The ketogenic diet (keto diet) is the lowest of the low carbohydrate diets. People achieve weight loss results because it typically involves cutting calories.
But at what cost? Is it like robbing Peter to pay Paul?
The traditional ketogenic diet contains 75% of energy (calories) from fat, 20% from protein and only 5% from carbs. In other words, a 3:1 ratio (3 grams of fat to 1 gram of combined protein and a small amount of carb).
Keto enthusiasts claim the diet burns fat faster and boosts brain function by switching to using fat as your body's primary fuel source. This metabolic state is called ketosis.
Sounds keto-awesome right?! Please keep reading.
One of the reasons why Burke and Wills were able to cross Australia from Melbourne in the south to the Gulf of Carpentaria in the north (3,250 kilometres) in the 1860s was because of ketosis.
It’s a survival mechanism. The brain, which typically relies on glucose (the breakdown product of carbohydrates) as its primary fuel source, switches to using ketone bodies released from the liver for energy. It's like an emergency generator.
So whenever you’re on a diet low in carbs you could be in a ketotic state. Diets such as Michael Mosley's 5 and 2 intermittent fasting diet, the Atkins diet, or even the Paleo diet may force your body into metabolising mainly fat, rather than glucose, and are therefore technically ketogenic diets as well.
And what do we know about fad diets to lose weight?
They generally require dramatic food restriction where the dieter finds it difficult to sustain the modified eating pattern. They require carefully planned meals with specific amounts of foods, often leaving out vital nutrients, including folate, B vitamins, calcium and trace elements essential for good health and well-being.
The keto diet naturally cuts calories (like all diets) so you will probably lose weight. However, even with its ‘fat burning’ capabilities, you can still put on weight whilst being in ketosis if you’re eating more calories than you burn.
Forget about starchy veggies, fruit, pasta, rice, legumes, bread, cereal and anything sugary. Seriously, an apple contains about 20g of carb!
Please consider whether you can limit carbs to between 20 and 50 grams a day to achieve ketosis. Considering approximately 80% of the shelf-space in Woolworths and Coles contains carbohydrate, you're really up against it.
Consider the social implications too. What would eating with your family look like? What would you take to work for lunch? What about going to parties etc…? There’s a reason why this diet is so difficult to sustain.
And then there’s the gut.
We know that maintaining a healthy gut involves eating a host of ‘prebiotic’ plant-based fibres (soluble, insoluble & resistant starch), many of which also contain carbohydrate.
These include foods such as grains, cereals, legumes, fruit and veggies. An unhealthy gut has been associated with chronic diseases including cancer, diabetes, heart disease and even dementia. Not to mention the link between gut health obesity.
So from a total well-being point of view, you achieve weight loss, but at a potential cost.
Where is the ketogenic diet applicable?
For the general population, I don't normally advocate for a low-fat meal pattern, nor do I advocate for a high-fat meal pattern either.
However, in certain circumstances, there may be an opportunity to apply a very low carbohydrate diet like the keto diet as medical nutrition therapy for a medical condition like epilepsy or brain cancer. Results from studies are mixed, however, more human trials are underway. Therefore, the application of the ketogenic diet in these circumstances is still a wait and see.
In relation to weight loss, there is potential for the ketogenic diet to be used in circumstances where people have a lot of weight to lose to improve their numbers (blood pressure, blood glucose levels, fatty liver etc…). However, this would need to be carried out under direct medical supervision and would be temporary, moving to a more complete meal pattern over the long-term.
The final word
A good weight loss strategy for most people is a less extreme low carb meal pattern. To achieve this, reduce your carbohydrate intake by reducing junk food and portions of processed carbs like low fibre bread, pasta, rice and cereal. Increase unprocessed whole foods, high in fibre and phytonutrients, including fruits, vegetables, legumes and wholegrains.