The ketogenic or keto diet is nothing 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.
Based on metabolic studies, a therapeutic diet was developed - without starch and sugar, which became 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 20s and 30s.last century.
The keto diet involves a high fat, moderate protein and very low carbohydrate diet.For most people, this ratio of nutrients is considered safe for a limited period of time and not only helps you lose excess weight, but also has therapeutic uses.
Indications for use
A low-carbohydrate keto diet for epilepsy, which was widely used in foreign clinical practice, helped reduce the frequency of seizures in children of different ages by 62-75% (after 12 weeks of the diet).At the same time, children who are prescribed this type of diet must be registered with a doctor who monitors their normal growth and weight gain, and adjusts the diet according to the needs of each child.
A low-carb diet has begun to be used for other disorders as well.Researchers have shown that ketogenic diets are useful in treating patients with DeVivo disease, a syndrome lacking the protein GLUT1 (which transports glucose across the blood-brain barrier), as well as several other metabolic birth defects.
It is believed that this diet can slow the progression of amyotrophic lateral sclerosis (Charcot disease);Indications for the ketogenic diet include neurodegenerative pathologies such as Alzheimer's and Parkinson's disease.Clinical research is underway on the impact 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 famous keto diet for weight loss is in the form of the Atkins diet for the treatment of obesity, which was modified and popularized by Dr. Robert Atkins (Dr. Atkins Diet Revolution, 1972).Although experts believe that only the induction phase of this diet is ketogenic.And, in fairness, it should be noted 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 this is essentially the same low-carbohydrate diet that was originally introduced to treat epilepsy.
Since the deposition of excess adipose tissue in the form of triglycerides concentrated in its cells occurs due to excessive consumption of food with carbohydrates (no one doubts this fact), limiting carbohydrates in the diet to a minimum - a keto diet for a month - helps to reduce fat reserves, i.e. weight loss.
In addition, the keto diet for oncology has been found to – by increasing the oxidative stress of cancer cells – significantly reduce the growth rate of malignant tumors localized in the colon, stomach, prostate and lungs.In addition, some cancers have already been shown to be more sensitive to chemotherapy due to an induced state of ketosis.
Over the past two decades, bodybuilders have been using the ketogenic diet to reduce the layer of fat under the skin: in their jargon, it's called keto cutting.
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).
Typically, the ratio of fat to protein to carbohydrates is 3:1 (ie 3 grams of fat for every 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 20 g per day).
The essence of the diet used to reduce excess weight is to introduce the organism into a state of adaptive ketosis - when the body receives energy (ATP) mainly from ketone bodies in the blood, and not from glucose, which comes from food containing carbohydrates.
Carbohydrates in food are converted into 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 reduced blood glucose levels, the pancreas begins to produce more of the hormone glucagon, which stimulates the catabolism of glycogen stored in the liver into glucose and release into the blood.Secondly, ketogenesis is activated, that is, the liver produces ketone bodies (acetoacetate, which is then transformed into β-hydroxybutyrate and acetone) and the conversion of fats in food into free carboxylic (fatty) acids.Third, due to the increase in glucagon levels, the activity of lipase, an enzyme that breaks down triglycerides (fats) accumulated in adipose tissue cells, increases significantly.
In addition, in the first two weeks of following a keto diet, significant weight loss occurs due to the removal of water from the body, which is also associated with increased glucagon production.And therefore, 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 a 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 the 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 most of the calories on the keto diet come from foods rich in natural fats and moderate amounts of protein.That is, this is not "protein overload", as some think.And if a person is used to eating a lot of meat, then his body will enter the state of adaptive ketosis much more slowly.So you will need to limit protein: daily to 1-2 g of protein per kilogram of body weight you are trying to achieve as a result of losing weight.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 fat, protein and carbohydrates in the diet (in grams) will depend on the age, goal, level of physical activity and health status of each individual man.But short-term fasting during the keto diet is recommended for everyone: in the first two days of switching to this food system, you should drink a lot of water and limit yourself to one meal a day (in a very small amount).By the end of the first week, you should eliminate carbohydrates as much as possible (below is a list of foods for the keto diet), but the portion sizes decrease very slightly.
Another nuance: they claim that the keto diet without sports does not lose its effectiveness, and in order to lose weight you do not need to go to the gym or simply do any additional physical exercise.However, physical activity, as part of a healthy lifestyle, accelerates the burning of excess fat, so you should not lie on the couch.Moreover, you can use the moment and, following the example of bodybuilders, build muscle mass: gaining weight on a keto diet is possible only with muscle load, and then the subcutaneous fat will disappear, revealing strong muscles.
Keto Diet for Women
The problem with the keto diet is that previous research into its effectiveness and safety has only focused on men.A natural question to ask is whether the keto diet is suitable for women, given that women's hormones tend to be more sensitive to most dietary changes.
Although opinions differ, most experts say that the ketogenic diet produces positive results, especially for perimenopausal or menopausal women.This nutritional system allows you to lose excess weight, control blood glucose levels, improve sleep quality and reduce menopausal symptoms such as hot flashes or night sweats.
However, there are also negative reviews and even complaints of nausea, fatigue and constipation due to the diet (more details below in the Possible Complications section).It is also worth noting that switching to a keto diet is contraindicated in case of irregularities in the monthly cycle, thyroid pathology or during pregnancy and breastfeeding.
Women are recommended to combine intermittent fasting with a ketogenic diet, i.e. simply skipping lunch and a break of 10-12 hours between morning and evening meals, which gives a rejuvenating effect after 50-55 years (this is 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 rest from digestive functions and direct energy resources to restore tissue cells and balance hormones.
If a woman with a body weight of 75 kg and a height of 165-168 cm wants to lose weight to approximately 68 kg, she should go from 2300 kcal per day to an intake of no more than 1855 kcal.Protein should be 1-1.5 g per kilogram of ideal weight, that is, you can get about 68-102 g of protein, 240-350 g of fat and 18-20 g of carbohydrates (in clean water, without fiber) per day.
How is the keto diet different from a high-fat diet?
A high-fat or LCHF diet differs from a keto diet in the proportions of protein, fat and carbohydrates in the diet, with a high-fat diet assuming a ratio of 50% fat and 25% protein and carbohydrates.
In Europe, a high-fat (low-carb) diet is called the Swedish diet.Apparently, the Swedish therapist Annika Dahlqvist is responsible for this, who started recommending her patients with diabetes to consume more fat and limit carbohydrates, which is contrary to the officially approved recommendations of endocrinologists in Sweden.
Among the modifications of the ketogenic diet system, starting with the Atkins diet and the LCHF diet, one can mention strange dietary recommendations, for example, the egg fast on the keto diet - when for several days you need to eat only boiled chicken eggs with mayonnaise...
Cyclic keto diet and other modifications
In recent years, the standard keto diet (SKD) has been modified in many ways.This is how the high-protein ketogenic diet (HPKD) was born, in which 60% of calories come from fat, 35% from protein and 5% from carbohydrates.
The targeted ketogenic diet (TKD) is more moderate, as carbohydrates can be eaten before and after training;It is considered a sport, so the number of calories obtained by consuming carbohydrates is higher than in SKD.
Cyclic keto diet (CKD) or, according to another version, rotating keto diet (alternating), is a low-carbohydrate diet with alternating periods of consumption of large or moderate amounts of carbohydrates: 5-6 days - a minimum amount of carbohydrates, then a carbohydrate load is carried out on a keto diet without restriction of carbohydrates - one or two days are consumption carbohydrates.The unknown authors of this version of the keto diet try to justify their innovations with the need to replenish glycogen reserves, restore hormone levels and thyroid gland activity, as well as to ensure moral and psychological stability - to continue the diet.In fact, anything lost in six days is regained instantly.
Benefit
As foreign clinical practice shows, almost 20% of children with epilepsy after a ketogenic diet (followed from six months to two years, with a gradual return to a normal diet) experience seizures significantly less often, and many of them can reduce their intake of anticonvulsants or completely abandon them.
Based on the results of about twenty 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 severe obesity.Despite the high amount of fat, this diet over 24 weeks resulted in a significant percentage of patients with a decrease in systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels and an increase in high-density lipoprotein (HDL), or good cholesterol.
In 2008, the American Diabetes Association (ADA) revised its dietary guidelines and recognized a low-carbohydrate diet as an effective short-term dietary intervention for patients with non-insulin-dependent diabetes.
And yet, during the keto diet, the skin reacts to the lack of carbohydrate food in its own way, for example, acne can be reduced.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);sour cream, sour cream, butter (butter and vegetables).Hard cheese is very useful on the keto diet.But be careful with regular milk, because 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 or 600 calories.
It is recommended to include in the menu:
- mushrooms (except dried porcini mushrooms and porcini mushrooms), an ideal option is champignons (only 0.5 g of carbohydrates per 100 g).
- all types of leafy vegetables and vegetables that do not contain complex starch carbohydrates: broccoli and kohlrabi;white, cauliflower and Brussels sprouts (3-6 g of carbohydrates per 100 g);cucumbers, courgettes, courgettes, aubergines, peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (range 1.8-4.5g carbs per 100g).
You can eat some berries: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, blackberries, cranberries (100 g contains 12 g of carbohydrates).
If you observe moderation in their consumption while following the keto diet for weight loss, then you can occasionally eat 100 g of apricots, pineapples or grapefruit: that's approximately 11.8-12.4 g of carbohydrates.But you shouldn't eat bananas: every 100 grams of carbohydrates contains almost 23 g.
What can't you eat?You will have to give up bread and all flour;pasta;sugar, honey and sweets;any cereal porridge;potatoes, carrots, beets, celery root;pumpkins and all melons;legumes and most fruits.
Keto diet menu for the week
Seriously getting rid of excess fat reserves in your own body, of course, requires creating a menu for a week of a keto diet.And the information from the previous section will help with that.
For breakfast, you can cook scrambled eggs or an omelet - with onions, mushrooms and spinach, bacon and tomatoes.Coffee or tea, naturally, without sugar.
Lunch can consist of salad (the recipe for one of them is given below), vegetable soup or soup with meatballs (without potatoes, rice or noodles), chicken broth and boiled chicken, fried fish or pork and mushroom stew.
For dinner, choose proteins, such as turkey, beef, fish, seafood, with which - as a side dish - broccoli, brussels sprouts, green beans or peppers, seasoned with cream cheese sauce, go well.
Keto Diet Recipes
Taking into account the list of foods that are allowed on the keto diet, you can prepare so many different dishes that it is impossible to list even a dozen keto diet recipes.Try these three.
Chicken baked with vegetables
Products for two servings: 500 g of chicken (thighs, breast or fillet, cut into medium pieces), a tablespoon of vegetable oil, 1 green pepper (in medium cubes), half an onion (in small cubes), 500 g of cauliflower (cut into cubes), half a fin of scallions (5 g of scallions) 100-150 g of heavy cream, 50 g of hard cheese (gratedcoarse 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;
- Specially stew onions and peppers (sweet and bitter) in vegetable oil;
- Blanch the cauliflower florets in salted boiling water for three minutes, let the water drain;
- put the chicken in a mold (pan), add salt and pepper, add onion, pepper and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle coriander on top, put butter (a few pieces, all over the surface), cover with sour cream, sprinkle with grated cheese and put in the oven for 40-45 minutes.
Quick salad with ham or brisket
Products for two portions: 100 g of ham or breast, 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 salt to taste.
Preparation:
- cut the breast or ham into large strips;
- cut boiled eggs into quarters, vegetables into thin slices;
- put lettuce leaves on a plate, put ham on them, and eggs and vegetables on it, 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, one clove of garlic, 4 tablespoons of sour cream or thick tablespoons of cream, 2 tablespoons of cream.
Preparation:
- pour vegetable oil into a deep pan or pot with a thick bottom, add onion and chopped garlic, simmer for five minutes;
- put pieces of meat and fry a little;
- add chopped mushrooms, stir, add nutmeg and ground black pepper, salt;
- cook on low heat for 15 minutes, then add sour cream (cream) and herbs;
- Cover the pan with a lid and simmer until it's done (another 15 minutes).
Contraindications
Absolute contraindications for switching to a ketogenic diet include:
- diabetic ketoacidosis caused by insulin deficiency;
- congenital and secondary carnitine deficiency;
- pyruvate carboxylase deficiency;
- mitochondrial diseases caused by disturbed beta-oxidation of fatty acids;
- porphyria;
- pronounced abnormalities in blood composition, anemia due to iron deficiency;
- pancreatitis;
- acute and chronic inflammation of the gallbladder (cholecystitis);
- liver dysfunction, primary or metastatic liver tumors;
- acute kidney failure;
- intestinal dysfunction, Crohn's disease;
- abdominal tumors;
- condition after cancer chemotherapy.
You should be especially careful when considering the advice of bodybuilders to "stimulate" the metabolism with the help of pharmacological means: you should not risk your health in search of a super effect.
Possible risks
Risks associated with a diet used long-term in the complex treatment of epilepsy in children include the risk of growth retardation (due to reduced levels of insulin-like growth factor 1), deterioration of bone mineralization (due to calcium deficiency) and nephrolithiasis (kidney stone formation).Hyperlipidemia (high level of lipids in the blood) occurs in almost 60% of children, and cholesterol levels can increase by about 30%.
Rare side effects include cardiomyopathy, long QT interval syndrome (ventricular rhythm disorder), lack of vitamins, micro and macro elements.
The most common side effect is constipation, which almost a third of those who lose weight complain about: the lack of fiber intake affects this.In addition, the ketogenic diet in the initial stages can be accompanied by increased fatigue, weakness, headaches and dizziness;in women - dysmenorrhea.
If the weight does not decrease with the keto diet, then there is most likely too much protein in the diet, because more than half of the excess protein in the body is converted into glucose, that is, the process of induced ketosis is disturbed.
When muscles are very painful on a keto diet, the reason may be related to the violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid), and to the enzymatic breakdown of muscle tissue glycogen in conditions of ketosis.
At the beginning of the diet, reducing carbohydrate intake leads to fluid loss, and leg swelling on a keto diet can also occur with minor kidney failure.
Weight loss reviews and results
Reviews of doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies are limited to stating its unconditional effectiveness: even in senile dementia and Parkinson's disease, the attention of patients increases, memory and the adequacy of perception are significantly improved.
Experts usually comment on the reviews and results of those who have lost weight.But the considerable controversy surrounding all low-carbohydrate diets also contributes to the evaluation of specific results.
Thus, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a keto diet lost an average of 3.6-4 kg more over six months than those who restricted their fat intake.British obesity experts (British National Obesity Forum) also note that low-carbohydrate, high-fat diets are superior to low-fat diets in terms of weight loss effectiveness.Although many of their colleagues claim that the keto diet's weight loss results are "contrary to the available evidence."