The ketogenic or keto diet is not new: a hundred years ago, before the advent of effective anticonvulsants, French pediatricians noticed that certain dietary restrictions reduced the frequency of seizures in children suffering from drug-resistant epilepsy.
Based on metabolic studies, a therapeutic diet was developed - without starch and sugar, which became part of the complex treatment of epilepsy in the early 1900s. The author of the name "ketogenic diet" is said to belong to the American doctor Russell M. Wilder, who used it in the treatment of epilepsy in the 20s-30s.in the last century.
The keto diet includes a high-fat diet, moderate protein intake, and very low carbohydrate intake.For most people, this ratio of nutrients is considered safe for a limited period of time and not only helps you lose weight, but also has therapeutic applications.
Indications for use
A low-carbohydrate keto diet for epilepsy, which was widely used in foreign clinical practice, helped reduce the frequency of seizures in children of different ages by 62-75% (after dietary treatment for 12 weeks).At the same time, children who are prescribed such a diet must be registered with doctors who monitor their normal growth and weight gain, as well as make dietary adjustments according to the needs of each child.
Low-carbohydrate diets have begun to be used for other disorders.Researchers have shown that ketogenic diets are useful in treating patients with DeVivo disease, a deficiency syndrome of the protein GLUT1 (which transports glucose across the blood-brain barrier), as well as several other inborn errors of metabolism.
It is believed that this nutritional system can slow down the progression of amyotrophic lateral sclerosis (Charcot disease).Indications for the ketogenic diet include neurodegenerative pathologies such as Alzheimer's and Parkinson's disease.Clinical studies are underway on the effect of the ketogenic diet on the condition of patients with autism, depression, type 2 diabetes mellitus (non-insulin dependent) and polycystic ovary syndrome.
The best-known keto diet for weight loss is in the form of the Atkins diet for treating obesity, modified and popularized by Dr.Robert Atkins (Dr. Atkins Diet Revolution, 1972).Although experts consider only the induction phase of this diet to be ketogenic.And, to be fair, it should be noted that long before him, many American doctors worked on the principles of the ketogenic diet: Peter Huttenlocher, Alfred Pennington, Richard McCarnes and others.For example, R. McCarnes wrote the book Eat Fat and Grow Slim in 1958, and this is essentially the same low-carb diet that was originally introduced to treat epilepsy.
Since the deposition of excess adipose tissue in the form of triglycerides concentrated in its cells occurs due to excessive consumption of carbohydrate foods (no one doubts this), limiting carbohydrates in the diet to a minimum - a keto diet for a month - helps to reduce fat reserves, that is, to lose weight.
In addition, the keto diet for oncology - by increasing the oxidative stress of cancer cells - has been found to significantly reduce the growth rate of malignant tumors found in the colon, stomach, prostate and lungs.In addition, it has already been shown that certain cancers are more sensitive to chemotherapy due to the induced state of ketosis.
For the past two decades, the ketogenic diet has been used by bodybuilders to reduce the layer of fat under the skin: in their slang, this is called cutting on a keto diet.
The essence of the keto diet
On a typical keto diet, your total daily calories should come from 70-80% fat, 15-20% protein, and 5% carbs (less than 50 grams per day).
Typically, the ratio of fat to protein to carbohydrates is 3:1 (ie 3 grams of fat for every gram of protein + carbohydrates).If the ratio is 4:1, then 90% of energy comes from fat, 8% from protein and only 2% from carbohydrates (about 20g per day).
The essence of the diet used to reduce excess weight is to enter the body into a state of adaptive ketosis - when the body receives energy (ATP) mainly from ketone bodies in the blood, and not from glucose, which comes from eating foods containing carbohydrates.
Carbohydrates in food are converted to glucose, but when a person consumes too few carbohydrates and too much fat, a chain of biochemical reactions is triggered in the body.Schematically this process looks like this.First, due to reduced blood glucose levels, the pancreas begins to produce more of the hormone glucagon, which stimulates the catabolism of glycogen stored in the liver into glucose and releases it into the blood.Secondly, ketogenesis is activated, i.e. the liver produces ketone bodies (acetoacetate, which is then converted into β-hydroxybutyrate and acetone) and the conversion of dietary fat into free carboxylic (fatty) acids.Third, due to the increase in the level of glucagon, the activity of lipase, an enzyme that breaks down triglycerides (fats) accumulated in the cells of adipose tissue, increases significantly.
In addition, in the first two weeks of following the keto diet, significant weight loss is observed due to the removal of water from the body, which is also associated with increased glucagon production.And therefore, a temporary side effect of a high-fat diet can be dehydration, which nutritionists advise to combat by drinking up to two liters of water daily.
Many people believe that a major advantage of the keto diet is the absence of hunger, the need to count calories and exercise for hours to burn off excess calories.
Keto diet for men
The keto diet is considered particularly effective for men with abdominal obesity.
If a therapeutic diet for obesity recommends reducing calorie intake to 2000 (2300) kcal per day, then the ketogenic diet does not control calories as strictly (but reducing them by at least 10-20% will not hurt).But the consumption of carbohydrates must be reduced five times: instead of 250 g to a maximum of 50 g per day.
Remember that most of the calories on a keto diet come from foods high in natural fats and moderate amounts of protein.That is, this is not a "protein load", as some may think.And if a man is used to eating a lot of meat, then his body will enter a state of adaptive ketosis much more slowly.So you should limit protein: per day to 1-2g of protein per kg of body weight you are trying to achieve as a result of weight loss.Example: if the initial weight is 112 kg and the desired weight is 85 kg, then the amount of protein during the course is 85-170 grams.
The exact ratio of fats, proteins and carbohydrates in the diet (in grams) will depend on the age, goal, level of physical activity and health status of each individual man.But short-term fasting during the keto diet is recommended for everyone: the first two days of switching to this diet system, you should drink a lot of water and limit yourself to one meal a day (in a very small amount).By the end of the first week, you should eliminate carbohydrates as much as possible (below is a list of foods for the keto diet), but the portion sizes are reduced very slightly.
Another nuance: they claim that the keto diet without sports does not lose its effectiveness, and to lose weight you do not need to go to the gym or simply do any additional physical exercise.But physical activity, as part of a healthy lifestyle, accelerates the burning of excess fat, so you should not lie on the couch.In addition, you can take advantage of the moment and, following the example of bodybuilders, build muscle mass: gaining weight on a keto diet is possible only with muscle load, and then subcutaneous fat will disappear, revealing strong muscles.
Keto diet for women
The problem with the keto diet is that to date, research into its effectiveness and safety has only focused on men.A natural question that arises is whether the keto diet is suitable 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 perimenopausal or menopausal women.This nutritional system allows you to lose excess weight, control blood glucose levels, improve sleep quality and reduce menopausal symptoms such as hot flashes or night sweats.
However, there are also negative reviews, even complaints of nausea, fatigue and constipation due to the diet (more details below in the Possible Complications section).It is also worth mentioning that switching to a keto diet is contraindicated in case of irregularities in the monthly cycle, pathologies of the thyroid gland or during pregnancy and lactation.
It is recommended for women to combine intermittent fasting with a ketogenic diet, that is, to simply skip lunch and take a break of 10-12 hours between breakfast and dinner, which after 50-55 years gives a rejuvenating effect (these are data from a 2016 study published in the Journal of the American Medical Association).According to Western nutrition experts, this dietary pattern allows the body to take a break from digestive functions and direct energy resources to tissue cell repair and hormone balance.
If a woman with a body weight of 75 kg and a height of 165-168 cm seeks to lose weight to about 68 kg, she should change from 2300 kcal per day to a consumption of no more than 1855 kcal.Protein should be 1-1.5 g per kg of ideal weight, that is, daily you can get about 68-102 g of protein, 240-350 g of fat and 18-20 g of carbohydrates (in pure water, without fiber).
How is a keto diet different from a high fat diet?
A high-fat or LCHF diet differs from a keto diet in terms of the proportions of protein, fat and carbohydrates in the diet, and a high-fat diet assumes a ratio of 50% fat and 25% protein and carbohydrates.
In Europe, the high-fat (low-carb) diet is called the Swedish diet.Apparently, this is due to the Swedish therapist Annika Dahlqvist, who began recommending to her patients with diabetes to consume more fat and limit carbohydrates, which contradicts the officially approved recommendations of endocrinologists in Sweden.
Among the modifications of the ketogenic diet system, starting with the Atkins diet and the LCHF diet, we can mention strange dietary recommendations, for example, fasting egg in the keto diet - when for several days you need to eat only boiled chicken eggs with mayonnaise...
Cyclical keto diet and other modifications
In recent years, the standard keto diet (SKD) has been modified in many ways.Thus, the high-protein ketogenic diet (HPKD) was born, in which 60% of calories come from fat, 35% from protein, and 5% from carbohydrates.
The targeted ketogenic diet (TKD) is more moderate, as carbohydrates can be consumed pre- and post-workout.It is considered a sport, so the number of calories obtained from the consumption of carbohydrates is higher than in SKD.
The cyclic keto diet (CKD) or, according to another version, the rotational keto diet (alternating), is a low-carbohydrate diet with alternating periods of high or moderate consumption of carbohydrates: 5-6 days - a minimal amount of carbohydrates, and then a carbohydrate load is carried out on a keto diet - one or two days of limited car consumption.The unknown authors of this version of the keto diet try to justify their innovations with the need to replenish glycogen reserves, restore hormone levels and thyroid activity, as well as ensure moral and psychological stability - to continue the diet.In fact, what is lost in six days comes back immediately.
Avail
As foreign clinical practice shows, almost 20% of children with epilepsy after a ketogenic diet (followed by six months to two years, with a gradual return to a normal diet) experience convulsions much less often, and many of them can reduce the intake of anticonvulsants or completely abandon them.
Based on the results of two dozen randomized controlled studies, experts concluded that the benefits of the keto diet include significant and fairly rapid loss of excess weight, especially in severe obesity.Despite the high amount of fat, this diet for 24 weeks resulted in a significant proportion of patients with a decrease in systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels and an increase in high-density lipoprotein (HDL), i.e. good cholesterol.
In 2008, the American Diabetes Association (ADA) revised its dietary guidelines and recognized low-carbohydrate diets as an effective short-term nutritional intervention for patients with non-insulin-dependent diabetes.
And yet, during a keto diet, the skin reacts to the lack of carbohydrate foods in its own way, for example, acne can be reduced.And this is confirmed by the results of a study published in the Journal of the American Academy of Dermatology.
What is possible and what is not?
What can you eat?The list of products recommended for the keto diet includes: any meat and meat by-products.bird;fish and seafood;eggs (all kinds);cream, sour cream, butter (butter and vegetable).Hard cheese is very useful on a keto diet.But be careful with regular milk, as it contains a lot of lactose - milk sugar, which is a disaccharide carbohydrate.But fermented milk products can be consumed without fear: during the fermentation of fermented milk, lactose undergoes hydrolysis.
Instead of popcorn, sweets or chips, walnuts (about 13 g of carbohydrates per 100 g) and sunflower seeds (10.5 g of carbohydrates per 100 g) are suitable.The number of calories is 655 and 600, respectively.
It is recommended to include in the menu:
- mushrooms (except dried porcini and boletus), the ideal choice is mushrooms (only 0.5 g of carbohydrates per 100 g).
- all types of leafy greens and vegetables that do not contain complex starchy carbohydrates: broccoli and kohlrabi.white, cauliflower and Brussels sprouts (3-6 g of carbohydrates per 100 g).cucumbers, courgettes, courgettes, aubergines, peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (range 1.8-4.5g carbs per 100g).
You can eat a few berries: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, blackberries, cranberries (100 g contains 12 g of carbohydrates).
If you observe moderation in their consumption while following a keto diet for weight loss, then you can occasionally eat 100 grams of apricot, pineapple or grapefruit: this is about 11.8-12.4 grams of carbohydrates.But you should not eat bananas: every 100 grams of carbohydrates contain almost 23 grams.
What can't you eat?You should give up bread and all flour.pasta;sugar, honey and confectionery.any cereal porridges;potatoes, carrots, beets, celery root.Pumpkins and all melons;legumes and most fruits.
Menu for a week of keto diet
Serious about getting rid of unnecessary fat reserves in your body, of course, requires creating a menu for the week of the keto diet.And the information in the previous section will help you with this.
For breakfast, you can cook omelets or scrambled eggs - with onions, mushrooms and spinach, bacon and tomato.Coffee or tea, of course, without sugar.
Lunch can consist of salad (a recipe for one of them is given below), vegetable soup or soup with meatballs (without potatoes, rice or noodles), chicken broth and boiled chicken, fried fish or pork and mushroom stew.
For dinner, choose a protein, such as turkey, beef, fish, seafood, with which - as a side dish - broccoli, Brussels sprouts, green beans or peppers, flavored with cream cheese sauce, go well.
Keto Diet Recipes
Considering the list of foods allowed on a ketogenic diet, you can prepare so many different dishes that it is impossible to list even a tenth of the keto diet recipes.Try these three.
Chicken baked with vegetables
Products for two servings: 500 g chicken (thighs, breast or fillet, cut into medium pieces), a tablespoon of vegetable oil, 1 green pepper (cut into medium cubes), half an onion (cut into small cubes), 500 g cauliflower (disassembled into pieces), half a small hot pepper (50 g chopped), 51gr.sour cream, 50 grams of hard cheese (grated on a coarse grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Preparation:
- Preheat the oven to 180°, grease a tray or pan with vegetable oil.
- Separately simmer the onions and peppers (sweet and bitter) in vegetable oil.
- Blanch the cauliflower florets in salted boiling water for three minutes, let the water drain.
- put the chicken in a form (pan), season with salt and pepper, add the onions and peppers and the cabbage (distribute the vegetables evenly over the meat).
- Sprinkle coriander on top, put butter (many pieces, all over the surface), pour with cream, sprinkle with grated cheese and put in the oven for 40-45 minutes.
Quick salad with ham or brisket
Products for two servings: 100 g of ham or brisket, 250 g of lettuce (dry well after washing), two fresh cucumbers, one tomato, two chicken eggs (boiled), 60 g of dill or parsley, 1 tablespoon of olive oil and the same amount of mayonnaise, salt.
Preparation:
- cut the brisket or ham into large strips.
- cut boiled eggs into quarters, vegetables into thin slices.
- Place the lettuce leaves on a plate, place the ham on top and the eggs and vegetables on top, add salt.
- mix the vegetable oil with the mayonnaise, add chopped herbs, mix and pour this sauce over the salad.
Pork stew with mushrooms
Products for three servings: 300-400 g of pork pulp, 350 g of fresh mushrooms, half an onion (chopped), 2 tablespoons of vegetable oil, half a teaspoon of nutmeg, a clove of garlic, 4 tablespoons of sour cream or heavy cream, 2 tablespoons of salty black cream, 2 tablespoons ofsavory black cream.
Preparation:
- Pour vegetable oil into a deep frying pan or pot with a thick bottom, add the onion and chopped garlic, simmer for five minutes.
- put pieces of meat and fry a little.
- add chopped mushrooms, mix, add nutmeg and ground black pepper, salt.
- cook over low heat for 15 minutes, then add sour cream (cream) and herbs.
- Cover the dish with a lid and simmer until done (about another 15 minutes).
Contraindications
Absolute contraindications to switching to a ketogenic diet include:
- diabetic ketoacidosis caused by insulin deficiency.
- congenital and secondary carnitine deficiency.
- pyruvate carboxylase deficiency?
- mitochondrial diseases caused by impaired beta-oxidation of fatty acids.
- porphyria?
- severe abnormalities in blood composition, iron deficiency anemia.
- pancreatitis;
- acute and chronic inflammation of the gallbladder (cholecystitis).
- liver dysfunction, primary or metastatic liver tumors.
- acute renal failure;
- bowel dysfunction, Crohn's disease;
- abdominal tumors;
- condition after cancer chemotherapy.
Particular attention should be paid when considering the advice of bodybuilders to "stimulate" the metabolism with the help of pharmacological agents: you should not risk your health in pursuit of a super result.
Potential risks
The risks associated with a diet used long-term in the complex treatment of epilepsy in children include the threat of growth retardation (due to reduced levels of insulin-like growth factor 1), worsening of bone mineralization (due to calcium deficiency) and nephrolithiasis (kidney stone formation).Hyperlipidemia (high blood lipids) occurs in almost 60% of children, and cholesterol levels may increase by about 30%.
Rare side effects include cardiomyopathy, long QT syndrome (ventricular arrhythmia), vitamin, micronutrient and macronutrient deficiency.
The most common side effect is constipation, which almost a third of those who lose weight complain about: the lack of fiber intake affects it.In addition, the ketogenic diet in the early stages can be accompanied by increased fatigue, weakness, headaches and dizziness.in women - dysmenorrhoea.
If weight is not reduced on a keto diet, then there is probably too much protein in the diet, since more than half of the excess protein is converted to glucose in the body, that is, the process of induced ketosis is interrupted.
When muscles are very sore on a keto diet, the reason may be related to both a violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid), and the enzymatic breakdown of muscle tissue glycogen under conditions of ketosis.
At the beginning of the diet, reducing carbohydrate intake leads to fluid loss and leg swelling on a keto diet can occur even with mild kidney failure.
Weight loss reviews and results
The reviews of doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies conclude with the declaration of its unconditional effectiveness: even with senile dementia and Parkinson's disease, the patients' attention increases, memory and perceptual efficiency improve significantly.
Usually, reviews and results of those who lose weight are commented by experts.But the considerable controversy surrounding all low-carb diets also contributes to evaluating specific outcomes.
So, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a keto diet, on average, lost 3.6-4 kilograms more over six months than those who restricted their fat intake.British obesity experts (British National Obesity Forum) also note that low-carb, high-fat diets are superior to low-fat diets in terms of weight loss effectiveness.Although many of their colleagues claim that the results of the keto diet for weight loss are "contrary to the available evidence".