The Ketogenic diet

What comes to our minds when we hear ‘‘Ketogenic diet’’? Bodies made of steal, a lot of meat and bulletproof coffee. But what’s really behind this lifestyle or this diet? Is it all about weight loss or is there something else?


Despite the recent hype, a ketogenic diet is not something new. It has been used for almost 100 years to treat drug-resistant epilepsy, especially in children.


Since Dr. Atkins popularised the low carb diet, which has an initial ketogenic phase, the concept of cutting out carbs has become very fashionable amongst people who want to lose weight.


In this article we will explain the connection between carbohydrates, fat and protein for weight loss. We will show how to go on a ketogenic diet and the pros and cons.


Do carbohydrates make us fat?

„If you want to lose weight, you have to cut out carbs“. I’m sure you’ve heard or read this a million times. Celebrities never eat carbs. Poor carbs, they’ve got such bad reputation lately that we almost see them as a fat boosting evil, a monster that increases your waist circumference and the number on the scales just by looking at it. But is that really true? Not quite.


If you want to lose weight you have to eat less calories than you burn. That’s a fact. But does it make a difference WHAT you eat? Yes, a tiny bit.


Every time you eat carbohydrates, your pancreas produces and releases insulin. Insulin is the key hormone for glucose to leave the bloodstream and enter the cells. Any type of carbohydrate we eat finally ends up as glucose in our blood. No matter, if it is simple carbs, like sugar in chocolate or complex carbs, like naturally occurring in starchy vegetables or whole grains. The only two differences are:

  • the amount of glucose and thus the amount of insulin the different types of food produce or require
    • High sugar, simple carbs = fast glucose raise and high insulin levels - not the best deal.
  • the time it takes the body to split the carbohydrate chains up to glucose
    • Complex carbs (whole grains, fiber, starch) = slow insulin raise, lower insulin levels - better deal

The problem with high insulin levels is:

  • It can lead to metabolic diseases like diabetes type II and insulin resistance
  • It is linked to obesity, heart disease and cancer

The concept is easy to understand: you eat carbs, the body digests the complex carbohydrate chains to glucose, insulin allows them to them enter in bodily tissues, the body uses it for the production of energy. So far so good.


If there is more glucose left than you need for energy, the body stores it as fat in our fat tissues and this is when and why carbohydrates make us fat. But NOT in general.


So far so good. But this is also the case with protein and fat. Each excessive amount of calories is stored as fat. The problem with carbs, all above with processed carbs, is that they are highly addictive and that you can eat way bigger amounts than from protein or fat. The way they act in our body is similar to other addictive substances. I’m sure you’ve been in the situation of not being able to stop after one cookie or one piece of chocolate several times in your life. And that’s why carbs in theory cause more problems when talking about weight loss/gain than protein and fat do. Overeating on eggs or ham is more difficult in general.


Another fact is, that carbohydrates bind water in our body. So if you stop eating carbs you lose a lot of water at the beginning. This has two effects in people who want to lose weight. First you look leaner because there is less water stored in your body and second the number on the scales drops significantly in the first weeks which has a big motivating effect.


So what about protein?

Protein will be split up to amino acids https://okamibio.com/blogs/news/pea-protein-you-rock-my-world and used for the production of new cells and body tissues, like muscles, hair, nails, hormones, etc. Every body tissue is made of protein.


Protein is the most important of the three macromolecules when it comes to weight loss or muscle building, which many times are the objective at the same time.


To build up muscle, your body needs protein. Apart from that it is very helpful for weight loss because of the following:

  • Protein takes longer to digest than carbohydrates. It makes you feel satiated for a longer time.
  • Protein doesn't cause insulin spikes, neither hypoglycemia. This means that hunger attacks are less likely to occur.
  • Protein pushes your metabolism because it takes more energy to be digested. A higher metabolic rate helps you to lose weight.

And last but not least: Fat

Eating fat makes you fat. No, not true!

Fat can be used as an energy fuel if there are no carbohydrates available, which is the basic concept of the ketogenic diet.


Without its main energy fuel, the carbohydrates, the body enters in a starvation mode, which is called “ketosis”, the name giver of the ketogenic diet.


Ketosis - the desired state of the ketogenic diet

So if you go into ketosis, which is comparable to a starvation mode, the body burns off body fat continuously by producing so called ‘ketone bodies’, which can be used as an energy fuel by the brain and our muscles. The nice side effect is, that you lose weight.


What can you eat on a ketogenic diet?

The real ketogenic diet requires you to get 80-90 percent of your calories from fat. Nowadays the recommendations are to consume 80% polyunsaturated and monounsaturated fat and 20% of saturated fats. You should also consume about one gram of protein per kilogram of bodyweight and limit carbs to 10-15 grams a day.


There are a lot of applications to track your macros (Macronutrients = Fat, Proteins and Carbohydrates). This helps you to fine tune your diet or to figure out possible carbohydrate food that you haven’t considered as them.


Basically your diet will consist of:

Vegetables

Meat

Fish

Eggs

Dairy (high fat dairy like heavy cream)

Coconut milk

Fats (avocados, nuts, olive oil)


Cons or possible harms of a ketogenic diet


Are ketone bodies harmful?

They change metabolic parameters in your body which can lead to disbalances, but there is more evidence needed to really know the effects, especially long term.


Long term effects of a ketogenic diet

The long term effects a ketogenic diet may have are not totally clear. There is one study done over a period of 24 weeks with very good results on blood lipids (such as triglycerides and cholesterol) and weight loss. The authors conclude that the ketogenic diet has beneficial effects long term. This study only had a look at a very limited amount of parameters. There may be a lot more that don’t show such beneficial outcomes and on top of that 24 weeks is only 6 months. What if people decide to do this for a lifetime. Well, there is more research needed to proof any possible beneficial or harming effect.


Kidney failure

Ketone bodies lower the pH of our blood. This has an effect on lots of metabolic functions but overall on the kidneys as one of their responsibilities is to keep the pH constant. In healthy individuals this is not a problem as the kidneys are able to deal with this situation. In people with kidney failure it can worsen the situation, so this diet is not recommended for people with kidney problems.


Bad breath

A side effect of the ketogenic diet is that you may get bad breath. This is due to metabolic byproducts that are produced once your body enters the state of Ketosis. This isn’t harmful per se but can be uncomfortable. You can help out with a chewing gum or some mints without sugar.


Fatigue

Some people need carbohydrates more than other. We are all different and it takes some time for the body to get used to the “new” energy source, which are fats. At the beginning you may feel less energized and some people probably never manage to get used to it. You can find out by trying and see how it works for you.


The microbiome

This is maybe the most important point. The importance of our microbiome gets more obvious and clear day by day. Research found vital links to our health. The trillions of bacteria we host in our intestine are involved in our health and wellbeing more than we probably know. Yet, it is Qclear that mood changes, inflammation processes, the development of chronic diseases and weight loss are highly linked to the composition of our gut bacteria. And this composition or the type of bacteria that lives and worked for us in our intestine is determined by the food we eat. Ketogenic diets tend to be very low in fiber and fiber is the main fuel for this bacteria. When on a ketogenic diet may shift the type of bacteria in your gut which can have negative effects on your overall health and wellbeing.


Bottom line:

The ketogenic diet works for weight loss. In the short run. It will help you to lose weight fast and efficiently. But what happens once you go back to normal? Just two things to keep In mind. Cutting out carbs can lead to tremendous sugar cravings. And once we’ve reached our weight goal and we go back to normal, this can lead to immense weight gain (more than before). But this is the problem with any diet and especially if they are as restrictive as the keto diet is.


Apart from other diets it has also protein health benefits like treating epilepsy and improving blood lipids. Latter one can also be achieved with