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 20-30s.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 excess pounds, but also has therapeutic applications.
Indications for use
A low-carb 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 should 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-carb diets are beginning to be used for other disorders as well.Researchers have shown that ketogenic diets are helpful in treating patients with DeVivo disease, a syndrome lacking the protein GLUT1 (which transports glucose across the blood-brain barrier), as well as several other metabolic birth defects.
It is believed that this nutritional system can slow the progression of amyotrophic lateral sclerosis (Charcot disease);Indications for the ketogenic diet include neurodegenerative pathologies such as Alzheimer's and Parkinson's diseases.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 most popular 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 as ketogenic.And, in fairness, 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 originally introduced to treat epilepsy.
Since the deposition of excess adipose tissue in the form of triglycerides concentrated in its cells occurs due to the excessive consumption of carbohydrate foods (no one doubts this fact), limiting carbohydrates in the diet to a minimum - a keto diet for a month - helps to reduce fat reserves, that is, weight loss.
In addition, it was found that the keto diet for oncology - by increasing the oxidative stress of cancer cells - significantly reduces the growth rate of malignant tumors located in the colon, stomach, prostate gland and lungs.In addition, it has already been proven that certain types of cancer are more sensitive to chemotherapy due to the induced state of ketosis.
Over the past two decades, the ketogenic diet has been used by bodybuilders to reduce the layer of fat under the skin: in their jargon, this is called a short for a keto diet.
The essence of this diet
On a standard keto diet, your total daily calories should come from 70-80% fat, 15-20% protein, and 5% carbohydrates (less than 50g 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 fats, 8% from proteins and only 2% from carbohydrates (about 20 g per day).
The essence of the diet used to reduce excess weight is to introduce 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 into 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 the decrease in blood glucose levels, the pancreas begins to produce more glucagon hormone, which stimulates the catabolism of glycogen stored in the liver into glucose and releases it into the blood.Secondly, ketogenesis is activated, that is, 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.Thirdly, due to the increase in the level of glucagon, the activity of lipase, an enzyme that breaks down triglycerides (fats) accumulated in adipose tissue cells, increases significantly.
In addition, in the first two weeks of following the keto diet, significant weight loss occurs due to the removal of water from the body, which is also associated with increased glucagon production.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 a day.
Many people believe that an important advantage of the keto diet is the absence of hunger, the need to count calories and exercise for hours to burn 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 so strictly (but reducing them by at least 10-20% will not hurt).But the consumption of carbohydrates should 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 rich in natural fats and moderate amounts of protein.That is, it 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 will need to limit protein: per day to 1-2g of protein per kilogram 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 g.
The exact ratio of fats, proteins and carbohydrates in the diet (in grams) will depend on the age, purpose, level of physical activity and health status of each man.But short-term fasting during the keto diet is recommended for everyone: in the first two days of switching to this food 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 little.
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 perform any additional physical exercises.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 the subcutaneous fat will disappear, revealing strong muscles.
Keto diet for women
The problem with the keto diet is that to date, research on its effectiveness and safety has only focused on men.A natural question that arises is whether the keto diet is suitable for women, given that female hormones tend to be more sensitive to most dietary changes.
While opinions differ, most experts say that the ketogenic diet provides positive results, especially for women in or near menopause.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 noting that the transition to a keto diet is contraindicated in case of irregularities in the monthly cycle, pathologies of the thyroid gland or during pregnancy and lactation.
Women are recommended to combine periodic 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 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 with a body weight of 75 kg and a height of 165-168 cm wants to lose weight to approximately 68 kg, she should go from 2300 kcal per day to consuming no more than 1855 kcal.Protein should be 1-1.5 g per kilogram of ideal weight, that is, every day 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 does a keto diet differ from a high-fat diet?
A high-fat or LCHF diet differs from a keto diet in 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-carbohydrate) diet is called the Swedish diet.Of course, this is due to the Swedish therapist Annika Dahlqvist, who began recommending that her patients with diabetes consume more fat and limit carbohydrates, which contradicted the officially approved recommendations of endocrinologists in Sweden.
Among the modifications of the ketogenic food system, starting with the Atkins diet and the LCHF diet, one can mention strange dietary recommendations, for example, egg fasting in the keto diet - when for several days you have to eat only boiled chicken eggs with mayonnaise ...
Keto cycle 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) appeared, 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 eaten before and after workouts;It is considered a sport, so the number of calories obtained from the consumption of carbohydrates is higher than in SKD.
Cyclic keto diet (CKK) or, according to another version, rotating 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, then a carbohydrate load is carried out on a keto diet - one or two days are consumed without consumption.The unknown authors of this version of the keto diet are trying to justify their innovations with the need to replenish glycogen reserves, to restore hormone levels and thyroid activity, as well as to ensure moral and psychological stability - to continue the diet.In fact, everything that is lost in six days is immediately returned.
benefit
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 seizures 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 have 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 over 24 weeks resulted in a significant percentage of patients with reductions 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 dietary 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 subside.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 types);cream, sour cream, butter (butter and vegetables).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, candy or chips, nuts (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 option is champignons (only 0.5 g of carbohydrates per 100 g).
- all types of greens and leafy 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, zucchini, zucchini, eggplant, bell peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (from 1.8-4.5 g of carbohydrates per 100 g).
You can eat some berries: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, blackberries, blueberries (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 g of apricots, pineapple or grapefruit: this is approximately 11.8-12.4 g of carbohydrates.But you should not eat bananas: every 100 grams of carbohydrates contains almost 23 g.
What can't you eat?You will have to give up bread and all flour;pasta;sugar, honey and confectionery;any cereal porridge;potatoes, carrots, beets, celery root;pumpkins and all melons;legumes and most fruits.
Menu for a week keto diet
The seriousness of getting rid of excess fat stores 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 with this.
For breakfast, you can cook scrambled eggs or omelet - with onions, mushrooms and spinach, bacon and tomatoes.Coffee or tea, of course, without sugar.
Lunch can consist of a salad (a recipe for one of them is given below), vegetable soup or meatball soup (without potatoes, rice or noodles), chicken broth and boiled chicken meat, fried fish or pork and mushroom soup.
For dinner, choose a protein, such as turkey, beef, fish, seafood, with which - as a side dish - broccoli, Brussels sprouts, green beans or bell peppers, flavored with cream cheese sauce, go well.
Keto diet recipes
Considering the list of foods that are 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.
Baked chicken with vegetables
Products for two servings: 500 g of chicken (thighs, breast or fillet, cut into medium pieces), one tablespoon of vegetable oil, 1 green pepper (cut into medium cubes), half an onion (cut into small cubes), 500 g of cauliflower (broken into florets), half a small chili pepper, 50 g of fine chili peppers, 50 g - 50 g of fine pieces.sour cream, 50 g of hard cheese (grated on a coarse grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Preparation:
- heat the oven to 180°, coat a baking dish or pan with vegetable oil;
- Boil onions and peppers (sweet and bitter) separately in vegetable oil;
- Blanch the cauliflower florets in boiling salted water for three minutes, let the water drain;
- put the chicken in a mold (pan), salt and pepper, add onions and peppers and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle coriander on top, put butter (a few pieces, all over the surface), put sour 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 breast, 250 g of lettuce (dried well after washing), two fresh cucumbers, one tomato, two chicken eggs (hard-boiled), 60 g of dill or parsley, 1 tablespoon of olive oil and the same amount of mayonnaise to taste.
Preparation:
- cut the breast or ham into large strips;
- Cut boiled eggs into quarters, vegetables into thin slices;
- put the lettuce leaves in a container, put the ham on top and the eggs and vegetables on top, add salt;
- mix vegetable oil with mayonnaise, add finely chopped herbs, mix and pour this dressing over the salad.
Pork stew with mushrooms
Products for three portions: 300-400 g of pork pulp, 350 g of fresh mushrooms, half an onion (finely 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 grated salt and black cream.
Preparation:
- pour vegetable oil into a deep frying pan or pan with a thick bottom, add chopped onions and garlic, cook for five minutes;
- put pieces of meat and fry a little;
- add chopped mushrooms, mix, add nutmeg and ground black pepper, salt;
- cook on low heat for 15 minutes, then add sour cream (cream) and herbs;
- Cover the pot with a lid and cook until ready (about another 15 minutes).
Contraindications
Absolute contraindications for switching to a ketogenic diet include:
- diabetic ketoacidosis caused by insulin deficiency;
- congenital and secondary carnitine deficiency;
- lack of pyruvate carboxylase;
- mitochondrial diseases caused by defective beta-oxidation of fatty acids;
- porphyria;
- marked abnormalities in blood composition, iron deficiency anemia;
- pancreatitis;
- acute and chronic inflammation of the gallbladder (cholecystitis);
- liver dysfunction, primary or metastatic liver tumors;
- acute kidney failure;
- intestinal dysfunction, Crohn's disease;
- abdominal tumors;
- condition after cancer chemotherapy.
Special care should be taken when considering the advice of bodybuilders to "stimulate" the metabolism with the help of pharmacological agents: you should not risk your health in search of a super effect.
Potential risks
The risks associated with a diet used for a long time in the complex treatment of epilepsy in children include the threat of growth retardation (due to reduced levels of insulin-like growth factor 1), deterioration 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 can increase by about 30%.
Rare side effects include cardiomyopathy, long QT syndrome (ventricular arrhythmia), deficiency of vitamins, micro and macro elements.
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 initial stages can be accompanied by increased fatigue, weakness, headaches and dizziness;in women - dysmenorrhea.
If the weight does not fall with a keto diet, then it is most 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 induced ketosis is interrupted.
When the muscles are very sore on a keto diet, the reason can be associated with both a violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid), and with the enzymatic breakdown of muscle tissue glycogen in ketosis conditions.
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
Reviews by doctors who prescribe a ketogenic diet for patients with neurodegenerative pathologies conclude by declaring its unconditional effectiveness: even with senile dementia and Parkinson's disease, patients' attention increases, memory and perceptual adaptability improve significantly.
Typically, reviews and results of those who lose weight are commented by experts.But the significant controversy surrounding all low-carb diets also contributes to the evaluation of specific results.
Thus, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a keto diet lost an average of 3.6-4 kg 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".