Keto Diet: Weight Loss, Risks, Benefits, Food to Eat & Avoid

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Keto Diet: ketogenic diet involves consuming a very low amount of carbohydrates and replacing them with fat to help your body burn fat for energy. Health benefits can include weight loss and lowering your risk for certain diseases.

The ketogenic diet (or keto diet, for short) is a low carb, high fat diet that offers many health benefits.

In fact, many studies show that this type of diet can help you lose weight and improve your health.

Ketogenic diets may even have benefits against diabetes, cancer, epilepsy, and Alzheimer’s disease.

Here is a detailed beginner’s guide to the keto diet.

What is Ketosis?

Ketosis is a metabolic state in which your body uses fat for fuel instead of carbs.

It occurs when you significantly reduce your consumption of carbohydrates, limiting your body’s supply of glucose (sugar), which is the main source of energy for the cells.

Following a ketogenic diet is the most effective way to enter ketosis. Generally, this involves limiting carb consumption to around 20 to 50 grams per day and filling up on fats, such as meat, fish, eggs, nuts, and healthy oils.

It’s also important to moderate your protein consumption. This is because protein can be converted into glucose if consumed in high amounts, which may slow your transition into ketosis.

Practicing intermittent fasting could also help you enter ketosis faster. There are many different forms of intermittent fasting, but the most common method involves limiting food intake to around 8 hours per day and fasting for the remaining 16 hours..

Blood, urine, and breath tests are available, which can help determine whether you’ve entered ketosis by measuring the amount of ketones produced by your body.

Certain symptoms may also indicate that you’ve entered ketosis, including increased thirst, dry mouth, frequent urination, and decreased hunger or appetite.

What is a Ketogenic Diet?

✔️ The ketogenic diet is a high-fat diet that drastically restricts carbohydrates. It produces a reaction in the body that is similar to the fasting state.

✔️ The low-carb, high-fat keto diet causes the metabolic state known as ketosis, in which substances known as ketones or ketone bodies accumulate in the blood. These are the same substances that accumulate during ketoacidosis in people with type 1 diabetes.

✔️ A ketogenic diet has been shown to be effective in treating seizure disorders that have not responded to two different anti-seizure medications. While this treatment is most often used in children, some adults with seizure disorders may also be helped by a ketogenic diet.

✔️ A ketogenic diet is typically not recommended for weight control because it is not superior to other more standard weight management plans and may be associated with health risks, including nutritional deficiencies.

✔️ Ketogenic diets have been the subject of research to determine if they have value in managing other conditions including cancer and diabetes, but there is currently no recommendation for this practice.

What are different types of the ketogenic diet?

Since ketosis can be achieved in various ways, there are several types of the ketogenic diet:

✔️ Standard ketogenic diet: This is the most popular version of the ketogenic diet and one with the most research. A standard ketogenic diet incorporates very low carbs (about 5%-10% of total calorie intake), moderate protein (about 20% of total calorie intake) and high fats (about 70%-75% of total calorie intake). This is the most recommended version for people seeking weight loss and blood sugar control.

✔️ Targeted ketogenic diet: This type of ketogenic diet is mainly recommended for athletes to enhance their performance. In a targeted ketogenic diet, additional carbs are allowed around periods of extensive physical activity such as 30-45 minutes before an athletic event. Carbs should be easy to digest so that once the athletic event is finished, ketosis can be achieved with the conventional ketogenic dietary pattern.

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✔️ Cyclical ketogenic diet: Adhering to a ketogenic diet can be difficult. The cyclical pattern of a ketogenic diet makes it easier to follow. As the name suggests, cyclical ketogenic diet, also called keto-cycling, involves ketogenic diet cycles interspersed with periods of higher carb intake. For example, the person may follow a ketogenic diet for five days of the week, and for the next two days, they can consume a higher amount of carbs. This version is best suited for people who find it too difficult to stick to the ketogenic diet.

✔️ High-protein ketogenic diet: This version of a ketogenic diet is mainly suited to people with high protein requirements such as bodybuilders. It incorporates about 30%-35% protein, 60%-65% fats and 5% carbs.

What are the health benefits and risks of the ketogenic diet?

The ketogenic diet has been shown in controlled studies to be effective in children and adults who have failed two lines of standard anti-seizure medication. However, it is not safe for use in people with certain genetic conditions that affect the metabolism of fatty acids. Nutritional deficiencies are a risk for any severely restricted diet, and in 2008 there was a report of two cases of sudden cardiac arrest in children who had been on the ketogenic diet for three years. Impairments in cardiac function may be due to deficiency in the mineral selenium from following the diet. Support from a dietitian or nutritionist may be required to help ensure that these and other potential nutrient deficiencies are addressed.

As a weight-loss measure, while there is some evidence to suggest that a ketogenic diet can be effective for weight control, there are also definitive health risks and complications associated with this low-carb, high-fat type of diet.

Some of the positive effects of the diet that have been described in addition to weight loss include:

  • Decreased food cravings due to the high-fat content decrease in the levels of hormones that stimulate appetite
  • Fat loss and an increase in calories burned

In some people, short-term following of a ketogenic diet has shown improvements in:

  • Blood pressure
  • Cholesterol levels
  • Blood sugar, but these effects are similar to those seen with conventional weight loss programs

Overall, the health benefits of a ketogenic diet include:

  • Improved metabolism
  • Better hunger control
  • Improved muscle mass
  • Increased weight loss
  • Better blood sugar control 
  • Improved blood pressure
  • Reduced risk of cardiovascular diseases (due to improvements in various parameters including blood cholesterol, inflammatory markers and blood pressure)
  • Lowered insulin resistance
  • Better control of seizures in some cases

Furthermore, the extreme carbohydrate restriction of the keto diet may cause symptoms including:

  • Hunger
  • Depressed mood
  • Constipation
  • Dizziness
  • Headache
  • Irritability

It has also been proposed that the long-term side effects of this keto diet may include:

  • Osteoporosis
  • Increased risk for kidney stones
  • Gout
  • Increased low-density lipoprotein (bad) cholesterol
  • Risk of hypoglycemia (low blood sugar levels) in people on antidiabetic medications
  • Poor gut health
  • Worsening of chronic kidney disease
  • Mineral and vitamin deficiencies
  • Binge eating

Currently, it remains unknown if the potential benefits of the keto diet for weight loss outweigh the health risks. It is recommended to eat whole foods, such as non-starchy vegetables, while on a keto diet to obtain adequate vitamins, minerals, and other antioxidants. Avoid eating processed foods to reduce any health risks. If you have certain health conditions such as eating disorders, pancreatic or liver disease, or chronic kidney disease, it is better to consult your doctor before you begin with a keto diet.

What are foods to avoid with the ketogenic diet?

Since the keto diet is a low-carb diet plan, foods to avoid with the ketogenic diet include all carbohydrate sources, including both refined and unrefined products. Not only sugars but also whole-grain carbohydrates are not allowed. Foods to avoid include:

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■  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: low fat mayonnaise, salad dressings, and condiments

■  Some condiments or sauces: barbecue sauce, honey mustard, teriyaki sauce, ketchup, etc.

■  Unhealthy fats: processed vegetable oils, mayonnaise, etc.

■  Alcohol: beer, wine, liquor, mixed drinks

■  Sugar-free diet foods: sugar-free candies, syrups, puddings, sweeteners, desserts, etc.

Foods to Eat

You should base the majority of your meals around these foods:

■  Meat: red meat, steak, ham, sausage, bacon, chicken, and turkey

■  Fatty fish: salmon, trout, tuna, and mackerel

■  Eggs: pastured or omega-3 whole eggs

■  Butter and cream: grass-fed butter and heavy cream

■  Cheese: unprocessed cheeses like cheddar, goat, cream, blue, or mozzarella

■  Nuts and seeds: almonds, walnuts, flaxseeds, pumpkin seeds, chia seeds, etc.

■  Healthy oils: extra virgin olive oil, and avocado oil

■  Avocados: whole avocados or freshly made guacamole

■  Low carb veggies: green veggies, tomatoes, onions, peppers, etc.

■  Condiments: salt, pepper, herbs, and spices

It’s best to base your diet mostly on whole, single-ingredient foods. Here’s a list of 44 healthy low carb foods.

A Sample Keto Meal Plan for 1 week

To help get you started, here’s a sample ketogenic diet meal plan for one week:

Monday

✔️ Breakfast: veggie and egg muffins with tomatoes

✔️ Lunch: chicken salad with olive oil, feta cheese, olives, and a side salad

✔️ Dinner: salmon with asparagus cooked in butter

Tuesday

✔️ Breakfast: egg, tomato, basil, and spinach omelet

✔️ Lunch: almond milk, peanut butter, spinach, cocoa powder, and stevia milkshake (more keto smoothies here) with a side of sliced strawberries

✔️ Dinner: cheese-shell tacos with salsa

Wednesday

✔️ Breakfast: nut milk chia pudding topped with coconut and blackberries

✔️ Lunch: avocado shrimp salad

✔️ Dinner: pork chops with Parmesan cheese, broccoli, and salad

Thursday

✔️ Breakfast: omelet with avocado, salsa, peppers, onion, and spices

✔️Lunch: a handful of nuts and celery sticks with guacamole and salsa

✔️ Dinner: chicken stuffed with pesto and cream cheese, and a side of grilled zucchini

Friday

✔️ Breakfast: sugar-free Greek, whole milk yogurt with peanut butter, cocoa powder, and berries

✔️ Lunch: ground beef lettuce wrap tacos with sliced bell peppers

✔️ Dinner: loaded cauliflower and mixed veggies

Saturday

✔️ Breakfast: cream cheese pancakes with blueberries and a side of grilled mushrooms

✔️ Lunch: Zucchini and beet “noodle” salad

✔️ Dinner: white fish cooked in olive oil with kale and toasted pine nuts

Sunday

✔️ Breakfast: fried eggs with and mushrooms

✔️ Lunch: low carb sesame chicken and broccoli

✔️ Dinner: spaghetti squash Bolognese

Always try to rotate the vegetables and meat over the long term, as each type provides different nutrients and health benefits.

Should people take supplements while on the ketogenic diet?

The keto diet is a restrictive dietary pattern that involves avoiding various groups of nutritious foods including fruits, whole grains, and legumes. Since nutritional deficiencies are a risk factor with any ketogenic diet plan, it is important to work with a health care provider, including a nutritionist or dietitian, to ensure that all nutritional requirements are met. In some cases, this may involve taking vitamin or mineral supplements.

Some of the nutritional supplements that may be needed while on a keto diet include:

  • Fiber
  • Calcium
  • Magnesium
  • Selenium
  • Potassium
  •  Sodium
  • Vitamins B, C, and K
  • Folate
  • Omega-3 fatty acids

Who is a good candidate for the ketogenic diet?

The ketogenic diet is a recognized medical treatment for children and some adults with seizure disorders that have not responded to two different anti-seizure medications. Specific seizure disorders with multiple reports in the medical literature of benefits from the ketogenic diet include the following:

  • Infantile spasms
  • Rett syndrome
  • Tuberous sclerosis complex
  • Epilepsy with myoclonic-atonic seizures (Doose syndrome)
  • GLUT1 deficiency
  • Severe myoclonic epilepsy of infancy (Dravet syndrome)
  • Pyruvate dehydrogenase (PDH) deficiency
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For people with certain other seizure disorders, the diet has also been suggested to be of benefit.

As a weight-loss tool, there is not adequate evidence to suggest that this diet is superior to other weight-control plans and may be associated with long-term risks or nutritional deficiencies.

Risks of the Keto Diet

Staying on the keto diet in the long term may have some negative effectsTrusted Source, including risks of the following:

  • Low protein in the blood
  • Extra fat in the liver
  • Kidney stones
  • Micronutrient deficiencies

A type of medication called sodium-glucose cotransporter 2 (SGLT2) inhibitors for type 2 diabetes can increase the risk for diabetic ketoacidosis, a dangerous condition that increases blood acidity. Anyone taking this medication should avoid the keto diet.

More research is being done to determine the safety of the keto diet in the long term. Keep your doctor informed of your eating plan to guide your choices.

Frequently Asked Questions

Here are answers to some of the most common questions about the ketogenic diet.

1. Can I ever eat carbs again?

Yes. However, it’s important to significantly reduce your carb intake initially. After the first 2 to 3 months, you can eat carbs on special occasions — just return to the diet immediately after.

2. Will I lose muscle?

There’s a risk of losing some muscle on any diet. However, protein intake and high ketone levels may help minimize muscle loss, especially if you lift weights.

3. Can I build muscle on a ketogenic diet?

Yes, but it may not work as well as on a moderate carb diet. For more details about low carb or keto diets and exercise performance, read this article.

4. How much protein can I eat?

Protein should be moderate, as a very high intake can spike insulin levels and lower ketones. Around 35% of total calorie intake is probably the upper limit.

5. What if I am constantly tired, weak, or fatigued?

You may not be in full ketosis or be utilizing fats and ketones efficiently. To counter this, lower your carb intake and revisit the points above. A supplement like MCT oil or ketones may also help.

6. My urine smells fruity. Why is this?

Don’t be alarmed. This is simply due to the excretion of by-products created during ketosis.

7. My breath smells. What can I do?

This is a common side effect. Try drinking naturally flavored water or chewing sugar-free gum.

8. I heard ketosis was extremely dangerous. Is this true?

People often confuse ketosis with ketoacidosis. Ketoacidosis is dangerous, but the ketosis on a ketogenic diet is usually fine for healthy people. Speak to your doctor before starting any new diet.

9. I have digestion issues and diarrhea. What can I do?

This common side effect usually passes after 3 to 4 weeks. If it persists, try eating more high fiber veggies.

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