The ketogenic diet is not new: A hundred years ago, before effective anticonvulsant drugs were available, French pediatricians noticed that certain dietary restrictions could reduce the frequency of seizures in children with drug-resistant epilepsy.
Based on metabolic research, a therapeutic diet free of starch and sugar was developed, which became part of the complex treatment of epilepsy in the early 1900s.The author of the name "ketogenic diet" is said to be American doctor Russell M. Wilder, who used it to treat epilepsy in the 1920s and 1930s.last century.
The ketogenic diet consists of a high-fat diet, moderate protein intake, and very low carbohydrate intake.This nutritional ratio is considered safe for a limited time for most people and can not only help you lose excess weight but also has therapeutic uses.
Instructions for use
A low-carbohydrate ketogenic diet widely used clinically in foreign countries to treat epilepsy has helped children of different ages reduce the frequency of epileptic seizures by 62-75% (after 12 weeks of dietary treatment).At the same time, children prescribed this diet must register with a doctor, have their normal growth and weight gain monitored, and have the diet adjusted according to each child's needs.
Diets containing minimal carbohydrates have begun to be used to treat other diseases.Researchers have shown that the ketogenic diet is effective in treating patients with DeVivo disease, a deficiency syndrome of the protein GLUT1 (which transports glucose across the blood-brain barrier), and several other inborn errors of metabolism.
This nutritional system is believed to slow the progression of amyotrophic lateral sclerosis (Charcot's disease); indications for the ketogenic diet include neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease.Clinical studies of the effects of the ketogenic diet on conditions such as autism, depression, type 2 diabetes (non-insulin dependent), and polycystic ovary syndrome are ongoing.
The best-known ketogenic diet for weight loss is the Atkins diet for treating obesity, modified and popularized by Dr. Robert Atkins (The Atkins Diet Revolution, 1972).Although experts believe that only the induction phase of this diet is ketogenic.In fairness, it should be noted that long before him, many American doctors were working on the principles of the ketogenic diet: Peter Huttenlocher, Alfred Pennington, Richard McCarnes, and others.For example, R. McCarnes wrote the book "Eat Fat to Lose Weight" in 1958, which is essentially the same low-carbohydrate diet originally used to treat epilepsy.
Since excessive intake of carbohydrate foods causes excess fat tissue to be deposited in cells in the form of triglycerides (a fact that no one doubts), limiting carbohydrates in the diet to a minimum (on a ketogenic diet for a month) helps reduce fat stores, i.e. lose weight.
Additionally, studies have found that the keto diet for oncology—by increasing oxidative stress on cancer cells—significantly reduces the growth rate of malignant tumors located in the colon, stomach, prostate, and lungs.Additionally, some cancers have been shown to be more sensitive to chemotherapy due to the induced state of ketosis.
For the past two decades, bodybuilders have used the ketogenic diet to reduce the layer of fat beneath their skin: in their slang, this is called "cutting the ketogenic diet."
The Essence of the Keto Diet
On a standard ketogenic diet, total daily calories should come from 70-80% fat, 15-20% protein, and 5% carbohydrates (less than 50 grams per day).
Typically, the ratio of fat to protein and carbohydrates is 3:1 (i.e. 3 grams of fat per gram of protein + carbohydrates).If the ratio is 4:1, then 90% of the energy comes from fat, 8% from protein, and only 2% from carbohydrates (about 20 grams per day).
The essence of a diet used for weight loss is to put the body into a state of adaptive ketosis—a time when the body obtains energy (ATP) primarily from ketones in the blood rather than from the glucose from eating carbohydrate-containing foods.
Carbohydrates in food are converted into glucose, but when a person consumes very few carbohydrates and large amounts of fat, a series of biochemical reactions are triggered in the body.The process looks roughly like this.First, as blood sugar levels decrease, the pancreas begins producing more of the hormone glucagon, which stimulates the catabolism of stored glycogen in the liver into glucose and its release into the blood.Second, ketogenesis is activated, in which the liver produces ketone bodies (acetoacetate, which is then converted to beta-hydroxybutyrate and acetone) and converts dietary fat into free carboxylic acids (fatty acids).Third, as glucagon levels increase, the activity of lipase (an enzyme that breaks down triglycerides (fat) that accumulates in adipose tissue cells) increases significantly.
Additionally, during the first two weeks after a ketogenic diet, significant weight loss occurs due to the elimination of water from the body, which is also associated with increased glucagon production.Therefore, a temporary side effect of a fat-rich diet may be dehydration, and nutritionists recommend drinking up to two liters of water per day to combat dehydration.
Many people consider an important advantage of the ketogenic diet to be the lack of hunger pangs and the need to count calories and exercise for hours to burn off excess calories.
ketogenic diet for men
The keto diet is thought to be particularly effective for men with abdominal obesity.
If a diet to treat obesity recommends reducing caloric intake to 2000 (2300) kcal per day, then the ketogenic diet does not control calories so strictly (but a reduction of at least 10-20% does not hurt).But carbohydrate intake must be reduced fivefold: from 250 grams per day to a maximum of 50 grams.
Remember, most of the calories on a ketogenic diet come from foods rich in natural fats and moderate amounts of protein.That said, this isn’t a “protein load” as some people think.And if a person is used to eating a lot of meat, his body will enter adaptive ketosis much more slowly.Therefore, you must limit your protein intake: 1-2 grams of protein per kilogram of body weight per day is what you want to achieve during your weight loss journey.For example: If the initial weight is 112 kg and the desired weight is 85 kg, the protein content during the course will be 85-170 grams.
The exact proportions (in grams) of fat, protein and carbohydrates in the diet will depend on each man's age, goals, physical activity level and health.But it is recommended that everyone perform short-term fasting during the ketogenic diet: during the first two days of switching to this food system, you should drink a lot of water and limit yourself to one (small) meal per day.By the end of the first week, you should be eliminating carbs as much as possible (here's a list of foods for the keto diet), but portion sizes will be slightly reduced.
Another nuance: they claim that the ketogenic diet without exercise does not lose its effectiveness, and to lose weight you do not need to go to the gym or simply perform any additional physical activity.But physical activity as part of a healthy lifestyle will speed up the burning of excess fat, so you shouldn't lie on the couch.In addition, you can take advantage of this opportunity and follow the example of bodybuilders and build muscle mass: weight gain can only be achieved with the ketogenic diet if the muscles are loaded, and then the subcutaneous fat will disappear, revealing strong muscles.
ketogenic diet for women
The problem with the ketogenic diet is that, to date, studies on its effectiveness and safety have only looked at men.A natural question is whether the ketogenic diet is appropriate for women, since female hormones tend to be more sensitive to most dietary changes.
While opinions vary, most experts say the ketogenic diet produces positive results, especially for women in perimenopause or menopause.This nutritional system can help you lose weight, control blood sugar levels, improve sleep quality, and reduce menopausal symptoms like hot flashes or night sweats.
However, there are also negative reviews and even complaints of nausea, fatigue, and constipation caused by the diet (see the Possible Complications section below for more details).It is also worth mentioning that switching to a keto diet is contraindicated if there are irregular menstrual cycles, thyroid disease, or abnormalities during pregnancy and lactation.
Women are advised to combine regular fasting with a ketogenic diet, which involves skipping lunch and taking a 10-12 hour break between breakfast and dinner, to produce rejuvenating effects after 50-55 years (these figures come from a 2016 study published in the Journal of the American Medical Association).According to Western nutrition experts, this dietary regimen allows the body to take a break from digestive functions and direct energy resources to restore tissue cells and balance hormones.
If a woman who weighs 75 kilograms and is 165-168 centimeters tall wants to lose weight to about 68 kilograms, she should change her daily intake from 2,300 kcal to no more than 1,855 kcal.The ideal protein per kilogram of body weight should be 1-1.5 grams, which means that every day you can get approximately 68-102 grams of protein, 240-350 grams of fat and 18-20 grams of carbohydrates (purified water, no fiber).
How is the keto diet different from a high-fat diet?
The high-fat or LCHF diet differs from the keto diet in the ratio of protein, fat and carbohydrates in the diet, with the high-fat diet assuming a 50% fat ratio and a 25% protein and carbohydrate ratio.
In Europe, a high-fat (low-carbohydrate) diet is known as the Swedish diet.Apparently, this is to the credit of Swedish therapist Annika Dahlqvist, who began recommending that her diabetic patients eat more fat and limit carbohydrates, contradicting the officially approved advice of Swedish endocrinologists.
Among the modifications of the ketogenic food system, starting with the Atkins diet and the LCHF diet, one can name strange dietary recommendations, for example, egg fasting on the ketogenic diet - for several days in a row you only have to eat boiled eggs and mayonnaise...
Cyclical Keto Diet and Other Modifications
In recent years, the standard ketogenic diet (SKD) has been modified in many ways.As a result, the high-protein ketogenic diet (HPKD) came into being, in which 60% of calories come from fat, 35% from protein, and 5% from carbohydrates.
The Targeted Ketogenic Diet (TKD) is gentler because carbohydrates can be consumed before and after exercise; it is considered exercise, so the calories gained from consuming carbohydrates are higher than with SKD.
The cyclic keto diet (CKD), or according to another version, the rotating keto diet (alternating), is a low-carb diet that alternates the consumption of large or moderate amounts of carbohydrates: 5-6 days - the lowest amount of carbohydrates, and then carb loading on the keto diet - one or two days of unrestricted consumption of carbohydrates.The unknown authors of this ketogenic diet are trying to justify their innovation through the need to replenish glycogen stores, restore hormone levels and thyroid activity, and ensure moral and psychological stability (to continue the diet).In fact, everything lost in six days comes back immediately.
benefit
Foreign clinical practice shows that nearly 20% of epileptic children have greatly reduced the number of epileptic seizures after a ketogenic diet (gradually returning to a normal diet after six months to two years), and many of them can reduce the intake of anticonvulsant drugs or give up anticonvulsant drugs completely.
Based on the results of two dozen randomized controlled studies, experts have concluded that the benefits of the ketogenic diet include significant and fairly rapid loss of excess weight, especially in cases of severe obesity.Despite being high in fat, the diet resulted in lower systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels, and increases in high-density lipoprotein (HDL), the good cholesterol, in a large proportion of patients over 24 weeks.
In 2008, the American Diabetes Association (ADA) revised its dietary guidelines to recognize a low-carbohydrate diet as an effective short-term dietary intervention for patients with non-insulin-dependent diabetes.
However, during the keto diet, the skin will respond in its own way to the lack of carbohydrate foods, such as acne may be reduced.The results of a study published in the Journal of the American Academy of Dermatology confirm this.
What is possible and what is impossible?
What can you eat?The list of products recommended for use on the keto diet includes: any meat and meat by-products; birds; fish and seafood; eggs (all types); cream, sour cream, butter (butter and vegetable).Hard cheese is great for the keto diet.But be careful with regular milk, as it contains high amounts of lactose—lactose, a disaccharide carbohydrate.But fermented dairy products can be eaten with confidence: during the fermentation process of fermented milk, lactose will be hydrolyzed.
Walnuts (approximately 13g carbohydrates per 100g) and sunflower seeds (approximately 10.5g carbohydrates per 100g) are suitable alternatives to popcorn, sweets or crisps.Calorie counts are 655 and 600 respectively.
It is recommended to include in the menu:
- Mushrooms (except dried porcini and porcini), the ideal choice is shiitake mushrooms (containing only 0.5 g of carbohydrates per 100 g).
- All types of green leafy vegetables and vegetables without starchy complex carbohydrates: broccoli and kohlrabi; bok choy, 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 (1.8-4.5 g carbohydrates per 100 g).
You can eat some berries: strawberries (100 grams contains about 8 grams of carbohydrates), cherries, raspberries, blackberries, cranberries (100 grams contains 12 grams of carbohydrates).
If you stick to moderation while following the ketogenic diet for weight loss, you can occasionally eat 100 grams of apricots, pineapple or grapefruit: this contains approximately 11.8-12.4 grams of carbohydrates.But it is not advisable to eat more bananas: every 100 grams of carbohydrates contains about 23 grams.
What not to eat?You will have to give up bread and all flour; pasta; sugar, honey and sweets; any cereal porridge; potatoes, carrots, beets, celery root; pumpkin and all melons; legumes and most fruits.
Ketogenic diet menu for one week
Of course, getting serious about eliminating excess body fat stores requires planning a menu for a week on the ketogenic diet.The information in the previous section will help with this.
For breakfast, you can make scrambled eggs or an omelet with onions, mushrooms, spinach, bacon, and tomatoes.Coffee or tea, of course, without sugar.
Lunch can include a salad (a recipe for one of these is given below), vegetable or meatball soup (without potatoes, rice or noodles), chicken soup and boiled chicken, fried fish or a pork and mushroom stew.
Choose a protein like turkey, beef, fish, or seafood for dinner, and it works well as a side dish with broccoli, Brussels sprouts, green beans, or bell peppers dressed in a creamy cheese sauce.
keto diet recipes
Considering the list of foods allowed on the ketogenic diet, you can prepare so many different dishes that it would be impossible to list even a tenth of the ketogenic diet recipes.Try these three.
Chicken and Grilled Vegetables
For two servings: 500 g chicken (thighs, breasts or fillets, cut into medium-sized pieces), 1 tablespoon vegetable oil, 1 green pepper (cut into medium-sized cubes), half an onion (cut into small cubes), 500 g cauliflowervegetable (cut into florets), half a small pepper (chopped), 50 g butter, 100-150 g fatty acid cream, 50 g hard cheese (grated with a coarse grater), salt and black pepper (to taste), coriander powder (half a teaspoon).
Preparation:
- Heat the oven to 180° and grease a baking sheet or frying pan with vegetable oil;
- Simmer onions and peppers (sweet and bitter) separately in vegetable oil;
- Blanch the cauliflower florets in salted boiling water for three minutes and drain;
- Place the chicken in the mold (frying pan), add salt and pepper, add the onions, peppers and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle parsley on top, put butter (a few slices, all over the surface), pour sour cream, sprinkle with grated cheese and bake in the oven for 40-45 minutes.
Quick Salad with Ham or Brisket
Product for two people: 100 grams of ham or brisket, 250 grams of lettuce (washed and dried), two fresh cucumbers, one tomato, two eggs (cooked), 60 grams of dill or parsley, a tablespoon of olive oil and an equal amount of mayonnaise, salt to taste.
Preparation:
- Cut brisket or ham into large strips;
- Cut hard-boiled eggs into quarters and thinly slice vegetables;
- Place the lettuce leaves on a plate, top with the ham, top with the eggs and vegetables, and add salt;
- Mix vegetable oil with mayonnaise, add chopped herbs, mix and pour this sauce over the salad.
Stewed Pork with Mushrooms
Serving three people: 300-400 g pork pulp, 350 g fresh mushrooms, half an onion (chopped), 2 tablespoons vegetable oil, half a teaspoon nutmeg, a clove of garlic, 4 tablespoons sour cream or heavy cream, 2 tablespoons chopped herbs, salt and black pepper, to taste.
Preparation:
- Pour the vegetable oil into a deep frying pan or heavy-bottomed pan, add the onion and chopped garlic, and cook for five minutes;
- Add the meat pieces and stir-fry briefly;
- Add chopped mushrooms, mix, add nutmeg and black pepper, salt;
- Simmer for 15 minutes, then add sour cream (cream) and vanilla;
- Cover and simmer until cooked through (about 15 minutes more).
Contraindications
Absolute contraindications to switching to a ketogenic diet include:
- Diabetic ketoacidosis caused by insulin deficiency;
- Congenital and secondary carnitine deficiencies;
- Pyruvate carboxylase deficiency;
- Mitochondrial diseases caused by impaired beta-oxidation of fatty acids;
- porphyria;
- Obvious abnormalities in blood components, iron deficiency anemia;
- pancreatitis;
- Acute and chronic inflammation of the gallbladder (cholecystitis);
- Liver dysfunction, primary or metastatic liver tumors;
- acute renal failure;
- Intestinal dysfunction, Crohn's disease;
- abdominal tumors;
- Conditions after cancer chemotherapy.
Special caution should be taken when considering the advice of bodybuilders about "stimulating" metabolism with the help of pharmaceutical preparations: you should not risk your own health in the pursuit of super effects.
possible risks
Risks associated with the long-term use of diet in the combined treatment of childhood epilepsy include growth retardation (due to decreased insulin-like growth factor 1 levels), worsening of bone mineralization (due to calcium deficiency), and the threat of nephrolithiasis (kidney stone formation).Nearly 60% of children suffer from hyperlipidemia (high blood fat), which can raise cholesterol levels by about 30%.
Rare side effects include cardiomyopathy, long QT syndrome (ventricular rhythm disturbance), and vitamin, micronutrient, and macronutrient deficiencies.
The most common side effect is constipation, which almost a third of dieters complain of due to lack of fiber intake.In addition, the initial stage of the ketogenic diet may be accompanied by worsening symptoms such as fatigue, weakness, headache, and dizziness; women - dysmenorrhea.
If there is no weight loss after a ketogenic diet, then it is likely that there is too much protein in the diet, since more than half of the excess protein is converted into glucose in the body, that is, the process of inducing ketosis is disrupted.
When muscles feel very sore on a keto diet, the cause may be related to the disruption of gluconeogenesis (synthesis of glucose from muscle lactate (lactic acid)) and the enzymatic breakdown of muscle tissue glycogen in ketosis.
Reducing carbohydrate intake at the beginning of the diet can cause fluid loss, and even with mild kidney failure, the keto diet can cause swelling in the legs.
Weight Loss Reviews and Results
Reviews of doctors who prescribe the ketogenic diet to patients with neurodegenerative diseases boil down to stating its unconditional effectiveness: even with Alzheimer's and Parkinson's disease, patients experience increased concentration, significant improvements in memory and perception.
Usually, weight loss reviews and results are reviewed by experts.But the significant controversy surrounding all low-carb diets also contributes to the assessment of specific results.
As a result, researchers found that men and women who switched to a ketogenic diet lost an average of 3.6-4 kilograms more over six months than men and women who restricted their fat intake, reports the American Journal of Clinical Nutrition .British obesity experts (the British National Obesity Forum) also point out that low-carb, high-fat diets are better than low-fat diets in terms of weight loss.This is despite claims by many of their colleagues that the weight loss benefits of the ketogenic diet are “contrary to existing evidence.”