduction in bread, rice and pasta that we normally associate with carbs guys, Fruits and vegetables are also sources of carbohydrates which are very nutrient-rich and are important sources of vitamins and minerals.
This means guys that people following the keto diet may have low intakes of vitamin A, C, K, folate and fiber among others. So this is something to pay special attention to.
On the other side to a deficiency in some foods guys, a keto diet may additionally lead to an overconsumption of bad fats.
Although fat of course will be prioritized above all other macronutrients via keto, we still want to be sure to choose good fats and oils like those that come from plants and organic or grass-fed animal products rather than saturated and trans fats as they are associated with an increased risk of heart disease and cancer while also making you feel very sluggish.
Moreover, kidney issues could arise from the ketogenic diet.
Kidneys indirectly regulate the breakdown of fats so if you are undergoing ketosis with the consumption of primarily fats, it may present difficulty for those with kidney disease. In addition, for the first few weeks on keto, there is an increase in uric acid in your blood which is a contributor to kidney stones especially, if you are already susceptible to them.
This is partly due to the lack of fiber in the diet but you can cut your risk by choosing keto-approved foods with high fiber content and staying hydrated. If you have kidneys issues already then again it is important to check with your doctor before attempting keto.
What’s more, is that keto may cause digestive distress for the first few weeks.
Again guys, make sure to stay hydrated and consume fiber along with electrolytes to limit diarrhea or constipation as much as possible.
Now in comparison to keto being good for aerobic activities such as jogging and cycling, it is not good generally for anaerobic activities like weight lifting or sprinting.
Remember guys, glycogen is the storage form of carbohydrates in your muscles which provides your body with a readily available source of energy.
Therefore, the reason keto is not good for anaerobic exercise is that the inadequate glycogen stores (as a result of a minimal carbohydrate intake) will not provide enough power for brief and intense activities like weight lifting and sprinting
However, there is a way to accommodate it through the use of the earlier reported targeted ketogenic diet.
For instance, while a standard ketogenic diet, which we talked about at the beginning of this lesson, requires 20-50 grams of net carbs per day, a targeted ketogenic diet would split these carbs between 30 minutes before your workout and 30 minutes after it. This will provide your muscles with the adequate amount of glycogen needed during training and during recovery.
Furthermore, keto is not suitable for pregnancy, as glucose is the main energy source that fuels fetal development.
In addition, severely limiting carbs may be taxing on the endocrine system leading to hormonal imbalances that may disrupt a woman’s menstrual cycle. So a woman may need more carbs on a keto diet than a typical man would.
and finally, the last con of the ketogenic diet is bad breath.
One temporary, yet inconvenient, side-effect of entering ketosis. This happens because your body is breaking down acetoacetic acid, which many people say produces a similar smell to nail polish and can taste metallic.
Now that we have discussed the potential positives and negatives of undertaking the keto diet for health, let’s talk about its effectiveness for weight loss.
How Keto is thought to influence weight loss in the short-term
Keto diets have, as I am sure you are aware, been found beneficial for many regarding weight loss in the short term.
Several theories as to why this could be include:
- A higher caloric deficit likelihood
- Decreased food cravings due to high-fat proportions in the diet
- A decrease in appetite due to hormones like ghrelin being suppressed when consuming a restricted amount of carbs
- A direct hunger reducing role from the bodies primary fuel source (ketone bodies) on the diet
- Promotion of fat loss partly due to decreased insulin levels alongside
- An increase in energy expenditure from breaking down fat and protein to glucose
However guys, one fact regarding successful dramatic weight loss from keto in the initial stages is that most of it is water.
To read our blog about how to read nutrition labels for weight loss, please follow the link here.
Keto’s effect on water retention
This is due to glycogen in our liver and muscles being responsible for water retention which, as mentioned before, is diminished from a ketogenic diet. Therefore, when glycogen levels fall, so does our water weight.
This means that if you were to stop keto, you would regain a large proportion of that water retention back via a replenishment of those glycogen stores. This is in the realm of possibility guys as adherence to the restrictedness of the diet is very difficult over time.
Additionally, Long term studies show that there’s not much difference in weight loss between keto versus alternative popular diets.
The long-term research behind Keto for weight loss
For example, a meta-analysis in 2013 compared adults on a ketogenic diet against those on a low-fat diet. What was found was that after at least a year, those with the ketogenic diet lost just two pounds more than those with the low-fat diet (Bueno, de Melo, de Oliveira, & da Rocha Ataide, 2013).
But guys, it is ultimately up to you whether or not to pursue a ketogenic diet based on your dietary preferences and health concerns so I will leave you with a few key take away points if you do decide to go keto!
The rules to follow if you do intend to start keto
- Consult with your doctor before starting and potentially a dietitian to closely monitor any biochemical changes after starting the regimen, to create a meal plan that is tailored to one’s existing health conditions and to prevent nutritional deficiencies or other health complications.
- Keep a food journal to track how you feel over time.
- Always read the nutritional information of foods before you eat them.
- Stick with healthy fats like eggs, avocado, and extra virgin olive oil.
- Use your available carb intake to eat low-carb greens, fruits and vegetables as much as possible to maximize your nutrient intake.
- Eat real food made from whole ingredients (nothing processed) and consume organic, grass-fed animal products as much as possible.
- Stay hydrated as it helps offset the loss of fiber in your diet.
- And consider a modified keto diet if the restrictions are too severe.
The aspects to avoid if undertaking keto
Then, on the other hand:
- Don’t follow the keto diet if you have a history of pancreatic disease, liver conditions, thyroid problems, eating disorders, or gallbladder disease.
- Avoid as much saturated and trans fats as possible.
- Don’t stress about calories as there’s little reason to monitor them if your macronutrient ratios are where they should be.
- and finally, but most importantly, don’t follow the keto diet if your doctor has advised against it.
In conclusion, keto can indeed be an effective diet for weight loss in the short term for those who have the necessary amount of discipline required. However, researchers are still skeptical of it’s benefit toward weight reduction over the long-term.
The literature suggests that undertaking a less restrictive diet like a low-fat diet or a low carb diet may be easier to maintain long-term while providing the same levels of weight loss as keto. Therefore, we recommend undertaking a less restrictive Mediterranean, Paleo or Atkins diet rather than keto when in pursuit of a healthier body size.
Regarding keto’s health benefits, there does seem to be some significant advantages associated with the diet. Although, this is not without its drawbacks. Ultimately, it is up to you to decide whether it is worth it from weighing the pros against the cons.
As mentioned, however, we strongly recommend consulting with your doctor prior to starting any new diet regimen.
If you are interested in undertaking one of our evidence-based and results-backed Plato Weight Management programs, please make sure to check what program may be suitable for you at this link or contact us here!
You can find out what some of our previous clients had to say about the program on our success stories page!
To read our blog explaining everything you need to know about micronutrients while dieting, please follow the link here.
Bueno, N. B., De Melo, I. S., De Oliveira, S. L., & Da Rocha Ataide, T. (2013). Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: A meta-analysis of randomised controlled trials. British Journal of Nutrition, 110(7), 1178-1187. doi:10.1017/s0007114513000548
Di Lorenzo, C., Coppola, G., Sirianni, G., & Pierelli, F. (2013). Short term improvement of migraine headaches during ketogenic diet: a prospective observational study in a dietician clinical setting. The Journal of Headache and Pain, 14(Suppl 1), P219. https://doi.org/10.1186/1129-2377-1-S14-P219
Volek, J. S., Freidenreich, D. J., Saenz, C., Kunces, L. J., Creighton, B. C., Bartley, J. M., . . . Phinney, S. D. (2016). Metabolic characteristics of keto-adapted ultra-endurance runners. Metabolism, 65(3), 100-110. doi:10.1016/j.metabol.2015.10.028