The ketogenic or keto diet is not new: a hundred years ago, before the advent of effective anticonvulsants, French pediatricians noticed that certain dietary restrictions reduced the frequency of seizures in children suffering from drug-resistant epilepsy.
On the basis of metabolic studies, a therapeutic diet was developed - without starch and sugar, which became an integral part of the complex treatment of epilepsy in the early 1900s. The author of the name "ketogenic diet" allegedly belongs to the American doctor Russell M. Wilder, who used it in the treatment of epilepsy in the 20-30s.last century.
The keto diet involves a high-fat diet, moderate protein intake, and very low carbohydrate intake.For most people, this nutrient ratio is considered safe for a limited period of time and not only helps you lose extra pounds but also has therapeutic applications.
Indications for use
A low-carbohydrate keto diet for epilepsy, widely used in foreign clinical practice, helped reduce the frequency of seizures in children of different ages by 62-75% (after 12 weeks of dietary treatment).At the same time, children who are prescribed such a diet should be registered with doctors who monitor their normal growth and weight gain, and also make dietary adjustments based on the needs of each child.
Diets containing minimal amounts of carbohydrates began to be used for other disorders.Researchers have shown that ketogenic diets are useful in treating patients with DeVivo disease, GLUT1 protein deficiency syndrome (which transports glucose across the blood-brain barrier), as well as several other inborn metabolic abnormalities.
It is believed that this nutritional system may slow the progression of amyotrophic lateral sclerosis (Charcot disease);Indications for the ketogenic diet include neurodegenerative pathologies such as Alzheimer's and Parkinson's diseases.Clinical studies are underway on the effect of the ketogenic diet on the condition of patients with autism, depression, type 2 diabetes mellitus (non-insulin-dependent) and polycystic ovary syndrome.
The most well-known keto diet for weight loss comes in the form of the Atkins diet for the treatment of obesity, modified and popularized by Dr. Robert Atkins (Dr. Atkins Diet Revolution, 1972).Although experts consider only the induction phase of this diet to be ketogenic.And, in fairness, you should know that long before him, many American doctors worked on the principles of the ketogenic diet: Peter Huttenlocher, Alfred Pennington, Richard McCarnes and others.For example, R. McCarnes wrote the book Eat Fat and Grow Slim in 1958, and it is essentially the same low-carb diet originally introduced to treat epilepsy.
Since the deposition of excess adipose tissue in the form of concentrated triglycerides in its cells is due to excessive consumption of carbohydrate foods (no one doubts this fact), limiting carbohydrates in the diet to a minimum - a keto diet for a month - helps to reduce fat stores, that is, to lose weight.
In addition, it was found that the keto diet for oncology - by increasing the oxidative stress of cancer cells - significantly reduces the growth rate of malignant tumors localized in the colon, stomach, prostate and lungs.Additionally, it has already been proven that certain cancers are more sensitive to chemotherapy due to the induced state of ketosis.
Over the past two decades, the ketogenic diet has been used by bodybuilders to reduce the layer of fat under the skin: in their slang this is called cutting the keto diet.
The essence of the keto diet
On a standard keto diet, your total daily calories should come from 70-80% fat, 15-20% protein, and 5% carbs (less than 50g per day).
As a general rule, the ratio of fat to protein and carbohydrates is 3:1 (i.e. 3 grams of fat for each gram of protein + carbohydrates).If the ratio is 4:1, then 90% of energy comes from fat, 8% from protein and only 2% from carbohydrates (about 20g per day).
The essence of the diet used to reduce excess weight is to introduce the body into a state of adaptive ketosis - when the body receives energy (ATP) mainly from ketone bodies present in the blood, and not from glucose, which comes from eating foods containing carbohydrates.
Carbohydrates in food are converted to glucose, but when a person consumes very few carbohydrates and a lot of fat, a chain of biochemical reactions is triggered in the body.Schematically, this process looks like this.First, due to the decrease in blood sugar, the pancreas begins to produce more of the hormone glucagon, which stimulates the catabolism of glycogen stored in the liver into glucose and releases it into the blood.Second, ketogenesis is activated, that is, the liver produces ketone bodies (acetoacetate, which is then transformed into β-hydroxybutyrate and acetone) and the conversion of dietary fats into free carboxylic acids (fats).Thirdly, due to an increase in the level of glucagon, the activity of lipase, an enzyme that breaks down triglycerides (fats) accumulated in adipose tissue cells, increases significantly.
Additionally, during the first two weeks following the keto diet, significant weight loss occurs due to the removal of water from the body, which is also associated with increased glucagon production.So, a temporary side effect of a high-fat diet can be dehydration, which nutritionists advise to combat by drinking up to two liters of water per day.
Many people believe that an important advantage of the keto diet is the absence of hunger, the need to count calories and exercise for hours to burn excess calories.
Keto diet for men
The keto diet is considered particularly effective for men with abdominal obesity.
If a therapeutic diet for obesity recommends reducing calorie intake to 2000 (2300) kcal per day, then the ketogenic diet does not control calories so strictly (but reducing them by at least 10-20% will not hurt).But the consumption of carbohydrates should be reduced five times: instead of 250 g to a maximum of 50 g per day.
Remember that the majority of calories on a keto diet come from foods high in natural fats and moderate amounts of protein.In other words, it is not a “protein filler”, as some might think.And if a man is used to eating a lot of meat, his body will enter a state of adaptive ketosis much more slowly.So you will need to limit protein: per day to 1 to 2 g of protein per kilogram of body weight you are trying to achieve through weight loss.Example: if the initial weight is 112 kg, and the desired weight is 85 kg, then the amount of protein during the course is 85-170 g.
The exact ratio of fats, proteins and carbohydrates in the diet (in grams) will depend on the age, goal, level of physical activity and health status of each man.But short-term fasting during the keto diet is recommended for everyone: in the first two days after switching to this food system, you should drink plenty of water and limit yourself to one meal per day (in a very small quantity).At the end of the first week, you should eliminate carbs as much as possible (below is a list of foods for the keto diet), but the portion size decreases very slightly.
Another nuance: they claim that the keto diet without sports does not lose its effectiveness, and to lose weight it is not necessary to go to the gym or simply perform additional physical exercise.But physical activity, as part of a healthy lifestyle, accelerates the burning of excess fat, so you should not lie on the couch.In addition, you can take advantage of the moment and, like bodybuilders, build muscle mass: gaining weight on a keto diet is possible only with muscle loading, then the subcutaneous fat will disappear, revealing strong muscles.
Keto diet for women
The problem with the keto diet is that to date, research into its effectiveness and safety has focused only on men.A natural question that arises is whether the keto diet is suitable for women, given that female hormones tend to be more sensitive to most dietary changes.
Although opinions vary, most experts say the ketogenic diet produces positive results, especially in perimenopausal or menopausal women.This nutritional system helps you lose excess weight, control blood sugar levels, improve sleep quality and reduce menopausal symptoms such as hot flashes or night sweats.
However, there are also negative reviews and even complaints about nausea, fatigue and constipation due to the diet (more details below in the Possible Complications section).It is also worth mentioning that switching to a keto diet is contraindicated in cases of irregularities in the monthly cycle, pathologies of the thyroid gland or during pregnancy and breastfeeding.
Women are recommended to combine periodic fasting with a ketogenic diet, that is, simply skip lunch and take a break for 10-12 hours between morning and evening meals, which after 50-55 years gives a rejuvenating effect (these are data from a 2016 study published in the Journal of the American Medical Association).According to Western nutrition experts, this diet allows the body to take a break from digestive functions and direct energy resources to restore tissue cells and balance hormones.
If a woman weighing 75 kg and height 165-168 cm is looking to lose weight to about 68 kg, she should go from 2,300 kcal per day to consuming no more than 1,855 kcal.Protein should be between 1 and 1.5 g per kilogram of ideal weight, that is, you can consume about 68 to 102 g of protein, 240 to 350 g of fat and 18 to 20 g of carbohydrates daily (in pure water, without fiber).
How is a keto diet different from a high fat diet?
A high-fat diet or LCHF differs from a keto diet in the proportions of proteins, fats and carbohydrates in the diet, and a high-fat diet assumes a ratio of 50% fat and 25% protein and carbohydrates.
In Europe, the high-fat (low-carb) diet is called the Swedish diet.This is obviously due to the Swedish therapist Annika Dahlqvist, who began recommending that her diabetic patients consume more fats and limit carbohydrates, which contradicted the officially approved recommendations of Swedish endocrinologists.
Among the modifications of the ketogenic food system, starting with the Atkins diet and the LCHF diet, one can mention strange dietary recommendations, for example, egg fasting in the keto diet - while for several days you have to eat only boiled chicken eggs with mayonnaise...
Cyclical Keto Diet and Other Modifications
In recent years, the Standard Keto Diet (SKD) has been modified in many ways.Thus was born the high-protein ketogenic diet (HPKD), in which 60% of calories come from fat, 35% from protein and 5% from carbohydrates.
The Targeted Ketogenic Diet (TKD) is more moderate, since carbohydrates can be consumed before and after training;It is considered a sport, so the number of calories obtained from consuming carbohydrates is higher than in SKD.
The cyclic keto diet (CKD) or, according to another version, the rotating (alternating) keto diet, is a low-carbohydrate diet with alternating periods of consumption of high or moderate amounts of carbohydrates: 5-6 days - a minimum amount of carbohydrates, then a carbohydrate load is carried out on a keto diet - one or two days of carbohydrates are consumed without restriction.The unknown authors of this version of the keto diet are trying to justify their innovations by the need to replenish glycogen stores, restore hormone levels and thyroid activity, as well as ensure moral and psychological stability - to continue the diet.In fact, whatever is lost in six days comes back instantly.
Advantage
As foreign clinical practice shows, almost 20% of epileptic children after a ketogenic diet (monitored from six months to two years, with a gradual return to a normal diet) have seizures much less frequently, and many of them can reduce their intake of anticonvulsants or abandon them altogether.
Based on the results of two dozen randomized controlled studies, experts have come to the conclusion that the benefits of the keto diet include significant and fairly rapid weight loss, especially in cases of severe obesity.Despite the high amount of fat, this 24-week diet resulted in a significant percentage of patients with a reduction in systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels and an increase in high-density lipoprotein (HDL), i.e. good cholesterol.
In 2008, the American Diabetes Association (ADA) revised its dietary guidelines and recognized low-carbohydrate diets as an effective short-term dietary intervention for patients with non-insulin-dependent diabetes.
And yet, during a keto diet, the skin reacts in its own way to the lack of carbohydrate foods, for example acne may decrease.And this is confirmed by the results of a study published in the Journal of the American Academy of Dermatology.
What is possible and what is not?
What can you eat?The list of products recommended for the keto diet includes: any meat and meat by-products;bird;fish and seafood;eggs (all types);cream, sour cream, butter (butter and vegetables).Hard cheese is very useful on a keto diet.But be careful with regular milk, as it contains a lot of lactose – milk sugar, which is a disaccharide carbohydrate.But fermented milk products can be consumed without fear: during the fermentation of fermented milk, lactose undergoes hydrolysis.
Instead of popcorn, candy or chips, nuts (about 13 g of carbohydrates per 100 g) and sunflower seeds (10.5 g of carbohydrates per 100 g) are suitable.The number of calories is 655 and 600 respectively.
It is recommended to include in the menu:
- mushrooms (except for dried porcini and porcini mushrooms), the ideal option is mushrooms (only 0.5 g of carbohydrates per 100 g).
- all types of leafy greens and vegetables that do not contain starchy complex carbohydrates: broccoli and kohlrabi;white cabbage, cauliflower and Brussels sprouts (3-6 g of carbohydrates per 100 g);cucumbers, zucchini, zucchini, eggplant, peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (range 1.8 to 4.5 g of carbohydrates per 100 g).
You can eat a little berries: strawberries (100 g contain about 8 g of carbohydrates), cherries, raspberries, blackberries, cranberries (100 g contain 12 g of carbohydrates).
If you stick to moderate consumption while following a keto diet for weight loss, you can occasionally eat 100 g of apricots, pineapple or grapefruit: this represents approximately 11.8 to 12.4 g of carbohydrates.But you shouldn't eat bananas: 100 grams of carbohydrates contain almost 23 g.
What can't you eat?You will have to give up bread and all flour;pasta;sweets, honey and confectionery;all cereal porridges;potatoes, carrots, beets, celeriac;pumpkins and all melons;legumes and most fruits.
Menu for a week of keto diet
To seriously want to get rid of excess fat reserves in your own body, you of course need to create a menu for the week of the keto diet.And the information in the previous section will help you with this.
For breakfast, you can cook scrambled eggs or omelets - with onions, mushrooms and spinach, bacon and tomatoes.Coffee or tea, naturally, without sugar.
Lunch can consist of salad (a recipe for one of them is given below), vegetable soup or meatball soup (without potatoes, rice and noodles), chicken broth and boiled chicken, fried fish or pork and mushroom stew.
For dinner, choose a protein, such as turkey, beef, fish, seafood, with which - as a side dish - broccoli, Brussels sprouts, green beans or peppers, flavored with cream cheese sauce, go well.
Keto diet recipes
Considering the list of foods allowed on the ketogenic diet, you can prepare so many different dishes that it is impossible to list even a tenth of the keto diet recipes.Try these three.
Baked chicken with vegetables
Products for two servings: 500 g of chicken (legs, breast or fillet, cut into medium pieces), a tablespoon of vegetable oil, 1 green pepper (cut into medium cubes), half an onion (cut into small cubes), 500 g of cauliflower (disassembled into florets), half a small chili pepper (finely chopped), 50 g of butter, 100-150 g of fatty sour cream, 50 g of soft cheesehard (grated on a coarse grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Preparation :
- heat the oven to 180°, grease a baking dish or pan with vegetable oil;
- Separately simmer onions and peppers (sweet and bitter) in vegetable oil;
- Blanch the cauliflower inflorescences in boiling salted water for three minutes, let the water drain;
- put the chicken in a mold (pan), salt and pepper, add the onions, peppers and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle coriander on top, put butter (several pieces, over the entire surface), pour sour cream, sprinkle with grated cheese and put in the oven for 40-45 minutes.
Quick salad with ham or brisket
Products for two servings: 100 g of ham or brisket, 250 g of lettuce (dry well after washing), two fresh cucumbers, one tomato, two chicken eggs (hard-boiled), 60 g of dill or parsley, 1 tablespoon of olive oil and the same amount of mayonnaise, salt to taste.
Preparation :
- cut the brisket or ham into large strips;
- cut the hard-boiled eggs into quarters, the vegetables into thin slices;
- arrange the lettuce leaves on a dish, place the ham on top, the eggs and vegetables on top, add salt;
- mix vegetable oil with mayonnaise, add finely chopped herbs, mix and pour this sauce over the salad.
Pork stew with mushrooms
Products for three servings: 300-400 g of pork pulp, 350 g of fresh mushrooms, half an onion (finely chopped), 2 tablespoons of vegetable oil, half a teaspoon of nutmeg, a clove of garlic, 4 tablespoons of sour cream or heavy cream, 2 tablespoons of chopped herbs, salt and ground black pepper, to taste.
Preparation :
- pour vegetable oil into a frying pan or saucepan with a thick bottom, add onion and chopped garlic, simmer for five minutes;
- put pieces of meat and fry a little;
- add chopped mushrooms, mix, add nutmeg and ground black pepper, salt;
- cook over low heat for 15 minutes, then add sour cream (cream) and herbs;
- Cover the dish with a lid and simmer until cooked (about another 15 minutes).
Contraindications
Absolute contraindications to switching to a ketogenic diet include:
- diabetic ketoacidosis caused by insulin deficiency;
- congenital and secondary carnitine deficiency;
- pyruvate carboxylase deficiency;
- mitochondrial diseases caused by impaired beta-oxidation of fatty acids;
- porphyria;
- pronounced abnormalities in blood composition, iron deficiency anemia;
- pancreatitis;
- acute and chronic inflammation of the gallbladder (cholecystitis);
- hepatic dysfunction, primary or metastatic liver tumors;
- acute renal failure;
- bowel dysfunction, Crohn's disease;
- abdominal tumors;
- condition after cancer chemotherapy.
Particular caution should be taken when considering the advice of bodybuilders aimed at “stimulating” metabolism using pharmacological agents: you should not risk your health by striving for a super effect.
Possible risks
Risks associated with a diet used long-term in the complex treatment of epilepsy in children include the threat of growth retardation (due to a decrease in insulin-like growth factor 1 levels), deterioration of bone mineralization (due to calcium deficiency), and nephrolithiasis (kidney stone formation).Hyperlipidemia (hyperlipidemia) occurs in almost 60% of children and cholesterol levels can increase by about 30%.
Rare side effects include cardiomyopathy, long QT syndrome (disruption of the ventricular rhythm of the heart), deficiency of vitamins, micro- and macroelements.
The most common side effect is constipation, which almost a third of people who lose weight complain about: the lack of fiber intake affects it.In addition, the ketogenic diet in the early stages may be accompanied by increased fatigue, weakness, headache and dizziness;in women - dysmenorrhea.
If the keto diet does not lose weight, there is probably too much protein in the diet, because more than half of the excess protein is transformed into glucose in the body, that is, the process of induced ketosis is disrupted.
When the muscles are very sore on a keto diet, the reason may be associated with both a violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid), and the enzymatic breakdown of muscle tissue glycogen in conditions of ketosis.
When starting the diet, reducing carbohydrate intake leads to fluid loss, and leg swelling on a keto diet can occur even with minor kidney failure.
Weight loss reviews and results
Reviews of doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies boil down to stating its unconditional effectiveness: even in senile dementia and Parkinson's disease, patients' attention increases, memory and adequacy of perception significantly improve.
As a rule, the reviews and results of those who lose weight are commented on by experts.But the significant controversy surrounding all low-carb diets also contributes to the evaluation of precise results.
So, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a keto diet lost an average of 8 to 10 pounds more over six months than those who limited their fat intake.British obesity experts (British National Obesity Forum) also note that low-carb, high-fat diets are superior to low-fat diets in terms of weight loss effectiveness.Although many of their colleagues claim that the weight loss results of the keto diet are “contrary to the available evidence.”