What is Keto?
Keto is short for 'Ketogenic', a low carbohydrate diet regime that is primarily protein and fats. Keto was bought in as a regime targeted to severely obese people, who struggled to lose weight. The primary focus of the Keto diet was to dramatically drop weight to reduce severe obesity numbers. The primary carbohydrates that were focused on being removed/reduced were sugar-laden foods. An increase in sugar-laden foods is associated with 44% of metabolic syndromes and obesity.
How does Keto Work?
A well-formulated ketogenic diet, besides limiting carbohydrates, also limits protein intake moderately to less than 1g/lb body weight, unless individuals are performing heavy exercise involving weight training when the protein intake can be increased to 1.5g/lb body weight. This is to prevent the endogenous production of glucose in the body via gluconeogenesis. However, it does not restrict fat or overall daily calories. People on a ketogenic diet initially experience rapid weight loss up to 10 lbs in 2 weeks or less. This diet has a diuretic effect, and some early weight loss is due to water weight loss followed by a fat loss. Interestingly with this diet plan, lean body muscle is largely spared. As a nutritional ketosis state sustains, hunger pangs subside, and an overall reduction in caloric intake helps to further weight loss.
Basically, carbohydrates are the primary source of energy production in body tissues. When the body is deprived of carbohydrates due to reducing intake to less than 50g per day, insulin secretion is significantly reduced and the body enters a catabolic state. Glycogen stores deplete, forcing the body to go through certain metabolic changes. Two metabolic processes come into action when there is low carbohydrate availability in body tissues: gluconeogenesis and ketogenesis.
A ketogenic diet primarily consists of high-fats, moderate-proteins, and very-low-carbohydrates. The dietary macronutrients are divided into approximately 55% to 60% fat, 30% to 35% protein and 5% to 10% carbohydrates. Specifically, in a 2000 kcal per day diet, carbohydrates amount up to 20 to 50 g per day.
Long Term studies have shown that long term compliance of the ketogenic diet is low. The Average Ketogenic diet timeframe can extend from a minimum of 4 weeks to 6-12 months. During the short term many health affects have been shown to take an impact to some individuals such as; nausea, vomiting, headache, fatigue, dizziness, insomnia, difficulty in exercise tolerance, and constipation - sometimes referred to as keto flu. These symptoms resolve in a few days to few weeks. Ensuring adequate fluid and electrolyte intake can help counter some of these symptoms. Long-term adverse effects include hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies.
The ketogenic is a great diet for severely obese individuals or individuals with pre established metabolic syndromes such as type II diabetes and insulin resistance.
The ketogenic diet is designed for obese individuals as it focuses on reducing the intake of sugar-laded foods such as processed meats, high sodium foods, high sugar contents per serve and low intake of key vegetables, nuts/seeds, omega-3,6,9 and lean meat/poultry which will then be increase from implementing the keto diet.
It is advised that the keto diet is only used in short stints as it does carry some severe short term effects and stress on the body. The keto diet can be used by the general population but it isn't advised as its important to focus on a sustainable nutrition protocol and get a diverse range of nutrients from multiple sources of food.
Roehl K, Falco-Walter J, Ouyang B, Balabanov A. Modified ketogenic diets in adults with refractory epilepsy: Efficacious improvements in seizure frequency, seizure severity, and quality of life. Epilepsy Behav. 2019 Apr;93:113-118. [PubMed]
Martin-McGill KJ, Lambert B, Whiteley VJ, Wood S, Neal EG, Simpson ZR, Schoeler NE., Ketogenic Dietitians Research Network (KDRN). Understanding the core principles of a 'modified ketogenic diet': a UK and Ireland perspective. J Hum Nutr Diet. 2019 Jun;32(3):385-390. [PubMed]
Jagadish S, Payne ET, Wong-Kisiel L, Nickels KC, Eckert S, Wirrell EC. The Ketogenic and Modified Atkins Diet Therapy for Children With Refractory Epilepsy of Genetic Etiology. Pediatr. Neurol. 2019 May;94:32-37.[PubMed]
Mohorko N, Černelič-Bizjak M, Poklar-Vatovec T, Grom G, Kenig S, Petelin A, Jenko-Pražnikar Z. Weight loss, improved physical performance, cognitive function, eating behavior, and metabolic profile in a 12-week ketogenic diet in obese adults. Nutr Res. 2019 Feb;62:64-77. [PubMed]
Ma S, Suzuki K. Keto-Adaptation and Endurance Exercise Capacity, Fatigue Recovery, and Exercise-Induced Muscle and Organ Damage Prevention: A Narrative Review. Sports (Basel). 2019 Feb 13;7(2) [PMC free article] [PubMed]
Guzel O, Uysal U, Arslan N. Efficacy and tolerability of olive oil-based ketogenic diet in children with drug-resistant epilepsy: A single center experience from Turkey. Eur. J. Paediatr. Neurol. 2019 Jan;23(1):143-151.[PubMed]
ArmenoM, Araujo C, Sotomontesano B, Caraballo RH. [Update on the adverse effects during therapy with a ketogenic diet in paediatric refractory epilepsy]. Rev Neurol. 2018 Mar 16;66(6):193-200. [PubMed]