Are ketogenic diets the new route to effortless weight loss?

Every January we hear about new healthy eating plans designed to help us shape up and lose any residual festive kilos. Why waste your time on a wellness plan that hasn’t already been put through its paces? Nutritional Therapist, Jackie Newson explains why ketogenic diets, which typically follow a high fat, low carb style of eating, that’s been tried, tested and perfected over the last century, makes light work of successful dieting.

Medical experts have been recommending a high-fat low-carbohydrate diet to people diagnosed with epilepsy since the 1920’s as a way to help manage epileptic seizures. Research over the decades has meant that ketogenic diets are still used in clinical settings today for a wider range of conditions including diabetes, heart health, neurological disease and metabolic syndrome¹.

Easy Weight Management

By far the greatest interest in ketogenic diets today is from those looking for a quick and easy way to lose weight. So, if you’ve finally shifted your mindset from lethargic and indulgent to motivated and determined, now is the time to plunge right in and give it a go. To help you get started, here’s a detailed guide of the key factors involved in a modern ketogenic diet.

Whats does a Ketogenic Diet Involve?

A ketogenic diet involves reducing your daily carb intake right down to 20g to 40g a day, while also eating higher levels of fat and a moderate amount of protein. This unique dietary combination provides enough protein for growth but insufficient carbs to cover your daily energy needs.

So how does your body generate all the energy you require each day? A ketogenic eating plan focuses on fat, as much as 90% of daily calories comes from fat, which your body cleverly converts into energy. With careful planning the ketogenic diet is a highly nutritious way of eating, based around whole unprocessed foods and plenty of fibre-rich vegetables.

Switching From Carbs to Fat

Normally, your body relies on sugar (found in carbs) for fuel but when you follow a ketogenic diet, you push your body into using fat instead of carbs for fuel, a process known as ketosis.

During ketosis, dietary fats and stored fats are shuttled to your liver where they are readily converted into ketones. Insulin levels in the body have to be low in order for ketosis to occur². The best and quickest way to reduce your insulin is to limit your carb intake to less than 50g a day.

Keeping insulin low is a key factor in the ketogenic diet because even at normal levels insulin activates enzymes that convert the energy generated from sugar (released from carbs in your diet) into stored fat. By reducing your insulin, you reduce the amount of fat available for storage in your body. Eating foods that don’t raise insulin levels gives your body the opportunity to switch from storing fat to burning fat. This switch usually takes a few days.

While following a ketogenic diet you need to avoid eating too much protein as this can interfere with ketosis. Your body can convert excess protein into glucose, a process known as gluconeogenesis. This is why a ketogenic diet favours moderate not high levels of protein.

The Science Behind Ketosis

When there is a scarcity of dietary carbs your glucose reserves drop below the level needed to fuel the brain and central nervous system. This spurs your body into finding an alternative source of energy, this where ketones come in handy! It tends to take about three to four days for glucose reserves to become diminished and then your liver starts to convert fats into ketones, the three main ones are known as:

• acetoacetate (AcAc)
• beta-hydroxybutyric acid (BHB)
• acetone

Liver cells don’t have the enzyme known as 3-ketoacyl CoA transferase needed to convert ketones into energy, so rather than use the ketones the liver simply releases them into the bloodstream as a source of fuel for body and brain cells³.

What are the benefits?

Once you’ve successfully entered a state of ketosis and your body has switched from burning glucose to burning fat for fuel, you might start to experience some benefits:

• easy weight loss
• more efficient metabolism
• reduction in fat deposits
• better insulin management
• more stable blood sugar balance
• feeling fuller quicker
• improvements in body conditioning and muscle tone
• better quality of sleep
• better management of inflammation

Five studies from a meta-analysis of 13 different randomised controlled trials identified significant weight loss from a ketogenic diet. What’s more, looking at long term results, those individuals assigned to a very low carb ketogenic diet were found to achieve greater weight loss than individuals placed on a low-fat diet⁴.

Interestingly, further research has shown that a ketogenic diet may significantly raises levels of adiponectin, a protein involved in fat metabolism and blood sugar regulation⁵.

Getting the Balance Right

To ensure success on this eating plan it is essential that you choose nutritious, natural whole foods and drink plenty of water. Forget about convenience foods or takeaways, time to start meal planning, cooking from scratch and freezing ahead.

Probably the most difficult aspect of this diet is eating enough fat without eating too much protein. This means initially weighing foods to gain an accurate picture of your daily intake. Although this may seem time-consuming the end results are worth it, plus the action of paying close attention to portion sizes helps maintain commitment and focus.

Fat: High –75% to 90% of your daily calorie intake

Protein: Moderate – 20% to 30% of your daily calorie intake

Carbohydrate: Very low – 5% to 10% of your daily calorie intake, no more than
50g carbs a day. Staying below 30g a day helps to maximise
ketosis.

Ketogenic Weightloss Diet

If you are embarking on a weight loss diet of around 1500 calories a day, the ideal ratio to work to would be around:

25g of fat + 30g of carbohydrate + 70g of protein

However, this ratio is dependent on your age, height, weight, activity levels and your own particular needs. One thing you really must embrace for this diet to work is that eating fat is the key to success! To meet the daily fat requirements of the ketogenic diet you should eat fat at every meal, including healthy fats as much as possible and avoiding highly processed fats and oils.

Good fats to include:

• Coconut oil
• Coconut butter
• Coconut cream
• Dairy butter
• Nut butter
• MCT oil/powder
• Olive oil
• Flaxseed oil
• Walnut oil
• Duck fat
• Goose fat
• Almond oil
• Avocado oil
• Lard

To maximise healthy nutrition, remember to include oily fish in your keto eating plan. Fish such as salmon, mackerel, fresh tuna, trout and herring are rich in omega 3 fats. This type of fat may help to support brain and heart health as well as support hormone balance.

All about Carbs!

Not everybody is aware that vegetables and fruits contain carbs, but this is where you need to pay close attention to your portions, particularly with fruits like bananas, which are very high in carbs. Other foods that are high in carbs are grains (rice, wheat, rye, barley, bulgur, millet, buckwheat, oats), grain-based products (cereals, bread, pasta, noodles, biscuits, cakes and legumes (beans, chickpeas, peas, lentils).

Vegetables are vital because they are rich in nutrients and fibre, so they should be eaten at each meal. By choosing low carb, high fibre vegetables you can benefit from filling your plate with vegetables instead of starchy carbs. Vegetables also provide another way to squeeze more fat into your diet as you can add a drizzle of olive oil, stir in pesto sauce, sauté them or roast and jazz up plain steamed vegetables by tossing them in melted butter! Here’s the low down on the best low carb vegetables to include:

Net carbs per portion

Asparagus 180g = 8g carbs
Aubergine 100g = 6g carbs
Avocado 150g = 13g carbs
Bell peppers 149g = 9g carbs
Broccoli 91g = 6g carbs
Brussels sprouts 78g = 6g carbs
Carrot 61g = 5.8g carbs
Cauliflower 100g = 5g carbs
Celery 101g = 3g carbs
Courgette 124g = 4g carbs
Cucumbers 104g = 4g carbs

Garlic (1 clove) 3g = 1g carbs
Green beans 125g= 10g carbs
Kale 67g = 6g carbs
Lambs lettuce 100g = 2g carbs
Lettuce 47g = 2g carbs
Mushrooms 70g = 2g carbs
Onion 115g = 11g carbs
Pak Choy 70g = 1.5g carbs
Rocket 100g = 3.65g carbs
Spinach 180g = 7g carbs
Tomato 150g = 5.88g carbs

What About Starchy Vegetables?

Be mindful of starchy root vegetables, these tend to easily increase your carb levels and potentially break ketosis. As an example, just 100g of potato contains 17g carbs. Whereas 100g of aubergine contains just 6g of carbs. Starchy vegetables to avoid include:

Beans
Butternut squash
Cassava
Parsnips
Peas
Plantains
Potato
Sweet potato
Sweetcorn
Yams

Can You Eat Fruit on a Ketogenic Diet?

Some fruits such as berries can be included in small, carefully measured portions and avocado should definitely be on your shopping list! Avocado is arguably one of the best keto-friendly fruits, being high in healthy fat with a mere 2.5g carbs per 100g. Avocados are also a valuable source of vitamins and minerals including vitamin C, C, K, folate, calcium, potassium and magnesium.

Net carbs per portion
Apple 1 medium = 19.06
Blackberries 1 cup = 13.84
Blueberries 1 cup = 21.01g
Grapes 1 cup = 28.96g
Kiwi 1 fruit = 11.14g
Mandarin 1 small = 8.04g
Orange 1 medium = 15.39g
Pear 1 medium = 25.66g
Strawberries 1 cup = 11.67g

Get to Know Your Proteins

Foods that are naturally packed full of protein include meat, fish, dairy, beans, nuts, seeds, eggs, tofu, quinoa, chickpeas and lentils. Your need to aim for around 40g to 50g per day (women) and 50-60g a day (men). If you are struggling to lose weight even though you are keeping an eye on your carbs, then you may be eating too much protein. Perhaps you are including too much cheese in your eating plan or snacking on too many nuts.

Top 5 Keto Foods.

1. Eggs are great keto foods because they are low in carbs and moderate sources of protein, plus they are filling so make an ideal snack. An average egg contains 6g protein and 0.38g carbs.

2. Dairy products provide good levels of fat so are a real staple on a ketogenic diet. Cream is preferable to milk for adding to tea or coffee.

3. MCT powder is delicious added to coffee. MCT powder is a carb-free staple for many keto diet enthusiasts which adds a creamy flavour and provides C8 medium-chain triglycerides which get readily absorbed and rapidly converted into ketones. Using an MCT powder that is blended with organic ghee and grass-fed butter is another way to help you keep on top of your fat intake.

4. Nut milks like unsweetened almond, coconut or hazelnut milk are great alternatives for cow’s milk but check the labels and choose a brand that is low in carbs

5. Nuts and seeds are high in fat, low in carbs and have moderate levels of protein, the perfect keto food! However, some nuts such as cashews are higher in carbs and best avoided. High-fat nut butters come in handy when you are feeling peckish. A teaspoon or two spread on a celery stick makes a delicious snack and can really take the edge off sudden food cravings.

Keto Flu

During the initial stages of ketosis, some people might experience uncomfortable symptoms which are often referred to as keto flu. These symptoms are believed to be due to glucose withdrawal or a loss of electrolytes and may include:

• Difficulty sleeping
• Feeling sluggish
• Headaches
• Irritable
• Nausea
• Skin problems
• Sluggish bowel
• Upset stomach

Keto flu tends to only last for around a week or two and may be eased by making sure you are adequately hydrated and ensuring you get enough salt and mineral-rich green vegetables in your diet.

A keto diet can be challenging at times, you may come across obstacles that could derail all your great efforts. Overcoming the occasional hiccup may require the support of some additional dietary supplements.

Adjusting to New Routines

Your first hot drink in the morning may be the hardest part of your routine to change. Tea or coffee without milk just isn’t the same for many people, but a teaspoon or two of MCT powder with organic ghee and butter could make all the difference.

Hunger and Sugar Cravings

If there are moments when you are hijacked with hunger pangs, then supplementing with chromium and cinnamon may be helpful. Studies show that chromium contributes to the maintenance of normal blood glucose levels and cinnamon is a spice that has been used for centuries to support active lifestyles.

Energy Dips

Most people on the keto diet report renewed and revitalised energy levels, but initially as you adjust to the dietary changes you may find yourself flagging a little. Supplementing with vitamin B complex helps contribute to normal energy-yielding metabolism and vitamins B2, B5, B6, B12, folate and niacin help reduce tiredness and fatigue.

Electrolyte Imbalances

The keto diet is associated with changes in electrolyte balance which are thought to be responsible for some of the initial keto flu effects. You can help to rectify this by supplementing with magnesium, a powerful mineral that not only contributes to electrolyte balance, but also helping to reduce tiredness and fatigue and including sea salt in your diet.

Sluggish Bowel

Changes in eating habits can often result in altered bowel movements, this should pass once your body adjusts but, in the meantime, you could support your gut microbiome with Bacillus coagulans and Bacillus subtilis. The correct balance of healthy bacteria in the gut not only improves bowel movements but may also have a positive effect on weight management⁶.

Keto Diet for the Long Term?

Recent research suggest that the keto diet is most effective over brief periods of about 20 days. A six-month maintenance period which involves following a Mediterranean diet seems to be the ideal formula for long term success7. Switching between the keto and Mediterranean diet helps to prevent diet burn out. You may find it much easier to keep up a healthy eating plan long term if your diet isn’t too restrictive and allows you to still enjoy the finer things in life!

Jacqueline Newson BSc (Hons) Nutritional Therapy

REFERENCES

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Diabetes. co.uk. What to eat on a ketogenic diet. https://www.diabetes.co.uk/keto/foods-to-eat-on-a-ketogenic-diet.html. [accessed 7.01.21.

Paoli A. Ketogenic diet for obesity: Friend or Foe? Int. J. Environ. Res. Public Health 2014, 11(2), 2092-2107; https://doi.org/10.3390/ijerph110202092.

Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013 Oct;110(7):1178-87. doi: 10.1017/S0007114513000548. Epub 2013.

Partsalaki I, Karvela A, Spiliotis BE. Metabolic impact of a ketogenic diet compared to a hypocaloric diet in obese children and adolescents. J Pediatr Endocrinol Metab. 2012;25(7-8):697-704. doi: 10.1515/jpem-2012-0131. PMID: 23155696.

Rial SA, Karelis AD, Bergeron KF, Mounier C. Gut Microbiota and Metabolic Health: The Potential Beneficial Effects of a Medium Chain Triglyceride Diet in Obese Individuals. Nutrients. 2016;8(5):281. doi:10.3390/nu8050281.

Paoli A, Bianco A, Grimaldi KA, Lodi A, Bosco G. Long term successful weight loss with a combination biphasic ketogenic Mediterranean diet and Mediterranean diet maintenance protocol. Nutrients. 2013;5(12):5205-5217.doi:10.3390/nu5125205.

FxMedicine. Understanding therapeutic ketosis with Dr Dominic D’Agostino. https://www.fxmedicine.com.au/omicspodcast/understanding-therapeutic-ketosis-dr-dominic-dagostino. [Accessed 7.01.21.]