The Ketogenic Diet: Is it for you?

THE KETOGENIC DIET: IS IT FOR YOU?

Recently, the ketogenic diet has become very popular for folks wanting rapid weight loss—which includes many of us seniors. It involves slashing the carbs you consume and replacing it with fat. This puts your body in a state of ketosis.

The ketogenic diet typically contains 75% fat, 20% protein and only 5% carbohydrates. This is more carb restrictive and fat favorable than the Atkins Diet which is 60-70% fat, 20-30% protein and 10% carbohydrates (although it begins with a strict 2-week ketogenic phase).

Here’s a more detailed description by Marcelo Campos, MD in the July 2017 Harvard Health Blog article Ketogenic diet: Is the ultimate low-carb diet good for you?

“In essence, it is a diet that causes the body to release ketones into the bloodstream. Most cells prefer to use blood sugar, which comes from carbohydrates, as the body’s main source of energy. In the absence of circulating blood sugar from food, we start breaking down stored fat into molecules called ketone bodies (ketosis). Once you reach ketosis, most cells will use ketone bodies to generate energy until we start eating carbohydrates again. The shift, from using circulating glucose to breaking down stored fat as a source of energy, usually happens over several days of eating fewer than 20 to 50 grams of carbohydrates per day.”

As with many health subjects, there are both strong proponents and opponents to the ketogenic diet.

On the PRO side, here are excerpts from a June 2017 healthline.com article by Rudy Mawer, MSc, CISSN, The Ketogenic Diet 101: A Detailed Beginner’s Guide

Ketogenic Diets Can Help You Lose Weight

A ketogenic diet is an effective way to lose weight and lower risk factors for disease.

In fact, research shows that the ketogenic diet is far superior to low-fat diets.

What’s more, the diet is so filling that you can lose weight without counting calories or tracking your food

One study found that people on a ketogenic diet lost 2.2 times more weight than those on a calorie-restricted low-fat diet. Triglyceride and HDL cholesterol levels also improved. Another study found that participants on the ketogenic diet lost 3 times more weight than those on the Diabetes UK’s recommended diet.

There are several reasons why a ketogenic diet is superior to a low-fat diet. One is the increased protein intake, which provides numerous benefits. The increased ketones, lowered blood sugar levels, and improved insulin sensitivity may also play a key role.

Health Benefits of the Ketogenic Diet

The ketogenic diet actually originated as a tool for treating neurological diseases, such as epilepsy.

Studies have now shown that the diet can have benefits for a wide variety of different health conditions:

• Diabetes and Prediabetes: The ketogenic diet can boost insulin sensitivity and cause fat loss, leading to drastic improvement for type 2 diabetes and prediabetes.
• 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.
• Epilepsy: Research has shown that the ketogenic diet can cause massive reductions in seizures in epileptic children,
• Parkinson’s disease: One study found that the diet helped improve symptoms of Parkinson’s disease.

However, keep in mind that research into these areas is far from conclusive.

Foods to Avoid

In short, any food that is high in carbs should be limited.

Here is a list of foods that need to be reduced or eliminated on a ketogenic diet:

• 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 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.

 

Foods to Eat

You should base the majority of your meals around these foods:

• 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
• Cheese: Unprocessed cheese (cheddar, goat, cream, blue or mozzarella).
• 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, tomatoes, onions, peppers, etc.
• Condiments: You can use salt, pepper and various healthy herbs and spices.

It is best to base your diet mostly on whole, single ingredient foods.

On the CON side of the ketogenic diet, here’s more from Dr. Marcelo Campos:

Lacking carbohydrates, a keto diet is extremely restrictive and very hard to follow over the long run. Carbohydrates normally account for at least 50% of the typical American diet. One of the main criticisms of this diet is that many people tend to eat too much protein and poor-quality fats from processed foods, with very few fruits and vegetables. People with kidney disease need to be cautious because this diet could worsen their condition. Additionally, some people may feel a little tired in the beginning, while some may have bad breath, nausea, vomiting, constipation, and sleep problems.

And, if you’re an athlete, here are more limitations from Chris Carmichael and Jim Rutberg in the trainright.com article Should Endurance Athletes Go Keto?

Ketosis is physiologically limiting

Without stored and exogenous carbohydrate during competition, you have very little fuel available for anaerobic glycolysis, the metabolic shortcut that rapidly produces energy by partially burning carbohydrate to meet elevated energy demands during short, high-intensity efforts.

Also, almost all endurance sports are actually intermittent-intensity sports rather than steady state intensity activities. While a long cycling event may have a moderate overall intensity, there are periods of high-intensity within it. Even ultramarathons and Ironman triathlons – long considered to be low-intensity, long-duration events – feature periods of intensity above lactate threshold. For competitors, hard efforts are required to drop rivals and build winning margins. Whether you are going for the win or trying to set a PR, you will achieve your best performances in events that feature intermittent high-intensity efforts by providing your body with adequate supplies of all fuels.

Ketosis is very disruptive to training  

Initially, you will have neither enough carbohydrate nor ketones to fuel your brain. While you are always producing ketones, it takes time (up to 2-3 weeks) for your body to increase production to the point you are relying on them as a primary energy source. During this period, training performance will definitely suffer (and lifestyle performance may suffer as well). Your power output will be lower than normal. Your running pace will be slower than normal. Perceived exertion will go up, at all intensity levels. Recovery from training sessions will be hindered.

Once you are adapted to fueling yourself primarily on ketones for day-to-day living, you still need to adapt to performing optimally as an athlete fueled by ketones. This can take months, during which time your only progress will be in fat adaptation, not aerobic development, the ability to produce power, or the ability to achieve faster paces.

If you’re going to try ketosis as an athlete, the best time to experiment would be a period of general aerobic endurance training. For summertime athletes this typically means fall or winter. It would be a mistake to try making this transition during a period of important, race-specific, high-intensity training.

What’s the bottom line?

Because I’m an advocate of us seniors staying healthy and physically active every day, I personally have to agree with Dr. Campos:

“A ketogenic diet could be an interesting alternative to treat certain conditions, and may accelerate weight loss. But it is hard to follow and it can be heavy on red meat and other fatty, processed, and salty foods that are notoriously unhealthy. We also do not know much about its long-term effects, probably because it’s so hard to stick with that people can’t eat this way for a long time. It is also important to remember that diets that lead to rapid weight loss fluctuation are associated with increased mortality. Instead of engaging in the next popular diet that would last only a few weeks to months (for most people that includes a ketogenic diet), try to embrace change that is sustainable over the long term. A balanced, unprocessed diet, rich in very colorful fruits and vegetables, lean meats, fish, whole grains, nuts, seeds, olive oil, and lots of water seems to have the best evidence for a long, healthier, vibrant life.”