THE KETOGENIC DIET - COMPREHENSIVE

By Myndaro 10-27-2020

Every year, hundreds of new trends about nutrition and fitness come out, only to discover that they’re totally ineffective.

Most diets target one or more of the following food intake elements:

1.    Total caloric intake (e.g., caloric deficit diets)
2.    Macronutrient ratio (e.g., ketogenic diet)
3.    Timing of caloric intake (e.g., intermitting fasting (insert the link of the intermittent fasting article))

In this article, we will focus on the ketogenic diet, its benefits, and the purpose of the modified version of this diet.

Before we dig in any deeper, let’s consider the macronutrients found in our diet and their respective ratio: (1)

·      Carbohydrates (sugars)
·      Lipids (fats)
·      Protein

Generally speaking, an average human consumes these macronutrients at the following ratio: (2)

·      Carbohydrates: 50-60%
·      Lipids: 20-25%
·      Protein: 10-30%

As you can see, the vast majority of your caloric intake comes from carbohydrates. More specifically, glucose is the major source of energy used by the cells to produce adenosine triphosphate (ATP), which mediates the millions of biochemical reactions that occur every day. (3)
In the past, this ratio did not cause any damaging effects since our ancestors did not have the luxury of overeating.
Unfortunately, one of the major drivers of the obesity epidemic we see today is the excessive intake of sugar that gets transformed into glycogen and triglycerides, increasing the risk of obesity and its related complications. (4)
Additionally, the frequent intake of sugar-rich foods stimulates the secretion of insulin, leading to recurrent spikes that significantly increases the risk of type 2 diabetes. (5)

With that out of the way, let’s see what the ketogenic diet is all about and how it can improve your health.

What is the ketogenic diet?

The ketogenic diet is a low-carb eating pattern that targets the ratio of macronutrients to increase fat intake and decrease sugar in the diet. (6)
The suggested ratio of carbs during the keto diet ranges between 5% to 10% of the total caloric intake. However, some people decrease their sugar intake to significantly lower levels (1%-3%) to optimize their results.
For those who are not familiar with this diet, it may seem paradoxical that loading up with fat would help burn the adipose tissue in your belly and love handles; however, the scientific community supports the effectiveness of the keto diet, and the physiology involved is quite fascinating! (7)

Here’s how it goes:

When you deprive yourself of sugar, hepatocytes (i.e., liver cells) start utilizing triglycerides to produce energy. As this process takes place, the by-products of these metabolic pathways get released into the bloodstream, which are known as ketone bodies. (8)
If the body keeps using these metabolic pathways for some time (between 7 to 10 days), it will automatically enter a state referred to as ‘ketosis’. (9)
Consequently, your primary source of energy will be switched from glucose to the triglycerides stored in your adipose tissue, leading to substantial weight loss.

How does the keto diet cause weight loss?

The process of utilizing fatty acids to produce energy occurs all the time; however, it never reaches the scale of full-blown ketosis. (10)
Once you’ve been on the diet for some time, your cells will seamlessly consume the fatty acids stored all over your body, which leads to massive weight loss that occurs in a relatively short period of time.
Researchers also reported that the keto diet induces weight loss by stimulating the production of hunger-suppressing hormones, such as ghrelin and leptin. (11)

Additionally, consuming large amounts of fats and protein will automatically fill up your stomach, resulting in a state of unintentional caloric deficit.

Overall, the ketogenic diet works by several mechanisms that all lead to weight loss, including:

·      Water loss
·      Ketosis
·      Unintentional caloric deficit

What is the keto flu?

The keto flu refers to a collection of signs and symptoms that resemble the common cold and seasonal flu, which are typically present during the first few days after starting the keto diet.

The clinical presentation includes the following signs and symptoms: (12)

·      Fever
·      Headache
·      Chills
·      Fatigue
·      Nausea
·      Vomiting
·      Arthralgia (joint pain)
·      Myalgia (muscle pain)

According to researchers, the keto flu occurs because of the abrupt elimination of glucose from the diet, which is exacerbated by dehydration and electrolytic imbalance. (13)

Can I cheat while on the ketogenic diet?

When you’re in the ketogenic diet, the liver starts using fatty acids to produce energy, putting you in a state of ketosis.
Each time you switch from a regular diet to a low-carb diet, it takes approximately 7-10 days for the transition to occur. (14)

This means that having a cheat day will put you back at the starting line.

When should I stop this diet?

The ketogenic diet can be thought of as a way to rapidly lose weight or be adopted as a wholesome lifestyle.
For the first group of people, they often stop the keto diet and get back to their regular eating habits after achieving their goals or switch to a new eating pattern (e.g., intermitting fasting).
On the other hand, the second group believes that the keto diet offers too many health benefits to be summarized in weight loss, which motivates them to keep following this diet for years.
A classic example of famous people who swear by the keto diet is Halle Berry, who has been on this diet for more than 15 years since it helped her control her blood sugar levels after being diagnosed with diabetes. (15)
However, if you started the keto diet and you want a way to swiftly get out of ketosis, the next section will be very helpful for you.

What is the modified ketogenic diet?

One of the major concepts that’s emphasized by the ketogenic diet is lowering your carbohydrate intake to 5%-10% relative to the total calories consumed per day. (16)
However, there is a derivative diet that stemmed from the standard ketogenic diet (SKD) to help individuals get in or out of ketosis.

This is referred to as the modified ketogenic diet, or the keto 2.0.

The major difference between the SKD and keto 2.0 is the amount of consumed carbohydrate, where the first diet mandates a ratio of 5%-10%, whereas keto 2.0 is more flexible and allows people to reach up to 20%. (17)
Perhaps the most important question in this situation is whether that amount of daily carbohydrate intake is compatible with ketosis.

The potential benefits of the modified keto diet

Acts as a swift introduction to the SKD

Many people hesitate before opting for the ketogenic diet as they’re not sure about its benefits nor their ability to cut sugar altogether.
For this group of people, the modified keto diet might be the solution to introduce them to the new lifestyle in an approachable way.
After a while, if they feel like the diet has optimized their health, it could serve as a gateway towards adopting the standard keto diet.
Keto 2.0 also serves to prevent undesirable adverse effects, such as sugar deprivation and the keto flu, which can be a double-edged sword since it could simply mean that you’ve never reached ketosis. (18)

Promotes weight loss

The modified keto diet also contributes to some weight loss by helping you make healthier lifestyle choices, including being more conscious about the foods you consume and lowering your intake of the harmful sugar molecules. (19)
When combined with an organized cardio training program (e.g., HIIT), this diet could become a furnace for fatty acids and adipose tissues. (20)

Prevents metabolic disease

Similar to the SKD, the modified keto diet reduces your risk of cardiovascular disease by tempering down inflammation and preventing the oxidation of cholesterol molecules in the lumen of the coronary artery. (21)
Overall, this leads to better physical performance and lowers your risk of experiencing angina pectoris and myocardial infarction (MI). (22)

Takeaway message

Ketogenic diet can be a good approach to optimize your health and reduce your body mass index (BMI). But we are still unaware of the long-term results and side effects of this diet, primarily because it is so restrictive that it is really hard to follow in the long run. Discuss with your health care professional if this is the right choice for you.
 

References

1- Carreiro, A. L., Dhillon, J., Gordon, S., Higgins, K. A., Jacobs, A. G., McArthur, B. M., ... & Mattes, R. D. (2016). The macronutrients, appetite, and energy intake. Annual review of nutrition, 36, 73-103.
2- Cordain, L., Miller, J. B., Eaton, S. B., Mann, N., Holt, S. H., & Speth, J. D. (2000). Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets. The American journal of clinical nutrition, 71(3), 682-692.
3- Bonora, M., Patergnani, S., Rimessi, A., De Marchi, E., Suski, J. M., Bononi, A., ... & Wieckowski, M. R. (2012). ATP synthesis and storage. Purinergic signalling, 8(3), 343-357.
4- Stanhope K. L. (2016). Sugar consumption, metabolic disease and obesity: The state of the controversy. Critical reviews in clinical laboratory sciences, 53(1), 52–67. https://doi.org/10.3109/10408363.2015.1084990
5- MacDonald, I. A. (2016). A review of recent evidence relating to sugars, insulin resistance and diabetes. European journal of nutrition, 55(2), 17-23.
6- Masood, W., Annamaraju, P., & Uppaluri, K. R. (2020). Ketogenic Diet. In StatPearls [Internet]. StatPearls Publishing.
7- Paoli, A. (2014). Ketogenic diet for obesity: friend or foe?. International journal of environmental research and public health, 11(2), 2092-2107.
8- Newman, J. C., & Verdin, E. (2014). Ketone bodies as signaling metabolites. Trends in Endocrinology & Metabolism, 25(1), 42-52.
9-Boison, D. (2017). New insights into the mechanisms of the ketogenic diet. Current opinion in neurology, 30(2), 187.
10-Paoli, A., Bosco, G., Camporesi, E. M., & Mangar, D. (2015). Ketosis, ketogenic diet and food intake control: a complex relationship. Frontiers in psychology, 6, 27.
11-Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2013). Ketosis and appetite-mediating nutrients and hormones after weight loss. European journal of clinical nutrition, 67(7), 759-764.
12-Bostock, E., Kirkby, K. C., Taylor, B. V., & Hawrelak, J. A. (2020). Consumer reports of “Keto Flu” associated with the ketogenic diet. Frontiers in Nutrition, 7, 20.
13-Masood, W., Annamaraju, P., & Uppaluri, K. R. (2020). Ketogenic Diet. In StatPearls [Internet]. StatPearls Publishing.
14-Harvey, K. L., Holcomb, L. E., & Kolwicz, S. C. (2019). Ketogenic diets and exercise performance. Nutrients, 11(10), 2296.
15- https://www.womenshealthmag.com/weight-loss/a22000172/halle-berry-keto-diet/
16-Masood, W., Annamaraju, P., & Uppaluri, K. R. (2020). Ketogenic Diet. In StatPearls [Internet]. StatPearls Publishing.
17-Oh, R., & Uppaluri, K. R. (2020). Low carbohydrate diet. In StatPearls [Internet]. StatPearls Publishing.
18-Ting, R., Dugré, N., Allan, G. M., & Lindblad, A. J. (2018). Ketogenic diet for weight loss. Canadian Family Physician, 64(12), 906.
19-Gulati, S., & Misra, A. (2014). Sugar intake, obesity, and diabetes in India. Nutrients, 6(12), 5955-5974.  
20-Cipryan, L., Plews, D. J., Ferretti, A., Maffetone, P. B., & Laursen, P. B. (2018). Effects of a 4-week very low-carbohydrate diet on high-intensity interval training responses. Journal of sports science & medicine, 17(2), 259.
21-Peters, S. J., & LeBlanc, P. J. (2004). Metabolic aspects of low carbohydrate diets and exercise. Nutrition & Metabolism, 1(1), 7.
22-Dong, T., Guo, M., Zhang, P., Sun, G., & Chen, B. (2020). The effects of low-carbohydrate diets on cardiovascular risk factors: A meta-analysis. PloS one, 15(1), e0225348.

Leave a reply

To leave a comment, Please Login

Wellness Coach