By: Dr. Keith Kantor
Breakdown of the “Keto Diet.”
The “keto diet” has gained mainstream popularity in the past few years due to its high success rate and unlike many fad diets that come and go with very limited rates of long-term success, the ketogenic (keto) works. It has always been popular among the bodybuilding community for its ability to shed body fat quickly while maintaining optimal amounts of lean muscle. The keto diet has been practiced for more than nine decades (since the 1920s) and is based upon a solid understanding of physiology and nutrition science.
The keto diet works for such a high percentage of people because it targets several key, underlying causes of weight gain including hormonal imbalances, especially insulin resistance coupled with high blood sugars, especially in those who have type 2 diabetes or hypoglycemia. The common cycle of restricting and “binging” on empty calories due to hunger that so many dieters struggle with is not common with those who adopt the keto lifestyle and the healthy whole foods that are on its food list.
Rather than counting calories, small portion sizes, and excessive exercise, which require unrealistic will power (especially when your energy levels are low due to restriction), the ketogenic diet takes an entirely different approach to weight loss and health improvements. It works because it changes the “fuel source” that the body uses to stay energized. The body goes from burning glucose (or sugar) to dietary fat and fat stores within the body. Combining the keto diet with intermittent fasting can provide long-term results without the starvation or suffering.
The diet was originally designed in the 1920’s to help control seizures of those who had epilepsy. Keto is short for ketosis, this is when the body is using ketones in the blood for energy rather than glucose from foods that contain carbohydrates. Ketosis can only occur when fat is the primary macronutrient consumed to meet daily calorie needs.
The keto diet does not require any calorie counting, the restriction is virtually eliminating all foods that contain sugar and starch (carbohydrates). These carbohydrate dense foods are broken down into sugar ( glucose and affecting insulin)) in our blood once we eat them, and if these levels become too high, extra calories are much more easily stored as body fat and results in unwanted weight gain. However, when glucose levels are cut off due to low-carb dieting, the body starts to burn fat instead and produces ketones that can be measured in the blood.
Rather than drawing energy from glucose, a person in ketosis stays fueled off of these circulating ketones or ketone bodies — essentially, burning fat for fuel. This is the principal goal of the ketogenic diet, which can be achieved by adhering to the macronutrient targets.
The keto diet is low carbohydrate, high fat and moderate protein.
Macronutrient percent ranges:
Like any nutrition plan the quality of food can impact the success rate. Aim to consume all certified all natural meats, seafood, poultry, vegetables and fruits.
Fat food sources include: olive oil, coconut oil, grass-fed butter, palm oil, and some nuts and seeds. Fats are a critical part of every ketogenic recipe because fat is what provides energy and prevents hunger, weakness and fatigue. If your fat intake is not high enough the diet will not work because you will not meet you daily calorie needs and you will feel terrible.
Non-starchy vegetables are essential, they are low in calories and carbohydrates yet high in fiber and water. Non- starchy vegetables include broccoli and other cruciferous veggies, all types of leafy greens, asparagus, cucumber, and zucchini.
Protein. A moderate amount of protein should be consumed to maintain lean muscle mass and keep you feeling full. These sources should be from certified all natural beef, chicken, pork, lamb, eggs, pure protein powder, and fish. It is very important to drink at least half of your body weight in ounces of water per day, ketosis can promote dehydration.
Drink. As far as drinks go only water, coffee, tea or bone broth are allowed. Diet no calorie drinks are not approved due to the pancreas still secreting a small amount of insulin when the tongue senses something sweet even though it is calorie free.
Condiments can include stevia, lemon, lime, un-sweet hot sauce, pickles, soy sauce, vinegar, sour cream, and heavy cream.
Foods you will need to avoid are high sugar fruits like melons, and bananas, juice, grains, wheat/white flour, potatoes, conventional dairy products and corn.
The benefits of a ketogenic diet include:
Increased ability to lose weight and excess fat, this is due to the body’s ability to transfer its primary fuel source from sugar to fat. This happens naturally when the carbohydrates and sugar are not available for fuel.
The ketogenic diet reduces the risk for chronic diseases such as Type 2 Diabetes, Cancer, and heart disease. There are several different reasons that disease risk is lower including decrease inflammation due to less processed foods consumed. Most people who follow a keto diet as a lifestyle achieve long-term results of healthy body weight management, decreasing the risk for chronic diseases associated with being overweight and obese. Sugar will essentially feed cancerous cells allowing them to grow at a faster rate. Cancerous cells actually uptake sugar 10-12 times higher than normal cells.
Ketogenic diet reduces risk for Alzheimer’s disease and other brain disorders. Over the past century, ketogenic diets have also been used to treat and even help reverse neurological disorders and cognitive impairments, including epilepsy and Alzheimer’s disease.
Contraindications to a ketogenic diet include those with compromised kidney and liver function , it is not forbidden but it is important to be under your doctor’s supervision and approval before starting a diet like this one.
This diet contradicts traditional nutrition recommendations that are or have been very popular including avoiding dietary saturated fats and red meat. Other recommendations include eating a high fiber diet with whole grains at every meal in addition to a variety of fruits. Science has proven those recommendations to be misleading and there are several health experts who have dedicated their lives to researching the obesity and type 2 diabetes epidemic and they recommend the ketogenic diet lifestyle to patients who want to reverse their symptoms and get their quality of life back.
Moerman CJ, et al. Dietary sugar intake in the aetiology of biliary tract cancer. Int J Epidemiol 1993 Apr;22(2):207-14
Benefits of intermittent fasting include
Increased longevity, improved brain function, increased insulin regulation, stronger resistance to stress, improved satiety, benefits of endogenous hormone production and increased mental clarity. In addition to these benefits, The NeuroChem Journal released a study that linked intermittent fasting to improving the success rate of those in substance abuse rehabilitation programs, due to its ability to suppress the opiate receptors.
Concerns associated with Intermittent Fasting and Fitness
A popular yet dated statement that you may hear often is that you should never exercise on an empty stomach. They will go on to say that training on an empty stomach will cause muscle wasting, defeating the purpose of working out and performance will decline. None of these statements are true and they are even less so if you are well adapted to a healthy eating strategy, that includes high quality all natural proteins, healthy fats and fibrous carbohydrates.
Fasted exercise can actually result in better metabolic adaptations (which mean better performance down the line), improved muscle protein synthesis, and a higher anabolic response to post-workout feeding. This means your post workout meals will be used more efficiently to develop lean muscle then if you were not in a fasted state.
Studies on Muslim athletes during Ramadan show no effect on performance while fasting, as well as improved lipid values in those who exercise and fast rather than just fast. When you train in a fasted state, glycogen breakdown is blunted and more fat is burnt, leaving you more glycogen stores of energy in the tank for when you really need it and less body fat because you have trained your body to use that as its primary fuel source.
Improved Mental Clarity with Fasting
Some health experts recommend keeping a “healthy” high carbohydrate snack such as a granola bar or crackers with you in case you feel like you are experiencing sluggishness or mental fog, typically related to a drop in blood sugar. This snacking mentality is a band-aid and only trains your body to rely on re-feeding carbohydrates, instead of training your body to operate more efficiently and use its own fat for fuel, rather than constantly depending on re-feeding it with carbohydrates from snacking. One of the most common differences people report about fasting compared to grazing is the improvement of mental clarity and their ability to focus better.
We were originally made to hunt and gather, eating one time or no times per day simply due to less availability of food. It makes sense that our body thrives when intermittent fasting is practiced.
Getting started with intermittent fasting
Like any new program ease your way into fasting especially if you are very sensitive to having low blood sugar spells or hypoglycemia. Start out with a 16-hour fast and allow yourself to only consume food within an 8-hour window throughout the day. This typically means you either skip breakfast or dinner. I personally do not skip a meal and have a healthy protein shake for breakfast. To experience all of the hormonal benefits of intermittent fasting, work your way into a 5-6 hour window of eating. Some programs recommend a 24-hour fast one time per week to reset the hormones, each person is individual and this may or may not be possible, it is best to work into this protocol under the supervision of a health professional. It is especially important to notify your doctor about your plans if you are on any medications. Improvements can happen fairly quickly and your doctor may even need to cut back on the milligrams of your medications after you experience improvements.
Fasting works best with a reduced carbohydrate diet that is rich in fibrous carbohydrates from vegetables, fruits in addition to heart healthy fats from oils, nuts, seeds, quality meats, and avocados. All natural meats that do not contain any preservatives or chemicals are very important.
Meals should be hearty, containing at least 4-6 ounces of all natural protein for women and 6-8 ounces for men, good sources include certified all natural beef, cold-water fish, all natural poultry, eggs, and all natural pork. Heart healthy fats from avocado, coconut oil, real butter, nuts, seeds or nut butters will improve satiety. In addition, the high fiber and water content in the copious amounts of non-starchy vegetables, including greens, broccoli, cauliflower, cabbage, brussel sprouts and high fiber fruits like berries will further improve satiety. You should feel satisfied after eating not wanting more. All natural proteins and healthy fats are essential to feeling good on this type of program.
Intermittent Fasting and Women
Women may not see the same results as men with fasting and some experts recommend adding in non-intermittent fasting days to their program 2-4 days per month to avoiding plateaus and progress forward with results.
It is no coincidences that after you go off of a “mini meal or grazing diet plan” you gain weight or feel hungry all of the time. Instead, adopt a new way of eating by experimenting with intermittent fasting. This will train your body to use its own fat stores as its primary fuel source, resulting in less effort and more weight loss.