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 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 authorship of the name “ketogenic diet” is attributed to the American doctor Russell M. Wilder, who used it in the treatment of epilepsy in the 20-30s.last century.
The keto diet includes a diet high in fat, moderate in protein, and very low in carbohydrates.For most people, this percentage of nutrients is considered safe for a limited period of time and not only helps you lose extra pounds but also has medicinal applications.
Indications for use
The low-carbohydrate keto diet for epilepsy, widely used in clinical practice abroad, has 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 prescribed such a diet must register with a doctor to monitor the child's normal growth and weight gain, and adjust the diet to suit each child's needs.
Minimal carbohydrate diets have begun to be used for other disorders.Researchers have shown that the ketogenic diet is useful in treating patients with DeVivo disease, a GLUT1 (glucose transport across the blood-brain barrier) protein deficiency syndrome, as well as several other inborn metabolic 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 conditions such as Alzheimer's and Parkinson's diseases.Clinical studies are underway on the effects of the ketogenic diet on the condition of patients with autism, depression, type 2 (non-insulin-dependent) diabetes, and polycystic ovary syndrome.
The best known keto diet for weight loss is the Atkins diet for obesity, modified and popularized by Dr. Robert Atkins (Dr. Atkins Diet Revolution, 1972).Although experts consider only the initial phase of this diet to be ketogenic in nature.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 it was essentially a low-carbohydrate 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-containing foods (no one doubts this fact), limiting carbohydrates in the diet to a minimum - keto diet for a month - helps reduce fat stores, that is, lose weight.
In addition, it was found that the keto diet for cancer - by increasing the oxidative stress of cancer cells - significantly reduces the growth rate of malignant tumors localized in the colon, stomach, prostate and lungs.Additionally, it has been shown that some cancers are more sensitive to chemotherapy due to the state of ketosis.
Over the past two decades, the ketogenic diet has been used by bodybuilders to reduce subcutaneous fat: in their slang, it is called keto cutting.
The essence of the keto diet
On a standard keto diet, your total daily calories should consist of 70-80% fat, 15-20% protein and 5% carbohydrates (less than 50g per day).
Typically, the ratio of fat to protein to carbohydrate is 3:1 (i.e. 3 grams of fat for every gram of protein + carbohydrate).If the ratio is 4:1 then 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 lose excess weight is to put the body in 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 eating foods containing carbohydrates.
Carbohydrates in food are converted into glucose, but when a person consumes very few carbohydrates and a lot of fat, a chain of biochemical reactions is triggered in the body.This process diagram looks like this.First, as blood sugar levels decrease, the pancreas begins to produce more of the hormone glucagon, which stimulates the catabolism of glycogen stored in the liver into glucose and release into the blood.Second, ketogenesis is activated, meaning the liver produces ketone bodies (acetoacetate, which is then converted to β-hydroxybutyrate and acetone) and converts dietary fats to free carboxylic (fatty) acids.Third, as glucagon levels increase, the activity of lipase, an enzyme that breaks down triglycerides (fats) accumulated in adipose tissue cells, increases significantly.
Additionally, during the first two weeks of the keto diet, weight is significantly reduced due to the body eliminating water, 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 overcome by drinking up to two liters of water a day.
Many people believe that the important advantages of the keto diet are not feeling hungry, not needing to count calories, and exercising for hours to burn excess calories.
Keto diet for men
The keto diet is considered especially effective for men with abdominal obesity.
If the therapeutic diet for obesity recommends reducing calorie intake by 2000 (2300) kcal per day, then the ketogenic diet does not control calories so strictly (but a reduction of at least 10-20% will not do any harm).But carbohydrate consumption must be reduced five times: from 250 g to a maximum of 50 g per day.
Remember that the majority of calories on the keto diet come from foods naturally high in fat and moderate amounts of protein.That is, this is not “protein loading” as some may think.And if a man is used to eating a lot of meat, then his body will enter the adaptive state of ketosis much more slowly.Therefore, you will have to limit your protein intake: per day to 1-2 g of protein per kg of body weight that you are trying to achieve through weight loss.For example, if the initial weight is 112 kg and the desired weight is 85 kg, then the protein intake during the course is 85-170 g.
The exact ratio of fat, protein and carbohydrates in the diet (in grams) will depend on a person's age, goals, physical activity level and health status.But people should fast short-term on the keto diet: during the first two days of switching to this food system, you should drink plenty of water and limit yourself to one meal a day (in very small quantities).By the end of the first week, you should eliminate as many carbohydrates as possible (here's a list of foods for the keto diet), but portion sizes will be reduced very slightly.
Another nuance: they claim that a keto diet without sports will not lose its effectiveness, and to lose weight you do not need to go to the gym or just do any additional physical exercises.But physical activity, as part of a healthy lifestyle, accelerates the process of burning excess fat, so you should not lie on the couch.Moreover, you can take advantage of this moment and, following the example of bodybuilders, build muscle mass: gaining weight on a keto diet is possible only with muscle loading, then subcutaneous fat will disappear, revealing healthy muscles.
Keto diet for women
The problem with the keto diet is that to date, research on its effectiveness and safety has focused only on men.A natural question to ask is whether the keto diet is suitable for women, as female hormones tend to be more sensitive to most dietary changes.
Although opinions vary, most experts agree that the ketogenic diet produces positive results, especially for premenopausal or postmenopausal 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 there are even complaints of nausea, fatigue and constipation due to the diet (see more details below in the Possible Complications section).It is also worth mentioning that switching to a keto diet is contraindicated in case of irregular monthly cycles, pathology of the thyroid gland or during pregnancy and lactation.
Women should combine periodic fasting with a ketogenic diet, that is, simply skipping lunch and resting 10-12 hours between breakfast and dinner, which after 50-55 years will bring a rejuvenating effect (this is data from a 2016 study published in the Journal of the American Medical Association).According to Western nutrition experts, this diet helps the body pause digestive functions and control energy sources to restore tissue cells and balance hormones.
If a woman weighing 75 kg and 165-168 cm tall wants to lose weight to about 68 kg, she should switch 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 is the keto diet different from a high-fat diet?
A high-fat diet or LCHF differs from a keto diet in the ratio 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-carbohydrate) diet is called the Swedish diet.Apparently, this is due to Swedish therapist Annika Dahlqvist, who began recommending that her diabetic patients 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 from the Atkins diet and the LCHF diet, one can name strange dietary recommendations, such as eating eggs on a keto diet - when for a few days you just need to eat 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.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 eaten before and after exercise;It is considered athletic so the number of calories obtained from consuming carbohydrates is higher than in SKD.
Cyclical keto diet (CKD) or, in another version, alternating (alternating) keto diet, is a low-carb diet with alternating periods of high or moderate carbohydrate consumption: 5-6 days - minimal carbohydrate intake, then keto carbohydrate loading - one or two days of carbohydrates consumed without restriction.The anonymous authors of this version of the keto diet are trying to justify their innovations by 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 lost in six days comes back immediately.
benefit
As foreign clinical practice shows, almost 20% of children with epilepsy after a ketogenic diet (followed by six months to two years, gradually returning to a normal diet) had fewer seizures, and many of them were able to reduce the amount of anticonvulsants or abandon them altogether.
Based on the results of two dozen randomized controlled studies, experts have concluded that the benefits of the keto diet include significant and fairly rapid weight loss, especially in severe obesity.Despite its high fat intake, this diet for 24 weeks reduced systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels and increased high-density lipoprotein (HDL), i.e. good cholesterol.
In 2008, the American Diabetes Association (ADA) revised its dietary guidelines and recognized a low-carbohydrate diet as an effective short-term dietary intervention for patients with non-insulin-dependent diabetes.
And yet, on the keto diet, the skin will react to the lack of carbohydrate foods in its own way, for example, acne may decrease.And this is confirmed by the results of a study published in the Journal of the American Academy of Dermatology.
What's possible and what's not?
What can you eat?The list of products recommended for the keto diet includes: any meat and meat byproducts;bird;fish and seafood;eggs (all types);cream, sour cream, butter (butter and vegetables).Hard cheese is very useful on the keto diet.But be careful with regular milk, because it contains a lot of lactose - milk sugar, which is a disaccharide carbohydrate.But fermented milk products can be consumed without worry: during the fermentation of fermented milk, lactose is hydrolyzed.
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.
Should include on the menu:
- mushrooms (except dried porcini and boletus), the ideal choice is mushrooms (only 0.5 g of carbohydrates per 100 g).
- all green leafy vegetables and vegetables that do not contain starchy complex carbohydrates: broccoli and kohlrabi;white, cauliflower and Brussels sprouts (3-6 g carbohydrates per 100 g);cucumbers, zucchini, zucchini, eggplant, bell peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (about 1.8-4.5 g carbohydrates per 100 g).
You can eat some berries: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, raspberries, cranberries (100 g contain 12 g of carbohydrates).
If you stick to moderate consumption while following a keto diet for weight loss, you can occasionally eat 100 g of apricots, pineapple or grapefruit: about 11.8-12.4 g of carbohydrates.But you shouldn't 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;macaroni;sugar, honey and confectionery;any grain;potatoes, carrots, radishes, celery root;pumpkin and all types of melons;legumes and most fruits.
Menu for a week of keto diet
Of course, getting serious about shedding excess fat stores in your body requires creating a menu for your keto week.And the information in the previous section will help with this.
For breakfast, you can cook scrambled eggs or omelets - with onions, mushrooms and spinach, bacon and tomatoes.Coffee or tea, natural, unsweetened.
Lunch can consist of salads (recipe for one of them is given below), vegetable soup or soup with meatballs (without potatoes, rice or noodles), chicken broth and boiled chicken, fried fish or pork and stewed mushrooms.
For dinner, choose a protein, such as turkey, beef, fish, seafood, with a side dish - broccoli, Brussels sprouts, green beans or bell peppers, flavored with a creamy cheese sauce, go well.
Keto diet secrets
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 1/10 of the keto diet recipes.Try these three.
Grilled chicken and vegetables
Products for two servings: 500 g of chicken (thigh, breast or fillet, cut into medium pieces), a spoonful of vegetable oil, 1 green bell pepper (cut into medium cubes), half an onion (cut into small cubes), 500 g cauliflower (disassembled into florets), half a small hot pepper (finely chopped), 50 g butter, 100-150 g fatty sour cream, 50 g hard cheese (coarsely grated).squeezed), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Prepare:
- Preheat the oven to 180°, grease a baking dish or frying pan with vegetable oil;
- Cook onions and peppers (sweet and bitter) separately in vegetable oil;
- Blanch cauliflower florets in salted boiling water for three minutes, then drain;
- Put the chicken in the mold (pan), salt and pepper, add onions, peppers and cabbage (evenly distribute the vegetables over the meat);
- Sprinkle coriander on top, put butter (a few 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
The product is for two servings: 100 g of ham or brisket, 250 g of lettuce (dried after washing), two fresh cucumbers, one tomato, two eggs (hard-boiled), 60 g of dill or parsley, 1 tablespoon of olive oil and the same amount of mayonnaise, salt to taste.
Prepare:
- cut brisket or ham into large strips;
- cut boiled eggs into quarters, vegetables into thin slices;
- Arrange lettuce leaves on a plate, put ham on top, eggs and vegetables on top, add salt;
- mix vegetable oil with mayonnaise, add finely chopped greens, mix and pour this dressing over the salad.
Pork stewed with mushrooms
The product is for three servings: 300-400 g of pork pulp, 350 g of fresh mushrooms, half an onion (finely chopped), 2 spoons of vegetable oil, half a spoon of nutmeg, a clove of garlic, 4 spoons of sour cream or heavy cream, 2 spoons of chopped herbs, salt and ground black pepper, season to taste.
Prepare:
- Pour vegetable oil into a pan or deep pan with a thick bottom, add chopped onion and garlic, simmer for five minutes;
- put the pieces of meat and fry a little;
- Add chopped mushrooms, mix well, add nutmeg and ground black pepper, salt;
- cook over low heat for 15 minutes, then add sour cream (cream) and herbs;
- Cover the dish and simmer until cooked (about another 15 minutes).
Contraindicated
Absolute contraindications to switching to a ketogenic diet include:
- diabetic ketoacidosis due to lack of insulin;
- congenital and secondary carnitine deficiency;
- pyruvate carboxylase deficiency;
- Mitochondrial disease due to impaired fatty acid beta-oxidation;
- porphyria;
- pronounced abnormalities in blood composition, iron deficiency anemia;
- pancreatitis;
- acute and chronic cholecystitis (cholecystitis);
- liver dysfunction, primary or metastatic liver tumors;
- acute kidney failure;
- bowel dysfunction, Crohn's disease;
- abdominal tumor;
- condition after cancer chemotherapy.
Particular caution should be taken when considering the advice of bodybuilders about “stimulating” metabolism with the help of pharmacological agents: you should not risk your health in pursuit of super performance.
Risks may occur
Risks associated with diets used long-term in the complex treatment of childhood epilepsy include risk of growth retardation (due to reduced insulin-like growth factor 1 levels), impaired bone mineralization (due to calcium deficiency), and nephrolithiasis (formation of kidney stones).Hyperlipidemia (high blood lipids) occurs in nearly 60% of children, and cholesterol levels can increase by about 30%.
Rare side effects include cardiomyopathy, long QT syndrome (ventricular arrhythmia of the heart), deficiencies of vitamins, trace elements and macronutrients.
The most common side effect is constipation, which almost a third of people who lose weight complain about: lack of fiber will affect it.Additionally, the ketogenic diet in the early stages may be accompanied by increased fatigue, weakness, headaches, and dizziness;in women - dysmenorrhea.
If weight does not decrease when using a keto diet, then most likely the diet has too much protein, because more than half of the excess protein will be converted into glucose in the body, that is, the process of creating ketosis is disrupted.
When there is a lot of muscle soreness when using a keto diet, the cause may be related to both a violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid) and the enzymatic breakdown of glycogen in muscle tissue under conditions of ketosis.
When starting the diet, reducing carbohydrate intake leads to dehydration and leg swelling on a keto diet that can occur even with mild kidney failure.
Weight loss reviews and results
Reviews from doctors who prescribe the ketogenic diet to patients with neurodegenerative diseases show its unconditional effectiveness: even with senile dementia and Parkinson's disease, patients' attention span increases, memory and cognitive abilities improve significantly.
Usually, reviews and results of people who have lost weight are commented on by experts.But the considerable controversy surrounding all low-carbohydrate diets also contributes to the assessment of specific results.
Thus, according to the American Journal of Clinical Nutrition, researchers found that on average, men and women who switched to a keto diet lost 3.6-4 kg over six months compared to those who restricted their fat intake.British obesity experts (UK 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 results of the keto diet for weight loss are “contrary to the available evidence”.