The ketogenic diet is the latest fad and certainly a trending internet topic. It’s been touted as a panacea for just about every chronic disease. The medical community is certainly divided on the short- and long- term impacts and safety of the ketogenic diet. It defies common sense to dump loads of fat (particularly animal-based) into the body when the health message for decades was the opposite. I thought I would throw my hat in the ring and detail all the glories and concerns of going “keto”.
The ketogenic diet is not new. It was designed by a physician in the 1920’s as a therapeutic diet for epileptic patients. Believe it or not, the macronutrient ratio has changed little from then till now. It acquired a bad name in the previous decades because of the unintentional mishaps that came from inept monitoring and supplementation; largely ketoacidosis, constipation, vomiting, coma, death, and hyperlipidemia.
It started increasing in popularity in the last 20 years, mostly related to the attention brought by various “success” stories, such as Mary Newport, Dave Asprey, Charlie Abraham, etc.. Celebrities, athletes, doctors, and wellness clinicians are screaming the praises of this diet as it is associated with improving cardiovascular disease, diabetes, obesity, neurodegenerative diseases, metabolic syndrome, cancer, seizures, mitochondrial reparation, and cognitive decline.
What’s my verdict on the ketogenic diet? Like everything else- it depends. Your genetics, organ health, lifestyle, nutrient status, stress levels, sleep patterns, intentions, and diligence with the diet all play a role in the success, effectiveness, and safety of the ketogenic diet. Part One of this ketogenic series will detail what it is, the benefits, and who should steer clear.
Let’s start with…
What Exactly Is a Ketogenic Diet?
In general, the ketogenic diet alters the macronutrient consumption ratio to a high percentage of fat with a low percentage of carbohydrates and protein. The cells in the body are forced to utilize fat as the main fuel source since you’re providing little glucose (carbohydrates). The metabolic end-result? Ketones. It was thought at one time that glucose was the preferred form of fuel for most cells (and many would argue it still is), including the brain. Research is now showing that ketones are not only an acceptable fuel, but may be preferred, given it lightens the mitochondrial load and does not require insulin for metabolism (1). In essence, it might be more efficient in producing and harvesting energy than glucose (2).
There is no exact way to do the diet and the method of macronutrient distribution differs with different practitioners. I’ve seen clinicians emphasize a carbohydrate intake less than 60 gm per day, with less focus on protein. Others focus on specific percentages- for example, a typical distribution would entail 65% fat, 25% protein, and 10% carbohydrates.
This is a key point- depending on what you’re trying to do, depends greatly on what ratio you choose. Which leads me to...
Why are you doing this and what are you trying to accomplish?
From my point of view, this splits you into two categories:
A) Those using it as a therapeutic diet for more serious conditions such as cancer, seizures, autism, traumatic brain injury, neurodegenerative disorders, brittle diabetics, etc.. In order for effective treatment, these individuals must strictly adhere to the diet with the ratio breakdown being extreme. The ratio is more stringent and resembles approximately 90% fat, 7% protein, and 3% carbohydrate. The goals are vastly different than casual weight loss and requires close monitoring from a clinician, as more things can definitely “go wrong”. In these cases, diet diligence, supplementation, and hypervigilance are incredibly important.
B) Weight loss and less severe conditions (i.e. pre-diabetes, obesity, GI disorders, skin conditions, etc.) loosens the rope on macronutrient guidelines. The ratio breakdown is roughly: 60-70% fat, 15-25% protein, 10-15% carbohydrate. Although less severe than the therapeutic counterpart, things can and do go wrong when attempting this diet.
Since the majority of people are falling into category B, the rest of this blog will focus on the different aspects and concerns of a modified ketogenic diet. I strongly recommend a clinicians’ help, if you are in category A, where the ratio of macronutrients is extreme and the likelihood of metabolic amiss is high.
What Are the Benefits of Going “Keto”?
The list is long, but here’s why the ketogenic diet is quickly gaining favor. I want to note that these possible benefits only happen with diet adherence. If you’re constantly wavering in and out of ketosis, you’re just dumping a bunch of fat calories on top of carbohydrate/protein calories. Wavering ketosis will not induce desirable, metabolic shifts. In other words, you have to get to where you want to go first with diet diligence. Potential benefits include:
When The Ketogenic Diet Will Likely Not Vibe With Your Body
If the benefits are so great, why isn’t everyone on the ketogenic diet? First, it’s challenging to properly adhere to the ketogenic diet. I’ve also heard countless times certain people just don’t “feel good” on the diet (which could be due to poor execution). Individuals who should NOT attempt the ketogenic diet, or at minimum, be closely monitored by a clinician:
Are you horrified or convinced the ketogenic diet is for you? With every great idea there is risk; so stay tuned for Part Two, where I will discuss my concerns and the process of getting into a modified ketotic state.
Shannon is a registered dietitian and functional nutritionist with a penchant for provocative topics, almond butter, and local theater.