Keto 101 - What are you REALLY Doing for Your Body on the Keto diet?
Many people are finally realizing that sugars and refined carbohydrates are more to blame for many diseases than salt or fats. But do you know exactly what "refined carbohydrates", "healthy fats", or "unhealthy fats" mean? To be successful on the Keto diet, you MUST know what your body is doing and what exactly you're trying to accomplish. Sure, it's a low-carb diet, but it's not JUST that. There's a lot more to it that go unknown, which causes many people to fail or not see the results they were looking for. So, I'm going to break it all down for you, in easy-to-understand terms.
Let's start with fats. You hear them being referred to as healthy or unhealthy fats. Which is which? How do you know what you're eating? Here's a little info about each type of fat and what it does:
Trans-fats - Popular because they're cheap to make and give food a better shelf life, texture, and taste. Most commonly found in vegetable oil, (soybean, corn, safflower, canola, cottonseed, and peanut oil). However, they produce a large amount of visceral fat deposits, increased risk of heart disease, can lead to Endothelial dysfunction (preceding atherosclerosis), systemic inflammation, increased insulin resistance (leading to diabetes), activates the TNF system (tumor necrosis factor). These are BAD. AVOID!
Saturated fats - Medium-chain fatty acids (found in coconut oil, palm kernel oil, butter, cheese, milk), short-chain fatty acids (come from bacteria in our digestive system, up-regulated by consuming foods high in fiber, such as fruit, veggies, and legumes. Also found in butter.) Long-chain fatty acids (found in lard, dairy, beef, bacon, eggs, and any other animal-derived foods.) When consumed in place of carbs keeps triglycerides down. But when these are replaced with unsaturated fats, it lowers LDL, raises HDL, and lowers triglycerides (better than trans-fats).
Unsaturated fats (mono and poly) - Easily moved into cells and burned for energy. Not too bad.
Polyunsaturated fats - Omega-3's and Omega-6's, found in fish, meat, dairy, nuts. These are essential nutrients. Your body cannot synthesize (fake) these, so they need to be eaten. This fat incorporates into nerve coverings and cell membranes. This is critical for muscle movement, blood clotting, and a healthy inflammation response. These are good! (see below regarding omega-6 consumption.)
Monounsaturated fats - Omega-9's, found in olive oil, avocados, safflower oil, canola oil, macadamia oil, and many other nuts and oils. These activate dopamine, strengthen bones, and increase insulin sensitivity. These are good! Eat them!
That being said, replacing saturated fats with poly's and mono's will have plenty of positive effects, such as lowered cholesterol, lower LDL cholesterol, increased HDL cholesterol, decreased triglycerides, and increased insulin sensitivity. This means, if you have high cholesterol or diabetes, this is what you want to do! Simply change the types of fats you're consuming.
Now, let's talk about the omegas... These are becoming widely popular and told they're a great thing and you NEED them, blah, blah, blah. That's true, to a certain extent. However, there is a LIMIT! Too many can actually be a bad thing! Here's what happens:
Too much Omega-6 can actually have serious side effects, such as increased inflammation, arthritis, heart disease, decreased insulin sensitivity, and fat accumulation, Alzheimer's, and many types of cancers. Our body can synthesize Omega-9, so it's not essential. Also, if you're like most people, you eat plenty of eggs, meat, dairy, and vegetable oils (Omega-6's) already, so try replacing the Omega-6's with Omega-3's, since our bodies cannot synthesize those. You could even replace them with more Omega-9's. Just remember, too much Omega-6 can be bad! Here's a chart showing the Omega 3/6/9 and saturated fat ratios of common oils, to help guide you:
So, as you can see, if you are already consuming enough Omega-6 through meat, dairy, eggs, and oils, then you do not need to be consuming sunflower oil, corn oil, soybean oil, peanut oil, or cottonseed oil. Instead try coconut oil, butterfat, palm oil, olive oil, or even flaxseed oil, which are higher in Omega-3's and 9's. On another note, you should also try to avoid eating meat or eggs from animals that have been fed these oils, especially corn and soybean oils, which are in most industrial animal feed. Here are the results of a 2015 study involving grass-fed, free-range, and pastured animals compared to standard industrial animals:
Curious about your nuts? (I know, that came out wrong.) Here's another chart that shows what's in the different nuts you consume. Keep in mind, you want to keep the Omega-6's low... which means most nuts (in high quantities) are NOT as good for you as you think!
Keeping that in mind, here's a brief summary of what we just discussed...
Omega-3's and 9's = GOOD
Trans-fats and Omega-6 = BAD
Saturated fats = OKAY/GOOD
Unsaturated fats = GOOD
Grass-fed meat, dairy, and eggs = GOOD
Standard industrial animal products = BAD
Monounsaturated fats = GOOD
So there's that. Now that we've covered the good and bad fats, let's get to the science behind the keto diet and how it works.
Ketogenesis means "generating ketones". which your body does naturally to generate energy from fat when carb sources are very low, such as after intense exercise and long periods of fasting. The ketogenic diet is a way of putting your body into a mock starvation-like state, producing and burning a large amount of ketones, by consuming 20-50 g net carbs per day. Besides counting net carbs (carbs minus dietary fiber minus erythritol), you must also consume healthy fats, protein, lower or avoid sugar, and maintain a healthy caloric intake. Your net carb/fat/protein ratio should looks similar to 7%/70%/23% (varies from person to person), with a notably low carb intake and higher "good" fats consumption.
On a "regular" diet, more than 100 g carbs per day, before sending excess energy to fat cells, your liver and muscles store carbs, which get reduced to glucose molecules. Insulin helps the glucose from the blood stream get into cells, where it is then used to generate energy.
Normally, your brain runs on 100 g of glucose per day. When your liver can't pump enough glucose for this, it starts producing ketones. It takes about three weeks to get up to 70% of your brain's energy from ketone bodies. During those three weeks, all other tissues in the body use a decreasing amount of ketones for energy, eventually using mainly fat from fat cells. After that time, your body is only producing a small amount of ketones, less than 280 calories worth, to keep your brain happy.
When there's not enough glucose to generate energy (like on the ketogenic diet), then it is generated mostly from oxidizing fatty acids. This produces a good amount of ATP (cell's main energy source) on its own, and the buildup of Acetyl-CoA (acetyl coenzyme A) in liver cells induces ketogenesis. Acetyl-CoA is a molecule involved with protein, carbohydrate, and lipid metabolism. Its main function is to deliver the acetyl group to the citric acid cycle to be oxidized for energy production. If the concentration is high enough in the blood, some of the molecules can be excreted in breath, sweat, and urine (causing that fruity keto smell).
You lose weight on the keto diet the same as you do on any other diet, because more fat is coming out of fat cells than is going into them. However, it's more complex than counting calories. 100 calories of spinach is different than 100 calories of chocolate cake. Reason you lose weight on the keto diet better than most other diets is because: 1. Hunger is decreased tremendously, forcing more fat to come out of storage and be used as energy. 2. With lower insulin levels, fat is pulled from fat cells more readily and the body gets used to burning fat (consumed and stored) for energy.
Not only that, but because you no longer have spiking blood-sugar levels, you wean off the dopamine addiction, raise HDL, lower LDL, and lower triglycerides (especially if you're obese).
If you're still with me up to this point, let's go over some of the benefits of the ketogenic diet. You may be surprised by some of these!
Brain - increased memory, cognition, clarity, seizure control, fewer migraines
Fights some types of cancers
Prevents heart disease - lower blood pressure, lower triglycerides, better cholesterol
Decreased inflammation - improves acne, arthritis, eczema, psoriasis, IBS, pain, etc.
Improves energy and sleep
Helps uric acid levels - helps kidney function, prevents gout
Gastrointestinal & gallbladder health - less heartburn and acid reflux, lowers risk of gallstones, improves digestion, less gas and bloating
Women's health - increases fertility, stabilizes hormones
Eyes - more stable vision, less risk of cataracts
Gain muscle and improve endurance
Curb diabetes, obesity, and metabolic syndrome
Spare muscle loss
Battles a variety of neurological and metabolic diseases (see chart below)
Studies are still being done to determine whether a ketogenic diet may improve or even treat other diseases, such as Multiple Sclerosis.
What should you eat on the keto diet?
1. Seafood and shellfish - While most do not contain any carbs at all, some do, so you will need to account for those. Salmon, most fish, shrimp, and most crab have no carbs. However, a 100-gram serving of clams has 5g net carb, mussels have 7g, octopus has 4g, oysters have 4g, and squid has 3g. Salmon, mackerel, sardines, and other fatty fish are high in omega-3's.
2. Low-carb vegetables - You want non-starchy veggies. Most range from 1-8g net carbs per cup.
3. Cheese - Low carbs and high good fats make them perfect for keto!
4. Avocados - 2g net carbs per 100g, provides many essential nutrients, and improves cholesterol and heart health.
5. Meat & Poultry - Basically, no carbs, plenty of protein, and full of nutrients. Choose grass-fed if possible!
6. Eggs - Low carb, source of protein, increases "fullness", stables blood sugar levels.
7. Coconut oil - Contains MCTs (converted by the liver into ketones and used for energy), increase ketone levels, helps sustain ketosis, increase metabolic rate, and lose belly fat.
8. Plain Greek yogurt and Cottage cheese - High-protein, 5g carbs, decrease appetite and promote "fullness".
9. Olive oil - Good for your heart, no carbs.
10. Nuts & Seeds - High-fat, high-fiber, low-carb. See nuts chart above for nutritional info. Remember, total carbs minus dietary fiber = net carbs. Also, keep in mind the omega-6 content.
11. Berries - Low-carb, high-fiber. Loaded with antioxidants, reduce inflammation, protect from disease. Most are 5-12g net carbs per 100-gram serving, so eat them in moderation.
12. Butter & Cream - Good fats, <1g net carb, promote fat loss.
13. Shirataki noodles - <1 g net carb, mainly water, made from fiber, decrease hunger and blood sugar spikes, aids in weight loss and diabetes management. Honestly, these have a "special" taste you have to get used to, but if you're creative, I'm sure you can cover up the flavor of the noodles. Make sure to rinse them!
14. Olives - Same benefits of olive oil, but in solid form.
15. Unsweetened coffee and tea - Carb-free, caffeine, boost metabolism, alertness, and mood, reduce risk of diabetes. Add butter and coconut oil or MCT oil/powder for a bulletproof coffee, or heavy whipping cream in place of creamer. Avoid lattes and flavored sweetened creamers, as they are full of sugar and carbs.
16. Dark chocolate & Cocoa powder - This is my personal favorite! Delicious sources of antioxidants, reduces risk of heart disease, lowers blood pressure, keeps arteries healthy. Choose 70% or higher dark chocolate. Dark chocolate contains 3-10g net carbs per ounce.
How do you get into ketosis?
Minimize your net carb consumption, approximately 20-50 grams per day. This range varies per person. Limiting your carbs lowers blood sugar and insulin levels, leading to the release of stored fatty acids that your liver converts into ketones.
Include coconut oil and MCTs in your diet. MCTs are rapidly absorbs and taken to the liver, where they're used immediately for energy or converted into ketones. Coconut oil contains MCTs and lauric acid (which you need), which may sustain ketosis. In fact, MCTs have been used to induce ketosis in epileptics without reducing carbs as drastically as the keto diet.
Increase physical activity. When you exercise, you deplete your body of its glycogen stores. These are replenished when you ear carbs, however, if carbs are restricted, glycogen remains low, forcing the liver to increase its production of ketones, which can be used as a fuel source for your muscles. Exercising before a meal rather than after a meal increases ketone levels. Remember though, it may take about three weeks for your body to adapt to using ketones and fatty acids as primary fuels. During that transformation, physical activity may be reduced. ("keto flu").
Increase healthy fat consumption. This can boost your ketone levels and help you reach ketosis. 60-80% of your calories should be from fat. The ketogenic diet for epilepsy is even higher, at 85-90% of calories from fat. Keep in mind, extremely high fat intake does NOT necessarily mean higher ketone levels. Remember, because fat makes up most of your caloric percentage, choose high-quality, healthy fats like avocados, olive oil, butter, lard, coconut oil, and tallow. Also, make sure if you're following the keto diet for weight loss, pay attention to calories. Consuming too many calories can stall your weight loss, or even worse, cause weight gain!
Maintain adequate protein intake. This should be "adequate", not excessive. For epilepsy and cancer patients, restricting both carbs AND protein was shown to maximize ketone levels, however, for most people, it's not healthy to restrict protein. It is important to consume enough protein to provide the liver with amino acids that can be used for gluconeogenesis (making new glucose). This is important to provide glucose to the few cells and organs in your body that can't use ketones as fuel, such as red blood cells and portions of the kidneys and brain. It also helps preserve muscle mass during weight loss. To calculate your protein needs on the keto diet, multiply your ideal body weight in pounds by 0.55 to 0.77. So if your ideal weight is 130 lbs, your protein intake should be 71-100 grams per day. To summarize, too little protein can lead to muscle mass loss, while too much protein can suppress ketone production.
How do you know you're in ketosis?
Ketosis is when your liver starts producing high numbers of ketones to supply energy for your brain. You will know you're in ketosis when:
"Fruity smell" on breath, sweat, and urine. This is caused by acetone, a ketone. Brush your teeth!
Weight loss. Fast weight loss can occur the first week. This is primarily stored carbs and water being used up. After the initial drop, you should continue to lose body fat consistently as long as you're persistent.
Increased ketones in blood. Along with a reduction in blood sugar levels, you will see an increase in ketone levels, a classic sign of ketosis. This measures BHB in your blood with a specialized device. It is the most accurate way of testing, used mostly for research studies. Test kits can be expensive though. So if you're not looking to spend a lot of money on this, you can try to watch for the other signs of ketosis instead.
Increased ketones in urine or breath. An alternative to the blood test, this measures acetone rather than BHB. This method is slightly less accurate than the blood test. These tests include a breath analyzer or urine test strips. They are cheaper and don't involve blood.
Appetite suppression. Decreased hunger can be a sign you're in ketosis.
Increased focus and energy. During the initial "keto flu" (that 3-week period I talked about earlier), you may actually experience brain fog, tiredness, and feeling sick. However, these side effects are only your body adjusting to the changes. After a few weeks, you will start to notice increased focus and energy, mental clarity, and improved brain function.
Keto flu. This is a brief period after starting the keto diet, where your body is adjusting to the changes. You may experience short-term fatigue, tiredness, digestive issues like constipation and diarrhea, and insomnia. These common symptoms go away after a few weeks, once your body has become used to using ketones as fuel instead of carbs.
Is the Keto diet safe?
To some people, no. Many people think it is dangerous. Ketosis is a natural metabolic state, not to be confused with ketoacidosis, which is caused by uncontrolled diabetes. Many studies have shown to have major benefits for weight loss, as well as diabetes, epilepsy, and several other conditions. Ketogenic diet is considered SAFE for most people, although it may have a few side effects in the beginning that many people dislike. When following the keto diet, it's extremely important to remember to drink lots and lots and lots of water. Seriously, about a gallon a day! Also, make sure you're getting enough vitamins and nutrients like potassium, magnesium, and iron. If you don't think you're getting enough, take a supplement to prevent issues like leg cramps. With its many, many awesome benefits, it is not for everyone. With that being said, yes and no. It is safe for most, but not for all. You should always talk with your doctor before making any major lifestyle changes.
Amanda T.
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