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Ketogenic Diet: Another fad?

By Monica Perry

The newest hot word of the diet population.   I come to find out that when I meet with new clients, they have been on 5 or 6 different diets prior to meeting with me.   It’s no wonder that people fail at dieting.  There is too much information out there, and not enough simplicity.  There are too many “experts” coming up with the next diet before people can give the diet they are on a go.

What many do not realize is diets like the Ketogenic, gluten free, paleo,  low carb etc start out by treating medical conditions.  With these listed diets your are eliminating food from your daily diet so of course you are going to see some type of weight loss.  Of course, the dieting and food industry, given what it is, will capitalizes on the newest trends before you even have time to educate yourself.  Before you know it ,you are umping on the trendy diet bandwagon without even knowing why.  The real question you should be asking yourself, Do I have a medical condition that requires me to be on a certain diet.

What is the Keto diet?

A ketogenic diet gets most of the calories from protein and fat sources, and very little from carbohydrates (below 50g/day).  The idea is that this allowance brings the body into ketosis.

Buckle up…..there some science below! Bear with me its important that you know how this works.  I do not want you get bad information from a misinformed friend.

Ketosis activates key enzymes, that store energy from carbs, and when there is an scarcity of carbs the resulting reduced insulin level leads to a reduction in the metabolic formation of fat and accumulation.  After a few days of low carbs, glucose (sugar/carb) reserves, the body’s first form of energy usage,  becomes unavailable for both the fat oxidation via Krebs cycle and the supply of glucose to the central nervous system.

The central nervous system can not use fat for energy, because it normally uses glucose, so it is forced to use other sources of energy.   This alternative energy source comes from the over production of acetyl coenzyme A (CoA).  A condition usually seen in fasting, type 1 diabetes and high fat/low carb diets, this leads to the production of higher than normal ketone bodies and acetoacetate, B-hydroxybutyric and acetone, a process called ketogenesis which occurs in the liver

under normal conditions, with adequate carbs available, the free acetoacetic acid is rapidly metabolized in various tissues. In conditions of overproduction, like ketogenesis,  it is converted into other ketones called, ketonemia and ketonuria.  This is wear you get bad breath from the keto diet, because these volatile compounds are exited the body thru respiration.

The concentration of ketones and glucose have a similar chemical makeup, so then it is used by the nervous system as energy. Thus, leaving your body to burn fat and some muscle tissue in the process leading to some weight loss.

According to a study, these are the reasons you lose weight while on the keto diet:

  1. Reduction in appetite due to a higher satiety affect of proteins, effects on appetite control hormones and a possible direct appetite suppressant action of ketones.
  2. Reduction in absorbing fat and increase burning fat
  3. Reduction in resting respiratory quotient and therefore greater metabolic effeciency in burning fats
  4. Increase metabolic cost of gluconeogenesis( burning an extra 400-600 cal/ day) and the thermic effect of protein.

When you should use the keto diet?

Besides weight loss there are people who use this diet to treat medical conditions.  Using the types of foods used on the keto diet, helps keep medications at bay saving tons of money over time. These conditions are:

  • Treats epilepsy
  • diabetes
  • inflammatory diseases like arthritis
  • acne
  • control blood sugar, and cravings for sugar
  • obesity
  • blood pressure and high cholesterol

How to tell if you are in Ketosis

There are ketosis urine strips, you can find them at pharmacy’s.  I have heard they are not accurate, I can not personally attest to this.  However, some physical symptoms are increased urination, bad breath,  dry mouth and lack of hunger.

Dangers of keto dieting

  • High cholesterol. Some protein sources — like fatty cuts of meat, whole dairy products, and other high- saturated fat foods — can raise cholesterol, increasing your chance of heart disease.
  • Kidney problems. If you have any kidney problems, eating too much protein puts added strain on your kidneys.
  • Osteoporosis and kidney stones. When you’re on a high-protein diet, you may urinate more calcium than normal. Leading to less calcium absorption in the body.
  • Binge eating disorders.  Extreme dieting and cutting has been shown to set a person up for extreme binge eating

Questionable Relationship with Food

The problem with diets is that you deprive yourself of something.  Keto diets deprive you of carbs.  Unless you are treating a medical condition it is hard to sustain these types of limitations, especially when carbs tastes so freaking good.  While keto diet is highly effective for weight loss, it shouldn’t be a long term solution.    Keto eating has lead many to binge eat and even gain back some weight that has already been lost.

Chances are you want to try this diet because you are an excess of carbs in the first place.  Why limit something you have indulged in the past?  Don’t you think that is setting yourself up for failure.   Learn to balance out your lifestyle eating choices.  Losing weight is and always will be hard.  Do not indulge often.  Instead find out the why you indulge? Why you chose the foods you do? Are you stressed? Angry? Emotional?

It is important to know that we need carbs to provide energy for our bodies basic functioning systems.   The best sustaining way to lose weight and keep it off over time is having a macronutrient balance of Protein, carbs and fats.

Can you gain weight back after eating keto?

I found a study that looked at the effects of a keto diet.  There were two groups a base group with a regular macro diet and the test group with just the keto diet.

The groups did their given diet for 8 weeks and they looked at the effects of the diet for 8 weeks after. The findings are as such:

  • The keto group consumed a significant amount of calories when returning to a normal diet
  • Insulin levels were normalized during the keto diet but were elevated in returning to a normal diet.
  • the keto group had developed hyperphasia over time( excessive hunger and abnormally large intake of solids) leading to the significant caloric increase.
  • The Keto group when returning to a regular diet increase adiposity and plasma leptin levels

The point here is a keto diet while highly effective in short term, needs to be just that.  It is used to treat certain medical conditions and its important you know that.  The longer you use this type of diet, the more physiological and psychological effects it has on your body, increased weight, calorie binging etc.  .  A normal Macronutrient diet is best long term when it comes to losing weight.  It is more sustainable and normalizes your body functions while also losing weight.



Source:  Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European Journal of Clinical Nutrition, 67(8), 789-96.

Mandel, A., Ballew, M., Pina-Garza, J., Stalmasek, V., & Clemens, L. H. (2002). Medical costs are reduced when children with intractable epilepsy are successfully treated with the ketogenic diet. American Dietetic Association.Journal of the American Dietetic Association, 102(3), 396-8.

Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European Journal of Clinical Nutrition, 67(8), 789-96.

Honors, M. A., Davenport, B. M., & Kinzig, K. P. (2009). Effects of consuming a high carbohydrate diet after eight weeks of exposure to a ketogenic diet. Nutrition & Metabolism, 6, 46.

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