Ketogenic Diets: Just the Facts Please!

There's more evidence supporting the ketogenic diet for faster weight loss and improved overall health. From better insulin sensitivity to reduction of circulating triglycerides, people are considering adopting this eating plan. So what is it exactly?

There are a few variations of this diet but the most researched is the Standard ketogenic diet (SKD): This is a very low-carb, moderate-protein and high-fat diet. It typically contains 75% of calories coming from fat, 20% from protein and only 5% of your total calorie intake from carbohydrates. The Cyclical ketogenic diet involves periods of higher-carb intake, such as 5 ketogenic days followed by 2 high-carb days. Also, there’s the targeted ketogenic diet which allows you to add carbs around workouts. There’s the High-protein ketogenic diet: This is similar to a standard ketogenic diet, but includes more protein. The ratio is often 60% fat, 35% protein and 5% carbs. These sounds like challenging ratios to put into practice but nutrition professionals can help you if there's an interest in trying it out. You will certainly require an expert to ensure you are meeting dietary requirements and guide you on to supplements (MCT oil, minerals/magnesium, in some cases.)

An article in The American Journal of Clinical Nutrition showed that this diet is so filling that you can lose weight without counting calories or tracking your food. Johnstone et al states that: In the short term, high-protein, low-carbohydrate ketogenic diets reduce hunger and lower food intake significantly more than high-protein do, medium-carbohydrate nonketogenic diets. Low fat /high sugar diets are a thing of the past (read: 1990's, remember Snackwells?!) while higher fat diets have recently captured the attention of the nutrition research community.

There is evidence for the ketogenic diet boosting insulin sensitivity and causing fat loss, leading to drastic improvement of type 2 diabetes and pre diabetes. This had been supported by the integrative medicine practitioners now recommending the omission of all sugars (simple and complex) from their patient's eating plans. That means eliminating:

Sugary foods: Soda, fruit juice, smoothies, cake, ice cream, candy, etc.
Grains or starches: Wheat-based products, rice, pasta, cereal, etc.
Fruit: All fruit, except small portions of berries like strawberries.
Beans or legumes: Peas, kidney beans, lentils, chickpeas, etc.Root vegetables and tubers: Potatoes, sweet potatoes, carrots, parsnips, etc.

Low-fat or diet products: These are highly processed and often high in carbs.

Some condiments or sauces: These often contain sugar and unhealthy fat.
Unhealthy fat: Limit your intake of processed vegetable oils, mayonnaise, etc.
Alcohol: Due to its carb content, many alcoholic beverages can throw you out of ketosis.
Sugar-free diet foods: These are often high in sugar alcohols, which can affect ketone levels in some cases. These foods also tend to be highly processed.

What should you include? The majority of your meals should be based around these foods:

Meat: Red meat, steak, ham, sausage, bacon, chicken and turkey.
Fatty fish: Such as salmon, trout, tuna and mackerel.
Eggs: Look for pastured or omega-3 whole eggs.
Butter and cream: Look for grass-fed when possible.
Cheese: Unprocessed cheese (cheddar, goat, cream, blue or mozzarella).
Nuts and seeds: Almonds, walnuts, flaxseeds, pumpkin seeds, chia seeds, etc.
Healthy oils: Primarily extra virgin olive oil, coconut oil and avocado oil.
Avocados: Whole avocados or freshly made guacamole.
Low-carb veggies: Most green veggies, tomatoes, onions, peppers, etc.
Condiments: You can use salt, pepper and various healthy herbs and spices.

Snack ideas could be:

Meat or fish.
Cheese.
A handful of nuts or seeds.
Cheese with olives.
1–2 hard-boiled eggs.
90% dark chocolate.
A low-carb milk shake with almond milk, cocoa powder and nut butter.
Full-fat yogurt mixed with nut butter and cocoa powder.
Strawberries and cream.
Celery with salsa and guacamole.
Smaller portions of leftover meals.

Snack on meat? Maybe not for you. You may be also asking yourself "will I ever be able to eat carbs again?" Yes, just limited to special occasions. What about losing muscle? Yes, you will be at risk of losing muscle so you are recommended to lift weights. Building muscle isn't as easy as if one was on a moderate-carb diet, and especially if you are over the age of 40. If you're an endurance athlete, there is not enough evidence to suggest this eating plan is appropriate for you. However, if you want to lose weight, you can learn more about the low carb-high/fat diet plan and see if its right for you. It is a challenging plan and you will need support and guidance as there are many restrictions. My mother incorporated this eating plan into her life about 8 years ago as per a recommendation from her doctor. She was diagnosed with diabetes and by following a ketogeneic diet, has lived diabetes-drug/insulin free.

As for giving the ketogenic diet my full support... for most people leading a healthy lifestyle with no chronic illness, the jury is still out. I am a believer in a modified Mediterranean diet (meaning less bread, pasta and other refined wheat products) for most people. I will continue to follow the research and evolve my practice based on the evidence.