A dietitian weighs in on the Ketogenic diet for weight loss

http://www.philly.com/philly/health...-ketogenic-diet-for-weight-loss-20180313.html

Things are always changing in the realm of health and wellness, but fad diets and marketed “quick fixes” for weight loss seem to be here to stay. A fairly new diet that has made national headlines lately is the ketogenic diet – a high fat, low carbohydrate diet that shifts metabolism from carbohydrates to fat.

The diet claims to result in rapid weight loss, and more importantly, fat loss. Unlike most trendy diets, this one didn’t rise to fame with celebrity promotion. It was developed in 1920 as a treatment for children with epilepsy who were not responding to multiple medications. According to the National Epilepsy Foundation, the ketogenic diet is “usually not recommended for adults, mostly because the restricted food choices make it hard to follow.”

The diet requires that 70-80 percent of your daily calories come from fat, 15-20 percent from protein, and 5 percent from carbohydrates. This is not in line with USDA dietary guidelines, which recommend that 20-35 percent of your calories come from fat, 10-35 percent from protein, and 45-65 percent from carbohydrates. Consuming high amounts of dietary fat with minimal carbohydrates forces the body into ketosis, a natural, physiological condition that occurs when there is not enough glucose (carbs) to break down for energy, causing the body to turn to fat as fuel.


These skewed nutritional needs cannot be met with the traditional American diet, nor can they be met with a healthy diet full of whole grains, fruits, vegetables, lean protein, and healthy fats. The diet excludes carbohydrates like grains, beans, and fruit (with the exception of small amounts of berries). The downside of excluding these food groups from your diet is that they are key sources of fiber, which is vital for weight loss, blood sugar control, bowel regularity, and desirable cholesterol levels. In addition, you’ll miss out excellent sources of vitamins, minerals, and antioxidants, which are crucial for optimal health.

So what can you eat on this extremely exclusionary diet? Mostly poultry, eggs, avocados, butter, non-starchy veggies, oils, nuts, and seeds. That’s not the worst line up, nutritionally speaking, but it’s not the most appetizing either. Keto dieters tend to gravitate the most towards bacon, coconut oil, and egg yolks to meet your high fat intake while keeping protein intake moderate. With these food choices though, your cholesterol levels will likely skyrocket. Therefore, this diet should not be followed by anyone with a family history of heart disease.

Limited food choices are not the only unglamorous part of the diet. In order to detect if your body is in ketosis, you must pee on a stick that will detect ketones in your urine. You will also experience some intense side effects. The combination of cramps, constipation, irritation, brain fog, insomnia, and more that are common during the start of the diet are labeled the “keto flu.” Symptoms seems to last anywhere from a week to a month until your body becomes accustomed to ketosis.

The keto diet will absolutely cause a weight loss – but a lot of this weight is water from glycogen stores, which become depleted due to low carb intake. It will also cause a large loss of lean muscle mass. Digesting carbohydrates produces insulin, which is necessary for muscle growth. So no matter how hard you exercise during this diet, expect minimal improvement in muscle mass with such low carb intake.

There is not enough research to date to conclude whether the keto diet causes a weight loss due its high fat, low carb profile or a reduction in calories secondary to such limited food options. But research does suggest that after rapid weight loss, keto dieters can expect rapid regain.

The bottom line is that when you choose a diet, the goal should be to fuel your body with foods that make you feel energized, focused, and confident. This diet doesn’t seem to match those goals. Excluding food groups from your daily intake (in this case, multiple food groups) sparks disordered eating by construing certain foods as “good” or “bad” for us. Rather than severely restricting carbohydrates, it’s important to understand the importance of fueling your body with the right carbs — starchy vegetables, whole grains rich in fiber, etc. Remember, the best diet for you is one that helps you feel your best self and is easy to maintain in the long run.

 

It is funny to read the comments section below the article you quote. The author is completely burned to the ground for giving a false representation of what the keto diet entails.

 

I am not a dietitian but I do know that the keto diet works. Most everybody on Reddit who used it lost weight, that is how, plus the science behind it is based on facts...

 

From the link in the article:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452247/

Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies:

Abstract
The treatment of obesity and cardiovascular diseases is one of the most difficult and important challenges nowadays. Weight loss is frequently offered as a therapy and is aimed at improving some of the components of the metabolic syndrome. Among various diets, ketogenic diets, which are very low in carbohydrates and usually high in fats and/or proteins, have gained in popularity. Results regarding the impact of such diets on cardiovascular risk factors are controversial, both in animals and humans, but some improvements notably in obesity and type 2 diabetes have been described. Unfortunately, these effects seem to be limited in time. Moreover, these diets are not totally safe and can be associated with some adverse events. Notably, in rodents, development of nonalcoholic fatty liver disease (NAFLD) and insulin resistance have been described. The aim of this review is to discuss the role of ketogenic diets on different cardiovascular risk factors in both animals and humans based on available evidence.

5. Conclusions
Based on the available literature, KD may be associated with some improvements in some cardiovascular risk factors, such as obesity, type 2 diabetes and HDL cholesterol levels, but these effects are usually limited in time. As KD are often rich in fats, some negative effects could happen. Mainly in rodents, developments of NAFLD and insulin resistance were described. In humans, insulin resistance is also a potential negative effect, but some studies have shown improvements in insulin sensitivity. Nevertheless, many subjects contemplating such diets are overweight or obese at baseline, and even a moderate weight loss could be metabolically beneficial for them. However, it is mandatory to maintain body weight after weight loss, which is usually a major problem. More studies are therefore warranted to better assess the effects of long term use of KD on metabolic diseases and cardiovascular risk factors, but also to better define which dietary macronutrient composition is optimal.

 

This has been my experience as well.

The way i see things is this. Low carbs = low energy = lame workouts = loss of muscle = slower metabolism. Carbs are not the enemy, a slow metabolism is. Any diet should be structured at minumum around keeping all muscle mass.

 

I got this far and realized the author was full of shit. A fairly new diet that has been around since 1920?

Plenty of evidence of success of keto diets that were squashed by people who wanted to blame fat as the evil part of our diets.

Also....a nutritionist? You can get a nutrition degree online in a few weeks...

 

I think the Keto diet is too extreme for an athlete to stick with, even full time body builders. Many of them will cycle through intermittent fasting for cutting but they really do not need to keep it up over the long-term given their workouts.

Full KD is best for the obese pre diabetic who is months away from serious metabolic disease or people in general working out trying to get lean but it is too easy to fall out of ketogenesis. Most intelligent KD diets now even advocate cycling in and out after you get a good rhythm going and simply keep carbs to fibrous fruits and vegetables but still cut out sugars, gluten and fake foods.

KD has also been medically proven to assist with epilpesy as well as slow down tumor growth rates in various types of cancers- people who have no choice but to really stick with it. But I would agree it is not a one-size fits all.

Most literature on "diet" and high level athletes seem to favor a more Paleo approach which is not about restricting carbs to some 25g level.

 

Fairly new for the general public; originally intended for children with epilepsy. Where is the contradiction?

Short-term results followed by retrace.

And what are the credentials of an Internet antagonist?

 

The contradiction is that the diet was not just a treatment for epilepsy, it was also an approach for obesity but was abandoned when "fat" became the villian and we moved to high sugar/carb, low fat diets. There is plenty of information if this approach being even tested in the 70's.

Short-term results followed by retrace is true for anything people don't stick to so that is not really scientific proof. Those who stick with it see the results. Those that go back to eat processed foods, high carb items and sugars should gain weight.

However KD is too strict for most people to stick with.