Keto Diet

  I am not a doctor – so I can’t help you with any medical advises. For these you will need to consult your doctor. But you will find (on the bottom of each page) medical articles on which I based my information. My advise is that after you read the information I presented – to print the references and have a discussion with your doctor.

  While I can’t help you medically, I am a certified Life Coach and Professional Engineer (PEng). So I can counsel and encourage you in taking the best decisions in your personal life.

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  Please read also the Lectins, the Evil Protein. It will explain certain facts about why you have gut issues and weight gain.

Started 82kg (181lbs)     got to 73kg (161lbs) and still losing   

What is Keto diet (also known as Ketogenic diet)?

  According with Wikipedia:

The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that in medicine is used primarily to treat difficult-to-control (refractory) epilepsy in children. The diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain-function. However, if there is very little carbohydrate in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source. An elevated level of ketone bodies in the blood, a state known as ketosis, leads to a reduction in the frequency of epileptic seizures.
The classic therapeutic ketogenic diet was developed for treatment of paediatric epilepsy in the 1920s and was widely used into the next decade, but its popularity waned with the introduction of effective anticonvulsant drugs. In the mid-1990s, Hollywood producer Jim Abrahams, whose son’s severe epilepsy was effectively controlled by the diet, created the Charlie Foundation to promote it. Publicity included an appearance on NBC’s Dateline programme and …First Do No Harm (1997), a made-for-television film starring Meryl Streep. The foundation sponsored a multicentre research study, the results of which—announced in 1996—marked the beginning of renewed scientific interest in the diet.
Almost half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet. The most common adverse effect is constipation, affecting about 30% of patients—this was due to fluid restriction, which was once a feature of the diet, but this led to increased risk of kidney stones, and is no longer considered beneficial. There is some evidence that adults with epilepsy may benefit from the diet, and that a less strict regimen, such as a modified Atkins diet, is similarly effective. Clinical trials and studies in animal models (including C. elegans) suggest that ketogenic diets provide neuroprotective and disease-modifying benefits for a number of adult neurodegenerative disorders. As of 2012, there is limited clinical trial data in these areas, and, outside of paediatric epilepsy, use of the ketogenic diet remains at the research stage.

   Beyond definition keto diet is also known for being a low carb diet, where the body produces ketones in the liver to be used as energy. It’s referred to as many different names – ketogenic diet, low carb diet, low carb high fat (LCHF), etc. When you eat something high in carbs, your body will produce glucose and insulin.

  Glucose is the easiest molecule for your body to convert and use as energy, so it will be chosen over any other energy source. Insulin is produced to process the glucose in your bloodsteam, by taking it around the body. Since the glucose is being used as a primary energy, your fats are not needed, and are therefore stored. Typically on a normal, higher carbohydrate diet, the body will use glucose as the main form of energy.

   On a ketogenic diet your entire body switches its fuel supply to run almost entirely on fat. Insulin levels become very low and fat burning increases dramatically. It becomes easy to access your fat stores to burn them off. This is obviously great if you’re trying to lose weight.

   There are several versions of the ketogenic diet, including:

  • Standard ketogenic diet (SKD): This is a very low-carb, moderate-protein and high-fat diet. It typically contains 75% fat, 20% protein and only 5% carbs.
  • High-protein ketogenic diet: This is similar to a standard ketogenic diet, but includes more protein. The ratio is often 60% fat, 35% protein and 5% carbs.
  • Cyclical ketogenic diet (CKD): This diet involves periods of higher-carb refeeds, such as 5 ketogenic days followed by 2 high-carb days.
  • Targeted ketogenic diet (TKD): This diet allows you to add carbs around workouts.

   However, only the standard and high-protein ketogenic diets have been studied extensively. Cyclical or targeted ketogenic diets are more advanced methods, and primarily used by bodybuilders or athletes.

   So, when I mention here keto diet I refer mostly to the Standard Ketogenic Diet.

Health Benefits of the Ketogenic Diet

   A quite large amount of studies have now shown that the diet can have benefits for a wide variety of different health conditions (I listed just a small amount of the studies under references. I found more than hundred articles stating different health benefits of the low carb diet):

  • Diabetes, prediabetes and metabolic syndrome: The ketogenic diet can help you lose excess fat, which is closely linked to type 2 diabetes, prediabetes and metabolic syndrome.
  • Heart disease: The ketogenic diet can improve risk factors like body fat, HDL levels, blood pressure and blood sugar.
  • Cancer: The diet is currently being used to treat several types of cancer and slow tumor growth. As this seems like a big claim I will mention, specifically, to look at reference 25. I found more studies, but as I mentioned will be almost impossible to list all the studies refering to different diseases. But I am sure that googling cancer and keto diet will reveal a lot of this studies.
  • Alzheimer’s disease: The diet may reduce symptoms of Alzheimer’s and slow down the disease’s progression.
  • Epilepsy: Research has shown that the ketogenic diet can cause massive reductions in seizures in epileptic children.
  • Parkinson’s disease: Some studies found that the diet helped improve symptoms of Parkinson’s disease.
  • Polycystic ovary syndrome: The ketogenic diet can help reduce insulin levels, which may play a key role in polycystic ovary syndrome.
  • Brain injuries: One animal study found that the diet can reduce concussions and aid recovery after brain injury. Check reference 26.
  • Acne: Lower insulin levels and eating less sugar or processed foods may help improve acne.

   So, what keto diet really involves. What means as the foods you can or can’t eat.

Foods to Eat

  • Meat: Red meat, steak, ham, sausage, bacon, chicken and turkey.
  • Fatty fish: Such as salmon, trout, tuna and mackerel.
  • Eggs: Look for pastured or omega-3 whole eggs.
  • Butter and cream: Look for grass-fed when possible. For people with lactose intolerance there are now milk substitutes that are lactose free including goat milk, almonds milk …
  • Cheese: Unprocessed cheese (cheddar, goat, cream, blue or mozzarella). Same here, if you are lactose intolerant there are options out there like lactose free cheese or goat cheese.
  • Nuts and seeds: Almonds, walnuts, flaxseeds, pumpkin seeds, chia seeds, etc.
  • Healthy oils: Primarily extra virgin olive oil, coconut oil and avocado oil.
  • Avocados: Whole avocados or freshly made guacamole.
  • Low-carb veggies: Most green veggies, onions, peppers, etc.
  • Condiments: You can use salt, pepper and various healthy herbs and spices.

Foods to Avoid

  • Sugary foods: Soda, fruit juice, smoothies, cake, ice cream, candy, etc.
  • Grains or starches: Wheat-based products, rice, pasta, cereal, etc.
  • Fruit: All fruit, except small portions of berries like strawberries.
  • Beans or legumes: Peas, kidney beans, lentils, chickpeas, etc.
  • Root vegetables and tubers: Potatoes, sweet potatoes, carrots, parsnips, etc
  • Low-fat or diet products: These are highly processed and often high in carbs.
  • Some condiments or sauces: These often contain sugar and unhealthy fat.
  • Unhealthy fat: Limit your intake of processed vegetable oils, mayonnaise, etc.
  • Alcohol: Due to its carb content, many alcoholic beverages can throw you out of ketosis.
  • Sugar-free diet foods: These are often high in sugar alcohols, which can affect ketone levels in some cases. These foods also tend to be highly processed.

Who should NOT do a ketogenic diet?

   Most people can safely do a ketogenic diet. But in these three situations you may need extra preparation or adaptation:

  • Are you on medication for diabetes, e.g. insulin?
  • Are you on medication for high blood pressure?
  • Are you breastfeeding?

   Please visit Diet Doctor website for more information about these situations. Also, this is a great website for a lot of other facts about keto diet. I recommend taking a look.

Are there any side effects with ketogenic diet?

   Yes there are some side effects mostly when you start switching your way of eating. This starting period is also called the induction period.

  • Induction flu: headache, lethargy, nausea, confusion / brain fog, irritability. The most common side effect on low carb is what most people experience during the first week, often during days 2-4. The “induction flu”, so called as it can mimic flu-like symptoms. Cure: water, salt and fat. Try adding half a teaspoon of regular salt to a large glass of water. Drink it. This may reduce or eliminate side effects in 15-30 minutes. If so, this may be repeated once daily if needed during the first week. Also, make sure to eat enough fat. Going low carb, low fat is a recipe for starvation and feeling hungry and tired. You should never endure hunger as you start low carb. A proper low-carb diet contains enough fat to feel satisfied and energetic. This can speed up the transition and minimize the time spent feeling low when starting low carb. If you can’t get that high fat easily in the next page Paleo and Keto My Way, Tips I included some tips. Practically add some coconut oil to your meals. Some people prefer butter. But I prefer coconut oil for its extra benefits.
  • Leg cramps: Leg cramps are not uncommon when starting a strict low-carb diet. In the start of the keto diet there is a fast weight loss due to water loss. Eating high carbs makes your body retain water. Once you switch your body to get its energy from fat instead of carbs – all that extra water will go away. Even more, did you know that for every 1 gram of body fat you retain 4 grams of water! So, as you start lossing waight part of it will be water retention. Back to leg cramps – it’s a side effect of the loss of minerals, specifically magnesium, due to increased urination. Cure: drink plenty of fluid and get enough salt. This can reduce any loss of magnesium and can help prevent leg cramps. If needed, supplement magnesium.
  • Constipation or diarheea: Constipation/diarheea is another possible side effect that can occur, especially during the first time on a low-carb diet, as your digestive system may need time to adapt. If your previous diet was relatively low in fat your body probably hasn’t ever had to process a consistently high-fat diet. When your pancreas isn’t producing enough fat-digesting enzymes to keep up with demand, improperly digested fat can cause diarrhea. Cure: Drink plenty of fluid and get enough salt. The most common cause of constipation on low carb is dehydration. This makes the body absorb more water from the colon and thus the contents get dryer, harder and constipation can result. Eat plenty of vegetables or another source of fibre. Getting enough good quality fiber from the diet keeps the intestines moving and reduces the risk of constipation/diarheea. Another, and completely carb-free, option for adding fibre to the diet is inulin (powder that can be dissolved in water).
  • Bad Breath: On a strict low-carb diet some people experience a characteristic smell on their breath, a fruity smell that often remind people of nail polish remover. Usually is temporary. The smell is from acetone, a ketone body. This is a sign that your body is burning lots of fat and even converting lots of fat to ketones to fuel the brain. You are burning fat. In about a week or two the body adapts and stops “losing” ketones through breath and sweat. Cure: again drink enough fluid and get enough salt. Maintain a good oral hygiene.
  • Heart Palpitations: It’s common to experience a slightly elevated heart rate during the first few weeks on low carb. It’s also common to experience that the heart is beating a bit harder. This is normal and usually nothing to worry about. One common cause is dehydration and lack of salt. A reduction in the amount of circulating fluid in the blood stream means that the heart will have to pump blood slightly harder or faster to maintain blood pressure. Cure: drink enough fluid and make sure to get enough salt. In the uncommon situation that the problem persists – and the palpitations are bothersome to you – it’s always possible to slightly increase the carb intake. This will reduce the effect of the low-carb diet somewhat, so it’s a trade-off.
  • Reduced Physical Performance: During your first time on a low-carb diet your physical performance can be severely reduced. Can be a lack of fluid and salts or the fact that simply takes time for the body to adapt from being a sugar-burner to burning primarily fat for energy, even in the muscles. It takes weeks or a few months. This adaptation will be faster the more you exercise while on a low carb, high fat diet. Cure: again drink enough fluid and get enough salt. And be patient. The benefits of LCHF diets in sports are mainly seen in long-distance running and other endurance events. The body’s fat stores are huge and dwarfs the minuscule glycogen stores. This means that once fat-adapted, an athlete can perform for long periods of time without needing much (if any) external energy. This frees the athlete from having to activate his or her gastrointestinal organs during activity – a large amount of blood flow can instead be directed to the muscles. This also minimizes the risk of stomach problems during the activity. Remember that acid reflux you have after a meal when you try to exercise or even do some house chores? You can take your good bye from it.

   You may find more about these side effects at Diet Doctor Side Effects. They have a very detailed description.

   If you want to read a short exert of some of the studies listed in the references, feel free to visit Authority Nutrition.


References:
1. Foster GD, et al. New England Journal of Medicine, 2003. A randomized trial of a low-carbohydrate diet for obesity.
2. Samaha FF, et al. New England Journal of Medicine, 2003. A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity
3. Sondike SB, et al. The Journal of Pediatrics, 2003. Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents
4. Brehm BJ, et al. The Journal of Clinical Endocrinology & Metabolism, 2003. A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women
5. Aude YW, et al. Archives of Internal Medicine, 2004. The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat.
6. Yancy WS Jr, et al. Annals of Internal Medicine, 2004.
A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia.
7. JS Volek, et al. Nutrition & Metabolism (London), 2004. Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women.
8. Meckling KA, et al. The Journal of Clinical Endocrinology & Metabolism, 2004. Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women.
9. Nickols-Richardson SM, et al. Journal of the American Dietetic Association, 2005. Perceived hunger is lower and weight loss is greater in overweight premenopausal women consuming a low-carbohydrate/high-protein vs high-carbohydrate/low-fat diet.
10. Daly ME, et al. Diabetic Medicine, 2006. Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes.
11. McClernon FJ, et al. Obesity (Silver Spring), 2007. The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms.
12. Gardner CD, et al. The Journal of The American Medical Association, 2007. Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study.
13. Halyburton AK, et al. American Journal of Clinical Nutrition, 2007. Low- and high-carbohydrate weight-loss diets have similar effects on mood but not cognitive performance.
14. Dyson PA, et al. Diabetic Medicine, 2007. A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects.
15. Westman EC, et al. Nutrion and Metabolism (London), 2008. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus.
16. Shai I, et al. New England Journal of Medicine, 2008. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet.
17. Keogh JB, et al. American Journal of Clinical Nutrition, 2008. Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity.
18. Tay J, et al. Journal of The American College of Cardiology, 2008. Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects.
19. Volek JS, et al. Lipids, 2009. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet.
20. Brinkworth GD, et al. American Journal of Clinical Nutrition, 2009. Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 months.
21. Hernandez, et al. American Journal of Clinical Nutrition, 2010. Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, low-carbohydrate diet.
22. Krebs NF, et al. Journal of Pediatrics, 2010. Efficacy and safety of a high protein, low carbohydrate diet for weight loss in severely obese adolescents.
23. Guldbrand, et al. Diabetologia, 2012. In type 2 diabetes, randomization to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss.
24. Yancy WS Jr, Foy M, Chalecki AM, Vernon MC, Westman EC Nutr Metab (Lond). 2005 Dec 1 A low-carbohydrate, ketogenic diet to treat type 2 diabetes.
25. Weihua Zhou, Purna Mukherjee, Michael A Kiebish, William T Markis, John G Mantis, and Thomas N Seyfried Nutr Metab (Lond). 2007 The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer.
26. Prins ML1, Fujima LS, Hovda DA. J Neurosci Res. 2005 Nov 1 Age-dependent reduction of cortical contusion volume by ketones after traumatic brain injury.