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.
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. It is said that the author of the name "ketogenic diet" 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 diet, moderate protein intake, and very low carbohydrate intake.For most people, this ratio of nutrients is considered safe for a limited period of time and not only helps you lose extra pounds, 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 various 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 adjustments to the diet in accordance with the needs of each child.
Low-carb diets have begun to be used for other diseases as well.Researchers have shown that ketogenic diets are helpful in treating patients with DeVivo disease, GLUT1 deficiency syndrome (which transports glucose across the blood-brain barrier), and several other metabolic birth defects.
It is believed that this nutritional system 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 diseases.Clinical studies are being conducted 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 famous keto diet for weight loss is 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 introductory phase of this diet to be ketogenic.And, frankly, 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 triglycerides concentrated in its cells occurs due to the excessive consumption of carbohydrate foods (no one doubts this fact), limiting carbohydrates in the diet to a minimum - a keto diet for one month - helps to reduce fat reserves, that is, weight loss.
In addition, the keto diet for oncology was found - by increasing the oxidative stress of cancer cells - to significantly reduce the growth rate of malignant tumors located in the colon, stomach, prostate gland and lungs.In addition, certain types of cancer have already been shown to be more sensitive to chemotherapy due to the induced state of ketosis.
For the past two decades, the ketogenic diet has been used by bodybuilders to reduce the fat layer under the skin: in their jargon, this is called reducing 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).
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 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 foods containing carbohydrates.
Carbohydrates in food are transformed into glucose, but when a person consumes too few carbohydrates and too much fat, a chain of biochemical reactions is triggered in the body.Schematically, this process looks like this.First, due to reduced blood sugar levels, the pancreas begins to produce more of the hormone glucagon, which stimulates the catabolism of glycogen stored in the liver into glucose and its release into the blood.Second, 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.Third, 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.
In addition, during the first two weeks of following the keto diet, significant weight loss is observed 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 daily.
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 high in natural fat and moderate amounts of protein.That is, it is not a "protein load" as some may think.And if a person is used to eating a lot of meat, then his body will enter a state of adaptive ketosis much more slowly.So 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 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 of each individual man.But short-term fasting during the keto diet is recommended for everyone: during 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 additional physical exercises.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: weight gain 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 so far research into its effectiveness and safety has only focused on men.The natural question that arises 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 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 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 menstrual cycle irregularities, thyroid gland pathologies or during pregnancy and breastfeeding.
Women are recommended to combine intermittent fasting with a ketogenic diet, that is, simply skip lunch and take a break of 10-12 hours between morning and evening meals, which after 50-55 years gives a rejuvenating effect (this is data from a 2016 study published in the Journal of the American Medical Association).According to Western nutritionists, this diet allows the body to rest from digestive functions and directs energy resources to repair tissue cells and balance hormones.
If a woman with a body weight of 75 kg and a height of 165-168 cm seeks to lose weight to approximately 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, daily you can get about 68-102 g of protein, 240-350 g of fat and 18-20 g of carbohydrates (in pure water, without fiber).
How does a keto diet differ from a high-fat diet?
A high-fat or LCHF diet differs from a keto diet in the ratio of protein, fat and carbohydrates in the food, and a high-fat diet suggests a ratio of 50% fat and 25% protein and carbohydrates.
In Europe, the high-fat (low-carbohydrate) diet is called the Swedish diet.Apparently, this is due to the Swedish therapist Annika Dahlqvist, who began recommending to 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 food system, starting with the Atkins diet and the LCHF diet, one can name strange dietary recommendations, for example, the egg fasting of the keto diet - when 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.This is how the High Protein Ketogenic Diet (HPKD) came about, where 60% of calories come from fat, 35% from protein, and 5% from carbohydrates.
The Targeted Ketogenic Diet (TKD) is more moderate in that carbohydrates can be taken before and after exercise;It is considered a sport, so the number of calories obtained from the consumption of carbohydrates is higher than with SKD.
The cyclic keto diet (CKD) or, according to another version, the rotational keto diet (alternating), is a low-carbohydrate diet with alternating periods of consumption of large or moderate amounts of carbohydrates: 5-6 days - a minimal amount of carbohydrates, after which a carbohydrate load is carried out on a keto diet - one or two days of consuming carbohydrates without restriction.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 ensure moral and psychological stability - to continue the diet.In fact, anything lost in six days is returned 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) have seizures much less often, and many of them can reduce the intake of anticonvulsants or completely abandon them.
Based on the results of two dozen randomized controlled trials, experts concluded that the benefits of the keto diet include significant and relatively rapid weight loss, especially in severe obesity.Despite the high amount of fat, this diet for 24 weeks resulted in a significant percentage of patients with a decrease in systolic blood pressure, blood sugar and insulin levels, plasma levels of C-reactive protein and an increase in high-density lipoprotein (HDL), i.e.the 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 to the lack of carbohydrate foods in its own way, for example, acne can 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 a keto diet includes: any meat and meat offal;a 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 fermented milk fermentation, lactose undergoes hydrolysis.
Instead of popcorn, candy or chips, walnuts (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 mushrooms and porcini mushrooms), the ideal option is champignons (only 0.5 g of carbohydrates per 100 g).
- all types of leafy vegetables and vegetables that do not contain starch complex carbohydrates: broccoli and kohlrabi;white, cauliflower and Brussels sprouts (3-6 g of carbohydrates per 100 g);cucumbers, courgettes, zucchini, aubergine, 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 contain about 8 g of carbohydrates), cherries, raspberries, blackberries, cranberries (100 g contain 12 g of carbohydrates).
If you adhere to moderation in their consumption while following a keto diet for weight loss, then you can occasionally eat 100 g of apricots, pineapple or grapefruit: this is approximately 11.8-12.4 g of carbohydrates.But you should not eat bananas: every 100 grams of carbohydrates contain almost 23 grams.
What can't you eat?You will have to give up bread and all flour;pasta;sugar, honey and confectionery;any cereals;potatoes, carrots, beets, celery root;pumpkins and all melons;legumes and most fruits.
Menu for a week on a keto diet
Seriously getting rid of excess fat stores in your own body, of course, requires drawing up a menu for the week of the keto diet.And the information in the previous section will help with this.
For breakfast, you can prepare scrambled eggs or an omelet - with onions, mushrooms and spinach, bacon and tomato.Coffee or tea, naturally, without sugar.
Lunch can consist of a salad (the recipe for one is given below), vegetable soup or meatball soup (no 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 broccoli, Brussels sprouts, green beans or bell peppers flavored with cream cheese sauce.
Keto Diet Recipes
Considering the list of foods allowed on a 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.
Roast chicken with vegetables
Products for two servings: 500 g of chicken (thighs, breast or fillet, cut into medium pieces), a tablespoon of 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 hot pepper (chopped finely), 50 g of butter, 100-150 g of fat sour cream, 50 ghard cheese (grated on a large grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Preparation:
- heat the oven to 180 °, grease a baking tray or pan with vegetable oil;
- Separately stew the onions and peppers (sweet and bitter) in vegetable oil;
- Blanch cauliflower florets in salted boiling water for three minutes, drain;
- put the chicken in a form (pan), salt and sprinkle with black pepper, add the onions and peppers and the cabbage (the vegetables are distributed evenly over the meat);
- Sprinkle coriander on top, put butter (several pieces, all over the 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 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 mayonnaise, salt to taste.
Preparation:
- cut breast or ham into large strips;
- cut boiled eggs into quarters, vegetables into thin slices;
- arrange the lettuce leaves on a plate, put 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, 350 g of fresh mushrooms, half an onion (finely chopped), 2 tablespoons of oil, half a teaspoon of nutmeg, one 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 a 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 (sour cream) and herbs;
- Cover the pot with a lid and let it simmer until done (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 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;
- bowel dysfunction, Crohn's disease;
- abdominal tumors;
- condition after cancer chemotherapy.
The advice of bodybuilders to "stimulate" the metabolism with the help of pharmacological means should be taken into account especially carefully: you should not risk your health in pursuit of 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 reduced levels of insulin-like growth factor 1), deterioration of bone mineralization (due to calcium deficiency) and nephrolithiasis (kidney stone formation).Hyperlipidemia (high lipids in the blood) occurs in almost 60% of children, and cholesterol levels can rise by about 30%.
Rare side effects include cardiomyopathy, prolonged QT interval syndrome (ventricular rhythm disorder), vitamin, micro- and macronutrient deficiencies.
The most common side effect is constipation, which is complained about by almost a third of those losing weight: the lack of fiber intake is reflected.In addition, the ketogenic diet in the initial stages can be accompanied by increased fatigue, weakness, headache and dizziness;in women - dysmenorrhea.
If the weight does not disappear with 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, i.e.the process of induced ketosis is impaired.
When the muscles are very painful during a keto diet, the reason can be related to both a violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid) and the enzymatic breakdown of muscle tissue glycogen under conditions of ketosis.
At the beginning of the diet, reducing carbohydrate intake leads to fluid loss, and leg swelling with a keto diet can occur even with mild kidney failure.
Weight loss reviews and results
Reviews of doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies are reduced to indicating its unconditional effectiveness: even with senile dementia and Parkinson's disease, the attention of patients increases, memory and the adequacy of perception significantly improve.
Usually, weight loss reviews and results are commented by experts.But the considerable controversy surrounding all low-carb 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 in six months than those who restricted 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 keto diet's weight loss results are "contrary to the available evidence."