In the world of weight-loss diets, low-carbohydrate, high-protein eating plans often grab attention. The Paleo, South Beach, and Atkins diets all fit into that category. They are sometimes referred to as ketogenic or "keto" diets.
But a true ketogenic diet is different. Unlike other low-carb diets, which focus on protein, a keto plan centers on fat, which supplies as much as 90% of daily calories. And it's not the type of diet to try as an experiment.
"The keto diet is primarily used to help reduce the frequency of epileptic seizures in children. While it also has been tried for weight loss, only short-term results have been studied, and the results have been mixed. We don't know if it works in the long term, nor whether it's safe," warns registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.
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How does it work?
The keto diet aims to force your body into using a different type of fuel. Instead of relying on sugar (glucose) that comes from carbohydrates (such as grains, legumes, vegetables, and fruits), the keto diet relies on ketone bodies, a type of fuel that the liver produces from stored fat.
Burning fat seems like an ideal way to lose pounds. But getting the liver to make ketone bodies is tricky:
• It requires that you deprive yourself of carbohydrates, fewer than 20 to 50 grams of carbs per day (keep in mind that a medium-sized banana has about 27 grams of carbs).
• It typically takes a few days to reach a state of ketosis.
• Eating too much protein can interfere with ketosis.
What do you eat?
Because the keto diet has such a high fat requirement, followers must eat fat at each meal. In a daily 2,000-calorie diet, that might look like 165 grams of fat, 40 grams of carbs, and 75 grams of protein.
However, the exact ratio depends on your particular needs.
Some healthy unsaturated fats are allowed on the keto diet — like nuts (almonds, walnuts), seeds, avocados, tofu, and olive oil. But saturated fats from oils (palm, coconut), lard, butter, and cocoa butter are encouraged in high amounts.
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Protein is part of the keto diet, but it doesn't typically discriminate between lean protein foods and protein sources high in saturated fat such as beef, pork, and bacon.
What about fruits and vegetables? All fruits are rich in carbs, but you can have certain fruits (usually berries) in small portions. Vegetables (also rich in carbs) are restricted to leafy greens (such as kale, Swiss chard, spinach), cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes. A cup of chopped broccoli has about six carbs.
Keto risks
A ketogenic diet has numerous risks. Top of the list: it's high in saturated fat. McManus recommends that you keep saturated fats to no more than 7% of your daily calories because of the link to heart disease. And indeed, the keto diet is associated with an increase in "bad" LDL cholesterol, which is also linked to heart disease.
Other potential keto risks include these:
Nutrient deficiency. "If you're not eating a wide variety of vegetables, fruits, and grains, you may be at risk for deficiencies in micronutrients, including selenium, magnesium, phosphorus, and vitamins B and C,"
Liver problems. With so much fat to metabolize, the diet could make any existing liver conditions worse.
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Kidney problems. The kidneys help metabolize protein, and McManus says the keto diet may overload them. (The current recommended intake for protein averages 46 grams per day for women, and 56 grams for men).
Constipation. The keto diet is low in fibrous foods like grains and legumes.
Fuzzy thinking and mood swings. "The brain needs sugar from healthy carbohydrates to function. Low-carb diets may cause confusion and irritability," McManus says.
Those risks add up — so make sure that you talk to a doctor and a registered dietitian before ever attempting a ketogenic diet.
What about the other diets?
The popular low-carb diets (such as Atkins or Paleo) modify a true keto diet. But they come with the same risks if you overdo it on fats and proteins and lay off the carbs. So why do people follow the diets? "They're everywhere, and people hear anecdotally that they work," McManus says. Theories about short-term low-carb diet success include lower appetite because fat burns slower than carbs. "But again, we don't know about the long term," she says. "And eating a restrictive diet, no matter what the plan, is difficult to sustain. Once you resume a normal diet, the weight will likely return."
All of the food above sticks to the strict 5% carbohydrate allowance that we use on keto. In general, you can eat from the following food groups:
• Fats & Oils. Try to get your fat from natural sources like meat and nuts. Supplement with saturated and monounsaturated fats like coconut oil, butter, and olive oil.
• Protein. Try to stick with organic, pasture-raised and grass-fed meat where possible. Most meats don’t have added sugar in them, so they can be consumed in moderate quantity. Remember that too much protein on a ketogenic diet is not a good thing.
• Vegetables. Fresh or frozen doesn’t matter. Stick with above ground vegetables, leaning toward leafy/green items.
• Dairy. Most dairy is fine, but make sure to buy full-fat dairy items. Harder cheeses typically have fewer carbs.
• Nuts and Seeds. In moderation, nuts and seeds can be used to create some fantastic textures. Try to use fattier nuts like macadamias and almonds.
• Beverages. Stay simple and stick to mostly water. You can flavor it if needed with stevia-based flavorings or lemon/lime juice.
If you scroll down, you can see in-depth breakdowns of each section along with some ideas on what types of food to eat! If you’re not much of the planning type and would rather follow along to get meal ideas, take a look at out
Fats and Oils
Fats will be the majority of your daily calorie intake when you are on a ketogenic diet, so choices should be made with your likes and dislikes in mind. They can be combined in many different ways to add to your meals – sauces, dressings, or just simply topping off a piece of meat with butter.
Fats are vital to our bodies, but they can also be dangerous if you are consuming too much of the wrong types of fats. There are a few different types of fat that are involved in a ketogenic diet. Different foods usually have various combinations of fats, but the unhealthy fats are easy to avoid. Here’s a brief overview:
• Saturated Fats. Eat these. Some examples of these are butter, ghee, coconut oil, and lard.
• Monounsaturated Fats. Eat these. Some examples of these are olive, avocado, and macadamia nut oils.
• Polyunsaturated Fats. Know the difference. Naturally occurring polyunsaturated fats in animal protein and fatty fish are great for you, and you should eat these. Processed polyunsaturated fats in “heart healthy” margarine spreads are bad for you.
• Trans Fats. Completely avoid. These are processed fats that are chemically altered (hydrogenated) to improve shelf life. Avoid all hydrogenated fats, such as margarine, as they’re linked to heart disease.
Saturated and monounsaturated fats such as butter, macadamia nuts, avocado, egg yolks, and coconut oil are more chemically stable and less inflammatory to most people, so they are preferred. Below, you can see some common ways to increase the amounts of fat you eat on a ketogenic diet.
You also want to have a balance between your omega 3’s and omega 6’s, so eating things like wild salmon, tuna, trout, and shellfish can help provide a balanced diet of Omega-3’s. If you don’t like fish, or just prefer not to eat it, we suggest taking a small fish oil supplement. You can also take krill oil for omega 3’s if you are allergic.
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Keep an eye on your intake for nut or seed based foods, as they can be quite high in inflammatory omega 6’s. These include items like almonds, walnuts, pine nuts, sunflower oil and corn oil. Eating fatty fish and animal meat, keeping snacking to a minimum, and not over-indulging in dessert items that are dense in almond flour is usually enough to keep your omega’s at normal ranges.
Essential fatty acids (the omegas) provide core functions to the human body, but they are often times out of balance when on a standard diet. On keto, with a little bit of preparation, your omega fatty acids are easily manageable. If you want to know more about essential fatty acids, omegas, and how they interact with our body on a ketogenic diet,
Some ketogenic diet foods that are ideal for fats and oils (organic and grass-fed sources are preferred):
• Fatty Fish
• Animal Fat (non-hydrogenated)
• Lard
• Tallow
• Avocados
• Egg Yolks
• Macadamia/Brazil Nuts
• Butter/Ghee
• Mayonnaise
• Coconut Butter
• Cocoa Butter
• Olive Oil
• Coconut Oil
• Avocado Oil
• Macadamia Oil
• MCT Oil
If you’re using vegetable oils (olive, soybean, flax, or safflower) choose the “cold pressed” options if they are available.
If you tend to fry things up, try to go after non-hydrogenated lards, beef tallow, ghee, or coconut oil since they have higher smoke points than other oils. This allows less oxidization of the oils, which means you get more of the essential fatty acids.
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