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Ketogenic Diet 101

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Improving your health, losing weight, or combating a long-term disease – whatever the reason you want to follow a ketogenic diet, starting is never as simple as it sounds.

The good news? From now on, you can throw all the guesswork out of the window. In this evidence-based guide, you’ll discover everything you need to know to start and stick to your own keto diet.

You’re about to learn what exactly a ketogenic diet is, why this eating style can boost your health and well-being, how to optimize your results going keto, and a lot more. So keep reading!

What Is the Ketogenic Diet?

The ketogenic diet is an eating style in which you consume a relatively high amount of fat, protein in moderation, and just a tiny bit of carbs (generally fewer than 30-50 grams a day) [10].

This means you’ll scratch carb-rich foods from your diet, such as sugar and sugary foods, most fruits, grains and starches, root vegetables, tubers, beans, legumes, alcohol, and certain dairy products.

Instead, you’ll get your calories from meat, eggs, fish and seafood, veggies, certain fruits (berries, coconut), nuts, seeds, healthy fats, and low-carb dairy products.

Here’s what a day of eating on the ketogenic diet can look like:

Breakfast: Fluffy omelet with ham, spinach, and Swiss cheese
Lunch: Arugula salad with bacon and pecans
Dinner: Grilled salmon with avocado salsa and parmesan cheese
Snack: Coconut milk protein shake and a handful of almonds

If you follow the ketogenic diet, meaning that you consume fewer than 30-50 grams of carbs a day, your body will enter a state called “ketosis,” which offers many benefits. One of them is that it can help you obtaining and maintaining your ideal body weight.

The Ketogenic Diet and Weight Loss

Perhaps the most common reason people follow a ketogenic diet is to lose weight. And guess what? It’s effective, too. Here’s what a meta-analysis published in the British Journal of Nutrition concluded [2]:

“Individuals assigned to a VLCKD [Very low carbohydrate ketogenic diet] achieve a greater weight loss than those assigned to an LFD [low-fat diet] in the long term; hence, a VLCKD may be an alternative tool against obesity.”

What’s more, research on obese women published in the Journal of Endocrinology and Metabolism found that following a ketogenic diet for six months led, on average, to a weight loss of 18.7 pounds [3].

Not bad, right? Especially when you consider that the women could eat as much as they wanted throughout the study as long as they kept their daily carb intake below 20 grams.

Why Is Keto Effective for Losing Weight?

The primary reason the ketogenic diet can yield impressive weight loss results – and prevent you from regaining the pounds shed – is that the eating style is excellent at satiating hunger [4-5]. Therefore, most people automatically reduce their food intake when they go keto.

Why is this diet effective at satiating hunger, you ask? Well, researchers believe the main reason is that ketosis suppresses appetite [4]. Besides, a ketogenic diet usually pairs with an increased protein intake, which raises the satiety hormones GLP-1, Peptide YY, and cholecystokinin while reducing the hunger hormone ghrelin.

Other Benefits of the Ketogenic Diet

In recent decades, millions of people have lost hefty amounts of weight by following a ketogenic diet. But reducing the number on your scale isn’t the only thing it has to offer. Here are three more of the myriad of benefits the ketogenic diet provides:

Decreased blood sugar and insulin levels

Carbs are the macronutrient that most severely raises glucose and insulin levels. And since you limit your intake of those on a ketogenic diet, you can expect a drop in blood sugar and insulin levels. That’s why the ketogenic diet is effective at improving and reversing type 2 diabetes [6].

Enhanced cardiovascular health

It’s well-known that elevated blood triglycerides levels increase the risk of cardiovascular disease. The good news? Ditching carbs tends to result in a drastic reduction in blood triglyceride levels and can thus lower the risk of those diseases [7].

Besides, ketogenic diets tend to cause weight loss, which decreases blood pressure, brings down the levels of “bad” LDL cholesterol, and raises those of “good” HDL cholesterol.

Improved neurological conditions

Back in 2008, a meta-analysis of 19 studies covering 1,084 children with epilepsy found that a ketogenic diet reduced seizures by at least 50% in more than half of the children [8].

Besides, research shows the diet can be helpful in treating various neurological diseases, including Alzheimer’s, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS).

The Function of Ketosis

As we’ve seen, the ketogenic diet is linked to a lot of benefits. But why does your body release ketones when you limit your carb intake? Let us explain.

Under regular circumstances, your body uses mainly glucose (carbs) and fatty acids (fat) for energy. However, if you consume fewer than 30-50 grams of carbs a day (as you do on a ketogenic diet), your body doesn’t have access to much glucose.

The thing is, while most of your bodily tissues can use fat for fuel, your brain cannot [1]. Therefore, your gray cells need an alternative energy source when carbs are scarce. And that’s where ketones come in.

Ketones are an energy source that function like fatty acids in your body. The main difference between the two, however, is that ketones don’t need to be transported through your blood. Instead, they’re diffused across cell membranes, which enables them to be used for fuel by your brain. For this reason, ketones can be used by your brain.

But not only are ketones used by your brain. Every tissue in your body except your liver can use ketones for energy. In fact, research published in Physiological Reviews suggests that ketones are the preferred fuel source for most tissues [16].

What Influences Ketone Production?

As we’ve seen, the primary function of ketones is supplying your brain with energy when carbs are scarce. In addition, most tissues can also – and often prefer to – use ketones for fuel. But which factors influence ketone production?

Well, there are a lot of factors at play. And to optimize your results on the ketogenic diet, it is important to be aware of those, so you can tweak them to aid your fitness and health goals.

By far the most important one is your carb intake. We’ve already discussed this before, but since this one is crucial, it bears repeating: to get into ketosis, you must keep your daily carb intake below 30-50 grams [10].

Secondly, the amount of glycogen stored in your liver plays an important role in ketosis. When you deplete liver glycogen, your blood glucose levels drop, which increases ketone production.

If you keep your daily carb intake below 30-50 grams, you’ll automatically deplete your liver glycogen stores. However, if you’re new to the ketogenic diet, or if you’ve had a high-carb refeed, you can reach a state of ketosis faster through exercise.

The best form of exercise to deplete liver glycogen is doing a weight training workout that’s based on compound exercises such as squats, lunges, and rows, done for a high amount of training volume (reps and sets), with short rest periods in between (e.g. 15-75 seconds).

While such workouts are not necessary to get into ketosis, it can be beneficial to speed up the progress.

How to Test if You’re in Ketosis

To reap the benefits of the ketogenic diet, you must be in ketosis. But how do you know if that’s the case? Well, there are various ways to tell.

The most accurate method to test if you’re in ketosis is by doing a blood test. But since this is impractical for most of us, the following options may work better.

The first method (and a very accurate one) involves using a breathalyzer – a device that measures the amount of acetone in your breath [11]. Acetone is a ketone body that gets released when you’re in ketosis.

The second option is using ketone urine strips, which measure levels of the ketone body called acetoacetate. This one is less accurate than the breathalyzer test but also cheaper.

The third way is by listening to the signals of your body. While it’s the least accurate of them all, it’s good enough for most people. Suppressed appetite, increased mental clarity, and improved energy levels are three common symptoms.

Variations of the Ketogenic Diet

Thus far, we’ve discussed the standard ketogenic diet, also known as the strict ketogenic diet. With this eating style, you keep your daily carb intake below 30-50 grams.

However, there are more ways to skin a cat, as they say. What follows are two popular variations, each with its pros and cons.

The cyclical ketogenic diet (CKD)

During the CKD, you combine the standard ketogenic diet for most of the week with times of higher carb intake. One popular approach is doing keto from Monday to Friday and going high-carb during the weekends.

The main benefit of the CKD is that it allows for more flexibility. While most people can maintain a ketogenic diet during weekdays, the weekends can make it harder to follow the regimen due to activities such as eating out, going for a drink, and having friends and family over.

In addition, the CKD allows you to replenish your muscle glycogen stores, which tend to get depleted when you follow a standard ketogenic diet continuously. This enhanced glycogen storage can boost workout performance, which is why the CKD can be an excellent option for athletes.

The downside is that the high-carb period pulls you out of ketosis. So, during the time you’re out of ketosis, you won’t enjoy the benefits it can provide.

The targeted ketogenic diet (TKD)

The TKD is the same as the standard ketogenic diet except for one tweak: you consume a small amount of carbs around your workouts. Doing so can be beneficial for athletes.

That’s because the pre-workout carbs slightly raise blood glucose levels, which can aid muscle fiber recruitment and decrease fatigue, while the post-workout carbs support muscle glycogen replenishment.

But won’t this affect ketosis? It won’t provided that you keep your carb intake low, as shown by a study published in The Journal of Physiology.

The researchers involved in it found that ketosis remained intact when a group of runners consumed 50 grams of glucose either 30 minutes before exercise or directly after a 90-minute running workout [12].

So, the TKD can be an excellent option for athletes to support performance without impairing ketosis. A good guideline is to consume between 25 and 30 grams of a fast-digesting carb 30 minutes before your workout and the same amount immediately after your training session.

High-Protein Ketogenic Diet

On a standard ketogenic diet, you get 60% to 75% (or even more) of calories from fat, 15% to 30% from protein, and 5% to 10% from carbs. While most people stick to this distribution pattern, switching to a higher protein intake will yield better results for some, particularly those who want to lose weight.

Why? Because protein is highly satiating. Consuming more of it tends to deliver an automatic drop in calorie intake and so lead to weight loss, as shown by a study published in American Journal of Clinical Nutrition [13].

The researchers found that when subjects raised their protein intake from 15% to 30% of their daily calorie count, they consumed, on average, 441 fewer calories per day. This led to an average weight loss of 11 pounds in just 12 weeks – and all they had to do was eat more protein.

Athletes can also benefit from increased protein intake. The reason is that protein aids recovery and muscle development, which allows athletes to train more often and perform better.

The downside? Higher protein intake can impair ketosis. This is because our bodies have a metabolic pathway called gluconeogenesis, which can convert amino acids (protein) to glucose (sugars).

That’s why excessive protein intake can affect ketosis, or even prevent you from reaching the state altogether. So, if you want to experience the benefits of ketosis to the fullest, following a ketogenic diet with a moderate protein intake will work better.

Negatives and Side Effects

The ketogenic diet is associated with numerous benefits. But just as every rose has its thorns, so the ketogenic diet has its flaws. And while not everyone will experience side effects after going keto, here are the three most common ones.

First off, there is the keto flu, which is a condition that can happen when you suddenly and drastically drop carbs from your diet. The three most common symptoms are fatigue, dizziness, and stomach pain.

If you experience these symptoms when switching to a ketogenic diet, you may start second-guessing whether it is right for you. Don’t worry – it’s merely your body’s reaction to carb restriction. The symptoms will usually disappear within a week because your body becomes “fat-adapted.”

Secondly, we have the keto rash – a side effect manifesting as an itchy skin condition. While the cause isn’t fully understood yet, it’s believed to originate from a rare inflammatory disease called prurigo pigmentosa.

Even though that name may sound scary, the keto rash is harmless. However, the itchiness and the red skin can be annoying. So, what can you do to get rid of it?

Well, because the cause isn’t quite clear yet, researchers aren’t sure about the best way to cure a keto rash. Fortunately, giving the body time to adapt to the ketogenic diet tends to be enough for most people to reduce the symptoms or even cure it entirely.

That said, if the symptoms haven’t faded away after a week or two of going keto, you may want to take steps to deal with them, and this article will help. [http://theketorash.com/].

Thirdly, we have the keto breath, which gives your breath a ‘fruity’ smell. In case you suffer from it, the explanation is that a ketone body called acetone gets released through your breath when you’re in ketosis.

You can usually reduce keto breath to almost non-existent or eliminate it altogether simply by being extra attentive to your oral hygiene: brushing and flossing your teeth twice per day, increasing water intake, chewing sugar-free gum, and using the ancient Ayurvedic remedy called “oil pulling.”

Common Beginner Mistakes

Everyone makes mistakes, but if you’re smart, you learn from yours. Then again, wouldn’t it be wiser to avoid them in the first place by learning from the blunders of others?

Well, to spare yourself unnecessary frustration, heed these four common mistakes so you can avoid them and do it right from the get-go.

Obsessing over the number on your scale:

Some people are shocked to see how fast their body weight can drop when they start a ketogenic diet.
And while fat loss benefits are certainly at play here, another reason many people shed a lot of weight during the first few weeks of going keto is water loss.

When you cut most carbs out of your diet, your blood sugar and insulin levels go down. This, in turn, decreases sodium retention and water re-absorption in your kidneys [14-15].

The result? You’ll drop water weight, and the number on your scale can indicate the loss of a few pounds. Hence, some people get rid of up to ten pounds in the first few days!

There is nothing wrong with this. But the thing is, you will regain most of this lost water weight if you eat more carbs again. This often greatly frustrates people to suddenly see a spike in their body weight, causing them to believe they have regained a lot of fat.

That’s why it is crucial not to pay too much attention to the scale. Instead, if you want to improve your figure, base your progress on changes you see in the mirror. Ideally, you combine this with taking weekly progress pictures and frequently measuring your body fat levels.

Not drinking enough water:

Water makes up around 60% of our bodies. It is found in all our cells, organs, and tissues, to regulate temperature and ensure proper function.

The problem? Most people are in a constant state of dehydration, and those following a ketogenic diet are even more prone to it. The reason, as we’ve discussed earlier, is that going keto can cause your body to shed water.

Therefore, it’s even more important to consume enough fluids on a ketogenic diet. While the optimal water intake varies across circumstances and among individuals, as a general rule, you should aim to have at least five clear urinations per day. Note well: we are not talking five urinations in total but five in which your urine looks clear.

Eating the wrong kinds of fat:

Sure, the ketogenic diet is a high-fat eating style. But this does not mean all fats are created equal. Some do more harm than good, both to your health and your figure, and are therefore best avoided.
Processed fats such as vegetable and seed oil are two examples. Both can wreak havoc on your body by causing inflammation, spiking LDL (bad) cholesterol levels, and increasing the risk of cancer, cardiovascular conditions, and other awful diseases.

So, eliminate those foods from your diet and focus instead on fat sources that contain beneficial nutrients and healthy fatty acids. Examples include fish, meat, eggs, nuts, and coconut oil.

Overeating protein:

Unless you follow a high-protein diet to aid fat loss or athletic performance, protein in moderation is usually better for reaping the benefits of the ketogenic diet. Why?

Because, as mentioned before, consuming too much protein can impair ketosis. The reason is a process called gluconeogenesis, which involves your body converting amino acids to glucose. The latter raises blood sugar levels and can push you out of ketosis.

So, don’t over-consume calories on a standard ketogenic diet. Instead, get between 0.6 and 0.8 grams of protein per pound of lean body mass.

The Bottom Line on the Ketogenic Diet

Millions have already switched to a ketogenic diet, and the reasons are obvious: it’s associated with a lot of life-enhancing benefits, including improved blood sugar and insulin levels, enhanced cardiovascular health, and healthier body weight.

Even NBA star LeBron James gave this eating style a try and went on a 67-day ketogenic diet. The result? He dropped 25 pounds and improved his athletic endurance!

How about you? Are you next? Well, it is up to you, but at least you now know everything you need about starting and sticking to your own successful keto diet. Good luck!

References

1. Cahill, G. F., Jr. (1976). Starvation in man. The Journal of Clinical Endocrinology & Metabolism, 5(2), 397-415.

2. 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), 1178-87.

3. Brehm, B. J., Seeley, R. J., Daniels, S. R., & D’Alessio, D. A. (2003). A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. Journal of Endocrinology & Metabolism, 88(4), 1617-23.

4. Gibson, A. A., Seimon, R. V., Lee, C. M., Ayre, J., Franklin, J., Markovic, T. P., . . . Sainbury, A. (2015). Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obesity Reviews, 16(1), 64-76.

5. McClernon, F. J., Yancy, W. S., Jr., Eberstein, J. A., Atkins, R. C., & Westman, E. C. (2007). The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms. Obesity, 15(1), 182-7.

6. Westman, E. C., Yancy, W. S., Jr., Mavropoulos, J. C., Marquart, M., & McDuffie, J. R. (2008). The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition and Metabolism, 19, 5-36.

7. Wood, R. J., Volek, J. S., Liu, Y., Shachter, N. S., Contois, J. H., & Fernandez, M. L. (2006). Carbohydrate restriction alters lipoprotein metabolism by modifying VLDL, LDL, and HDL subfraction distribution and size in overweight men. Journal of Nutrition, 136(2), 384-9.

8. Freeman, J. M., Kossoff, E. H., & Hartman, A. L. (2007). The ketogenic diet: one decade later. Pediatrics, 119(3), 535-43.

9. Stafstrom, C. E., & Rho, J. M. (2012). The Ketogenic Diet as a Treatment Paradigm for Diverse Neurological Disorders. Frontiers in Pharmacology, 3, 59.

10.
Freeman, J. M., Kossoff, E. H., & Hartman, A. L. (2007). The ketogenic diet: one decade later. Pediatrics, 119(3), 535-43.

11. Musa-Veloso, K., Likhodii, S. S., & Cunnane, S. C. (2002). Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals. American Journal of Clinical Nutrition, 76(1), 65-70.

12. Koeslag, J. H., Levanrid, L. I., Lochner, J. D., & Silve, A. A. (1985). Post-exercise ketosis in post-prandial exercise: effect of glucose and alanine ingestion in humans.  The Journal of Physiology, 358, 395-403.

13. Weigle, D. S., Breen, P. A., Matthys, C. C., Callahan, H. S., Meeuws, K. E., Burden, V. R., & Purnell, J. Q. (2005). A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. American Journal of Clinical Nutrition, 82(1), 41-8.

14. Horita, S., Seki, G., Yamada, H., Suzuki, M., Koike, K., & Fujita, T. (2011). Insulin resistance, obesity, hypertension, and renal sodium transport. International Journal of Hypertension, 2011, 91762.

15. Tiwari, S., Riazi, S., & Ecelbarger, C. A. (2007). Insulin’s impact on renal sodium transport and blood pressure in health, obesity, and diabetes. American Journal of Physiology-Renal Physiology, 293(4), 974-84.

16. Robinson, A. M., & Williamson, D. H. (1980). Physiological roles of ketone bodies as substrates and signals in mammalian tissues. Physiological Reviews, 60(1), 143-87.

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