The ketogenic or keto diet is nothing new: one hundred years ago, before the advent of effective anticonvulsants, French pediatricians noticed that certain dietary restrictions reduced the frequency of seizures in children with 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" is said to belong to the American doctor Russell M. Wilder, who used it in the treatment of epilepsy in the 1920s and 1930s.last century.
The keto diet involves a high-fat diet, a moderate protein intake, and a very low carbohydrate intake.For most people, this nutrient ratio is considered safe for a limited period of time and not only helps to shed extra pounds, but also has therapeutic applications.
Directions 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 dietary treatment for 12 weeks).At the same time, children who are prescribed such a diet must be registered with doctors who monitor their normal growth and weight gain, and also make dietary adjustments according to the needs of each child.
Minimal carbohydrate diets have begun to be used for other ailments.Researchers have shown that ketogenic diets are useful in treating patients with DeVivo disease, a deficiency syndrome of the protein GLUT1 (which transports glucose across the blood-brain barrier), as well as numerous other inborn metabolic defects.
It is believed that this nutritional system can slow the progression of amyotrophic lateral sclerosis (Charcot's disease);Indications for the ketogenic diet include neurodegenerative conditions such as Alzheimer's disease and Parkinson's disease.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 best-known keto diet for weight loss is 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, 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-carb diet originally introduced to treat epilepsy.
Since the deposition of excess adipose tissue in the form of concentrated triglycerides in its cells occurs due to excessive consumption of carbohydrate foods (no one doubts this), limiting carbohydrates in the diet to a minimum - a keto diet for a month - helps to reduce fat reserves, that is, to lose weight.
Furthermore, the keto diet for oncology – by increasing the oxidative stress of cancer cells – has been found to significantly reduce the growth rate of malignant tumors located in the colon, stomach, prostate and lungs.Furthermore, it has already been shown that some tumors are more sensitive to chemotherapy due to the induced state of ketosis.
For the last twenty years the ketogenic diet has been used by bodybuilders to reduce the subcutaneous fat layer: in their jargon this is called “cutting a 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% carbohydrates (less than 50g per day).
Typically, the ratio of fat, protein and carbohydrates is 3:1 (i.e. 3 grams of fat for every gram of protein + carbohydrates).If the ratio is 4:1, 90% of the 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 body 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 the consumption of carbohydrate-containing foods.
Carbohydrates present in foods are transformed into glucose, but when a person consumes very few carbohydrates and a lot of fats, a chain of biochemical reactions is triggered in the body.Schematically this process looks like this.First, due to the decrease in blood glucose levels, the pancreas begins to produce more hormone glucagon, which stimulates the catabolism of glycogen stored in the liver into glucose and releases it into the blood.Secondly, ketogenesis is activated, i.e. the liver produces ketone bodies (acetoacetate, which is then transformed into β-hydroxybutyrate and acetone) and the conversion of dietary fats into free carboxylic (fatty) acids.Thirdly, due to the increased level of glucagon, the activity of lipase - an enzyme that breaks down triglycerides (fats) accumulated in adipose tissue cells - significantly increases.
Additionally, in the first two weeks after the keto diet, significant weight loss occurs due to the removal of water from the body, which is also associated with an increase in glucagon production.And therefore, a temporary side effect of a high-fat diet can be dehydration, which nutritionists recommend combating by drinking up to two liters of water a day.
Many people believe that an important benefit 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 especially 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 carbohydrate consumption must be reduced five times: from 250 g to a maximum of 50 g per day.
Remember that most of the calories on a keto diet come from foods high in natural fats and moderate amounts of protein.That is, this is not a “protein load,” 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.Then you will need to limit protein: per day to 1-2 g of protein per kilogram of body weight that you are trying to achieve as a result of weight loss.Example: If the starting weight is 112 kg and the desired weight is 85 kg, the amount of protein during the course is 85-170 g.
The exact ratio of fat, protein and carbohydrate in the diet (in grams) will depend on each individual man's age, goal, level of physical activity and health status.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 very small quantities).By 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 portion sizes decrease 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 carry out any 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, 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 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, as female hormones tend to be more sensitive to most dietary changes.
While opinions vary, most experts say the ketogenic diet produces positive results, especially for women in perimenopause or menopause.This nutritional system allows you to lose excess weight, control blood glucose levels, improve sleep quality and reduce menopause symptoms such as hot flashes or night sweats.
However, there are also negative reviews and even complaints about nausea, tiredness and constipation due to the diet (more details later in the Possible Complications section).It is also worth remembering that switching to the keto diet is contraindicated in case of monthly cycle irregularities, thyroid pathologies, or during pregnancy and breastfeeding.
Women are advised to combine periodic fasting with a ketogenic diet, that is, simply skip lunch and take a 10-12 hour break between the morning and evening meals, which after 50-55 years gives a rejuvenating effect (these are the 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 with a body weight of 75 kg and a height of 165-168 cm tries to lose weight to around 68 kg, she should go from 2300 kcal per day to consuming no more than 1855 kcal.Protein should be 1-1.5 g per kilogram of ideal weight, that is, every day you can take around 68-102 g of protein, 240-350 g of fat and 18-20 g of carbohydrates (in pure water, without fiber).
How is a 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, 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.Obviously, this is due to the Swedish therapist Annika Dahlqvist, who began to recommend that her patients with diabetes consume more fat and limit carbohydrates, which contradicts the officially approved recommendations of Swedish endocrinologists.
Among the modifications of the ketogenic food system, starting from the Atkins diet and the LCHF diet, one can mention strange dietary recommendations, for example, egg fasting in the keto diet - when for several days it is necessary to eat only boiled chicken eggs with mayonnaise...
Cyclic keto diet and other changes
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, as carbohydrates can be consumed before and after workouts;It is considered a sport, so the number of calories obtained from carbohydrate consumption is higher than that of SKD.
The cyclical keto diet (CKD) or, according to another version, the rotational (alternating) keto diet, is a low-carbohydrate diet with alternating periods of consuming high or moderate amounts of carbohydrates: 5-6 days - a minimal amount of carbohydrates, then carbohydrate loading is carried out with a keto diet - one or two days carbohydrates are consumed without restrictions.The unknown authors of this version of the keto diet are trying to justify their innovations with the need to replenish glycogen reserves, restore hormone levels and thyroid activity, as well as ensure moral and psychological stability - to continue the diet.In fact, everything that is lost in six days returns instantly.
Advantage
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 the normal diet) experience much less frequent seizures, and many of them can reduce the intake of anticonvulsants or abandon them completely.
Based on the results of two dozen randomized controlled trials, experts have come to the conclusion that the benefits of the keto diet include significant and fairly rapid loss of excess weight, especially in severe obesity.Despite the high amount of fat, this diet for 24 weeks 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.
Yet, during a keto diet, the skin reacts in its own way to the lack of carbohydrates, for example acne may decrease.And the results of a study published in the Journal of the American Academy of Dermatology confirm this.
What is possible and what is not?
What can you eat?The list of products recommended for the keto diet includes: any meats and meat by-products;bird;fish and seafood;eggs (all types);cream, sour cream, butter (butter and vegetable).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, sweets 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 dried porcini and boletus), the ideal option is champignons (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;whites, cauliflowers 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 1.8-4.5 g 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 keep your intake moderate while following a keto diet for weight loss, you can occasionally eat 100g of apricots, pineapple or grapefruit – that's about 11.8-12.4g of carbohydrates.But you shouldn't eat bananas: every 100 grams of carbohydrates contain 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, celeriac;pumpkins and all melons;legumes and most fruit.
Menu for a week of keto diet
To seriously eliminate excess fat reserves in your body, of course, you need to create a menu for the week of the keto diet.And the information in the previous section will help with this.
For breakfast you can cook scrambled eggs or omelettes with onions, mushrooms and spinach, bacon and tomato.Coffee or tea, of course, without sugar.
Lunch can consist of a salad (the recipe for one of them is given below), vegetable soup or soup with meatballs (without potatoes, rice or pasta), chicken broth and boiled chicken, fried fish or pork and mushroom stew.
For dinner, choose a protein dish, such as turkey, beef, fish, seafood, with which - as a side dish - broccoli, Brussels sprouts, green beans or peppers go well, seasoned with cream cheese sauce.
Keto diet recipes
Taking into account 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 recipes of the keto diet.Try these three.
Baked chicken with vegetables
Products for two servings: 500 g of chicken (thighs, breast or fillet, cut into medium pieces), a spoonful of vegetable oil, 1 green pepper (cut into medium cubes), half an onion (cut into cubes), 500 g of cauliflower (disassembled into florets), half a hot pepper (finely chopped), 50 g of butter, 100-150 g of fatty sour cream, 50 g of hard cheese(coarsely grated) 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;
- Cook onions and peppers (sweet and bitter) separately in vegetable oil;
- Blanch the cauliflower inflorescences in boiling salted water for three minutes, let the water drain;
- put the chicken in a mold (frying pan), salt and pepper, add onions, peppers and cabbage (evenly distribute the vegetables over the meat);
- Sprinkle coriander on top, put butter (several pieces, over the entire surface), pour sour cream, sprinkle with grated cheese and bake for 40-45 minutes.
Quick salad with ham or brisket
Products for two portions: 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 boiled eggs into quarters, the vegetables into thin slices;
- arrange the lettuce leaves on a plate, place the ham on top, the eggs and vegetables on top, season with 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 champignons, 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 cream, 2 tablespoons of chopped herbs, salt and ground black pepper, to taste.
Preparation:
- pour vegetable oil into a deep pan or thick-bottomed saucepan, add onion and chopped garlic, simmer for five minutes;
- put the pieces of meat and fry them 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 through (about 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 impaired beta-oxidation of fatty acids;
- porphyria;
- pronounced abnormalities in the composition of the blood, iron deficiency anemia;
- pancreatitis;
- acute and chronic inflammation of the gallbladder (cholecystitis);
- liver dysfunction, primary or metastatic liver tumors;
- acute renal failure;
- intestinal dysfunction, Crohn's disease;
- abdominal tumors;
- condition after anticancer chemotherapy.
Particular attention should be paid when considering the advice of bodybuilders to “stimulate” the metabolism with the help of pharmacological agents: 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 decreased levels of insulin-like growth factor 1), deterioration of bone mineralization (due to calcium deficiency) and nephrolithiasis (kidney stone formation).Hyperlipidemia (high blood lipids) occurs in nearly 60 percent of children, and cholesterol levels can increase by about 30 percent.
Rare side effects include cardiomyopathy, long QT syndrome (ventricular rhythm disorder of the heart), vitamin, micro and macroelement deficiency.
The most common side effect is constipation, which almost a third of those who lose weight complain about: it is affected by the lack of fiber intake.Furthermore, the ketogenic diet in the initial stages may be accompanied by increased fatigue, weakness, headaches and dizziness;in women - dysmenorrhea.
If weight does not decrease on a keto diet, then most likely there is too much protein in the diet, since more than half of the excess protein is transformed into glucose in the body, that is, the process of induced ketosis is interrupted.
When 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 glycogen of muscle tissue 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 occur even in mild kidney failure.
Weight loss reviews and results
Reviews of doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies are reduced to declaring its unconditional effectiveness: even with senile dementia and Parkinson's disease, patients' attention increases, memory and adequacy of perception improve significantly.
Typically, 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 specific outcomes.
Thus, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a keto diet, on average, lost 7 to 10 pounds more in six months than those who limited 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 effectiveness in weight loss.Although many of their colleagues claim that the results provided by the keto diet on weight loss are “contrary to the available evidence”.