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The term “ketogenic” is basically a fancy term for “very low carbohydrate diet.” Despite its current trendy state, the ketogenic diet or “keto” diet has actually been used since the 1920s to treat epilepsy in children.  However, it wasn’t until the 1960s that people started using ketogenic diets for weight loss. The ketogenic diet has also been touted as a potential treatment for cancer, Alzheimer’s disease, acne, PCOS, and diabetes. The verdict is still out on all these health claims, but there’s no doubt that ketogenic diets do work for weight loss.

How do ketogenic diets work?

A ketogenic diet is very low in carbohydrates, and contains a high amount of fat and moderate amount of protein. Under normal circumstances, the body prefers to use carbs as the main source of energy.  However, when carbs are restricted, the body starts breaking down fat for energy, resulting in the production of ketones. “Ketosis” occurs when the body is burning fat instead of glucose as the main energy source. A desirable side effect of ketosis is rapid weight loss.

Everybody has a different threshold for inducing ketosis, but most people need to limit carbs to under 50 grams per day to stay in ketosis. There are two benefits to staying in ketosis when it comes to weight loss. First, ketones suppress appetite, helping people naturally reduce their calorie intake. Secondly, insulin levels drop as carbohydrates are restricted. One of insulin’s main jobs is to convert excess blood sugar into fat. When blood sugar and insulin levels are lower, fat is easier to break down.

Ketosis should not be confused with the life threatening condition, ketoacidosis, a complication of diabetes that results in dangerously high levels of ketones. Diabetic ketoacidosis is very dangerous as it causes blood to become too acidic . Unlike ketoacidosis, ketosis is a normal condition that happens after fasting or when following a very low carbohydrate diet.

What do you eat on a ketogenic diet?

Most ketogenic diet plans include large amounts of high fat foods, such as full fat dairy, oil, meat, and nuts, supplemented with low carb vegetables. Keto diets require cutting out most high carb foods, even highly nutritious options, such as fruits, beans, and whole grains.  A typical “Keto” day might include eggs and bacon for breakfast, salad with chicken and avocado for lunch and fish with low carb veggies for dinner.  If you decide to follow a ketogenic diet, be sure to include mostly heart healthy fats, from nuts, avocados, fish and olive oil. Avoid filling up on artery clogging high fat meats, cheese, cream and butter.

Effectiveness of the ketogenic diet

People starting a ketogenic diet typically lose weight faster initially compared to those on other diets. Some of this initial weight loss is actually water weight. As muscles break down their carbohydrate stores, they release water.  After a week or so, this initial rapid weight loss slows down. However, when researchers look at even longer term weight loss outcomes, the advantage of ketogenic diets disappears.

A recent study found that there was actually no difference in weight loss after one year, between those on high carb diets and those on very low carb diets.  One reason that weight loss tends to taper off on the ketogenic diet is that it is a hard to follow! Most people can only sustain such a low carb diet for more than a few months. After all, you can only eat cauliflower crust sandwiches and “keto bread” for so long! Basically, the ketogenic diet works just as well as other diets when we look at maintaining weight loss.

The Bottom Line on Ketogenic Diets

The bottom line is that a ketogenic diet is a quick way to lose weight, but it may not be the best way to lose weight.  Following a ketogenic diet for a short period of time and then quitting may result in rapid weight regain.  A better approach to weight loss is to make small sustainable changes you can stick with forever.  Also, the ketogenic diet requires people to cut out many nutritious foods with known health benefits, like fruits and whole grains.  Such a restrictive diet could lead to nutritional deficiencies over time.

Safety Concerns Related to Ketogenic Diets

There are some safety concerns related to ketogenic diets. People with diabetes, kidney disease or heart problems should not follow a ketogenic diet without medical supervision.  Drastically reducing carbohydrate intake, without adjusting diabetes medications, could lead to severe hypoglycemia. Rapid weight loss may also impact liver and gall bladder function, and can worsen gout. Be sure to talk to your health care provider before starting any diet, especially a ketogenic diet.

If you are interested in weight loss or need help with your diet, contact us at 301-288-1319 to set up a nutrition counseling appointment with our experienced Registered Dietitian, who can help you create a sustainable weight loss plan that works for you.  For more healthy eating advice check out our post Create a Healthy Plate to Lose Weight and our recent workshop Make Every Bite Count.