The ketogenic diet A detailed beginner's guide to the ketogenic diet
The ketogenic diet is a low-carb, high-fat diet that has many health benefits. In fact, over 20 studies show that this type of diet can help you lose weight and improve your health (1).
Ketogenic diets can even have benefits for diseases such as diabetes, cancer and epilepsy (2, 3, 4, 5).
Here's a detailed beginner's guide to the ketogenic diet.
What is a ketogenic diet?
The ketogenic diet is a very low-carb, high-fat way of eating that shares many similarities with the Atkins diet and low-carb diets.
It involves a drastic reduction in carbohydrate intake and the replacement of these carbohydrates with fats. This reduction in carbohydrate intake puts the body into a state called ketosis.
When this happens, your body becomes amazingly efficient at burning fat for energy. It also converts fat in the liver into ketones, which can provide the brain with energy (6,7).
Ketogenic diets can cause massive reductions in blood sugar and insulin levels. This, along with the increased number of ketones, has numerous health benefits (6, 8, 9, 10, 11).
Different types of ketogenic diets
There are several versions of ketogenic diets, which include the following:
- Standard ketogenic diet (SKD): this is a very low-carbohydrate ketogenic diet with moderate protein and high fat intake. It typically includes 75% fat, 20% protein and only 5% carbohydrates.
- Cyclical ketogenic diet (CKD or cyclical ketogenic diet): This variant includes phases of so-called refeeds with higher carbohydrate intake. A scheme of 5 ketogenic days followed by 2 high-carbohydrate days is often used.
- Targeted ketogenic diet (TKD or targeted ketogenic diet): This variation allows carbohydrates around training sessions.
- High-protein ketogenic diet (high-protein ketogenic diet): This variation is similar to the standard ketogenic diet, but includes more protein. The ratio is often 60% fat, 35% carbohydrates and 5% carbohydrates.
However, of these variations, only the Standard Ketogenic Diet and the High-Protein Ketogenic Diet have been extensively studied. Cyclical or targeted ketogenic diets are more advanced methods and are primarily used by bodybuilders and athletes.
The versions presented in this article are primarily applicable to the Standard Ketogenic Diet (SKD), although many of these principles are also applicable to the other versions.
Ketogenic diets can help you lose weight
A ketogenic diet is an effective way to lose weight and reduce risk factors for certain diseases (8, 9, 10, 11, 12, 13). In fact, research shows that the ketogenic diet is far superior to the commonly recommended low-fat diet (2, 14, 15, 16).
In addition, the ketogenic diet is so satiating that you can lose weight without having to count calories or control your food intake (16).
One study found that people on a ketogenic diet lost 2.2 times more weight than people on a calorie-restricted low-fat diet. Triglyceride levels and cholesterol levels also improved (17).
Another study found that people who followed a ketogenic diet lost three times more weight than those who followed the diet recommended by Diabetes UK (18).
There are several reasons why a ketogenic diet is superior to a low-fat diet, including the increased protein intake, which has numerous benefits (14, 19, 20).
The increased amounts of ketones, lower blood glucose levels and improved insulin sensitivity may also play a key role (21, 22, 23, 24, 25, 26).
Ketogenic diets for diabetes and prediabetes
Diabetes is characterized by metabolic changes, high blood glucose levels and impaired insulin function (27).
The ketogenic diet can help lose fat, which is closely associated with type II diabetes, prediabetes and metabolic syndrome (28, 29, 30).
One study found that the ketogenic diet could improve insulin sensitivity by an astonishing 75% (29). Another study conducted with type II diabetics found that 7 of the 21 study participants were able to discontinue all of their diabetes medications (28).
In yet another study, the ketogenic group lost 11.1 kilos, while the higher carbohydrate group lost only 6.9 kilos. This is an important advantage when considering the link between weight and type 2 diabetes (2, 31). In addition, 95.2% of members of the ketogenic group were able to reduce or discontinue their diabetes medications, while only 62% of members of the higher carbohydrate group were able to do so (2).
Other health benefits of a ketogenic diet
The ketogenic diet was originally developed as a tool to treat neurological conditions such as epilepsy. Studies have also shown that the ketogenic diet can have benefits for a wide range of conditions:
- Heart disease: the ketogenic diet can improve risk factors such as body fat, HDL cholesterol, blood pressure and blood sugar (32, 33).
- Cancer: The ketogenic diet is currently used to treat several types of cancer and slow tumor growth (4, 34, 35, 36).
- Alzheimer's disease: The ketogenic diet may reduce symptoms of Alzheimer's disease and slow the progression of the disease (5, 37, 38).
- Epilepsy: Studies have shown that the ketogenic diet causes massive reductions in seizures in epileptic children (3).
- Parkinson's: One study found that the ketogenic diet helped to reduce Parkinson's symptoms (39).
- Polycystic ovary syndrome: The ketogenic diet can help lower insulin levels, which may play a key role in this disease (40).
- Brain injuries: A study conducted with animals found that a ketogenic diet can alleviate concussions and aid recovery after brain injury (41).
- Acne: Low insulin levels and consuming less sugar or processed foods could help alleviate acne.
However, you should keep in mind that research in many of these areas is still in its infancy and inconclusive.
Foods you should avoid
Any food that is high in carbohydrates should be limited. Here is a list of foods that you should reduce or eliminate from your diet when following a ketogenic diet:
- Sugary foods: sugary soft drinks, fruit juice, smoothies, cakes, ice cream, sweets, etc.
- Cereal and starch products: Wheat-based products, rice, pasta, cereals, etc.
- Fruit: All fruit except small portions of berries such as strawberries
- Beans and pulses: peas, kidney beans, lentils, chickpeas, etc.
- Root vegetables and tubers: Potatoes, sweet potatoes, carrots, parsnips, etc.
- Low-fat or diet products: These products are often highly processed and high in carbohydrates.
- Some condiments or sauces: These often contain sugar and unhealthy fats.
- Unhealthy fats: limit your consumption of processed vegetable oils, mayonnaise, etc.
- Alcohol: Due to their carbohydrate content, many alcoholic drinks can throw you out of ketosis.
- Sugar-free diet foods: These are often high in sugar alcohols, which in some cases can affect ketone levels. These foods also tend to be highly processed.
Foods you should eat
The majority of your meals should be based on these foods:
- Meat: red meat, steak, ham, sausages, bacon, chicken and turkey.
- Fatty fish: such as salmon, trout, tuna and mackerel.
- Eggs: look for omega-3 eggs.
- Butter and cream: look for varieties from grass-fed cows if possible.
- Cheese: unprocessed cheese such as cheddar, goat cheese, mozzarella, gouda, blue, etc.
- Nuts and seeds: Almonds, walnuts, flax seeds, pumpkin seeds, chia seeds, etc.
- Healthy oils: primarily extra virgin, cold-pressed olive oil, coconut oil and avocado oil.
- Avocados: Whole avocados or freshly made guacamole.
- Low-carb vegetables: most green vegetables, tomatoes, onions, peppers, etc.
- Spices: You can use pepper, salt and different healthy herbs and spices.
A sample keto diet plan for one week
To help you get started, here is a sample ketogenic diet plan for one week:
Monday
- Breakfast: Bacon, eggs and tomatoes.
- Lunch: Chicken salad with olive oil and feta cheese.
- Dinner: Salmon with asparagus cooked in butter.
Tuesday
- Breakfast: Eggs, tomatoes, basil and goat's cheese omelette.
- Lunch: Almond milk, peanut butter, cocoa powder and stevia milkshake.
- Dinner: Meatballs, cheddar cheese and veggies.
Wednesday
- Breakfast: A ketogenic milkshake.
- Lunch: Shrimp salad with olive oil and avocado.
- Dinner: Pork chops with parmesan cheese, broccoli and salad.
Thursday
- Breakfast: Omelette with avocado, salsa, peppers, onions and spices.
- Lunch: Handful of nuts and celery sticks with guacamole and salsa.
- Dinner: Chicken stuffed with pesto and soft cheese, served with vegetables.
Friday
- Breakfast: Sugar-free yogurt with peanut butter, cocoa powder and stevia.
- Lunch: Beef stir fry with coconut oil and vegetables.
- Dinner: Burger without bun with bacon, eggs and cheese.
Saturday
- Breakfast: Ham and cheese omelette with vegetables.
- Lunch: Ham and cheese slices with nuts.
- Dinner: White fish, eggs and spinach fried in coconut oil.
Sunday
- Breakfast: Scrambled eggs with bacon and mushrooms.
- Lunch: Burger with salsa, cheese and guacamole.
- Dinner: Steak and eggs with a side salad.
Try to rotate vegetables and meats in the long run, as each type provides different nutrients and health benefits.
Healthy keto snacks
If you're hungry between meals, here are some healthy, keto-friendly snacks:
- Fatty meat or fatty fish
- Cheese
- A handful of nuts or seeds
- Cheese with olives
- 1 to 2 hard-boiled eggs
- Dark chocolate with 90% cocoa
- A low-carb milkshake with almond milk, cocoa powder, nut butter and protein powder
- Full-fat yogurt with nut butter and cocoa powder
- Strawberries with unsweetened cream
- Celery with salsa and guacamole
- Smaller portions of leftovers from previous meals
Tips for eating out during a ketogenic diet
It's not particularly difficult to make most restaurants "keto friendly" if you want or need to eat out.
Most restaurants offer meat or fish-based dishes. Order these and replace any carbohydrate-rich side dishes with additional vegetables.
Egg-based meals such as omelettes or eggs with bacon are also a good option.
Another favorite is burgers without buns. You can also swap fries for vegetables. Order extra avocado, extra cheese, extra bacon or extra egg.
For dessert, you can order a mixed cheese platter or berries with cream.
Possible side effects and how you can minimize them
Even though a ketogenic diet is healthy for healthy people, there may be some initial side effects as your body adjusts. This is often referred to as 'keto flu' and is usually over after a few days.
A "keto flu" includes lack of energy, impaired mental function, increased hunger, sleep problems, nausea, digestive discomfort and reduced exercise performance.
To minimize this, you can try following a regular low-carb diet for the first few weeks. This can teach your body to burn more fat before you completely eliminate carbohydrates.
A ketogenic diet can also alter the body's fluid and mineral balance, so adding extra salt to your meals or taking a mineral supplement can help.
In terms of minerals, you can try to take 3,000 to 4,000 mg of sodium, 1,000 mg of potassium and 300 mg of magnesium per day to minimize possible side effects.
At least in the beginning, it is important to eat until you are full and avoid restricting your calorie intake too much. A ketogenic diet usually results in weight loss even without deliberate calorie restriction.
Supplements for a ketogenic diet
Even if no supplements are needed in principle, certain ones can be useful.
- MCT oil: Added to drinks or yoghurt, MCT oil provides energy and helps to increase keto body levels.
- Minerals: Additional salt or minerals may be important in the beginning due to shifts in water and mineral balance.
- Caffeine: Caffeine may have benefits for increased energy, fat loss and performance
- Exogenous ketones: This supplement may help to increase the levels of ketones in the body.
- Creatine: Creatine provides numerous health and performance benefits. This can help when combining a ketogenic diet with exercise.
- Whey protein: Use a scoop of whey protein in your shakes or yogurt to increase your daily protein intake.
FAQ:
Here are answers to some of the most frequently asked questions about the ketogenic diet.
1. can I ever eat carbohydrates again?
Yes, but it is important to significantly reduce your carbohydrate intake initially. After the first 2 to 3 months, you can eat carbohydrates on special occasions - but be careful to switch back to a ketogenic diet immediately afterwards.
2. will I lose muscle?
With any diet there is a risk of losing some muscle mass. However, the high protein intake and high levels of ketones can help minimize muscle loss, especially when combined with weight training. If no calorie deficit is maintained and a ketogenic diet is chosen as a lifestyle, there is no risk of muscle loss.
3. can I build muscle on a ketogenic diet?
Yes, but it may not work as well as with a moderate carbohydrate intake.
4. do I need to refeed or carb load?
No, but a few higher calorie days now and then can be useful.
5. how much protein can I eat?
Protein intake should be moderate, as a very high protein intake can stimulate insulin secretion and lower ketone levels. About 35% of total calorie intake in the form of protein is probably the upper limit.
6 What if I am constantly tired, weak or fatigued?
You may not be fully in ketosis or using fat and ketones efficiently. To counteract this, you can lower your carbohydrate intake and go back to the points above. A supplement such as MCT oil or ketones could also help.
7. my urine smells fruity, why is that?
Don't worry about it. This is simply related to the excretion of by-products formed during ketosis.
8. my breath stinks. What can I do?
This is a common side effect. Try drinking naturally flavored water or chewing sugar-free gum.
9. i have heard that ketosis is very dangerous, is this true?
People often confuse ketosis with ketoacidosis. The former is natural, while the latter can only occur when diabetes is not controlled.
Ketoacidosis is dangerous, but ketosis during a ketogenic diet is completely normal and healthy.
10. i have indigestion and diarrhea, what can i do?
This is a common side effect that usually disappears after 3 or 4 weeks. Try to eat more fiber-rich vegetables. Magnesium supplements can help with constipation.
A ketogenic diet is great, but not for everyone
A ketogenic diet can be great for people who are overweight, suffer from diabetes or want to improve their health.
However, it may be less suitable for elite athletes or those looking to gain large amounts of muscle mass or weight.
And like any diet or form of nutrition, the ketogenic diet will only work if you are consistent and stick to it long-term.
Having said that, it's worth mentioning that few things are as tried, tested and proven as the powerful health and weight loss benefits of a ketogenic diet.
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Source: https://www.healthline.com/nutrition/ketogenic-diet-101