Though not a new diet, the ketogenic diet has in recent months become more and more popular as a means for prompting weight loss. The ketogenic diet has been used for many years, mostly in clinical settings like hospitals, as part of the treatment protocol for children and adults suffering from epilepsy.
The ketogenic diet is extremely strict and requires following specific guidelines of about 25 to 35 grams of net carbohydrates (total carbs minus fiber) daily, about the equivalent of one apple. The rest of a ketogenic person's diet is comprised of 5 percent or so protein and then fat for the remaining 70 to 80 percent of the calories.
The purpose of the ketogenic diet is to switch our bodies from using carbohydrates for fuel to burning ketones instead. When the body is starved of carbohydrates, fat is broken down and ketones are formed by the liver and then burned for energy instead of glucose. When followed strictly, the excess ketones that our bodies make can be measured in the urine; strict followers of the diet will sometimes check their urine to ensure they find ketones.
While there’s reasonable evidence to support the use of the ketogenic diet for clinical purposes as mentioned above, the use of the ketogenic diet for people just looking to optimize their diet and lose weight is a bit more controversial. Here are the pros and cons:
Pros of the ketogenic diet:
1. It reduces insulin levels (and inflammation).
Insulin is a key hormone that helps move glucose from the bloodstream to the muscles and tissues. Higher levels of circulating insulin have been linked to increased inflammation (a bad thing for many reasons), and the ketogenic diet may help to reduce insulin levels and thereby help to potentially reduce inflammation in the body.
2. It possibly leads to weight loss.
Some people, especially at first, often notice some weight loss. This is partially because of the increased satiety due to fat intake (fat slows digestion and promotes balanced blood sugar), partially because of more balanced blood sugar levels, but also because many people will cut out much of the sugar- and carb-heavy food they’re eating. These carb- and sugar-laden foods can contribute to water retention, so when that water weight goes away, people feel and look thinner.
3. You'll end up eating more (hopefully healthy) fat.
Fat is so crucial to health, and most of us really don't get enough of it. One of the pros of this diet is increased fat, especially if it’s healthy fat from avocado, nuts, or wild fatty fish.
4. It's a great way to detox from sugar.
Due to the fact that this diet allows only 25 to 35 grams of carbs total, most people will have to cut out their intake of really sugary foods, which is certainly a plus and something I think most of us can benefit from!
Cons of the ketogenic diet:
1. It can be quite difficult to follow.
It’s really difficult even for an expert like me to live my life and follow a plan that's 70 to 80 percent fat, 10 percent carb, and 15 percent protein, as every single meal (for the most part) has to be planned and calculated. For most people this will be the hardest part.
2. Many people end up eating fats that aren't so healthy.
While the upside of this plan is the increased fat intake, the downside is that many people actually end up eating a lot of highly saturated animal fats. Though the carbohydrates are out of the equation, making the fats potentially less dangerous, these types of fats aren't health-promoting. In addition, many people aren’t purchasing organic and/or grass-fed animal products, so quality of food can be an issue as well. Bottom line: if you’re using a lot of animal-based foods for fats and proteins, try to make them organic and well-sourced whenever possible.
3. It may not promote significant long-term weight loss.
Though there is some weight loss for many (and even significant amounts for others), many of my clients don't lose as much as they would like to (perhaps because it's so hard to strictly adhere to it).
4. You won't be eating as much heart-healthy, gut-healthy, satiating fiber.
Though this diet can be high in heart-healthy fats (depending on the ones you choose), it's often low in fiber. It can also be lower in plant-based healthy nutrients, as many foods that contain fiber also contain more carbs than permitted on this type of plan.
If you want to do the ketogenic diet, and give it a try, here’s what I recommend:
- Choose the healthiest fats you can to make up the 70 to 80 percent: egg, avocado (watch out, though; these do have a few net carbs), and almonds (they do have some net carbs, but the fiber is helpful) are my favorite picks.
- Include as many greens as you can—they’re lower in carbs and packed with nutrients.
- Try to get organic/grass-fed animal products whenever you can, including cheeses, eggs, other dairy products, and animal meats of all kinds.
- Drink plenty of water. With more fat and less fiber (generally), you can get a little constipated, so water helps.
- Assess as you go, how you feel, and keep a journal of your progress that you can track.
Don’t be afraid to try a little less strict similar diet if you’re really interested in pursuing a ketogenic-style diet, called the Modified Atkins. The Modified Atkins Diet allows more protein, still restricts carbs, and is also high in fat but may allow more protein for people who can't include cheese and other high-fat dairy as a means for meeting fat needs on the ketogenic diet. Please also note that you should check with your doctor whether it’s safe to do either of these diets if you have diabetes or other similar health conditions or are breastfeeding.
Primal expert Mark Sisson explains how you can become a fat-burning machine with the keto diet—and how to make it a little easier.