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 with drug-resistant epilepsy.
Based on metabolic studies, a therapeutic diet - without starch and sugar - was developed, which became part of the complex treatment of epilepsy in the early 1900s.The author of the name "ketogenic diet", as they say, belongs to the American doctor Russell M.Wilder, who used it in the 20s and 30s to treat epilepsy.in the last century.
The keto diet involves a low-fat diet, moderate protein intake, and very low carbohydrate intake.For most people, this ratio of nutrients is considered safe for a limited time and not only helps you lose extra pounds, but also has therapeutic uses.
Indications for use
A low-carbohydrate keto diet for epilepsy, widely used in foreign clinical practice, helped reduce the frequency of seizures in children of various ages by 62-75% (after 12 weeks of dietary treatment).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 adjust the diet according to the needs of each child.
A low-carbohydrate diet was started in other disorders.Researchers have shown that the ketogenic diet is useful in treating patients with DeVivo disease, a syndrome characterized by deficiency of the protein GLUT1 (which transports glucose across the blood-brain barrier), as well as other congenital metabolic 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 trials are underway on the effects of the ketogenic diet on autism, depression, type 2 diabetes (insulin-dependent), and polycystic ovary syndrome.
The most famous keto diet for weight loss is the Atkins diet for obesity, modified and popularized by Dr. Robert Atkins (Dr. Atkins Diet Revolution, 1972).However, experts consider only the induction phase of this diet to be ketogenic.And, in fairness, it should be noted that many American doctors worked on the principles of the ketogenic diet long before him: Peter Huttenlocher, Alfred Pennington, Richard McCarnes and others.For example, R.McCarnes wrote the book Eat Fat and Grow Slim in 1958, and it's essentially the same low-carb diet that was originally introduced to treat epilepsy.
Since excess adipose tissue is deposited in the form of concentrated triglycerides in its cells due to excessive consumption of carbohydrate foods (no one doubts this), limiting carbohydrates to a minimum in the diet - a keto diet for a month - helps to reduce fat reserves, that is, to lose weight.
In addition, it has been found that the keto diet for oncology - by increasing the oxidative stress of cancer cells - significantly reduces the growth rate of malignant tumors localized in the colon, stomach, prostate and lungs.In addition, some cancers have been shown to be more sensitive to chemotherapy due to their 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 jargon, this is called keto diet reduction.
The essence of the keto diet
On a standard keto diet, your total daily calories should be 70-80% fat, 15-20% protein, and 5% carbs (less than 50g per day).
As a general rule, 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 put the body in 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 carbohydrate-containing foods.
Carbohydrates in food are converted into glucose, but when a person consumes too few carbohydrates and too much fat, a chain of biochemical reactions occurs in the body.Schematically, this process looks like this.First, due to the decrease in the level of glucose in the blood, 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, that is, the liver produces ketone bodies (acetoacetate, which is then converted to β-hydroxybutyrate and acetone) and the conversion of dietary fats into free carboxylic (fatty) acids.Third, due to the increase in glucagon levels, the activity of lipase, an enzyme that breaks down triglycerides (fats) accumulated in adipose tissue cells, increases significantly.
In addition, during the first two weeks of following a keto diet, significant weight loss occurs due to the removal of water from the body, which is also associated with the production of glucagon.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 a day.
Many people believe that the main advantage of the keto diet is the absence of hunger, calorie counting and hours of exercise to burn extra calories.
Keto Diet for Men
Keto diet is especially effective for men with abdominal obesity.
If the obesity treatment diet recommends reducing the intake of calories 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 the majority of calories on a keto diet come from foods rich in natural fats and moderate amounts of protein.That is, it is not "protein loading" as some may think.And if a person is used to eating a lot of meat, then his body will enter the state of adaptive ketosis much more slowly.So you'll have to limit your protein to 1-2g of protein per day per kilogram of weight you're trying to lose.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 (in grams) of fat, protein, and carbohydrates in the diet will depend on each person's age, goal, level of physical activity, and health.But short-term fasting during the keto diet is recommended for everyone: during 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 (very small).At the end of the first week, you should eliminate carbohydrates as much as possible (below is a list of keto diet foods), but the number of portions is 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 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.Moreover, you can take advantage of the moment and, like bodybuilders, build muscle mass: on the keto diet, you can gain weight only by loading the muscles, and then the subcutaneous fat will disappear, revealing strong muscles.
Keto Diet for Women
The problem with the keto diet is that until now, 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, given that women's hormones are more sensitive to most dietary changes.
Although opinions differ, most experts say that the ketogenic diet provides 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 and even complaints about nausea, fatigue and constipation due to the diet (see below in the section on possible complications).It should also be noted that switching to a keto diet is contraindicated during menstrual cycle disorders, thyroid gland pathologies, pregnancy and lactation.
Women are recommended to combine intermittent fasting with a ketogenic diet, that is, simply skip lunch and take a break of 10-12 hours between morning and evening meals, which gives a rejuvenating effect after 50-55 years (this is the data of a 2016 study published in the Journal of the American Medical Association).According to Western nutrition experts, this dietary regimen allows the body to rest from digestive functions and direct energy resources to repair tissue cells and balance hormones.
If a woman with a body weight of 75 kg and a height of 165-168 cm is trying to lose weight to about 68 kg, she should go from consuming 2300 kcal to no more than 1855 kcal per day.Protein should be 1-1.5 g per kilogram of ideal body weight, so 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) per day.
How is the keto diet different from a high-fat diet?
A low-fat or LCHF diet differs from a keto diet in the proportions of protein, fat, and carbohydrates, with a low-fat diet providing a ratio of 50% fat to 25% protein and carbohydrates.
In Europe, a high-fat (low-carb) diet is called the Swedish diet.Obviously, this is due to Swedish therapist Annika Dahlqvist, who began recommending that diabetic patients consume more fat and limit carbohydrates, which is contrary to the officially approved recommendations of endocrinologists in Sweden.
Among the modifications of the ketogenic nutrition system, starting with the Atkins diet and the LCHF diet, we can name strange dietary recommendations, for example, egg fasting on the keto diet - when for several days you only need boiled chicken eggs with mayonnaise...
Cyclic Keto Diet and Other Modifications
In recent years, the standard keto diet (SKD) has changed 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 since carbohydrates can be consumed before and after exercise;It is considered a sport, so the number of calories from carbohydrate consumption is higher than in SKD.
Cyclic keto diet (CKD) or, in another version, rotational keto diet (alternating), is a low-carbohydrate diet with alternating periods of high or moderate consumption of carbohydrates: 5-6 days - a minimum amount of carbohydrates, then the carbohydrate load is carried out on a keto diet - for one or two days without consuming a car.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 to ensure moral and psychological stability - the continuation of the diet.In fact, everything that is lost in six days is instantly regained.
benefits
As foreign clinical practice shows, almost 20% of children with epilepsy after a ketogenic diet (from six months to two years, gradually returning 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 trials, experts have come to the conclusion that the benefits of the keto diet include significant and fairly rapid weight loss, especially in cases of severe obesity.Despite being high in fat, this diet resulted in significant reductions in systolic blood pressure, blood sugar and insulin levels, plasma C-reactive protein levels, and increases in high-density lipoprotein (HDL), or good cholesterol, over 24 weeks.
In 2008, the American Diabetes Association (ADA) revised its dietary guidelines and recognized a low-carbohydrate diet as an effective short-term dietary intervention for patients with non-insulin-dependent diabetes.
And yet, during the keto diet, the skin reacts in its own way to the lack of carbohydrate food, 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 eatThe list of products recommended for the keto diet includes: any meat and meat by-products;a birdfish and seafood;Eggs (all kinds);Cream, sour cream, butter (butter and vegetables).Hard cheese is very useful on the keto diet.But be careful with regular milk, because it contains a lot of lactose - milk sugar, which is a disaccharide carbohydrate.But fermented milk products can be consumed without fear: lactose undergoes hydrolysis during the fermentation of fermented milk.
Instead of popcorn, candy 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, respectively, 655 and 600.
It is recommended to include in the menu:
- Mushrooms (except dried porcini and boletus), champignons are an ideal option (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, zucchini, aubergines, bell peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (range 1.8-4.5g carbs per 100g).
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 follow the keto diet for weight loss in moderation, then you can eat 100 g of apricots, pineapple or grapefruit from time to time: this is about 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;Pastasugar, honey and confectionery;Porridges of any grain;potatoes, carrots, beets, celery root;pumpkin and all melons;Legumes and most fruits.
Menu for a week of keto diet
If you are serious about getting rid of excess fat reserves in your body, of course, you need to create 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 scrambled eggs or an omelet - with onions, mushrooms and spinach, bacon and tomatoes.Coffee or tea, naturally, without sugar.
Lunch can consist of salad (the 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 a side dish of broccoli, Brussels sprouts, green beans, or bell peppers, flavored with a cream cheese sauce.
Keto Diet Recipes
Given 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.
Baked chicken with vegetables
Products for two servings: 500 g chicken (thighs, breast or fillet, cut into medium pieces), a tablespoon of vegetable oil, 1 green bell pepper (cut into medium cubes), half an onion (finely chopped), 500 g cauliflower (cut into florets), half a small hot pepper (50 g finely), 50 g.sour cream, 50 g of hard cheese (grated on a large grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Preparation:
- Heat the oven to 180°, grease a baking form or pan with vegetable oil;
- Fry onion and pepper (sweet and bitter) separately in vegetable oil;
- Soak the cauliflower florets in salted boiling water for three minutes, let the water drain;
- Put the chicken in a mold (pan), sprinkle with salt and pepper, sprinkle with onion, pepper and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle coriander on top, spread butter (several pieces, on the entire surface), pour sour cream, sprinkle with grated cheese and put in the oven for 40-45 minutes.
A quick salad with ham or brisket
Products for two portions: 100 g of ham or patty, 250 g of lettuce (after washing, dry well), 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, salt.
Preparation:
- cut the breast or ham into large strips;
- Cut boiled eggs into four pieces, vegetables into thin slices;
- Put lettuce leaves on the dish, put ham on top, eggs and vegetables on top, sprinkle salt;
- Mix vegetable oil with mayonnaise, add finely 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 champignons, half an onion (finely chopped), 2 tablespoons of vegetable oil, half a teaspoon of nutmeg, one clove of garlic, 4 tablespoons of sour cream or heavy, 2 tablespoons of salt and ground black pepper.
Preparation:
- pour vegetable oil into a deep pan or pot with a thick bottom, add onion and chopped garlic, boil for five minutes;
- Put the 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 dish with a lid and cook until ready (about 15 minutes).
Contraindications
Absolute contraindications to switching to a ketogenic diet include:
- diabetic ketoacidosis caused by insulin deficiency;
- Congenital and secondary deficiency of carnitine;
- pyruvate carboxylase deficiency;
- Mitochondrial diseases caused by violation of beta-oxidation of fatty acids;
- porphyria;
- Marked disorders of 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 following the advice of bodybuilders, "stimulating" the metabolism with the help of pharmacological agents: you should not risk your health to achieve a super effect.
Possible risks
Risks associated with a long-term diet in the complex treatment of epilepsy in children include the risk 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 nearly 60% of children, and cholesterol levels may be elevated in about 30%.
Rare side effects are 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 weight loss patients complain about: the lack of fiber affects it.In addition, the ketogenic diet in the initial stages may be accompanied by increased fatigue, weakness, headaches and dizziness;In women - dysmenorrhea.
If weight is not lost on a keto diet, then there is probably too much protein in the diet, because more than half of the excess protein is converted into glucose in the body, that is, the process of induced ketosis is broken.
When the muscles hurt a lot on the keto diet, the reason may be related to the violation of gluconeogenesis - the synthesis of glucose from muscle lactate (lactic acid), as well as the enzymatic breakdown of muscle tissue glycogen in ketosis.
Reducing carbohydrate intake at the beginning of the diet leads to fluid loss, and leg swelling during the keto diet can occur even with mild kidney failure.
Weight loss reviews and results
Reviews of doctors who prescribe the ketogenic diet to patients with neurodegenerative pathologies are based on its unconditional effectiveness: even with senile dementia and Parkinson's disease, patients' attention increases, memory and perceptual adequacy improve significantly.
As a rule, weight loss reviews and results are commented by experts.But significant controversy surrounding all low-carb diets also favors evaluation of specific outcomes.
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 to 4 kg more over six months than those who restricted their fat intake.British obesity experts (British National Obesity Forum) also note that a low-carb, high-fat diet outperforms a low-fat diet in terms of weight loss effectiveness.Although many of their colleagues claim that the keto diet's weight loss results "contrary to the available evidence."