The ketogenic or ketogenic 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 at the beginning of the 20th century.It is said that the author of the name “ketogenic diet” belongs to the American doctor Russell M. Wilder, who used it to treat epilepsy in the 20s-30s.last century.
The keto diet involves a high-fat diet, moderate protein intake, and very low carbohydrate intake.For most people, this nutrient ratio is considered safe for a limited period of time and not only helps you lose extra pounds, but also has therapeutic applications.
Indications for use
A low-carbohydrate keto diet for epilepsy, widely used in foreign clinical practice, helped to reduce the frequency of seizures in children of different ages by 62-75% (after dietary treatment for 12 weeks).At the same time, children receiving this diet must be registered with doctors who monitor their normal growth and weight gain, as well as make adjustments to the diet according to each child's needs.
Diets with minimal amounts of carbohydrates began to be used for other disorders.Researchers have demonstrated 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 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 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 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 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 your cells occurs due to excessive consumption of foods rich in carbohydrates (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, lose weight.
Furthermore, it turned out 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 and lungs.Furthermore, it has been proven that some types of cancer 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 the keto diet.
The essence of the keto diet
On a standard keto diet, your total daily calories should come from 70-80% fat, 15-20% protein and 5% carbs (less than 50g per day).
Typically, the ratio of fat to protein and carbohydrates is 3:1 (i.e. 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 blood ketone bodies, and not from glucose, which comes from eating foods containing carbohydrates.
Carbohydrates in food are transformed 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 transformed into β-hydroxybutyrate and acetone) and the conversion of dietary fat into free carboxylic acids (fatty).Thirdly, due to an increase in the level of glucagon, the activity of lipase, an enzyme that breaks down triglycerides (fats) accumulated in adipose tissue cells, significantly increases.
Furthermore, in the first two weeks of following the keto diet, there is significant weight loss 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 combating 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 especially 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 carbohydrate consumption should be reduced five times: instead of 250 g to a maximum of 50 g per day.
Keep in mind that most of the calories on a keto diet come from foods high in natural fats and moderate amounts of protein.In other words, it is not a “protein load”, as some may think.And if a man is used to eating a lot of meat, his body will enter a state of adaptive ketosis much more slowly.Therefore, you will have to limit protein: per day to 1-2 g of protein per kilogram of body weight that you are trying to achieve as a result of weight loss.Example: if the starting 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 proportion of fats, proteins and carbohydrates in the diet (in grams) will depend on each man's age, goal, level of physical activity and health status.But short-term fasting during the keto diet is recommended for everyone: in the first two days of switching to this eating system, you should drink a lot of water and limit yourself to one meal per day (in very small quantities).At 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 portion sizes decrease slightly.
Another nuance: they claim that the keto diet without sports does not lose its effectiveness, and to lose weight it is not necessary to go to the gym or simply perform any additional physical exercise.But physical activity, as part of a healthy lifestyle, accelerates the burning of excess fat, so you shouldn't lie on the couch.In addition, you can seize 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, as female hormones tend to be more sensitive to most dietary changes.
Although opinions vary, most experts say the ketogenic diet produces positive results, especially for women in perimenopause or 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, and even complaints of nausea, tiredness and constipation due to the diet (more details below in the Possible Complications section).It is also worth noting 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.
Women are recommended to combine periodic fasting with a ketogenic diet, that is, simply skip lunch and take a break of 10-12 hours between morning and evening meals, which after 50-55 years gives a rejuvenating effect (data from a 2016 study published in the Journal of the American Medical Association).According to Western nutrition experts, this eating regimen allows the body to take a break from digestive functions and direct energy resources toward restoring tissue cells and balancing hormones.
If a woman with a body weight of 75 kg and a height of 165-168 cm seeks to lose weight to approximately 68 kg, she should go from 2,300 kcal per day to consuming a maximum of 1,855 kcal.Protein should be 1 to 1.5 g per kilogram of ideal weight, that is, daily you can get about 68 to 102 g of protein, 240 to 350 g of fat and 18 to 20 g of carbohydrates (in pure water, without fiber).
What is the difference between a keto diet and a high-fat diet?
A high-fat diet or LCHF 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-carb) diet is called the Swedish diet.Obviously, this is due to Swedish therapist Annika Dahlqvist, who began recommending that her diabetes patients 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 from the Atkins diet and the LCHF diet, one can mention strange dietary recommendations, for example, egg fasting on the keto diet - when for several days it is necessary 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 several ways.This is how the hyperprotein ketogenic diet (HPKD) emerged, in which 60% of calories come from fats, 35% from proteins and 5% from carbohydrates.
The targeted ketogenic diet (TKD) is more moderate, as carbohydrates can be consumed before and after workouts;It is considered a sport, so the number of calories obtained from consuming carbohydrates is greater than in SKD.
The cyclical ketonic diet (CKD) or, according to another version, the rotating (alternating) ketonic diet, is a low-carb diet with alternating periods of consumption of high or moderate amounts of carbohydrates: 5-6 days - a minimum amount of carbohydrates, then a carbohydrate load is carried out on a keto diet - one or two days of carbohydrates are consumed without restriction.The unknown authors of this version of the keto diet try to justify their innovations by the need to replenish glycogen reserves, restore hormonal levels and thyroid activity, as well as ensure moral and psychological stability - to continue the diet.In fact, everything that is lost in six days comes back instantly.
Benefit
As foreign clinical practice shows, almost 20% of children with epilepsy after a ketogenic diet (followed from six months to two years, with a gradual return to a normal diet) experience seizures much less frequently, and many of them can reduce the intake of anticonvulsants or abandon them altogether.
Based on the results of two dozen randomized controlled studies, experts came to the conclusion 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 percentage of patients with reductions in systolic blood pressure, blood sugar and insulin levels, plasma levels of C-reactive protein and an increase in high-density lipoprotein (HDL), that is, 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 may decrease.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 recommended products for the keto diet includes: any meat and meat by-products;bird;fish and seafood;eggs (all types);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, 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 porcini and dried boletus), the ideal option is champignons (only 0.5 g of carbohydrates per 100 g).
- all types of green leafy vegetables and vegetables that do not contain starchy complex carbohydrates: broccoli and kohlrabi;white cabbage, cauliflower and Brussels sprouts (3-6 g of carbohydrates per 100 g);cucumber, zucchini, zucchini, eggplant, peppers (green), tomatoes, radishes, leeks, rhubarb, green beans and leeks (range 1.8-4.5 g carbohydrates per 100 g).
You can eat some fruits: strawberries (100 g contains about 8 g of carbohydrates), cherries, raspberries, blackberries, cranberries (100 g contains 12 g of carbohydrates).
If you adhere to moderation in consumption while following a keto diet for weight loss, you can occasionally eat 100 g of apricots, pineapple or grapefruit: this represents approximately 11.8-12.4 g of carbohydrates.But you shouldn't 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;noodle;sugar, honey and confectionery sweets;any cereal porridge;potatoes, carrots, beets, celery root;pumpkins and all melons;legumes and most fruits.
Menu for a week of keto diet
Seriousness in getting rid of excess fat reserves in your own 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 prepare scrambled eggs or omelets - with onions, mushrooms and spinach, bacon and tomatoes.Coffee or tea, naturally, without sugar.
Lunch can consist of a 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 which - as a side dish - broccoli, Brussels sprouts, green beans or peppers, seasoned with cream cheese sauce, go well.
Ketogenic Diet Recipes
Taking into account the list of foods allowed on the ketogenic diet, you can prepare so many different dishes that it is impossible to list even a tenth of the ketogenic diet recipes.Try these three.
Roast Chicken with Vegetables
Products for two servings: 500 g of chicken (legs, 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 of cauliflower (disassembled into florets), half a small pepper (finely chopped), 50 g of butter, 100-150 g of fatty sour cream, 50 g of cheesehard (coarsely grated).grater), salt and ground black pepper to taste, ground coriander (half a teaspoon).
Preparation:
- Heat the oven to 180°, grease a baking tray or frying pan with vegetable oil;
- Cook the onions and peppers (sweet and bitter) separately in vegetable oil;
- Blanch the cauliflower inflorescences in boiling salted water for three minutes, let the water drain;
- place the chicken in a pan (frying pan), salt and pepper, add the onion and pepper and cabbage (distribute the vegetables evenly over the meat);
- Sprinkle coriander on top, add butter (several pieces, over the entire surface), pour in cream, sprinkle with grated cheese and bake for 40-45 minutes.
Quick salad with ham or brisket
Products for two servings: 100 g of ham or brisket, 250 g of lettuce (well dried 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 to taste.
Preparation:
- cut the breast or ham into large strips;
- cut boiled eggs into quarters and vegetables into thin slices;
- put the lettuce leaves on a plate, put the ham on top and the eggs and vegetables on top, add salt;
- mix vegetable oil with mayonnaise, add chopped herbs, mix and pour this dressing 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, a clove of garlic, 4 tablespoons of cream or sour cream, 2 tablespoons of chopped herbs, salt and ground black pepper, to taste.
Preparation:
- pour vegetable oil into a deep frying pan or saucepan with a thick bottom, add chopped onion 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 over low heat for 15 minutes, then add cream (cream) and herbs;
- Cover the dish 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;
- pyruvate carboxylase deficiency;
- mitochondrial diseases caused by impaired beta-oxidation of fatty acids;
- porphyria;
- pronounced 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;
- intestinal dysfunction, Crohn's disease;
- abdominal tumors;
- condition after cancer chemotherapy.
You should be especially careful when considering the advice of bodybuilders to “stimulate” metabolism with the help of pharmacological agents: you should not risk your health in pursuit of a super effect.
Possible 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 decreased levels of insulin-like growth factor 1), deterioration of bone mineralization (due to calcium deficiency) and nephrolithiasis (formation of kidney stones).Hyperlipidemia (high blood lipids) occurs in almost 60% of children and cholesterol levels can increase by around 30%.
Rare side effects include cardiomyopathy, long QT syndrome (heart ventricular rhythm disorder), deficiency of vitamins, micro- and macroelements.
The most common side effect is constipation, which almost a third of people who lose weight complain about: the lack of fiber intake affects it.In addition, the ketogenic diet in the early stages may be accompanied by increased fatigue, weakness, headaches and dizziness;in women - dysmenorrhea.
If weight does not decrease on a keto diet, there is probably too much protein in the diet, since more than half of the excess protein is transformed into glucose in the body, that is, the process of induced ketosis is interrupted.
When muscles become very sore on a keto diet, the reason may be associated with 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 minor kidney failure.
Weight loss reviews and results
Reviews of doctors who prescribe a ketogenic diet to patients with neurodegenerative pathologies boil down to affirming its unconditional effectiveness: even with senile dementia and Parkinson's disease, patients' attention increases, memory and adequacy of perception improve significantly.
Normally, the evaluations and results of those who lose weight are commented on by experts.But the significant controversy surrounding all low-carb diets also contributes to the assessment of specific outcomes.
So, according to the American Journal of Clinical Nutrition, researchers found that men and women who switched to a keto diet lost, on average, 3.6-4 kg more in six months than those who limited 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 his many colleagues claim that the results the keto diet offers for weight loss are “contrary to available evidence.”