Use fat as a lever. We’ve been taught to fear fat, but don’t! Both keto and low carb are high fat diets. Fat is our source of energy as well as satiety. The key to understand, though, is that fat is a lever on a low carb or keto diet. Carbs and protein stay constant, and fat is the one you increase or decrease (push the lever up or down) to gain or lose weight, respectively. So if your goal is weight loss, eat enough fat to be satisfied, but there’s no need to “get your fats in” once you’re satisfied.
Blanket statement: It’s always best to check with your doctor before starting on this regimen. With that said, “the keto diet isn’t recommended for those with liver or kidney disease, or someone with a medical condition, such as a gastrointestinal issue, who can’t metabolize high amounts of dietary fat,” says Sarah Jadin, a Los-Angeles based registered dietitian and founder of Keto Consulting, LLC. If you’ve had your gallbladder removed, the keto diet may be a no-go. Women who are pregnant or breastfeeding and people with certain rare genetic disorders shouldn’t try this diet.
Ketosis is a nutritional process characterised by serum concentrations of ketone bodies over 0.5 mM, with low and stable levels of insulin and blood glucose. It is almost always generalized with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted (or from metabolising medium-chain triglycerides). Ketones can also be consumed in exogenous ketone foods and supplements.
The high fat content in the diet, especially if you’re eating saturated fats, can raise your cholesterol levels and contribute to developing cardiovascular disease. Without the fiber from whole grains and fruits, you’re also likely to get constipated and have other digestive issues. Plus you need fiber to maintain a health gut microbiome, which tends to come from the kind of whole grains that you can’t eat on the diet, and though it is possible to get enough fiber from vegetables on the keto diet you have to carefully monitor your eating to ensure that. Neither Giancoli nor Fung any of the other dietitians and nutritionists who evaluated keto for a recent US News & World Report diets ranking would recommend it. Many of them said they had serious concerns about long-term safety of doing keto. Though you may very well lose weight, most people on most diets gain the weight back (and sometimes even more) when they go off the diet, which many dieters do because radical shifts in what you eat are hard to maintain for long periods of time.
Drink lots of water. This is especially crucial on a low carb or keto diet. Why? When you eat carbohydrates, your body stores the extra as glycogen in the liver, where they are bound to water molecules. Eating low carb depletes this glycogen, which allows you to burn fat – but it also means you are storing less water, making it easier to get dehydrated. Instead of the traditional recommendation of 8 cups of water per day, aim for 16 cups when following a low carb lifestyle.
Schele E., Grahnemo L., Anesten F., Hallen A., Backhed F., Jansson J. O. (2013). The gut microbiota reduces leptin sensitivity and the expression of the obesity-suppressing neuropeptides proglucagon (Gcg) and brain-derived neurotrophic factor (Bdnf) in the central nervous system. Endocrinology 154, 3643–3651. 10.1210/en.2012-2151 [PubMed] [CrossRef]
Bread probably isn’t the first thing that comes to mind when you think about the ketogenic diet because it’s generally full of carbs. But, if you replace your store-bought bread with a homemade keto bread recipe, it can fit seamlessly into your keto low-carb, high-fat diet. How does bread even become keto-friendly? With almond flour, a lot of eggs, cream of tartar, butter, baking soda and apple cider vinegar.
There are three instances where there’s research to back up a ketogenic diet, including to help control type 2 diabetes, as part of epilepsy treatment, or for weight loss, says Mattinson. “In terms of diabetes, there is some promising research showing that the ketogenic diet may improve glycemic control. It may cause a reduction in A1C — a key test for diabetes that measures a person’s average blood sugar control over two to three months — something that may help you reduce medication use,” she says.