A few years ago, the whole world seemed to have gone crazy over the keto diet: absolute­ly every­one seemed to be fol­low­ing it, regard­less of their health sta­tus or body weight. But is it real­ly that use­ful, and most impor­tant­ly, safe? Who is the keto diet suit­able for, where to start if you decide to stick to it, what are the con­traindi­ca­tions and what can you eat on the keto diet?

The keto diet is a very fash­ion­able nutri­tion­al sys­tem, the essence of which is to immerse the body in a state of keto­sis, in which it receives ener­gy not from the usu­al car­bo­hy­drates, but by pro­cess­ing fat. We tell you what you need to know about the keto diet.

What is the ketogenic diet?

The keto­genic diet is a diet that is very low in car­bo­hy­drates (sug­ars, includ­ing lac­tose, fruc­tose, starch) and high in fat. It is sim­i­lar in many ways to the Atkins diet and the low-carb diet. The keto diet involves dra­mat­i­cal­ly cut­ting down on car­bo­hy­drates and replac­ing them with fats.

When this hap­pens, your body con­verts fat into ketones in the liv­er, which can sup­ply ener­gy to the brain. Keto diets can lead to sig­nif­i­cant reduc­tions in blood sug­ar and insulin lev­els. This, along with the increased ketone con­tent, has some health ben­e­fits.

Why do you love the keto diet?

Of course, no mat­ter what they say, for the fact that you can eat tasty things, name­ly, foods con­tain­ing ani­mal fat. But­ter, cheese and oth­er dairy prod­ucts of nor­mal fat con­tent, bacon, fried meat — all this is “pos­si­ble”.

What types of keto diets are there?

There are sev­er­al ver­sions of the keto­genic diet, includ­ing:

  • Stan­dard Keto­genic Diet (SKD): This is a diet that is very low in car­bo­hy­drates, mod­er­ate in pro­tein, and high in fat. It typ­i­cal­ly con­tains 70% fat, 20% pro­tein and only 10% car­bo­hy­drates.
  • Cycli­cal Keto­genic Diet (CKD): This diet includes peri­ods of high-car­bo­hy­drate refeed­ing, such as 5 keto­genic days fol­lowed by 2 high-carb days.
  • Tar­get­ed Keto­genic Diet (TCD): This diet allows you to add car­bo­hy­drates dur­ing your work­outs.
  • High Pro­tein Keto­genic Diet: Sim­i­lar to the stan­dard keto­genic diet, but includes more pro­tein. The ratio is often 60% fat, 35% pro­tein and 5% car­bo­hy­drates.
  • How­ev­er, only stan­dard and high-pro­tein keto­genic diets have been stud­ied exten­sive­ly. Cycli­cal or tar­get­ed keto­genic diets are more advanced meth­ods and are pri­mar­i­ly used by body­builders or ath­letes.

What about brain nutrition? After all, sugar is needed for the brain to function?

This is usu­al­ly one of the most fre­quent­ly asked ques­tions before start­ing a nutri­tion pro­gram. The main source of ener­gy for brain func­tion is glu­cose, and not sug­ar, as many peo­ple think. Glu­cose is found in var­i­ous cere­als, and sug­ar is found in sweets (sug­ar con­sists of two mol­e­cules: glu­cose and fruc­tose). The brain real­ly can­not use fat­ty acids as an ener­gy source (since they do not pass from the blood ves­sels into the nerve cell), but it has been proven that after 3–4 days of fast­ing or when fol­low­ing a high-fat, low-carb eat­ing pro­gram, the brain begins to use an alter­na­tive source of ener­gy, which are ketones.

It should be empha­sized that the lev­el of glu­cose in the blood, while fol­low­ing the nutri­tion pro­gram, although decreas­es, still remains with­in the phys­i­o­log­i­cal range.

What is associated with the weight loss effect of following a keto diet?

There are three mech­a­nisms under­ly­ing weight loss when fol­low­ing the keto diet:

  • Sup­pres­sant effect of ketones on appetite.
  • Main­tain­ing an ener­gy deficit, due to which weight loss occurs.
  • Due to a sharp reduc­tion in the amount of car­bo­hy­drates in the diet, excess flu­id is removed from the body, which affects weight.

Is ketosis a life-threatening condition?

Many peo­ple con­fuse two con­cepts: keto­sis and ketoaci­do­sis. Despite the fact that the root in terms is the same, these are com­plete­ly dif­fer­ent states. Keto­sis is a phys­i­o­log­i­cal state, while ketoaci­do­sis is a life-threat­en­ing con­di­tion that occurs in uncon­trolled dia­betes mel­li­tus, main­ly type 1.

How do I know if I’m in ketosis?

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The state of phys­i­o­log­i­cal keto­sis is indi­cat­ed by the appear­ance of ketones in the urine and blood, as well as the appear­ance of a fruity odor from the mouth. The appear­ance of a char­ac­ter­is­tic fruity odor is due to the fact that ketones are excret­ed from the body not only through urine, but also through breath­ing, and this is a sign of phys­i­o­log­i­cal keto­sis, and not nec­es­sar­i­ly just a sign of any patho­log­i­cal process.

A char­ac­ter­is­tic sign of keto­sis is also the appear­ance of ketones in the urine, which can be deter­mined using spe­cial test strips. The col­or of the strip cor­re­sponds to the lev­el of ketones in the urine.

Final­ly, the most accu­rate method is to mea­sure your blood ketone lev­els.

What are the side effects of the keto diet and are there any contraindications?

Despite some of the pos­i­tive results of the keto diet, fol­low­ing the nutri­tion­al pro­gram may come with some side effects. So, in the first days of fol­low­ing the keto diet, weak­ness, fatigue, headache, decreased phys­i­cal activ­i­ty, and decreased con­cen­tra­tion may appear.

These symp­toms are asso­ci­at­ed with the body’s adap­ta­tion when switch­ing from a car­bo­hy­drate type of diet to a fat­ty one. How­ev­er, these symp­toms are tem­po­rary and dis­ap­pear with­in a few days. Dur­ing the ear­li­est phase of the keto­genic diet (the first 4 or 5 days), com­plaints of malaise and weak­ness may appear, but this con­di­tion quick­ly pass­es.

Also, in the first days of fol­low­ing the nutri­tion pro­gram, stool reten­tion may be observed; this is due to a change in the type of diet, but in most cas­es with insuf­fi­cient con­sump­tion of dietary fiber. If there is a suf­fi­cient amount of veg­eta­bles in the diet, the symp­toms dis­ap­pear with­in a few days.

If you have cer­tain dis­eases, the keto diet is con­traindi­cat­ed. Thus, high-fat, low-car­bo­hy­drate nutri­tion is con­traindi­cat­ed in cas­es of hered­i­tary dis­eases of fat­ty acid metab­o­lism, severe dys­lipi­demia, urolithi­a­sis, pan­cre­ati­tis, liv­er fail­ure, as well as when tak­ing glu­cose-low­er­ing drugs. In any case, it is rec­om­mend­ed to con­sult a doc­tor before start­ing a diet.

What can be dangerous about the keto diet?

Many nutri­tion­ists are wary of the keto diet—as well as oth­er prac­tices that dra­mat­i­cal­ly dis­rupt the nutri­tion­al bal­ance. Here are just six of the side effects of keto­sis that adher­ents of a “fat” diet are unlike­ly to talk about. Worth read­ing before ditch­ing your morn­ing oat­meal in favor of pork neck kebab.

Insulin at a minimum

If you fol­low a tra­di­tion­al diet, your blood insulin lev­els rise every time you eat some­thing con­tain­ing glu­cose. Keto­sis can only devel­op against a back­ground of low insulin: this way, fat­ty acids are more eas­i­ly released from the fat­ty tis­sues of the body. But be care­ful: long-term insulin fast­ing can lead to dia­betes!

I don’t feel like eating

Large-scale stud­ies of this effect have not yet been con­duct­ed, but sci­en­tists have already not­ed that peo­ple on a keto diet often feel less hun­gry than, for exam­ple, adher­ents of low-carb eat­ing plans. It is pos­si­ble that due to the over­pro­duc­tion of ketone bod­ies in the body, the brain cen­ters respon­si­ble for appetite may be sup­pressed.

The smell from the mouth is not very good

There is noth­ing strange here: one of the ketone bod­ies pro­duced by the liv­er is ace­tone, which has a pun­gent odor; accord­ing­ly, more of it is released in the keto­sis stage. So don’t be sur­prised if, after start­ing a diet, peo­ple first com­pli­ment your slim­ness, and when you respond, they try to run away as quick­ly as pos­si­ble. How­ev­er, this mis­for­tune does not affect all keto-los­ing dieters—many man­age to main­tain fresh breath.

Constipation appeared

Of course, because you began to eat less fiber. Many keto dieters say con­sti­pa­tion is com­mon. If dif­fi­cult stool becomes a seri­ous prob­lem, your diet should def­i­nite­ly be recon­sid­ered.

Stamina drops

Gen­er­al weak­ness dur­ing the peri­od of get­ting used to a new diet is also com­plete­ly com­mon. Peo­ple who switched to the keto diet noticed that in the first weeks the effec­tive­ness of train­ing in the gym decreased, but then they returned to their nor­mal rhythm and even improved their per­for­mance.

And in general it’s somehow not good!

This side effect, char­ac­ter­is­tic of the adap­ta­tion peri­od after a sig­nif­i­cant reduc­tion in car­bo­hy­drate intake, has already been called ketoflu. The symp­toms are famil­iar: headaches, dizzi­ness, fatigue, mus­cle spasms, nau­sea. Usu­al­ly, the body needs a week to accept new rules of the game, so if such pseu­do-flu drags on, you should con­sult a doc­tor — and in any case, get more sleep.

How much weight can you lose on a keto diet?

The keto­genic diet is not the most effec­tive way to lose weight. In fact, research shows that the keto diet can be just as effec­tive for weight loss as a low-fat diet. What’s more, the diet is so fill­ing that you can lose weight with­out count­ing calo­ries or track­ing your food intake. Which again sug­gests that you will lose weight by cre­at­ing a calo­rie deficit, which can be main­tained in health­i­er ways.

One review of 13 stud­ies found that fol­low­ing a very low-carb diet, a keto­genic diet was slight­ly more effec­tive for long-term weight loss than a low-fat diet.

Peo­ple who fol­lowed the keto diet lost an aver­age of 0.9 kg more than the group that fol­lowed the low-fat diet. More­over, it also result­ed in a reduc­tion in dias­tolic blood pres­sure and triglyc­eride lev­els.

Anoth­er study, which only includ­ed 34 old­er adults, found that those who fol­lowed a keto­genic diet for 8 weeks lost near­ly five times more total body fat than those who fol­lowed a low-fat diet.

What can and cannot be eaten on the keto diet?

Foods that are excluded on the keto diet

Any food high in car­bo­hy­drates should be lim­it­ed. Here is a list of foods that you need to reduce or elim­i­nate from your diet on a keto­genic diet:

  • sweet foods: car­bon­at­ed drinks, fruit juices, smooth­ies, cakes, ice cream, can­dies, etc.;
  • grains or starch­es: wheat-based prod­ucts, rice, pas­ta, cere­als, etc.;
  • fruits: all fruits except small por­tions of berries such as straw­ber­ries;
  • beans or legumes: peas, beans, lentils, chick­peas, etc.;
  • root and tuber crops: pota­toes, sweet pota­toes, car­rots, parsnips, etc.;
  • low-fat or diet prod­ucts: low-fat may­on­naise, sal­ad dress­ings and sea­son­ings;
  • some sea­son­ings or sauces: bar­be­cue sauce, hon­ey mus­tard, teriya­ki sauce, ketchup, etc.;
  • unhealthy fats: processed veg­etable oils, may­on­naise, etc.;
  • alco­hol: beer, wine, liquor, cock­tails;
  • sug­ar-free dietary prod­ucts: sug­ar-free can­dies, syrups, pud­dings, sweet­en­ers, desserts, etc.

Products that are allowed

You should base most of your meals on the fol­low­ing foods:

  • meat: red meat, steak, ham, sausage, bacon, chick­en and turkey;
  • fat­ty fish: salmon, trout, tuna, her­ring, mack­er­el;
  • eggs: chick­en, goose, quail;
  • oils: but­ter and cream;
  • cheese: unprocessed cheeses such as feta cheese, goat cheese, cream cheese, parme­san cheese, moz­zarel­la cheese;
  • nuts and seeds: almonds, wal­nuts, flaxseeds, pump­kin seeds, chia seeds, etc.;
  • healthy oils: extra vir­gin olive oil and avo­ca­do oil;
  • low car­bo­hy­drate veg­eta­bles: green veg­eta­bles, toma­toes, onions, pep­pers, etc.;
  • sea­son­ings: salt, pep­per, herbs and spices;

It’s best to base your diet on sin­gle-ingre­di­ent whole foods.

Sample keto meal plan for 1 week

To help you get start­ed, here is a sam­ple keto­genic diet meal plan for one week:

Monday

Break­fast: Fried eggs with bacon, cof­fee.

Din­ner: cel­ery cream soup, pork steak, cucum­ber, toma­to and cab­bage sal­ad.

Din­ner: boiled chick­en fil­let, cab­bage.

Tuesday

Break­fast: boiled eggs and toast with cream cheese and avo­ca­do.

Din­ner: fried meat with spinach and aspara­gus.

Din­ner: Cae­sar sal­ad and cau­li­flower frit­ters.

Wednesday

Break­fast: omelette with egg, toma­toes, basil and goat cheese.

Din­ner: milk­shake made with almond milk, peanut but­ter, cocoa pow­der and ste­via.

Din­ner: meat­balls with veg­eta­bles and ched­dar cheese.

Thursday

Break­fast: mush­room casse­role.

Din­ner: chick­en soup.

Din­ner: chop with avo­ca­do and green beans fried in but­ter.

Friday

Break­fast: sausage, fried zuc­chi­ni.
Din­ner: cream soup of green veg­eta­bles with melt­ed cheese, pork chop.
Din­ner: baked fish on a bed of onions, sal­ad with cheese and toma­to.

Saturday

Break­fast: scram­bled eggs with sausage, a slice of cheese, tea.

Din­ner: fish soup, veal roast beef, sal­ad of greens, avo­ca­do, cheese.

Din­ner: stewed pork ribs with veg­eta­bles, tea.

Sunday

Break­fast: egg, toma­toes, basil and spinach omelette.

Din­ner: cau­li­flower soup with chick­en broth, fried meat with arugu­la sal­ad.

Din­ner: baked chick­en legs with mush­rooms, pump­kin, sal­ad with toma­toes and olives.

Healthy Keto Snacks

In case you get hun­gry between meals, here are some healthy keto snacks:

  • fat­ty meat or fish,
  • cheese,
  • a hand­ful of nuts or seeds
  • sushi with­out rice,
  • olives,
  • one or two hard-boiled or stuffed eggs,
  • 90% dark choco­late,
  • full-fat Greek yogurt mixed with nut but­ter and cocoa pow­der,
  • sweet pep­per and gua­camole,
  • straw­ber­ries and sim­ple cot­tage cheese,
  • cel­ery with sal­sa and gua­camole,
  • beef jerky,
  • small­er por­tions from left­overs.

Where to start if you decide to go on a keto diet?

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While start­ing a keto­genic diet can be dif­fi­cult, there are some tips and tricks you can use to make it eas­i­er.

  • Start by read­ing food labels and check­ing the grams of fat, car­bo­hy­drates and fiber to deter­mine how your favorite foods can fit into your diet.
  • Plan­ning your meals in advance can also be help­ful and can help you save extra time dur­ing the week.
  • Many web­sites, food blogs, apps, and cook­books also offer keto-friend­ly recipes and meal ideas that you can use to cre­ate your own menu.

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